Teaching That Which Can’t be Taught

By: Mason Cobb

Rather than traditional book learning, being ‘educated’ first means learning professionalism; after that, the knowledge can follow. We respect doctors as having the highest level of professionalism, but how do they get there?

A person is only a professional as he or she relates to others; after all, being a professional all alone has no meaning, it must be a two-way process. How the doctor interprets the Patient’s Bill of Rights (see box) determines in large part how the patient respects the doctor. So, above all, a professional has deep human respect for those he/she serves, or he/she is simply not a professional.

How does a doctor achieve this professionalism? It’s not from the medical school lectures, but from learning by example from a truly admirable, professional mentor. Objective and specialised knowledge is almost secondary, as most information in the cyber-era is an easily obtained commodity.

Professionalism is honed and refined by immersion in a positive culture that has the best professionalism in its DNA.

The dominant healthcare culture in Vietnam is still in the process of becoming more international in its standards. In the State sector, overcrowding and underfunding pose challenges for the highest professional behaviour. Fortunately, this is changing, and the Ministry of Health is intensively working to tackle the negative aspects of this stressed culture. One tactic? Studying overseas.

It is very helpful for a budding physician in Vietnam to see a strong, positive healthcare culture in another country. Immersion for some period shapes the individual and gives their newfound professionalism deeper roots. These young doctors come back to Vietnam with a new ethic and a definite sense of mission. This is a huge asset to their healthcare systems, their patients, and ultimately to Vietnam.

Professionalism is being the best that you can be in the service of others. That is passed from a mentor to a learner who in turn passes it on. The highest level of professionalism is transformational for a medical system.

Patient’s Bill of Rights

(Adapted from the American Medical Association)

Respect: Each individual will be treated as unique and their human dignity will be respected.

Autonomy: The patient shall determine what will be done with his or herself. The patient has a right to confidentiality of their medical treatment and records, and to have all medical personnel safeguard that right

Truthfulness: Physicians will be truthful with patients and their families and should avoid withholding information. This allows the patient to make informed decisions.

Beneficence: Medical personnel must follow the ethical principle of always doing or promoting the best care that they can offer.

Non-maleficence: The Hippocratic principle, named after the ancient Greek physician whose ethics are still followed 2,300 years later: “DO NO HARM” (Primum non nocere in Latin).

Justice: Fairness; each patient will be treated equally to all others with the kindness and respect that are given to all.

Fidelity: Medical personnel must remain faithful to promises made.

Right-to-know: Nothing shall be done to a patient without his/her informed consent.


Staying Healthy When Dining Out

By: Nat Paolone

With such a variety of enticing food options coercing our palates into gluttony, eating healthy outside your home proves quite challenging.

Looking at the menu, densely packed with highly caloric, over-sized portions (which we have become accustomed to in our modern world) we succumb and gorge. Busy lifestyles and poor choices while eating out often lead to further weight gain. Let’s have a look at how we can better deal with this and make better choices at the restaurant.

Societal Pressure

Socio-economics definitely influence our food choices both in selecting a restaurant/cafe and what we decide to order. We like to “fit in,” and eat what our friends munch on.

We’ve all heard too often from friends and family, “Oh come on, just eat it! You only live once, it won’t kill you…” Seemingly when you choose to eat healthy, you may become the outcast among your friends. This compounds matters as striving for acceptance is human nature.

Why all the talk of sociological factors when we just want healthy eating tips? Because the challenge is largely psychological and habitual. Most of it is really common sense but unfortunately eating substandard food has simply become socially accepted.

Right then, let’s get into making some better nutritional choices.

Photo by Pixabay

Local Food Suggestions

Vietnamese grilled fish and meats are ideal dishes, as well as soups and hot pots. Many Japanese and Korean restaurants around Saigon have solid, healthy choices in contrast to the majority of most Western menus offered throughout the city.

Next time you enjoy your favourite pho or bun bo, ask for less noodles in order to maximise your healthy diet. In regards to MSG, well, you know what it is, and we must accept that it’s nearly unavoidable when eating out in HCMC. Goi cuon (chicken spring roll), goi xoai (mango salad) and ca nuong la chuoi (grilled fish with banana leaf) are a few healthy Vietnamese options.

