Hidden Tragedy Of Under-reported Neonatal Mortality In Northern Vietnam

ScienceDaily (Mar. 31, 2008) — In Northern Vietnam, neonatal mortality is almost four times higher than the official figure according to a report published today in the open access journal BMC International Health and Human Rights. This under-reporting could mean neonatal healthcare in the country is massively under-funded.

Lars-Ake Persson, Mats Målqvist and colleagues at Uppsala University, along with researchers at Karolinska University Hospital, Stockholm, Sweden, are working with the Uong Bi General Hospital, in Quang Ninh, and the Vietnamese Ministry of Health, in Hanoi, on the question of unreported births and neonatal deaths.

The researchers explain that in order to reduce infant mortality in low-income countries, such as Vietnam, there is an urgent need to have valid health statistics. Such data would highlight the need for national and international health initiatives and for the provision of sufficient funds to implement them. Without valid statistics many children could be dying unnecessarily at birth.

Information on all births and neonatal deaths in Quang Ninh province in Northern Vietnam during 2005 was collected through questionnaire surveys and group interviews with healthcare staff at 187 Community Health Centers and 18 hospitals, as well as with 1372 village health workers. Information was also gathered from health facility records. The team then compared these results with official statistics from the Provincial Health Bureau.

The researchers found that the neonatal mortality rate was 16 deaths in 1000 births. The official figure is just 4 in 1000. This discrepancy is attributed to a dysfunctional registration system that relies on grieving families, and not the health system, to report a death. This has severe consequences because at the national and international level a low mortality rate does not necessitate urgent healthcare investment.

“Such faulty health information systems are not unique to Vietnam”, say the researchers. “Improving reporting systems on births and neonatal deaths is a matter of human rights and a prerequisite for reducing neonatal mortality,” the researchers add.

Journal reference: Unreported births and deaths, a severe obstacle for improved neonatal survival in low-income countries; a population based study. Mats Malqvist, Leif Eriksson, Nguyen T Nga, Linn I Fagerland, Dinh P Hoa, Lars Wallin, Uwe Ewald and Lars-Ake Persson. BMC International Health and Human Rights (in press)

 http://www.sciencedaily.com/releases/2008/03/080328070133.htm

Vietnamese man, on anti-abortion mission, opens home to moms and babies

April 1, 2008: Read the update on Tong Phuoc Phuc story HERE.

NHA TRANG, Vietnam: Sitting cross-legged on a straw mat in the middle of the living room, Tong Phuoc Phuc sings a soothing Vietnamese lullaby. For a moment, his deep voice works magic, and the tiny room crammed with 13 babies is still.Phuc giggles like a proud papa. He’s not related to any of them, but without him, many of these children likely would have been aborted. And to Phuc, abortion is unimaginable.
The 41-year-old Catholic from the coastal town of Nha Trang has opened his door to unwed expectant mothers in a country that logs one of the world’s highest abortion rates. In 2006, there were more than 114,000 abortions at state hospitals in Ho Chi Minh City — outnumbering births.Most pregnant, unmarried Vietnamese women have few options. Abortion is a welcome choice for many who simply cannot afford to care for a baby or are unwilling to risk being disowned by their families.The communist government calls premarital sex a “social evil.” Abortion, however, is legal and performed at nearly every hospital. And unlike in some Western countries where the issue is hotly contested, the practice stirs little debate here.

But shelters for women who want to keep their babies are rare. Phuc promises them food and a roof until they give birth, and then cares for the children until the mothers can afford to take them. In the past four years, he’s taken in 60 kids, with about half still living in his two houses.

“Sometimes we have 10 mothers living here … sleeping on the floor,” says Phuc, a thin man with dark, weathered skin and teeth stained brown from years of smoking. “The problem is that a lot of young people live together and have sex, but they have no knowledge about getting pregnant. So they get abortions.”

