After changing the conference dates for the 3rd time and having a difficult 4 day trip (from Boston-N.Y.-L.A.-Hong Kong) to Hanoi (see Dick's Log, we are finally at the Vietnam National Nursing Conference. Sponsored by the Vietnam Ministry of Health and the World Health Organization, the conference is on "Health Manpower Development of Nurse and Midwife and Medical Technicians at the Threshold of the 21st century", in Hanoi 8/12-14/99. 

We were very fortunate to be invited to attend - few foreigners (12) were invited including nursing volunteers from Friendship Bridge (Denver), Teachers College (NYC), Rutgers University.(NJ), Temple University (PA), and 2 delegates from WHO. My nursing honors student, Nu Vo (3rd from right), was immediately given an assignment as interpreter - translating articles and speeches in writing and by spoken word. I am so proud of her abilities and professional demeanor.

We are learning much about nursing in Vietnam. For example, 3 out of 4 nurses work 24/24 hour shifts. There are not enough nurses in many of the hospitals - It is not uncommon partly because the salary is so low - $1/day. Often they have no nurses on duty after 4pm until the next day and on Sundays.

According to one of the Australian volunteers, this is the 1st time that the Vietnamese have identified any of their weaknesses in such a forum. This in itself is a positive change and progress.

A key point however made by Eric Chan, Nursing Consultant of the WHO, is that
"Nursing Manpower planning is not just about numbers. It is about building an appropriately educated work force to meet the health service needs of a country. The goal is to provide the right number of appropriately educated nurses in the right time at the right place".

This national conference provides a forum for the development of nursing and
nursing practice to benefit public health and improve the health of Vietnam.

Chao (Bye)

A highlight was the presentation of a "National Strategic Nursing Plan 2000-2010 by Dr. Janet Quilliam (in photo), WHO Consultant. She identified some notable gains in the past decade including the establishment of the Vietnamese Nursing Association-VNA-(1990), establishment of the chief nurse position (1999), and Ministry of Health (MOH) approval of 3 year nursing program at Nam Dinh as the official professional nursing program in Vietnam. Commending these actions, she called for additional actions to improve nursing and midwifery in Vietnam by making fundamental changes in nursing education and further development of the role and practice of nursing.

Strategies to achieve these goals included:

• strengthening nursing education through advancement of nursing at the masters, baccalaureate, RN, and associate nurse categories
• revising nursing curricula to include primary health care and community health content
• developing a Code of Ethics and National Standards of Practice to serve as the basis of curricula revision
• expanding continuing education to the provinces
• placing midwifery education within a nursing education framework
• developing a regulatory board to register and license nurses and midwives.

The position of the WHO stresses the importance of nurses and midwives to the health of people. Within a primary health care framework, nurses can provide 80% of the services needed.

Nurses can indeed make a difference!

The 3rd day of the national meeting sponsored by the Vietnamese Ministry of Health and WHO brought the conference to a conclusion today. Deputy Health Minister Le Ngoc Trung attended the conference along with representatives of WHO, several foreign Health organization, 21 medical schools, and 23 hospitals.

Participants focused on improving the quality and training of health care workers as well as the quantity. It is estimated that Vietnam needs to double its health care work force, particularly through more training. Local health authorities were urged to focus more on the living standards of health care workers to encourage both new and experienced compassionate nurses to continue their work.

The final presentation was given by Ms. Trinh Thi Loan (2nd from left), the Vice President of the southern region of the Vietnamese Nursing Association (VNA). My nursing student, Nu Vo, and I worked over 5 hours to prepare a written translation in English of her speech. However, many last minute changes were made. Ms. Loan reviewed that the VNA has worked with the MOH over the past 10 years to meet the government objectives to provide adequate health care for the Vietnamese people. However, these objectives still have not been met. This is attributed to not enough nurses, inadequate education, lack of funds, and low salaries. The present salary for nurses, about one dollar per day, is not enough to support an individual let alone a family. This forces nurses to work second jobs which impacts their ability to adequately perform their nursing jobs.

In summary, the conference was a big step forward for Vietnamese nurses. It will be interesting to see if and how any of the proposed strategies will be implemented. I wish them all the best of luck.