Viet Nam – Blog IV

Today, I’ll finish the ten observations about Viet Nam I promised.

Observation Seven: The Viet Nam government appears to have taken the threat of Avian Influenza seriously. They seem to be doing what they can. Inherent in that observation is the acknowledgement that they don’t have the capacity to do much. However, I have now been in two small village areas in Viet Nam during different visits. The first was where a family of five contracted the virus. The second visit was in an area where H5N1 was in the poultry population. In both cases, I was impressed by the response.

On this trip I met Mr. Chien, who I’m guessing by the fact that he started in the chicken raising business 18 years ago, is in his late thirties. He appears to be a natural entrepreneur. He started with 200 chickens in 1991 and now has over 11,000.

We walked through his operation while he showed me how he vaccinates his chickens. He told me about the morning he found 100 out of 200 breeder hens dead. He didn’t know what it was, but he called a vet from the Province who determined it was avian influenza.

Vaccinating a chicken

We went back to his house where a group of his friends from the area had gathered to talk. I asked about how the village reacted when they understood what they were dealing with. Mr. Chein said, “Our children were afraid, and we were afraid for them.”

There is no question if the H5N1 virus begins to spread efficiently, person to person, all of southeast Asia is highly vulnerable including Viet Nam. However, we have a much better chance of catching it quickly there, than in other countries in the region.

Observation eight: There are promising signs that Viet Nam may have acted fast enough to avert a major spike in HIV/AIDS cases. Viet Nam is one of the 15 countries in the President’s Emergency Plan for Aids Relief. I’m told the decision was made to invest aggressively in Viet Nam because it looked like HIV/AIDS was just about ready to spike dramatically. Over the past four years, our investment has increased from $17 million to $88 million a year.

I was pleased to learn we are spending much of that amount on building infrastructure and people. The reports I received were quite positive.

I visited a clinic in a section of Ho Chi Min City where they are starting a program to focus on intravenous drug users. A high percentage of the HIV/AIDs in Viet Nam comes from the use of dirty needles. The approach is to help people stop drug use, hence having fewer risks generally. They use a system of peer educators; kids that have had a drug problem but overcame it. I spent about an hour talking with them. I saw the use of this technique in Africa. They have teams of people who are HIV positive trying to convince others to “know their status and get tested.” It seems very effective.

When I met with the Health Minister, we discussed the fact that rapid response HIV/AIDs tests are not being used in Viet Nam. I hope we made some progress in persuading them.

Observation Nine: The rapid increase in the price of food is becoming a big problem in Viet Nam. I mentioned in my blog entry on Indonesia what a problem the rising price of food has become. I simply hadn’t focused on this as an issue until this trip. Rice is now more than $700 a ton, more than three times the rate of five years ago.

Apparently there are many contributing reasons for the price going up. There is a growing problem with various pests and viruses that adversely affects the crops. Also, there has been a series of weather-related matters, which have been part of the problem too. This could become a major issue worldwide if it continues to develop.

Observation Ten: Viet Nam is a young country and I saw a disproportionate number of women emerging in leadership roles within the bureaucracy. I don’t know if that is true within the Communist party however.

More than 60 percent of the population is under 30 years old. As one moves around Viet Nam, it is highly evident. If they can find a way to educate this group and provide an economic system where they can succeed, the youth of their population is a huge asset because they are hungry to succeed.

I gave a lecture and answered questions at the Hanoi School for Public Health. It was a delightful hour. The students were more than willing to engage. Apparently attendance at the school is highly competitive with many applications for each slot. Again, it interested me that the group I spoke to was nearly three quarters female.

Comments

[Kobie]

Secretary Leavitt,

You say "60 percent of the population is under 30 years old" On one hand that scares me for the average person was born after 1970. On the other hand, it means they feel they can do anything.

My 24 year old nice is scared of H5N1 and HIV. She does not want me to talk about it for "I get enough of it at college." My response was "if you feel you can do something about global warming, know that you can do something about H5N1 and HIV. Fear is a motivator, but knowledge and projects are empowering. Showing folks how to do things makes them feel that they can in stead of feeling they can not.

On the Flu wiki many participants are female. The knee jerk reaction is "of course, because they have time to blog" but look at the whole Read Mom's project with hand outs. Just like in Viet Nam, the UK, the USA there are a lot of presentations and research being done by people on both sides of gender fence. A battle where we are all on the front lines and the same side.

H5N1 does not know gender nor sexual orientation - it just prefers the young under 25. (Source:http://www.wpro.who.int/NR/rdonlyres/FD4AC2FD-B7C8-4A13-A32C-6CF328A0C036/0/S4_1113.jpg)

Now people are monitoring H5N1 coming to Alaska (Source:http://www.recombinomics.com/News/05020801/H5N1_Japan_Alaska.html)

In both Viet Nam and USA, education for prevention may be the best defense. As Benjamin Franklin said "The only thing more expensive than an education is ignorance."

If you can read this then you had to use a computer and the internet. That proves you are more than capable of preparing yourself for the pandemic. Start today.

Kobie

[Goju]

Secretary Leavitt,

It is encouraging to see you travel to H5N1 hotspots as well as becoming aware of the food crisis developing around the world.

questions for you:

Did you take Tamiflu or other antivirals before, during after your trip?

When at the H5N1 hotspots, how did you protect yourself?
If you used PPE what did you use?

Does the growing food shortage alarm you because:
it would make it harder for people to prepare for a 3 month SIP, or
during a pandemic, the food JIT system would collapse that much sooner?
Or is it so bad that people are beginning to starve and fight over food?

[Kobie]

Goju,

I like your post. These are good questions.

To add to your question about the food shortage - people will not be 100% efficient. Their three month supply may include stuff they do not need. They may miss things the do need. I'm not just talking can openers but baking powder. Hence it is not three months supply of food but four or more that people will try and get. Unless people are eased into the news with instructions they will do the best they can as fast as possible, in my opinion.

Unlike India and Viet Nam who live close to the earth, most developed countries are so far removed from food a garden is all they can muster. Well there is a growing trend to raise chickens in the city. No rosters but hens. Even if so, animals need feed.

As Secretary Leavitt wrote, it is good to use kids as educators to speak to kids and adults. There are things kids learn from kids that they do take from adults. Sometimes parents will listen to a kid do a presentation.

If Viet Nam can slow or stop HIV than bird flu is not that different. HIV, like H5N1, is a slowly spreading virus for which we have no vaccine nor medical defense only NPIs of social distancing (abstinence for HIV), PPE (French envelope) and limiting the number of social contacts (partners).

Sigh, I hope talking about H5N1 does is not as hard as HIV. Ignorance kills.

Regards and best wishes,
Kobie

"You are given the chance to take part in a great adventure" - fortune cookie

[Paul Bogush]

I think it's great that you are blogging -- great example for others in the administration. When are you running for President?

[Phil Marino]

Mr. Secretary,

Saw you on C-span Wednesday, being "interrogated" by the committee. Stick to your guns. You're absolutely right. Thanks for having the courage to defend the law.

Best of luck

Phil