Photo by Pixabay

Indian food doesn’t have to be heavy. Go for the tandoor chicken breast or lamb as long as you make sure to request it with no butter or cream. Choosing brown rice over naan is also another way to manoeuvre around the fattening dishes lingering at your table. When eating Italian, skip the primi and go straight for secondi.

Sugar and excess carbs are fundamentally problematic. Lower these and increase the veggies and proteins. For all the lovely vegetarians, choose protein rich beans and legumes. This is a challenge in Vietnam as most vegetarian restaurants do not include beans on the menu. Sure tofu is good, but this protein packed veggie has a long history of nutritional controversy.

Portion size is paramount. Share a pizza instead of having a whole one, as so many of us are carb junkies consuming these saccharides voraciously, reducing portions is the goal.

How Unhealthy is Alcohol?

Alcohol! The ultimate socially accepted evil. What? Nothing wrong with a few glasses of wine paired with your meal you say? Well, not exactly. Regarding weight gain, alcohol is more than a double whammy. This potion is broken down into acetate, which your body will use first for energy before anything else you eat or drink. Alcohol is metabolised, fat oxidation stops, weight gain may occur and slowed metabolism may result.

Photo by Stephen Bentsen

An average glass of wine has 150 calories, and beer has about the same. People who drink alcohol with a meal often eat up to 30% more food, and considering the culture of pairing food and drink in HCMC, this may cause a problem for many.

Juices and Sodas

Photo by Lavanya Kumara Krishnan

Fruit juices are commonly thought to be a healthier choice over soda. Studies show that the effects on our bodies are virtually the same. According to a recent publication in the Nutrition journal, fruit juice has a fructose concentration of about 45.5 grams per litre, slightly less than the average of 50 grams per litre for sodas.

"The human body isn't designed to process [fructose] at such high levels. Fructose is processed almost entirely in the liver where it is converted to fat, which increases risk for diabetes, cardiovascular disease and liver disease,” says Michael Goran, Director of Childhood Obesity Center in Southern California.

Essentially sodas and fruit juices should be avoided altogether. Eat fresh fruit instead, which includes fibre, slowing down absorption of sugars and allowing the normal metabolism of fructose. As an alternative, drink lots of local fruit smoothies (like avocado) but without condensed milk or sugar. Try an avocado smoothie for healthy fats.

“The only way to keep your health is to eat what you don’t want, drink what you don’t like, and do what you’d rather not.” - Mark Twain


Pollution, Water and Disease in Saigon: What You Should Know

By: City Pass Guide

We are all in danger of the negative effects of air pollution, water contamination, unclean food, worms and tropical diseases in HCMC. I sat down with Dr. Nicolas Lagüe from Centre Medical International to learn how we can manage to avoid these health problems.

Air Pollution

It’s no secret that there are substantial pollution problems in Vietnam. However, just how dangerous the air is, and exactly what effects it has on our health can be difficult to decipher. The main parts of the body that are affected by air pollution are the nose, throat, ears and lungs. Whether you are on a motorbike, in your car, walking or in your apartment, exposure to air pollution in HCMC is nearly unavoidable, and we need to make a personal choice if living here is worth the risk, especially considering how difficult it is to evaluate the related dangers.

Photo via Pixabay

The air contains toxic particles and nanoparticles, which can come from a variety of sources. One interesting fact I learned from Dr. Lagüe was that the non-exhaust particles, like the iron, copper and barium that are released during the breaking of a car or motorbike, produce significant nanoparticles. This fact, combined with the high concentration of exhaust emissions, make stopping at red lights a prime hotspot for heavy toxic air. According to the expert himself, the best way to protect yourself, outside of not living in the city, is to wear a proper mask. For this, you will need to spend the money and get a thick carbon cloth mask (FFP3 class) which will help filter out the bigger pollutants in the air.

