KERRY GOULSTON. Vietnamese and Australian doctors learning together: reflecting on 20 years of collaboration

This is a story of friendship and support between doctors in Australia and Vietnam, originating some 20 years ago, which shows how modest beginnings have evolved into important and lasting relationships of mutual respect and learning with one of our increasingly important Asian neighbours.

In 1998, I unexpectedly received an invitation from Professor Ton That Bach, then Rector (Dean) of Hanoi Medical University (HMU), to visit him in Hanoi. Over the intervening years, we developed a strong friendship and mutual professional respect, which grew into what later became the Hoc Mai Foundation, a collaboration between Sydney University Medical School and its counterpart in Hanoi, but more of that later.

Sometime after first meeting Bach, I discovered that his father, Ton That Tùng, was known throughout the world as a pioneer in liver surgery, through his invention of a new technique called “dry liver surgery”, a technique to divide blood vessels in the liver during planned liver resection, for which he was awarded the Silver Medal of the University of Paris. Tùng became Deputy Minister of Health and Head of Surgery at HMU, recognised in France, Russia and Germany, and responsible for training many young surgeons. He was a good friend of Ho Chi Minh and became his personal physician.

Bach himself, born in Hanoi in 1946 and named by Ho Chi Minh, graduated from HMU and became its Rector [Dean] in 1993. A year later, he was offered the position of Minister of Health, but refused, saying he wanted to “spend time with the sick”. Later, he became an independent member of the National Assembly of Vietnam and was not a member of the Party.

Bach worked assiduously to build up HMU, introducing many innovations, becoming recognised as a cardiac surgeon in France and Ukraine, amongst other countries. He was Director of and cardiac surgeon at Viet Duc Hospital, Vietnam’s largest surgical hospital, now with 1,500 beds, and conducting 180 operations a day.

For 6 days a week, Bach worked as a cardiac surgeon and President of the growing and respected HMU, which graduates some 600 students each year. On Sundays, he worked as a Doctor with ethnic minorities in Vietnam’s North.

Walking through HMU with Professor Bach was astounding – he knew the name and identity of each student we passed.

When I first met him, Bach stressed that in previous years there had been a close relationship between Vietnam and Russia, and then between Vietnam, France and Germany. He said he would like to see develop a close relationship between Vietnam and Australia, and to nurture relations for doctors and nurses in our two countries.

In 2001, Bach visited Sydney University and gave a hospital lecture on “New Concepts of Liver Surgery”. Professor John Young, then Dean of Medicine, made him an Honorary Fellow of the Sydney University Medical Faculty. Soon afterwards, a Memorandum of Understanding between the two Medical Schools was signed.

The “Hoc Mai Foundation” was established later in 2001. Hoc Mai means “forever learning” in Vietnamese.

The Foundation is not about overseas aid to a developing country. Rather, it exists, as Bach said, to nurture lasting relationships between doctors and nurses of both countries. Bach always reminded us: “We learn from you, and you learn from us.”

His concept of mutual learning, rather than the paternalistic notion of developed countries educating their colleagues in developing countries, is an important one. Vietnam is developing astonishingly quickly. The standard of patient care in their hospitals is very impressive.

Over the nearly 20 years since the Hoc Mai Foundation was established, funding has come a combination of grants from AusAid (until recently), The University of Sydney, Ramsay Healthcare, the RSL and numerous private donors. These included doctors and nurses who visited Vietnam to teach, as well as some Australian Vietnam Veterans. Interestingly, until recently, donors have not been forthcoming from Vietnamese living in Australia, with some exceptions. We are told that is because most have been refugees fleeing from South Vietnam. In the last few years, funding has become available from some Vietnamese hospitals and some Vietnamese doctors have been self-funded.

Funds raised have been spent on bringing hundreds of young doctors and nurses from Vietnam to Australia for 4 weeks at a time as Hoc Mai Fellows. Here they spend half that time in a clinical attachment and the other half attending a course featuring subjects not normally taught in their own country. In addition, a group of 20 to 30 Australian academic clinicians have over the years visited Vietnam, at their own expense, for one week at a time, twice a year, to teach and to learn. Hoc Mai has also sent Australian medical students to Vietnam for their Elective Term.

Many Hoc Mai Fellows have become leaders in Vietnamese healthcare and medical education in Vietnam. For example, the first Hoc Mai Fellow, Le Ngoc Thanh, is now Director of E Hospital and Dean of the Medical School of the Vietnam National University in Hanoi, and another Hoc Mai Fellow, Tran Binh Giang, is Director of Viet Duc Hospital.

This is not the conventional story of overseas aid. Rather, it charts the evolution of personal and professional relationships. Starting small, and with no fanfare, these have proved lasting and meaningful, and their significance has transcended the individuals involved.

Michael Mann, Australia’s Ambassador to Vietnam from 1998 to 2002, saw the Hoc Mai Foundation as forging friendships between future leaders in healthcare.

Sadly, Australia’s formal overseas aid budget has been gradually but significantly decreasing over recent years, falling from 0.48% of Gross National Income (GNI) in 1967-8 to a current level of around 0.21% of GNI, its lowest level ever.

Australia’s aid to South East Asian countries and the Pacific Islands should arguably be spent on nurturing people-to-people relationships, particularly amongst young people, and not for political reasons, nor attempting to rival Japanese and Chinese government financial support.

Kerry Goulston, Vice-Chairman of the Hoc Mai Foundation, was Associate Dean, Northern Clinical School of Sydney University, from 1993 to 2001.

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