<![CDATA['I hope my son dies before me': 44 years after US-Vietnam war, Agent Orange victims are treating brain damage with painkillers]>
The painkillers and anti-epilepsy medication provide relief for the 32-year-old, who has brain damage and muscular dystrophy caused by wartime toxin Agent Orange. "If she does not take the pills, she will be up all night crying and knocking her head against the wall," says Tai's mother, Tran Thi Gai, 58, at their home in Vietnam's poverty-stricken Quang Tri province.
Four of Gai's eight children have medical conditions linked with Agent Orange. The family lives on less than US$30 a month, crammed in a tattered house in rural Cam Tuyen village.
Quang Tri Provincial Hospital is a run-down place. Photo: Khairul Anwar
Three million Vietnamese born after the Vietnam war ended in 1975 have birth defects associated with Agent Orange. They need medication and rehabilitation therapy, but the lack of access to health care leaves many relying on over-the-counter painkillers instead.
Vietnam has become one of the fastest-growing markets for painkillers, according to market research firm Euromonitor International, with sales figures jumping nearly 80 per cent from US$76.1 million to US$135.4 million between 2014 and 2018.
Many of those with Agent Orange-related conditions and living in rural areas cannot be weaned off cheap painkillers, which doctors say is worrying because of long-term health risks.
Quang Tri has one of the highest concentrations of Agent Orange victims in Vietnam with 15,000 of its 650,000 population affected, according to local government body the People's Committee.
Tu Du Hospital in Ho Chi Minh City has a ward providing round-the-clock care for children born with deformities caused by Agent Orange. Photo: Khairul Anwar
Officially, the province is served by 156 "health care facilities". In reality, however, that means 12 provincial hospitals, one polyclinic and five rehabilitation hospitals for chronic illnesses. Mostly, people go to basic, ill-equipped "commune health stations" for primary health care.
This is a world apart from the situation in better served cities. The Tu Du Hospital in Ho Chi Minh City, for example, has a ward providing round-the-clock care for children born with deformities caused by Agent Orange.
And even though Quang Tri has one doctor per 1,429 citizens, a ratio comparable to that in cities, a World Bank report found commune health stations to be inadequately staffed. Only 79 out of 136 centres had at least one trained doctor. Another World Bank study found that most doctors at these centres did not receive standard medical school training.
Most villagers are exempted from paying for medical consultations and medicines, but patients must be present to claim their benefits, and parents find it too difficult to take their disabled children to seek treatment.
Quang Tri Provincial Hospital is collaborating with the Japan International Cooperation Agency on a rehabilitation programme to equip doctors with speech and physical therapy skills. Photo: Khairul Anwar
Dr Doan Thanh Nhan of the Hue University Hospital says victims of Agent Orange need to start therapy early. "There is no one universal treatment for these patients and we need to intervene individually," he says.
The Quang Tri Provincial Hospital is a run-down place, with ancient air conditioners that do not work, and overcrowded wards where patients lie on metal-framed beds. It announced last November that it was collaborating with the Japan International Cooperation Agency on a rehabilitation programme to equip doctors with speech and physical therapy skills.
Nhan says more community-based rehabilitation programmes, such as house calls, are being explored and hopefully will help the people in Quang Tri.
For many villagers, however, getting to a hospital is too much of a challenge.
Tran Thi Ngiem, 56, does not take her son, Tran Van Hung, 18, to the nearest district hospital 10km from their home in Bang Son village because it is too far to travel. The bedridden youth has severe brain damage, and is unable to speak or chew.
Ngiem says: "I am getting old and he is getting heavier by the day. It's hard for me to even take him to the toilet to bathe him, let alone go to the hospital."
Buddhist nun Thich Nu Lien Thien provides free physiotherapy at her temple in Cam Lo district to children with physical disabilities. Photo: Khairul Anwar
In nearby Phuong An village, 70-year-old Le Thi Bich and her 75-year-old husband, Nguyen Van Loc, survive on US$21.50 a month from the government. They earn a little more by selling chickens that they raise, and tea leaves from their garden.
Two of their three children have died, leaving the couple to care for their 32-year-old son, Nguyen Van Theong, who is severely brain damaged.
They cannot afford to pay to get him to the nearest hospital, 20km away.
They buy over-the-counter drugs for their son, who takes three mental stabilisers and four painkillers a day to soothe his hysteria and muscle spasms.
"It is a struggle," Bich says. "I hope my son dies before me, so I won't have to worry about what will happen to him when I'm gone."
To ease the burden of parents like her, Buddhist nun Thich Nu Lien Thien began providing free physiotherapy at her temple in Cam Lo district to children with physical disabilities.
A certified physiotherapist, she sees about 10 to 15 children daily. Since 2010, she has helped more than 100 children, some as young as eight months old.
"It's sad to see young children suffer. If I can help them when they are still young, they might have a higher chance of some improvement," Thien says.
She has noticed a rise in the number of children being brought to her for help. Last year, there were "a few dozen more parents" with disabled newborns than in 2017.
This article originally appeared on the South China Morning Post (SCMP).
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