Although driving a car exposes you to slightly less toxicity than when you are on a motorbike, it is still not enough to make a significant difference. In regards to your home, location is key. The further from the busy areas the less pollution there is, and the higher up your apartment the better. Therefore, if air quality is a major concern for you, try to find a flat on the highest floor possible. The closer to the ground your apartment is, the more exposure it receives.

Drinking Water Contamination

Everyone knows the first rule of thumb when living in most developing countries - don’t ever drink the tap water! It contains dangerous levels of nitrates and iron, not to mention a variety of other unsafe chemicals. The best way to ensure you are taking in the cleanest drinking water is to stick to mineral water. Alba is the name of one local company that is producing high quality bottled mineral water that contains an impressive amount of bicarbonates.

Photo via Pixabay

Bicarbonates are great for balancing the body’s gastric acidity levels and are also highly effective in preventing dental cavities. Not only is mineral water a sound alternative to many of the questionable drinking water sources available, but its health benefits are scientifically backed and heavily researched throughout the world. Another suggestion is to constantly switch the brands of mineral water that you drink due to the fact that each brand is comprised of different levels of electrolytes. A regular rotation like this is good for the body, and helps you maintain a healthy level of energy.

Food, Worms and Bacteria

Statistically, Vietnam does have a lower quality of food than most countries, which can result in an array of digestive problems, amongst other health related issues like diabetes, heart disease and cancer. However, the main concern lies in regards to bacteria and worms, and these are real threats that every resident needs to be taking precautions against. Let’s make it known that there are numerous varieties of worms and parasites out there and they are very easy to acquire. You might have worms and not even show any symptoms. Dr. Lagüe highly recommends that everyone living here take Zentel every six months. This is readily found at pharmacies all over town and is highly effective in expelling any worms that you may have. Worms and other parasites can lead to other more complicated issues if left untreated, like schistosomiasis, a condition that can cause diarrhoea, abdominal pain, a bloody stool or much worse.

Photo via Pixabay

In regards to food, the number one cautionary measure to take is with vegetables, as they can very easily harvest bacteria. Just by touching the outer skin of contaminated vegetables, larvae can be transferred into your body. It is suggested that any vegetables you buy need to be thoroughly washed while wearing gloves. Meat is another cause of concern, but also a debatable topic. Keep in mind that everyone’s body is different, and each individual can have different levels of immunity to different bacteria. Although it’s an undisputed fact that unrefrigerated meat increases the chances of bacterial contamination, doctors often disagree on how dangerous it is to consume it. Consumers should do their best to buy quality meat that is within their budget. Annam Gourmet is one trusted shop that sells quality meat that has been properly stored, and it’s a notable place to buy safer products. I’ve interviewed doctors that passionately advised against eating any street food under any circumstance, while others have said it’s perfectly fine to indulge once in awhile. Either way, it’s best to know your body and act accordingly.

Photo via Pixabay

Tropical Diseases in Vietnam

The best way to avoid many tropical diseases is to get vaccinated before you come to Vietnam. As many of the symptoms crisscross each other, it is often very difficult to identify what exactly you might have. Vietnam also has limited medical technology, which can make diagnostic processes more difficult. If you feel any strange symptoms like fatigue or joint pain as a result of a suspected insect bite, seek a medical expert immediately to get some blood work. Hydration and proper rest are crucial during this time.

Some of the most prevalent tropical diseases in Vietnam are Dengue Fever and Zika Virus. The danger with these viruses is that their symptoms vary and there is not much technology available in Vietnam to give proper blood tests. Do your best to wear mosquito repellent, especially outside of the city limits, where the number of mosquitos increases. There are several types of mosquitos which can carry dangerous tropical diseases, and many cannot withstand the pollution of the city. However, once you leave the city limits, and the pollution levels are lower, there is a substantially higher risk of exposure. As a whole, it’s next to impossible to control if you are bitten by a mosquito or not. The best thing you can do is to be aware of the symptoms of Dengue and Zika, and if you experience them do not procrastinate seeking treatment.


The Lowdown on Lower Back Problems

By: City Pass Guide

Lower back pain is one of the leading causes of disability in the world, according to the World Health Organization.

