Dr Phuong Anh Lam

GP, Vietnam Field Trip 2013

The following is an extract from my diary as one of the volunteer GPs working with the Vietnam Vision Project Australia (VVPA) in the July 2013 field trip to Nha-Trang, Vietnam:

As the first heat hits, steam rises from the whitewashed walls enclosing the small treatment room housing two chipped glass tables, a dozen stackable plastic stools and fold-up aluminum chairs. The air is thick with yesterday’s sweat and disinfectant, as shards of unforgiving sunlight pierce the two-foot-long window situated high up the back wall, not unlike that of a prison cell, permitting a squinted glimpse of the clear blue sky and nothing more.

Through the hazy humidity and organized chaos of medical equipment and supplies, begins the deafening sound of human activity, drowning out the static and steady hum of machinery operating the newly finished local hospital; and of whispered voices of patients and their relatives laced with anxiety and hope, scattered amongst the VVPA volunteer staff, trying to be heard over the crescendo of urgency and necessary procedures.



FearlessnessA sudden loud burst of laughter from one of our colleague silences the room, commanding all ten pairs of eyes (both clouded and not!). We have a mischievous elderly advertising his shrapnel scar on his forehead from the Vietnam War. He grins widely, reassuring us that he has “no anxiety in regards to the eventual cataract operation that will certainly be quick and comfortable, being that it is provided by some of the best ophthalmologists that VVPA is known for”. He tells us that each day that he is alive on this earth is a blessing and that ever since the fateful event thirty years ago, when he was saved from his fatal wound, he has lived his life filled with gratitude and unshackled by fear. Such is the simplicity of his happiness despite his extreme poverty.


Grace. For one patient, our silence was for the tears that fell. Here, grace exists in the stoic acceptance of mortality, the knowledge of a lethal diagnosis and poor prognosis that eliminates all denial of a suspected truth. A cataract operation is scheduled to restore his eyesight to assist somewhat in his dying days and final preparations.


HopeIn the same hour, hope! A dark-skinned boy enters our sphere. He treads carefully but confidently, having never had full vision due to bilateral congenital cataracts. His smile is on the ready, despite his anxiety to finding himself surrounded by new fans in an alien environment. He is rare, only fourteen years of age, a bright young thing amidst all his elders. He carries our beacon of light, an opportunity of a possible future beyond darkness. His courage in the face of adversity dissipates our exhaustion and renews our purpose of making a difference.



"I am numb of all emotion in my effort to process the multitude of patients, relying solely on instinct honed by years of clinical experience to survive the beehive that I have suddenly fallen into."


It is not until the end of the second working day, with another day ahead of a one week journey, that I am able to slowly take stock and reflect. The adrenalin that courses through my vein does not allow exhaustion.

It is not until the end of the second working day, with another day ahead of a one week journey, that I am able to slowly take stock and reflect. The adrenalin that courses through my vein does not allow exhaustion.

FaithCotton and camphor permeates through a salty, earthy scent that cannot be masked by the isopropyl alcohol-slathered surfaces and powdered surgical gloves; a scent that is closest to nature and ironically, humanity.

And here I am, in the midst of it again. A woman of four foot and ten inches curls neatly upon a red plastic stool, one foot flat on the tiled floor and the other flex fully at the knee, which is hugged firmly to her chest by sinewy arms. Back hunched yet head straight, and with clouded eyes she waits, listens. When I address her, there is the slightest perceivable nod, a sudden alertness in her face, ancient by the harsh sun and toil. Her proud children have dressed her in her best outfit, neat and tidy in thin yet vibrant cotton of the yesteryears. It is most endearing when her solemnity dissolves into girly giggles only a few minutes into medical examination when she is “admonished” for her lack of modesty in a room full of strangers and “handsome” doctors. I am both humbled and upset by her complete trust in my aid, for I can only provide a short-term supply.


HappinessHis scent is of wood and mushroom, his nails blackened by fertile soil. Lines etched into deep crevices vying for dominance, leathery skin that may have never known soap or lotion, a landscape in drought. Yet amidst all this, he cracks a brilliant smile when told by his doctor that his box of sampled medicine is the best of the lot (albeit produced from the same production line as the rest)! His cheerfulness is a contagion, pure and unmarred by wants and has nots, things that we mortals cannot escape.



ConclusionOur common goal and forced proximity has created an intimacy; an awareness for each and every member of our team. From our medical director, Dr. Hien, to our team leader, Dr. Loc, to the main working bees, Dr. Patrick, Dr. Diep, Dr. Hoang and I, we work as one. Not forgetting the tremendous assistance from My-Phung, our pharmacist, who works tirelessly and without rest. And young Christine, our teenage student/ translator, bright eyed and all heart, who keeps us on our best behavior lest we frighten her off medicine.


More often than not, the distress of the multitude of medical conditions left undiagnosed and untreated by poverty is eased by the attitude of the patients themselves. A highlight and pander to our own vanity was a rumor whispered down the queue of patients that our doctors were “handsome” and “young”, despite us all being in our late forties to sixties. It became the butt of our jokes. Who could deny such a fact when nine out of ten of Dr. Diep’s patients suffered from high blood pressure on the first reading?


As GPs, we are fortunate to be able to take turns to accompany one or two of the patients into the theater.  It reminds me of my intern days and it never ceased to amaze me, the efficiency of the surgeons and theater staff. The surgical team, without whom VVPA will not exist, is a story worthy of its own, but I am fortunate indeed to witness part of the operation of the young fourteen year-old-patient.

Last but not least, the brightest light for me this week has been the young local volunteers. To borrow an old cliché, the future belongs to the young, and in this case there is hope and I dare to dream.


"Look no further for beauty, for here it exists in the simplest grace of giving and receiving."