Vietnam

VIETNAM

Dear fellow caregivers,
You are receiving a patient from Afghanistan.
Here is a list of useful information to know in the context of their medical care.

General Information

Distance Paris – – – > – – – Hanoi : 5 710 miles
98.7 million people / Average salary: $449.93 per month
Literacy rate: 95% / Life expectancy: 73.5 years
Spoken language : Vietnamese

● Most Vietnamese follow Buddhist concepts, especially in the field of health.
● Buddhism implies resistance to pain. Preventive treatments and the taking of painkillers are not habitual.
● Vietnamese may expect immediate relief of symptoms and a clear diagnosis from the doctor.
● The Vietnamese may stop treatment as soon as symptoms end. An explanation of the duration of the prescription may be helpful.
● The Vietnamese may vary the dosages of western drugs, thinking that they would not be suitable for them.

Communication

Two friends sharing a friendly moment under the lights that illuminate the night

● The Vietnamese greet each other by joining the two palms. Non-verbal communication is of paramount importance in Vietnam. It is best not to keep your hands in your pockets, on your hips, or pointing fingers.
● Vietnamese rarely seek confrontation, especially with a person of higher rank. Direct eye contact or elevated physical positioning is considered impertinent and rude.
● Care decisions can be made by the whole family. The family may ask to be involved in treatment.
● For Buddhists, the head is sacred and the feet are unclean. It is recommended not to touch the patient’s head. Pointing with the foot or finger may be inappropriate.
● Vietnamese people easily answer “yes”. It is best to check for understanding.

Beliefs, Practices & Rituals

Celebration of the Lunar New Year in front of Hoang Phap pagoda

● Some Vietnamese practice cults directed towards their ancestors. According to them, these could bring them wealth and health for the family.
● The mother is traditionally accompanied by a female family member during childbirth.
● When a child has a respiratory ailment, the parents try to bring out the “bad spirits” with a traditional Southeast Asian practice: “Cao gio”/”Gua Sha” “scratching the disease to allow it to escape through the skin”. This practice can leave marks on the skin.

Eating habits

Family meal for these three generations

● Vietnamese people eat a lot of Buddhist vegetarian dishes. Their cuisine emphasizes fresh vegetables and/or herbs, accompanied by a dipping sauce.
● The most common meats and fish are pork, beef, chicken, shrimp and several kinds of tropical fish.
● A typical Vietnamese dish consists of a roasted meat or fish dish, a stir-fry vegetable dish, rice to share with the whole family, small bowls of sauces and a large bowl of soup to share with the family.
● The mother feeds her baby with breast milk. Cabbage, carrot, cauliflower and potato soup would help the milk production.

Pregnancy and motherhood

Baby resting in a small hammock
● For the Vietnamese, the newborn at birth is already one year old.
● Childbirth is considered to take away a woman’s warmth, blood and breath of life. Thus, during the first month postpartum, women are more vulnerable. They therefore stay at home, do not wash their hair, dress warmly and walk in small steps.
● During the first few months, the baby’s body is massaged with gentle firmness. This helps to firm up his muscles and “bring the body parts into harmony”.
● In Vietnam, it is customary to draw with lipstick on the forehead of the newborn to ward off evil spirits.
● Abortion in Vietnam is legal and encouraged, even forced. The government imposes a policy of birth control, creating a demographic imbalance.
● Most newborns have a blue/grey spot (the Mongoloid spot) on the lower back and/or buttocks that appears at birth. It disappears over time.

End-of-life care

Nurse caring for an elderly patient
● The idea of being buried far from the family burial site is a source of stress for seniors.
● Some Vietnamese do not like to talk about death. Death is associated with the devil and bad luck. The misfortune that befalls the family can be attributed to the dissatisfaction of the ancestors.
● Grief and mourning are not necessarily private and limited in time.
● Vietnamese patients may prefer to be at home during their last moments of life, surrounded by their family. They may fear the wandering of the soul. Thus, in order to be able to leave the hospital, patients may mask their pain.
● Some Vietnamese may combine several medical treatments without telling their caregivers.
● The patient and family may feel that surgery is a last resort. They may also think that blood tests could make them sicker. Thus, it may be necessary to explain the reasons for and benefits of the procedures.

Exemples

In Vietnam, when a child is affected by a respiratory ailment, it is the duty of the parents, if they are experienced, to give first aid and try to bring out the “bad spirits”. First aid consists of an old traditional Southeast Asian practice, the “Cao gio” which means “scratching the disease to allow it to escape through the skin”. In 1984, in the United States, a school nurse discovered traces that appeared to have been made with a knife on the chest of an 8-year-old girl of Vietnamese origin during a medical examination. The nurse reported the incident to Youth Protection and the father was incarcerated. After learning about the family’s culture, the investigation continued, but the father, disgraced by his arrest, committed suicide in his cell.

Diversity Toolkit – Cleveland Clinic
“Reflets: la pratique en contexte interculturel” de Carlo Serlin et François Dutheuil.
Vietnam Travel - Usages et règles de politesse au Vietnam
Livre de Quy N.H. Tran, University of California Davis Health, Sacramento, California, VA Northern California Health Care System, Mather, California -  Providing Culturally Respectful Care for Seriously Ill Vietnamese American
Stanford School of Medicine - Advance Directives and End of Life Issues : Vietnamese
University of Washington, Medical Center UW Medecine - End-of-Life Care: The Vietnamese Culture. Culture Clues

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