Vietnam Mission Trip 2019: Bệnh Viện Nhi Khoa #1...

It's Tuesday, the 7th, here in HCMC and we just returned from a great dinner at Te Te (pronounced "Tay Tay")...a craft brew pub here, which has some yummy craft beers.

The cool staircase at the gastropub. There is a main level, which has large windows opened to a relatively quiet alley.

(left) Kloudy Kolsch (in the style of a German kolsch), was my choice. (right) Amy chose the Mellow Red. They were both delicious! They are made here in HCMC.

Amy had their beer ~ their IPA ~ while we were in Can Tho and wanted to buy a couple of their glasses for Robert's and her home, but the guy in Can Tho said he only had about 6-7 glasses and couldn't sell her any. So, he recommended we come to their HCMC locale and Amy was successful in buying 2 glasses.

Another mantra to live by, perhaps???

This was my delicious dinner ~ Falafel with red cabbage coleslaw and a matcha sauce. Amazing!

We began our work at the Pediatric Hospital #1 here in HCMC yesterday and have had 2 great days working in the Rehabilitation Department. I learned today that there are 3 children's hospitals in HCMC ~ #1, which is where we work, #2 and the City Children's Hospital. My understanding is they all focus on some different things, but it is not fully clear what those things are.

We have been working with the staff at the Bệnh Viện Nhi Khoa #1 (children's hospital) since 2003. In that time, we have really forged some great friendships and working relationships. Amy and I were discussing today how far the department has come since 2003 in terms of complexity of thought and practice, as well as space and specialization of treatment. They are still learning how to transition from a more passive approach to treatment to a more active approach, but this too has improved greatly over the many years we have been coming.

This trip Amy and I are not working together, as we typically have done in the past. I am working directly with the Physiotherapists and one Physician and Amy is working with the Speech Therapists. So, we see each other in the morning, at lunch and then again at the end of the day. It's strange not working together, but I think it represents a maturation of the staff and their needs and we both have a more focused 'working plan' than we have in the past. During past trips, we have held more 'open clinic,' where the staff present a child and their history, etc., and then we demonstrate how we would do treatment for that particular child.

This year, Amy is providing more clinical supervision + follow-up/debriefing with the Speech Therapists, observing them directly treat their patients, which is very akin to what she does at Northwestern University in Evanston, IL. I have been seeing 3-4 patients per day with a lecture at the end of the day. The goal is that the children we see during the day fit the lecture material and so far, it's worked fairly well, but again, I just roll-with-it.

Again, this change in plan, to us, represents a maturation within the department and it's been good, so far.


They are in the process of building a new hospital, which will be, for here, completely state-of-the-art, which is amazing! They feel it will be done within the next couple of years. The existing hospital is likely more that 30 years old and the new hospital is being build amid the old one, so it is a bit dusty and busy ~ more than normal. We have been told that once the new hospital is completed, the old hospital will be torn down.

This is the Rehabilitation staff. We have worked with many of these folks since 2003. Giao (pronounced "Yow") is the Director (back row, 4th from the left). Quyen (pronounced "Q-en) is the Assistant Director (back row, 3rd from the left).

This is the 'working plan' for our time at the hospital. The red indicates who is responsible for our lunch each day.

The main hallway of the department. They are in a new location, moving here in the past year or so. There are some rooms in this new location that are air conditioned. That is amazing!

A custom-molded seat for a child with footplates (look toward the front of the picture). They are super-creative with their ideas and make-do very well with what they have. Over the many years we have been coming, we typically bring along many therapy supplies, but since the internet has opened up here a bit more, they have more access now to things they couldn't access in the past.

These are ride-on toys that bob back/forth and play music for the children to sit in to pass the time. They are so cute and were in the previous location on the campus near the Rehabilitation department, so it's good they live on. Behind the lady sitting is the construction site.

More equipment. The reddish item is a floor-sitter, a molded support for a child who cannot sit independently. The blue one is as I showed above.

This room has been my home-base for the past 2 days. I am working with a group of Physiotherapists (PTs) and one Physician, seeing patients, as well as presenting a lecture each afternoon on 5 different topics. This room is equipped with 2 fans and an air conditioner that works a tiny bit, but it's been very comfortable overall when compared to our working environment during past mission trips. No complaints here.

This is the point at which we enter the hospital. Each morning, Mr. Hung, one of the Physiotherapists, comes, with a driver from the hospital, to our hotel to pick us up. We, in the past have taken cabs to/from the hospital, but they insist on providing us rides to/from the hospital. They have communicated their worry that the cab drive might get us there late or get lost. It is very nice that they pick us up.

This is the cyclo parking lot at the hospital and where people/families enter and leave the hospital. Many people in HCMC wear masks when traveling via cyclo, as there is pretty significant pollution here. The women usually wear a face mask, long gloves and a coat when on their cyclos to protect their skin from the sun.

