The latest update from Vietnam brings good news: we’ve received our permit of operations. We’re excited that the opportunity to expand our model into Vietnam is getting closer to realization. Of course, it also means much more work ahead and our plans are being further developed and fine-tuned.
The ongoing support we have for entering Vietnam encourages us and we sense that we’ll hit the ground running rather soon. However, we’re at the stage where we wish to ensure our steps towards kicking off operations rest on a strong foundation. Our ties and the increasingly collaborative discussions we’re going through seem quite promising. We hope to soon make a difference by treating some of the most disadvantaged tuberculosis patients in the country.
There were some bad news this quarter and a lot of good developments, which I would like to share with you. As I’m a bad news first type of person, allow me to share that with you right off the bat. We still don’t have our project up and running and it doesn’t seem likely that we will be able to get the permit of operations this year. Sounds pretty bad, doesn’t it? Well, let me try to assuage the negative impressions from this opening statement with a few good news.
Firstly, we have finally been able to meet the next level of stakeholders in Ho Chi Minh City, who would have a say about the execution of our project. Through a series of connections, I was able to connect with the retired deputy director of the department of health for Ho Chi Minh City, Dr. Le. This was a key connection for us as he in turn facilitated meetings with Dr. Nguyen, the deputy manager of the NTP and head of the Pham Ngoc Thach TB reference hospital for the entire southern region – through one short phone call no less – and the TB officer of the district in which we are planning to implement the first project. Furthermore, this gentleman has 40 years of experience in the Vietnam’s political and public health system and suggested we entertain a different route to make this project happen.
Based on his experience and opinion, Operation ASHA needs to have verifiable results and legal entities vouching for our work and our success. Without that, a permit of operations application is sure to get rejected or will take forever to push through the political red tape. However, without a permit of operations, one is not allowed to open bank accounts, hire staff and start operating in general. Joseph Heller would be proud of the catch-22 in which we have found ourselves.
It just so happens that Dr. Le is also president of a local NGO. He suggested that his NGO could serve as the implementing agency with Operation ASHA as the donor and technical agency. Meanwhile, the local NGO would contract with the government to source the necessary material, people and medication for the project. While this solution would limit the influence and freedom of Operation ASHA to operate independently, it would also serve as potentially great showcase of cross-border public-private partnership. Furthermore, with this type of collaboration, according to Dr. Le, we could have approval to implement the project within several months, anticipating a start in June or July instead of next year.
The engagement and support of all parties involved has been demonstrated last week at the event hosted by Pham Ngo Thach hospital in honor of World TB Day, during which both Dr. Le and Dr. Nguyen announced the upcoming partnership with Operation ASHA on public television. With this type of development and support, I hope you join me in my continuous cautious optimism. Thank you for your continued interest and support and please don’t hesitate to reach out to me, should you have any questions. Make sure you also continue to spread awareness about TB and this project to your friends and family, especially in light of World TB Day.
As so often in life, one has to be prepared to accept that things do not develop as well and as quickly as planned. The old adage saying that patience is a virtue particularly applies to this past quarter. Despite the progress we made during the previous quarter, which included the draft of a new memorandum of understanding with the Vietnamese government and the submission of our application for the permit of operations, over the past three months we had to face a few setbacks and delays, which we hope will sort themselves out in the first quarter of the new year.
The first setback is that we still have not received the permit from the Vietnamese government. As the government had just revised its laws on the presence of international NGOs in Vietnam in July 2012, the procedures and requirements had to undergo steady additional changes. As such, the Ministry of Foreign Affairs issued additional guidelines on the required documentation in November, according to which we were required to submit further documentation such as my official, notarized and consulate-legalized police record, which had not been required previously. Obtaining these documents naturally required more time and another round of document submission and review.
The good news is that several sources within the government had assured me that these additional documents requested will be the final step prior to the issuance of the permit in January or February. We will keep our fingers crossed in the hopes of providing you our first report of actual operations in the next progress report.
During the past quarter we also had the chance to work closely with the Medical Committee Netherlands-Vietnam (MCNV). The collaboration consisted of the development and submission of a large grant application to one of the major funding programs in the sector called TB Reach. While we worked hard for several weeks on the application and received strong feedback from several sources regarding our output, the application unfortunately was unsuccessful and funding was denied. However, the silver lining is that we were able to develop a strong working relationship with MCNV, which we will want to explore further in the future.
Lastly, during the last quarter I was also granted the opportunity to present our work and anticipated plans for Vietnam to the staff of the Oxford University Clinical Research Unit. To my pleasant surprise, the presentation was very well attended with almost 70 attendees. The meeting lasted 1.5 hours including an extended questions and answer session. Overall, the information presented was very well received and was met with universal support from the attendees.
I sincerely hope that 2013 will bring about the long anticipated start of our operations in Vietnam and the begin of cost-effective case detection and TB treatment for Vietnamese patients. I would also like to thank you for your ongoing interest and support. Please continue to spread the word to family and friends about TB and about our project. We appreciate any help or support you can provide in our continued battle against TB. In the meantime, I hope you had a peaceful holiday season and a happy start into the new year.