In the U.S. for example, around 31 million people will experience lower back problems at any given time, says the American Chiropractic Association. These problems affect the spine's flexibility, stability and strength, causing pain, discomfort, and mobility issues.

And the problem is certainly not confined to America. In 2012, a research paper by Professor Stephen Bevan of Lancaster University in the UK covered 30 European countries, and found that a staggering €240 billion was lost to musculoskeletal conditions.

I sat down with Dr. Nicolas Dupaux, the man in charge of the Osteopathy department at Centre Medical International, and one of the leading back specialists in HCMC. We began the discussion with the difference between osteopathy and chiropractic practices.

Photo by www.lifenurturingeducation.com

An osteopath differs from a chiropractor in quite a few ways. As someone who has suffered at the hands of a chiropractor in the past, I was interested to learn more about the subject of osteopathy.

The osteopath will look at the cause of the imbalance rather than just the symptoms. They will not just crack bones back but try and balance the whole body; they have a wider spectrum of techniques. It is really difficult to know if a patient, for example, has a problem with their veins. If they have a pathological problem and don’t inform the practitioner, they can do more harm than good. There are some techniques that are no longer considered safe to employ.

I asked Mr. Dupaux to answer some common questions about back problems.

What do you think about massage parlours in HCMC?

Anyone can get a licence to open a massage parlour here after taking just eight hours of theory. There is no real culture of massage in the country; there are no real schools and traditional massage houses. Ten years ago Thai girls were being paid by hotels to teach the techniques. But there was no homegrown skill, they imported it. The physiology is so different between East and West.

Even in my surgery I have to do different treatments for different nationalities. This is why Western people don’t find the massage to be as beneficial. Eastern people like to have very strong massages, and cracking of the bones. However, I treat, on average, two people per week who come in suffering from a blocked neck or severe back pain, caused by a massage.

What is your attitude to the use of painkillers with back pain?

Pills often have side effects. It is often necessary to take anti-inflammatory drugs and/or muscles relaxants but pain killers should be seen as a last resort.

Do you think that alternative treatments like acupuncture have a role to play in treating back problems?

Alternative treatments do have a place in the treatment of patients, but some, like hypnotherapy, are restricted to rich people and the elite. In my opinion there are both new and old technologies that are very good. Acupuncture, for example, is very good, for spinal problems. Serious scientific studies have shown that the acupuncture points are definitely different to other areas of the skin. It has been electromagnetically proven that acupuncture works.

Photo by www.groupon.com

If the need arises for surgery, would you advise people to go abroad or have it done here?

Dr. Claudio Duek at Family Medical Practice is a very good surgeon working on hands, and Dr. Phatat at FV Hospital is a specialist in knees and legs. So for these problems it is good here. These guys are at the same level as European doctors. However for complicated surgeries you are better off going to Bangkok or Singapore.

Have you got any advice on how people should carry backpacks?

A correct backpack should cause no issues at all. Good quality packs are fine as long as the weight is spread. People who carry a pack every day get stronger. Use both shoulders and balance the weight.

Having some age related arthritic issues myself, I find the warm weather here hugely beneficial. Why is this?

The microclimate here is definitely good for joints. There is something going on here in the climate that is great for people with joint problems, asthma and other issues. The diet is also healthy. Pho uses herbs that have medical properties and of course, there is no gluten in pho.

The cure to lower back pain seems to be an illusive thing at times, but when you consider that, as one doctor told me years ago, the difference between being pain free and in agony is often less than half a millimetre, maybe it’s not surprising.

Header photo by www.thelifesquare.com


A Brighter Smile in Saigon

By: Patrick Gaveau

We sat down with Dr. Philippe and Chau Guettier, two well-known dentists who have run the Starlight Dental Clinic for over 20 years, in order to find out more about dental care in HCMC and Vietnam.

In your opinion, is the Vietnam dental industry currently developed in HCMC?

Philippe: During the last 15 years it has developed a lot. Especially in terms of quality, it has improved much in the past three to four years. At the university level, the education of the dentists is getting better and better. There is much more training done by foreign universities - namely French universities. Now young dentists who graduate receive much better education for their practice.