We walk straight down the corridor (in the center of the photo) to get to the Rehabilitation Department, while dodging cyclos coming and going. We are pretty good at it now.

This was my first patient on Monday. A little 3 month old girl, who the staff was concerned wasn't developing properly. I have taught them a 'test' to do with babies that can help to identify neurological impairments in babies. Good news is that she was terrific and totally fine. She does have torticollis ~ a tippy head to the left ~ so, we got to talk about how to fix this with her mother and the staff. She cannot come to the hospital for therapy, as she and her family live 2 hours from HCMC.

Quyen (left), Hung (middle) and Amy (right).

This is a patient I saw on Monday, who is 10 1/2 months old. She has a diagnosis of Cri du Chat (pronounced "Cree doo Sha"), which is a genetic syndrome. She was very floppy and has some feeding challenges. She was very interested in me and the other therapists, which was nice.

She is working on learning to sit-up by herself, by propping on her hands for support. Her facial features are consistent with her diagnosis and these kids demonstrate a 'cat-like cry,' which is what Cri du Shat means in French.

This 7 year old little guy has cerebral palsy and had recently gotten Botox injections into his muscles behind his knees and ankles, which is done to help relax spastic muscles. He hasn't had any therapy for the past 2-3 years, but just recently restarted PT at the hospital. He is very weak in his trunk and lower extremity muscles, but has good potential to make improvements. His walker is far too tall for him, but it is the only walker the family has, as it was apparently a relatives, so we make due. He was pretty tired at the end of our session, but did a great job.

These are his AFOs (ankle-foot-orthoses), which were made this hospital. There are 2-3 gents in the Rehabilitation department that make braces and do a pretty great job. I have worked with them over the years, bringing them examples of braces that they will re-work to fit other children and working on casting for stretching too.

These are really good and fit him well.

This little charmer is nearly 1 year of age and has a birth history of hypoxia, meaning he didn't get enough oxygen to his brain. As a result, he has cerebral palsy. He is a very bright and engaging little guy and if I lived here, I would love to treat him, as he has a lot of potential. His mother's main concern, understandably, was if he would 'walk like all of the other children.' We discussed his potential for learning to walk (which is high), but that he likely will need support from a walker, and mom said she understood and loved him nonetheless (cue: tears).

He was so smiley and engaging. Made everyone in the room smile.

This itty-bitty baby is 1 month old. He came for evaluation, as he had a small brain hemorrhage on the left at birth. Today, he had a brain ultrasound, which was normal, but the doctor diagnosed him with seizures. Per his parents, he has never had a seizure and I didn't observe any either. During our evaluation, he startled to loud noises a few times (totally normal) and I suspect the doctor saw this and thought it was a seizure. So, the Physician who has been attending my sessions was going to speak with the other doctor to discuss this. He was terrific and looked great. No concerns at this point. He will be seen again by the Physiotherapists at the hospital at 4 months for a re-check of his development.

This is a walker that the therapists have modified for a child I am scheduled to see tomorrow, who has Arthrogyposis. It is a complex diagnosis, in which, typically, there are 2 or more joints that are contracted (stiff/tight). I am curious to see this child on Wednesday.

Over the many times I have come to Vietnam, I continue to be amazed at the creativity and ingenuity the Physiotherapists, people and families exhibit, making items for their children, loved ones, and themselves. I think there are lessons we can all learn from this.

Speaking of amazing ingenuity...


I cannot get over how great this is. Wow. This photo was taken by a member of our team, who is still in Can Tho. Love it!!

Last night, after working, we went to a favorite restaurant, which is so uniquely put together, but also kind of funky. The pictures don't do it full justice, but Amy describes it as though we entered an "Alice in Wonderland" house. There are stairs that are impressively steep and so narrow to part of the seating areas (this is where we sat) and very small/short doors you have to navigate through, as well as huge steps to climb in other areas. So interesting, but fun...and delicious!

This is a very short door to climb through. Even Amy had to bend over. Then, there are 2 huge steps to climb to get to the level at which our table was located.

The underside of the stairs. There is a railing, but each step is a different height and they are narrow. Walk slowly, is my advice.

Another small door to more seating.

Another angle.

Vietnamese Spring Rolls with Prawns and Peanut Sauce. So yummy!

Another short door to more seating. In the jar is a snack of puffed rice.

A tall plant growing in the center of the restaurant.

This is an old 4 poster bed, which is actually a table with 2 benches (one on each side). Have to climb over the bed rails to get into the seating.

In the past 4 years, Amy and I feel the traffic in HCMC has gotten way worse and so traveling about takes a lot more time now. There is also a ton of construction, especially in District 1, the shopping and market district, where Ben Thanh Market is located. We got to this area last night, after dinner, and were totally disoriented, as there is a HUGE construction project going on. They are building a light-rail system, which will run the length of Le Loi Street, a huge boulevard in HCMC. Several folks have given us very different time frames for completion ~ 2 to 5 years.