Phuc says he made a deal with God seven years ago when his wife encountered complications while in labor with their son. He vowed that if they were spared, he would find a way to help others. As his wife lay recuperating after the difficult birth, he recalls seeing many pregnant women going into the delivery room but always leaving alone.

“I was wondering, ‘where are the babies?'” he says, cradling an infant in each arm. “Then I realized they had abortions.”

Phuc, a building contractor, started saving money to buy a craggy plot of land outside town. He then began collecting unwanted fetuses from hospitals and clinics to bury in graves on the property. At first, doctors and neighbors thought he had gone mad. Even his wife questioned spending their savings to build a cemetery for aborted babies.

But he kept on, and now some 7,000 tiny plots dot the shady hillside, many marked with bright red, pink and yellow artificial roses.

“I believe these fetuses have souls,” says Phuc, who has two children of his own. “And I don’t want them to be wandering souls.”

Vietnam was ranked as having the world’s highest abortion rate in a 1999 report by the U.S.-based Guttmacher Institute, which tracks the statistics. More recent reliable data for both public and private clinics are unavailable. Aid agency Pathfinder International says abortions remain high in Vietnam but appear to be declining slightly.

Dr. Vo Thi Kim Loan has run her own clinic just outside Ho Chi Minh City since 1991. She says the number of young, unmarried women seeking quick, discreet abortions has increased with more teen girls having sex before marriage. She also still sees a steady stream of married women coming in for repeat abortions because their husbands disapprove of contraceptives.

Preference for boys is another factor. Vietnamese women with access to ultrasound sometimes terminate pregnancies after discovering they’re carrying girls in a country where couples are encouraged to have just two children.

Phuc isn’t sure why so many Vietnamese choose abortion and says more women need to understand safer forms of birth control are available.

He says word of his unusual graveyard eventually spread, and women who had undergone abortions started visiting to pray and burn incense. Phuc urged them to tell others considering the same option to talk with him first.

Phan Thi Hong Vu looks lovingly at her chubby 7 1/2-month-old baby boy sucking on a pacifier surrounded by all the other babies on Phuc’s floor. She shivers at the thought of how close she came to losing him.

“I actually went to the hospital intending to get an abortion, but I was so scared,” says Vu, who was 3 1/2 months pregnant at the time. “I decided to go home and think about it. Two weeks later, I met with Phuc.”

She moved into the 904-square-foot (84-square-meter) house soon after and remains there with seven other new or expectant mothers. They spend their days washing, feeding, burping, changing and playing with the babies — all but one are under a year old. The constant chorus of crying, coughing and cooing fills the living room, which is lined with pink and blue cribs and adorned with a crucifix, the Virgin Mary and a photo of the late Pope John Paul II.

It’s a full-time operation that involves Phuc’s entire family. His older sister manages the chaos, mixing vats of strained potatoes and carrots and preparing formula for bottles, while shushing crying babies and chasing crawlers. The entrance to the single-level cement house tells the story: rows of bibs, booties, jumpers and spit rags hang drying in the sun.

It costs about US$1,800 (€1,200) a month to care for all 33 babies and the women. Phuc gets donations from Catholic and Buddhist organizations and from people who have heard about his work. On a recent day, a local family dropped by with an envelope sent from their daughter in California who had read about Phuc on a Vietnamese Web site. Two years ago, he even got a letter from Vietnamese President Nguyen Minh Triet praising him for caring for women and children scorned by society.

Health authorities say they support what he’s doing, but also keep a close eye on him to ensure everything is legitimate in a country where baby selling and child trafficking are a problem. Some people accuse Phuc of condoning premarital sex.

Phuc’s operation is not a registered orphanage, which means he cannot put any of the children up for adoption. But even if he could, he shakes his head and says his goal is to reunite each child with its mother or to raise them as his own. So far, 27 babies have gone home.

“I will continue this job until the last breath of my life,” he says. “I will encourage my children to take over to help other people who are underprivileged.”

http://www.iht.com/articles/ap/2008/03/28/asia/AS-FEA-GEN-Vietnam-Abortion-Orphans.php