Vietnam -- a Land of Opportunity
By Martha Henderson, MSN, FNP, RN

Vietnam was a land of opportunity for me when I sought professional and personal growth and a way to practice in a war-torn country from 1969-1971.  After graduating from Duke School of Nursing in 1968 and working at San Francisco General Hospital for a year, I had the opportunity to go to Vietnam with Vietnam Christian Service.  This was a service organization whose mission was to offer medical, social, and agricultural services to Vietnamese civilians suffering from war.  This organization was Christian and nonpolitical, but the members were there to offer non-military services to Vietnam and alternative service for US conscientious objectors, such as Quakers, Mennonites, Brethren, and others interested in peace.  On arrival, my first assignment was to learn conversational Vietnamese.  With expert teachers and an intense submersion course, I amazed myself with being able to learn the basics of a tonal language.  This was an invaluable skill, not only in communicating about health, but also in efforts to share understanding and concern beyond health issues.

The one job I wanted was to teach in a small Vietnamese nursing school in lovely Nha Trang on the South China Sea.  The school was attached to a Christian hospital, clinic, and TB wards.  I got my wish.

The school was a 1-year program in which applicants must have completed 7 years of school to apply and they would function with as much responsibility as RN's when they graduated.  My biggest challenge was to decide how much content to teach without overwhelming them.  I had a wonderful Vietnamese co-teacher, Nguyen thi Cuc, who had come to the US to earn a BSN and returned to help educate Vietnamese nurses. I also had an excellent interpreter, Kim Sa, who had completed the nursing program and translated my lectures in the classroom.  On the wards, my students became proficient in figuring out what I was trying to say in Vietnamese.  My first job during the overlap with the US nurse/instructor who was going home, was to learn operating room nursing, since this was the first course I would teach.  Since I had observed one operation, eye surgery, during which I fainted, I knew I must find a crash course quickly.  Fortunately, the US AID nurses at the large province hospital took me under their wings and taught me circulating and scrub nursing, while the US surgeons taught me more than I ever wanted to know about surgery, including how to close a belly.  When my first class of students started, I was only 2 steps ahead of them in knowledge and experience.  The US AID nurses helped teach my students, fortunately, but strangely expected them to speak English!  It was in this province hospital that I saw the horrors of war, children who had stepped on land mines and had to have amputation repairs and burn victims with terrible wounds.  It was tragic and I was glad to return to our small hospital in the countryside.

At the hospital, we saw all ages of civilians who had primarily infectious diseases like malaria, parasites, sometimes resulting in severe anemia, eye diseases, and any other kind of illness.  We also performed minor eye surgery and inserted IUD's.  (Birth control was against the law, in this country at war, which required repopulation in the face of killed soldiers.)  Regarding our patients' illnesses, one person had hookworm so badly that she got severely anemic.  Since we had no blood except recently outdated, but safe whole blood that we could scrounge from the US military, we ended up giving this and causing the patient to go into congestive heart failure, which we then treated successfully.  A woman came in in labor and the physician told me to have my students give her an enema.  Although I knew relatively little about obstetrics, I thought I remembered that enemas might speed up labor.  We followed the doctor's order and before I knew it, I was catching a baby.

The experience of teaching nursing in another culture and another language was challenging and thrilling. Many of the students had health beliefs and practices, as did the patients,  that required my opening my beliefs and learning from them. I can remember when one of my students became sick and I gave her advice about what to do from a Western or allopathic perspective.  When I visited her in our small nurses' residence, a fellow student was putting a suction device all over her back to draw out the bad humours.  The old women with teeth red from beetle nut juice would spit this juice into wounds for the healing properties in this natural product.  Newborn babies would be given tea with unboiled water and begin instant inoculation with the endemic hepatitis A virus, while foreigners like me would come down quite easily with hepatitis A and become very yellow and very ill.

The experience of living in a country at war with US support was also a disturbing and disillusioning one.  I learned the horrors of war, including not only the lives lost and the numbers wounded physically and psychologically, but also the social and economic disintegration of that country.  Poverty and lack of human services in the midst of a war economy meant that few Vietnamese wanted to go to nursing school to do a job, which commanded poor salaries. The war also brought foreign (US) entrepreneurs, prostitution, drug trade, the black market, and the dismemberment of families.  The costs to Vietnam vets have been great, with more deaths from suicide since the war than US soldiers killed during the war.

While my sadness at the effects of war grew, so also did the bonds of friendship among those who lived and worked together with a similar commitment to peace.  These friendships have lasted for 30 years and a reunion last year was heartwarming.

Two years ago, my husband and I returned to Nha Trang, the site of the original hospital, with an organization called Peacework, which was led by another former worker with Vietnam Christian Service.  There is now a government hospital and nursing school, which includes some of the original structures.  We helped complete a very small neurological diagnostic clinic.  I visited with a few of my former students and was sad to find that the new government in 1975 had revoked the licenses of any nurses trained under the South Vietnamese government.  I saw another sad consequence of war.  The current medical director was very gracious and interested in slides that I had brought from 30 years ago which identified the origins of the hospital. He and other staff had never known that the hospital had been started by the Vietnamese Christian Church which partnered with other international medical personnel to work there.  We presented him with a framed picture of the original hospital, which he displayed in the hospital.

Nursing continues to offer opportunities for nurses to reach across cultural, geographic, and political boundaries to offer service, healing, and understanding.  We are very fortunate to have a profession where some principles of healing are universal and the need for nursing will always be there.