Following the big leap from India to Vietnam and the unofficial establishment of an Operation ASHA presence in Vietnam, things are finally starting to move into the right directions. And while we have not been able to actually start operations yet, there have been a few positive developments that I would like to share with you.
As you may remember from the last progress update, a revision of the law governing the operations of foreign NGOs in Vietnam earlier this year rendered the existing agreement we had signed with the National TB Control Program ineffective with regard to applying for the permit of operations. Hence, right after my arrival in Vietnam, I took a brief trip to Hanoi to meet with the directors of the National TB Control Program (NTP) and discuss potential next steps that would avoid months of cutting through bureaucratic layers to obtain all the necessary approvals.
To my surprise and the credit of the director and deputy director of the NTP, after a one hour meeting we had come to a conclusion on next steps, exchanged a softcopy of a new contract I had drafted and by the end of the day both gentlemen had reviewed, edited and returned the draft to me. While this is a true tribute to the leadership of the Vietnamese NTP, it is also a testament to the urgency of the TB problem in Vietnam and the need for organizations like Operation ASHA to intervene. The next day I returned to their offices and within half an hour we had a new, signed contract in our hands, with which we would be able to reapply for the permit of operations.
The same day I also managed to squeeze in a meeting with another NGO, the Medical Committee of Netherlands-Vietnam (MCNV), with whom we had already met last year to discuss a potential way to collaborate. Out of that meeting came the idea of collaborating on a proposal with TB Reach, a major funding facility sponsored by the Stop TB Partnership and the WHO. About a week ago we managed to complete and submit the application and we are keeping our fingers crossed for a positive outcome.
On the third day of that initial Hanoi trip, I was granted a meeting with the deputy director general of the authority issuing permits of operation. In that meeting I was able to briefly present and simply handover the paperwork for the permit. The next day, after I had already returned to Ho Chi Minh City, he also told me that he had already submitted the paperwork for processing. In the following weeks up until today, I had to follow-up and submit a few additional documents, but a few days ago a dispatch from Hanoi had been issued to the local authorities in Ho Chi Minh City about the granting of a permit to Operation ASHA. It seems that the end of this road is finally within reach.
In the meantime, I was invited by the Oxford University Clinical Research Unit to give a presentation on Operation ASHA’s work and its impact in India and Cambodia next week. Hopefully, new friends will be made during that meeting as well.
While the process has been highly encouraging and has made major leaps forward, the grain of salt is that the permit has still not been issued. Furthermore, it seems that a potential major future funder for our operations in Vietnam is downsizing and withdrawing support on which we had initially counted. Hence, I want to thank you for your ongoing support now more than ever.
Additionally, allow me to ask you to continue raising awareness to family and friends about TB and our project and hope they will decide to contribute and join our circle of friends in the fight against the disease as well.
A little less than a year ago, the idea was born to extend our well-established and recognized TB treatment program in India to a new country, Vietnam, after we had already successfully transplanted our model to Cambodia. After almost a year of meetings, discussions, translations, explanations, presentations, fundraising and whatever else is required for such a significant step, the time has arrived that Operation ASHA will finally make the leap to our third country of operations. More specifically, yours truly will relocate to Ho Chi Minh City, Vietnam, during the first week of August to drive the work forward directly on the ground.
Of course, a number of successes were necessary before we were able to take this step, the biggest being the achievement of our minimum fundraising goal for year one. This victory was in part made possible through the fervent support of friends and family, the confidence placed in us by our board of directors and the gracious support of various third-party organizations and donors. In the process, Operation ASHA even managed to reach almost 10,500 unique viewers with a short video/slideshow illustrating the plight of TB in Vietnam - incidentally also placing second in a contest hosted by the company operating the technology platform (sliderocket.com), which further aided our fundraising efforts. However, year two and three funding continue to be outstanding and while we are exploring a few avenues, your support is naturally always appreciated.
Another significant step forward was the verbal agreement between us and the leadership of the Vietnamese National TB Control Program on certain detailed, key requirements within our operating model - all of which were agreed upon in our favor and will represent groundbreaking progress in terms of collaboration between government and NGO, particularly in relation to patient treatment.
Unfortunately, it was not all good news during the past three months. An area previously believed to be well on track - regulatory approval to start operations - has hit a slight road block. This was brought about by the revision of the law governing the presence and operations of foreign NGOs in Vietnam - the law was officially introduced July 1st, 2012, which raised the attestation requirements (i.e., paperwork) for new NGOs looking to start working in Vietnam. As a result, our contract with the government, which previously should have satisfied the regulatory requirements, will need to be reworked. Hence, our anticipated start date has been pushed by 2 months to allow sufficient time to incorporate the incremental requirements.
As mentioned at the beginning, despite this setback things have been moving along nicely and we anticipate to make even better progress once we have hit the ground...running, of course.
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