When Global Medic Force began working in Vietnam in 2002, the main focus of our efforts involved HIV and infectious diseases healthcare capacity building programs. Since then, Global Medic Force’s work has expanded to include cancer care, diabetes, cardiovascular and other chronic diseases. However, HIV/AIDS work remains critically important in this country of over 86 million people.
The HIV epidemic in Vietnam is still in a concentrated phase, with the highest prevalence rates found in injecting drug users, female sex workers, and men who have sex with men (the national HIV prevalence rate is 0.4% or approximately 280,000 people). In the last few years, there has been much progress in the country’s HIV response. While only 30% of those who needed antiretroviral treatment (ART) were receiving it in 2007, that number increased to over 50% in 2009. Pediatric HIV treatment and prevention of mother to child transmission services are also improving.
There has also been a significant focus on HIV prevention. The implementation of a methadone maintenance program has been particularly important in Vietnam, since HIV continues to be spread mainly among people who inject drugs and then who pass it on to their sexual partners and children.
The continued progress in the country’s HIV/AIDS program is a reminder of the importance of mentoring and training. Jane Whitney is a Physician Assistant who has participated in Global Medic Force’s mentoring programs in Lesotho, South Africa, and Vietnam. During her work in Vietnam, she mentored the doctors who would be supervising HIV/AIDS treatment for the first time. In her view, the biggest change for local physicians was from short-term to long-term, chronic care. “They were used to curing the immediate problem,” said Whitney. “You can understand that they practice medicine like that. They don’t have the whole armamentarium of medicines that we do; they concentrate on the things they can do right now.” But for AIDS drugs, she said, “someone will be on this for life. You need to plan for that. It takes another mindset.”
Ultimately, that’s why mentoring programs work. By changing mindsets and leaving behind local health workers who have the skills, knowledge, and desire to provide long-term care, a system is created that lasts long after the mentor leaves.