VNAH Supports the Development of Social Work Practice Law in Vietnam

Mr. Do Manh Hung, Vice Chairman of CSA, NA

Mr. Do Manh Hung, Vice Chairman of CSA, NA

October 11-12,  2017 in Hue City of Vietnam, VNAH and the Ministry of Labor, Invalid and Social Affairs (MOLISA) organized a consultative workshop to discuss the first draft of the social work practice law for Vietnam.  The workshop was part of a 5-year project funded by USAID and implemented by VNAH to support the enforcement of disability-related policies, especially the Convention of the Rights of Persons with Disabilities (CRPD), and the services for persons with disabilities in Vietnam.

MOLISA, our key project partner, is leading the drafting of the social work practice law, which is expected to promote the development of professional social workers and to improve services for the vulnerable groups in the country.  MOLISA estimated that the future social work law will benefit about 28% of population, or around 25 million people, who are the elderly, the disadvantaged children, the persons with disabilities, the poor and others.  VNAH has been supporting this law project since 2016, with technical assistance for international research and public consultation, including the workshop organized in Hue.

Professor Sarah Gehlert, University of South Carolina

Professor Sarah Gehlert, University of South Carolina

The consultative workshop in Hue – which was convened by senior officials from the National Assembly and MOLISA, and participated by 130 representatives of government organizations, social work practitioners, NGOs and academia- was for participants to discuss and give inputs to the first draft of the law.  Among the highlights were the presentations by the Dean and a professor from South Carolina University in the U.S, and an adjunct professor from the University of New England, Australia, who shared international experience about social work practices, particularly in the U.S and Australia.   VNAH has commissioned a social work lecturer from the U.S to conduct a comparative analysis on social work legal framework and practices in several countries, especially the U.S.  The research was shared with the workshop and the drafting team.   The agencies involved in drafting of the law expected that it will be completed and submitted to the National Assembly for hearing in late 2019 or early 2020. 

Introducing the US Quality Improvement Process to Nursing Faculty at University Dong A

Danang City, Vietnam - VNAH arranged for two senior American health professionals to visit the University Dong A (UDA) and lead a seminar on Quality Improvement (QI) for nursing faculty and other members of the University and health services community. Dr. Mary Segall, a Nurse Educator specializing in Quality Improvement and Prof. Mellen Tanamly, a Public Health Nutritionist were the invited speakers.  The seminar was held at the main UDA campus conference hall in Danang City, Vietnam, on January, 2017. This event was part of the VNAH and UDA partnership to introduce American practices into the Nursing Department curriculum.

Improving the quality of health services provided in the private and public health sectors in Viet Nam is one of the aims of ASHA support to VNAH and UDA. The project was implemented during period from 10/2014-9/2016, with a goal to improve capacity to meet the growing needs for quality higher education services and market demands for skilled workers in the central region of Vietnam.   The project specific objective was to improve the capacity for, and access to higher education and vocational training to ensure young people and the vulnerable populations receive industry-driven training and needed skill sets for employment.

The UDA now is able to offer training at its own facilities equipped like a real operation or business, which gives students practical work opportunities which prepare them for jobs in the industries for which they have been trained.  As a result, the UDA has seen steep increases in enrollments, especially in the three majors that the ASHA has provided commodities to.  The new enrollment in this school year (2016-2017) increased by 65% (from 915 to 1,510 students) in nursing program; and 88% in the electrical program (from 199 to 375 students); and 14% in the hospitality management (from 277 to 315 students), compared to previous years.    Prior to the project, these programs have an average increase of 10% annually.  These results are strong indicators of the project successes in capacity building for the UDA.

The speakers introduced American quality improvement concepts to nursing faculty and other invited guests. Dr. Segall presented “Building a Foundation for Improved Quality at Hospitals and Health Centers: The Role of the Nurse”. This was an overview quality improvement processes and tools that are used globally to strengthen health care services for better patient outcomes. Session Objectives were: to increase knowledge about safety and quality improvement; how to initiate a QI project in your setting: a review of selected priorities from data about Sustainable Goals & indicators of a package of health care services; to increase appreciation for the importance of measurement and monitoring in QI; to learn about a culture of innovation; learn about the Role of Quality Improvement Teams, the Role of the Nurse, & Use of Improvement Collaborative; and to learn about resources faculty can utilize for teaching QI. Ms. Tanamly discussed the application of quality improvement approaches to infant and young child feeding programs in Viet Nam.

