Give Children a Chance
Help for physically disabled children and young adults in Vietnam
Vietnam has an unusually high percentage of people with severe physical disabilities (>15% of the over 5 year old’s).
One reason for this is the high environmental pollution caused by lead and mercury as well as pollution from coal-fired power plants. In addition, the limited medical care leads to a high rate of complications at birth with corresponding consequential damages such as spastic cerebral palsy. Furthermore, the population still suffers from the late effects of the Vietnam War, especially due to the highly toxic defoliant Agent Orange used by the U.S. troops. It causes genetic damage over generations, sometimes with severe physical disabilities. An estimated 2 – 5 million Vietnamese came into contact with this poison.
Until the 1990s, orthopaedic care in Vietnam consisted mainly of the treatment of fractures and infections. The treatment of acquired or congenital deformities, osteoarthritis, fracture mishaps or soft joint injuries are still considered “affluent medicine” in some cases. It is necessary to accept the corresponding personal fate and to cope with the associated economic and social disadvantages for the family.
Under the presidency of Michael Gorbachev, the aid organisation Green Cross (organisation for the support of victims of environmentally induced health damage) primarily supported the victims of Chernobyl. The Swiss representation of Green Cross wanted to lend its support to Vietnam and in 2003 asked the internationally renowned Basel orthopaedic technician Dr. hc. Daniel Hueskes whether he could treat five disabled children in Hanoi. After an initial review of the situation, it was clear to Daniel Hueskes that he could only make a meaningful contribution if he was regularly deployed. The project “For the children of Vietnam: Helping them to help themselves” was developed in cooperation with the Orthopaedic School in Hanoi (VIETCOT).
Daniel Hueskes and his son Benjamin, also an orthopaedic technician, who was involved at an early stage, quickly realised that many of the deformities presented could not be satisfactorily treated with orthopaedic measures alone. They succeeded in winning the Basel orthopaedic surgeon Dr. Claude Müller for the project. The German-speaking Vietnamese Pham Thuy, who was in charge of the administrative management of VIETCOT, became our most important contact person. Her linguistic and professional knowledge, as well as her understanding of both cultures, proved to be a stroke of luck. To this day she is the link for all our activities.
After various difficult beginnings, a constructive cooperation with the orthopaedic rehabilitation hospital in Thai Nguyen (approx. 100 km north of Hanoi) was established. Until today, this hospital together with the school for orthopaedic technology in Hanoi forms the centre of the Basel aid project.
Through regular annual visits by Daniel and Benjamin Hueskes as well as Dr. med. Claude Müller, numerous children and adults with congenital and acquired deformities have been successfully treated and consulted. Patients with late consequences of injuries seek advice just as frequently. In addition to the actual treatment of patients, the training of local doctors is a major focus of the project. This includes setting up simple treatment schemes that are comprehensible to the local doctors. The practiced operations should also be practicable with the locally available materials, and thus be reproducible for the doctors.
Through the recurring visits and follow-ups of already treated patients, a motivating and lasting learning effect for all sides can be observed. An example of a lasting learning effect is the treatment of congenital clubfoot. In the first few years, it was mainly late complications of insufficiently or completely untreated clubfoot that had to be operated on or treated with medical aids. Dr. Claude Müller invested a great deal of energy in the instruction of early diagnosis and the manual plaster cast redression technique in infants (Ponseti method). Thanks to the active distribution of what has been learned by Vietnamese doctors, this technique is now standard in large parts of North Vietnam. Children with untreated clubfoot deformity are becoming less frequent.
Since mobility and walking upright are among our primary basic needs in everyday life, problems and deformities of the lower extremity were the main focus during the reconstruction phase. Over the years, Vietnamese doctors have increasingly expressed the desire to be able to help patients with deformities and injuries of the upper extremity as well. A second orthopaedic surgeon, Dr. Jiri Skarvan, who focuses on the upper extremity, strengthened the project. As the volume of work increased, Dr. Britta Broede (lower extremity) and Dr. Christiane Brinkmann (upper extremity) have also joined the team.
In addition to the clinic in Thai Nguen, which is still central to our project, a firm cooperation with the hospital of Hai Phong and the University Hospital of Hanoi Viet Duc has been established.
Strengths of the project
With a small team the administrative effort is kept to a minimum. We deliberately refrain from advertising, mailings etc. to save costs. The continuous cooperation with the same clinics creates a close mutual trust, commitment and sustainability. By working out clear treatment schemes using materials available on site, what has been learned is reproducible.
Introduction of the early and late treatment of clubfeet.
Improving the treatment for children with deformities by means of prostheses and support splints.
Introduction of treatment of stiffened joints (especially knees and elbows).
Surgical correction of axial deformities of the extremities.
Optimization of postoperative treatment after surgical interventions (immobilization and physiotherapy).
The visible successes led to a good network in North Vietnam including the University Hospital of Hanoi.
Our daily work routine in Vietnam:
The doctors on site collect suitable patients. During consultation hours, these patients are examined together and treatment proposals are discussed. In the process, a decision is made as to which patients will be provided with aids or treated surgically in the following days. During regular stays of two to three weeks per year, about 60 patients are examined at each of the three locations, of which about one third receive orthopaedic care or surgical treatment.
Without your generous donations the fulfilment of this project would not be possible. We would like to thank all those involved for their voluntary commitment.
Thank you for your donations with the intended purpose of payment.
Dr. hc. Daniel Hueskes and Benjamin Hueskes (Orthopaedic Technology)
Dr. Claude Müller, Dr. Jiri Skarvan, Dr. Britta Broede, Dr. Christiane Brinkmann (Leonardo Practice, Birshof Clinic, Hirslanden)