Is developing the dental industry and pushing dental care a concern for the Ministry of Health?

Philippe: The Ministry has a good control over the quality of the clinic. In France, once you graduate and open your clinic, you will never get any check-ins from the government on a yearly basis to see if everything is taken care of. In Vietnam, each clinic gets a check-in from the Ministry of Health every year. This is good for maintaining the quality of clinics here.

In terms of equipment, are there concerns or issues based on the different levels of clinics? Or is there a general standard?

Philippe: Basically, what the government will control are x-rays, sterilisation, and product lifespan. After, they will not check if the tools or the products you are using to treat the patient are good quality or not. Unfortunately in Vietnam you have many products made in China - machines, or products you put into the patient's mouth. The instruments used to treat and restore a patient’s teeth will not be of the same quality. There is quite a big discrepancy from one clinic to another.

Do the majority of locals value the importance of having healthy teeth?

Philippe: You have a growing middle class. Once you go outside Ho Chi Minh City or Hanoi, there’s still a big gap. You have to look at the ratio of how many dentists there are for the population. In France, it’s 1 dentist for 1,500 people. In Vietnam, it’s 1 dentist for nearly 10,000 people.

We’ve seen more obesity in children in Vietnam in the past 10 years. Is this also affecting dental care?

Chau: I think the main reason for cavities is how you brush and take care of your teeth. Even if they eat a lot, if they brush their teeth afterwards they will not have problems. Now, people have more education on how to keep their teeth clean.

Philippe: We go to a lot of schools and have a program for this. We teach the children what are cavities, how to brush your teeth, and we give them a toothbrush. But to answer your question, I think we have more cavities than before for the kids. The quality of food (with fast food and soft drinks) has decreased. Even if you have kids in international schools with wealthy families, you’d still be surprised by the number of cavities that can be found.

Will there be an expanding future market for orthodontics?

Philippe: By definition, everybody knows Vietnam is a young country [laughs] with a lot of kids, so sure there is a market for orthodontics. Now, you have parents who want their children to have great teeth for the future, so they bring them in for orthodontics. But you also have a lot of young Vietnamese adults who get orthodontics, because as kids they didn’t have this. As opposed to France, where mostly children get orthodontics, in Vietnam we have many more adults patients.

If you had to give a price difference between the majority of treatments, how much less expensive would it be here than Australia, including the cost of travel and board?

Philippe: Australia would be three to four times as expensive, at least.

Chau: But it depends on the treatment. To give an example, I had a quotation from a patient in Australia for one impacted wisdom tooth removal for $1,200. At our clinic in HCMC the cost is $120.


Saigon’s Sick Can Count On A Wealth Of Healthcare Providers

By: Keely Burkey

Looking for an effective oncologist or just need to get a routine annual teeth cleaning? Look no further than City Pass Guide’s list of health specialists in Ho Chi Minh City.

We’ve compiled a list of 14 healthcare providers including doctors in a range of fields and specialties. And they’re all working in Saigon here to get you well again.

Cardiology

Tam Duc Heart Hospital

hospitalImage source: vicare.vn

Dedicated to all matters of the heart, Tam Duc Heart Hospital has been the go-to cardiology stop for years. Private clinics will have excellent cardiology departments, but the heart is Tan Duc’s bread and butter.

4 Nguyen Luong Bang, D7 | +84 28 5411 0025 | hospital@tamduchearthospital.com | tamduchearthospital.com/home/en

Oncology

FV Hospital

FV’s Hy Vong Cancer Centre is top-of-the-line and has the Joint Commission International’s Gold Seal of Approval. Both Dr. Vo Kim Dien and Dr. Tran Thi Phuong Thao are highly experienced and fluent in English, French and Vietnamese.

6 Nguyen Luong Bang Tan Phu, D7 | +84 28 5411 3333 | information@fvhospital.com | fvhospital.com

Gastroenterology

Victoria Healthcare

Helmed by Dr. Nguyen Vinh Tuong, a member of the American College of Gastroenterology and the American Society of Gastrointestinal Endoscopy, this department is fully equipped and internationally known.