The seminar was well attended by all senior and junior nursing faculty, other UDA officials, representatives of Ministry of Health and private health facilities, and UDA nursing students.  Following the event, the consultants met with the President of the University and the Dean of the Nursing School to discuss faculty development strategies.

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Binh Phuoc Province: Yen Nhi, Right and Timely Support Changes Life

Yen Nhi, who could barely walk two years ago, now can ride a bicycle

Yen Nhi, who could barely walk two years ago, now can ride a bicycle

Yen Nhi is a 9-year-old girl born to a family in Binh Phuoc that pledged by disabilities. Her father, grandfather and uncle are living with disabilities.  For many years, Nhi kept falling down and get injured when walking without knowing why. The local hospital and family thought she is a victim of malnutrition.  Nhi’s situation has become a burden to the poor family.  She relies mainly on the grandfather and the uncle, both have difficulties themselves, as the father works away from home.

In April 2016, Nhi went through a clinical assessment by a VNAH’s team of national and international rehabilitation professionals.  Only then the family learnt that Nhi has a scoliosis that affects her standing, walking and leg’s strength.  The therapists informed that if Nhi is not intervened correctly and timely, she would get worse and harder to rehabilitate.

Right after that, our therapists started an intensive treatment program for Nhi, which includes therapies at hospital and at home, with a focus on correcting and straightening the spine and improving the strength of the lower limbs.  Our bio-medical engineers visited Nhi’s home, designed and made a table that helps her in sitting for meal and for school’s home-works.   Her grandfather also helped with the treatment. He printed out and posted on the board pictures of therapy/exercise so Nhi can follow and practice under his supervision. Our therapists and local health providers conducted regular follow ups at home to provide therapy and evaluation of Nhi’s progress.

The support gains result after a five-month: Nhi has begun to walk firmer, with less time of falling.   She can even ride a bicycle, which she dared not do before, but now has become a favorite.  Everyone in the family is happy. 

The grandfather, her main caregiver, told us “it is a big relief” for them to see Nhi is getting better, not worse as they thought in the past.  “she can continue school”, he added.

This is one of the many positive stories of the DIRECT project- which is a USAID funded project implemented by VNAH and local partners - has a goal to provide rehabilitation services to 4,000 beneficiaries, and to build up rehabilitation service capacity in Tay Ninh and Binh Phuoc, including setting up rehabilitation units and training for 5,400 service providers, in a five year period, from 2016 to 2020.

Tay Ninh Province: A Story of Duong Van Cuong

A Story Duong Van Cuong

By Kate Lhuede (VNAH Volunteer Occupational Therapist)
 

VNAH's Physio Therapist Ms. Nhu and Duong Van Cuong

VNAH's Physio Therapist Ms. Nhu and Duong Van Cuong

The OT and the VNAH team including a physiotherapist conducted a home visit Duong Van Cuong, a young man of 28 years living with his mother and father in rural Tay Ninh.  The beneficiary had a diagnosis of Cerebral Palsy with upper and lower limb contractures and challenges with increased tone. His father works and his mother’s role is as her son’s caregiver and home maker.  The beneficiary is dependent on his mother for all his ADL’s. He cannot walk or move from floor to bed or bed to chair. He needs help from his mother for all his mobility and she carries him to the bathroom and toilet and his mother props him up for eating.  The beneficiary has no verbal speech but had good sight and hearing and is able to communicate his needs by nonverbal gestures and sounds. This man spends the majority of his time on the floor in the front living area. He appeared to be well cared for by his mother.  The beneficiary was obviously pleased to see the team visiting him by frequently giving us all a big smile.

 

What was I thinking the Occupational Therapy intervention might be?

