HA NOI — A shortage of essential medical workers threatens the control of the contagious diseases that constantly stalk Viet Nam.
Flu, dengue fever, malaria, encephalitis and diarrhoea strike an estimated 3.5 million people throughout the country each year.

But Health Ministry figures show that only about 8,600 preventative health workers are available to meet the threat.

Of these, about 1,200 work in central facilities and meet about 77 per cent of demand; another 7,397 are in the provinces where they meet 54 per cent of demand.

Up to 75 per cent of the workers have not been professionally trained.

Still, they have to monitor formerly infected zones; inspect the environment; find the causes of outbreaks and mobilise people to take preventive and control measures to stop dieseases from spreading.

Too small spending is blamed for the shortage.

The budget for preventive medicine accounts for just 25 per cent of all medical spending.

Expenses

Medical worker Doan Tat Thang, of the Cuu Long (Mekong) Delta Soc Trang Province preventive medicine centre, complained that although he and his fellow workers sometimes had to travel long distances to do their job, their expenses met only 30 per cent of cost.

"We sometimes have to travel up to 80 km by boat and motorbike to spray chemicals to kill mosquitoes and control dengue fever," he said.

"It often takes us from early morning to late at night to complete the work."

Very few preventive medicine workers were willing to work in remote regions for the prevailing daily pay of just VND30,000 (US$1.5), said Dr Luu Thi Thu Ha from the southern delta's Dong Thap Province preventive medicine centre.

Many of the workers also wanted to attend training courses to improve their skills.

"I was unclear about how to write a report about an epidemic and how to manage my staff to employ effective preventive measures before I had a chance to join a training course last year," she said.

Target

Viet Nam needs an extra 5,500 tertiary-educated preventive medical workers; 1,000 post-graduates and 4,200 nurses and technicians to meet the strategy for national preventive medicine to 2020.

The target will not be easily met.

A lack of qualified lecturers will be a major hindrance.

"In addition facilities and equipment for the study and practice of preventive medicine at the medical universities are obsolete and do not meet demand," said Health Ministry's Science and Training Department director Truong Viet Dung.

The low rate of student enrollments for preventive medicine compared with other health disciplines was also a barrier, he said.

"The low salary and hard work makes preventive medicine unattractive." he added.

A 2009 survey revealed that the number of students applying to study general medicine accounted for 91 per cent; the figure for preventive medicine was 73.8 per cent.

But Ha Noi College of Medicine and Pharmacy graduate Nguyen Thi Linh, said she had decided to train as a general nurse instead of a preventive medical worker as the former would provide her with more employment opportunities.

"I can apply for jobs at hospitals or any medical centres as a general nursing graduate, while the opportunities for a preventive medical worker is limited," she said.

The health ministry planned to spend more for facilities, lecturers and training programmes to address the shortage, Dung said.

The ministry would also providepreventive-medical-training for diploma holders in other medical disciplines to encourage them to work in the field.

The Ha Noi Medical University was piloting the training programme and if successful, it would be applied at other medical universities.

Potential students might also be provided scholarships or made exempt from tuition fees.

The health ministry's preventive medicine department's deputy director Phan Trong Lan said the ministry would work to provide preventive medical workers with a variety of preferential policies to help improve their working and living conditions.

A five-year preventive medical training master plan is to begin next year to train 1,000 preventive medical workers by 2015. — VNS