81 Dien Bien Phu, D1 | +84 28 3910 4545 | info@victoriavn.com | victoriavn.com

Obstetrics and Gynaecology

Hanh Phuc Hospital

hospitalImage source: hanhphuchospital.com

The most well-known and beloved women’s health department in the city. Top marks go to Dr. Robert Riche, a native of France, who runs the department with great aplomb and bedside manner.

Binh Duong Boulevard, Thuan An District, Binh Duong Province | +84 274 363 6068 | info@hanhphuchospital.com | hanhphuchospital.com

Diagnostics

The Diag Medical Center

If you need to get a blood test, a screening or a general checkup, there’s no better place than the Diag Medical Center. It just opened a new and beautiful facility earlier this year.

414-420 Cao Thanh noi dai, D10 | + 84 28 3979 8181 | info@diag-center.com | diag-center.com

Dentistry

Westcoast International Dental Clinic

You’ll be able to find cheaper dentistry in the city, but if you want some quality work and peace of mind, we recommend Westcoast. One major advantage here is the large range of top-of-the-line dental equipment.

17-19 Ly Tu Trong, D1 | +84 28 3825 6999 | info@westcoastinternational.com | westcoastinternational.com

Elite Dental

Patients love Elite Dental’s team: they’re warm, friendly and knowledgeable. They also specialise in dental implants.

57A Tran Quoc Thao, D3 | +84 28 3933 3737 | inquiry@elitedental.com.vn | e.elitedental.com.vn

Psychology

The International Center for Cognitive Development

hospitalImage source: iccd.info

Azrael Jeffrey and his team of fully accredited mental health practitioners have been serving the Ho Chi Minh City community for two years. Plus, initial meetings are free of charge so you can find out if they’re a good fit.

191 Nguyen Van Huong, D2 | +84 0965 729 346 | ICCD.hcmc@gmail.com | iccd.info

Pediatrics

Victoria Healthcare

Victoria Healthcare’s newest clinic includes not one but two floors entirely dedicated to pediatrics. One level is for checkups, while the other handles children with infectious symptoms—no cross-contamination here.

81 Dien Bien Phu, D1 | +84 28 3910 4545 | info@victoriavn.com | victoriavn.com

Hanh Phuc Hospital

Famously operating on “Singapore Standard”, Hanh Phuc has a pediatric centre, a safari-themed patient ward and a neonatal intensive care unit. They’re the real deal.

Binh Duong Boulevard, Thuan An District, Binh Duong Province | +84 274 363 6068 | info@hanhphuchospital.com | hanhphuchospital.com

Neurology

Columbia Asia

Columbia Asia’s Binh Duong hospital includes a high-quality neurology department. It can treat issues including Alzheimer's, epilepsy, stroke and many more brain-related disorders.

Street 22/12, Lot 178, Hoa Lan, Binh Duong Province | +84 274 381 9933 | customercare.binhduong@columbiaasia.com | columbiaasia.com/vietnam/hospitals/binh-duong/binh-duong-overview

Dermatology

Stamford Skin Center

hospitalImage source: Stamford Skin

Internationally run and well staffed, this high-tech palace of skin care doesn’t just stop at dermatology. Come here for all your issues involving hair and nails as well, but expect an international-sized bill when you’re done.

99 Suong Nguyet Anh, D1 | +84 28 3925 1990 | info@stamfordskin.com | stamfordskin.com

Tropical Medicine

Centre Medical International

Dr. Nicholas Lagüe is one of the only tropical medicine specialists in the city. Vaccinations and treatments for tropical diseases should be presented to this qualified professional.

1 Han Thuyen, D1 | +84 28 3827 2366 | info@cmi-vietnam.com | cmi-vietnam.com

Optometry

Ngoc Toan Optical

This small mom-and-pop glasses shop is a great and trusted place to a good eye checkup at a reasonable price. Vietnamese-owned, they speak fluent English, so you’ll be sure you’re in good hands.

106 Le Thanh Ton, D1 | +84 28 3823 2059

Banner image source: Elite Dental


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