If you spend all your time because of your disability lying on your back, your world becomes very small and limited. A core philosophy of OT is about the capacity of all people including those with severe disabilities to participate and be active in their communities. I immediately wanted to assess and provide interventions that would result in the beneficiary sitting in a chair.

 

What did we do?

We placed the beneficiary in a chair with arm rests and he sat upright for the first time in many years. We firstly trialed the patient in a plastic chair without armrests or a high back and the patient was able to sit but needed a lot of support by staff on either side of him to do so and his poor balance made him at risk of falling.

The Occupational Therapist was assessing and scanning the home environment for another chair that might provide better support for the patient and noticed furniture in the more private area of the home used for guests. The mother generously gave us permission to carry this heavy chair from the formal room to the kitchen area where the interview and assessment was conducted.  This chair was identified as much more suitable for her son to commence sitting in; it was heavier and sturdier with solid armrests that son could be taught to hold onto to assist his mother when transferring from the floor.

We educated the mother and patient about the best and easier method of transferring her son from the floor onto the chair.

 

What were the results?

We talked to the patient and his mother about the new things he could see sitting upright in a chair. The patient could now observe what was happening in the kitchen area around him as well as the movement of cattle in the front yard, the dogs sleeping under the bed and the neighbors going past on scooters.

The VNAH team could communicate with the patient with full eye to eye contact sitting opposite us rather than standing over and above him to talk with him. Communicating with us while sitting also meant that the patient was less reliant on his mother to communicate his needs. The patient had much more functional use of his upper limbs and hands more easily; he could better observe, manipulate and hold a bottle of water from a seated position with the bottle placed in his lap.

Most importantly was the response of the mother and son. The patient was able to communicate how pleased and excited he was to be able to observe and communicate with the team and his mother from a seated position. His mother was very affected by the pleasure she saw in her son’s eyes at the change in his abilities and increased independence and social participation all resulting from the simple intervention of moving her son from lying on the floor to sitting upright and straight in a chair.

The team offered to return the chair back to the formal area of the home. The son made it clear he wanted to remain in the chair for the rest of the day and the mother stated the chair would now remain permanently in the kitchen to be used every day by her son. This decision by the mother was a measure of the usefulness of the occupational therapy assessment and intervention that was conducted.

At completion of this, the Occupational Therapist and the VNAH team went onto conduct home assessments for another two young men also with cerebral palsy who also spent all of their time in a lying position on either their floor or bed. The team repeated at these visits what was done at the visit outlined above.

This success story outlines the impact of very simple and inexpensive interventions of changing posture and positioning of patients with severe deformities associated with cerebral palsy. These interventions can significantly improve the functional abilities and increase the range of occupations and activities people with disabilities can participate in. This case also highlights how the impact of simple solutions has the potential to address caregiver burden. Finally, simple interventions including environmental assessment improves the lived experience and quality of life of patients, their families and caregivers.

Tay Ninh Action Plan in Disability of the Year by DOLISA and DIRECT

Mr. Mike Greene, Mission Director, USAID/Vietnam

Mr. Mike Greene, Mission Director, USAID/Vietnam

April 2017, Tay ninh, Vietnam -- The workshop on reviewing action plans in disability of 2016 and disseminating action plans to support the people with disabilities of 2017 in Tay Ninh was jointly organized by DOLISA and DIRECT program/VNAH on 26th of April 2017. The workshop attended by more than 100 participants from local government agencies, provincial and district People’s Committees, local and international organizations such as USAID, VietHealth, DRD, Tay Ninh VAVA, Blind Association… working on disability in Tay Ninh Province.
Workshop concentrated on presentation of achievements and discussion on the challenges in implementation of the year 2016. In addition, DOLISA also disseminated Tay Ninh action plans in disability of 2017 and CRPD plan approved by Tay Ninh People’s Committee. Mr. Micheal Green, General Director of USAID was invited to attend and giving remarks in this workshop. In his speeches, he appreciated the efforts of Tay Ninh province in supporting the people with disability, especially the initial success of USAID DIRECT project implemented by VNAH. These plans and program are regarding as major mechanism for enforcement of CRPD and other disability policies in Tay Ninh.