By David Snyder
Though a qualified medical doctor with the Hanoi Red Cross, Dr. Nga Nguyen Hang says that Vietnam’s medical schools only teach emergency medicine to those who are going to specialize in the field. This leaves considerable gaps in many doctor’s skills when it comes to trauma care.
“In medical school we don’t focus on things like injuries unless we want to work in an emergency room,” Dr. Hang explains. “There are many branches in medical school, just like in hospitals, but we don’t all have specific emergency room training.”
With traffic accident-related injuries on the rise, Counterpart wanted to address this issue as part of its Vietnam Injury Control Program, which took place from 2001-2009.
In keeping with its mission to empower local communities to sustain their own development, Counterpart linked up with the Hanoi Red Cross to train a select group of doctors and nurses in injury treatment and prevention.
“The doctors and nurses who work in the Red Cross system do not work in the hospitals,” explains Duc Pham My, Head of Administration with the Hanoi Red Cross. “It would have been difficult to train hospital staff, but we could easily reach our own staff with trainings.”
Those chosen from within the organization to become trainers were carefully selected based on a number of criteria to help ensure their success in the program.
“They needed to have medical backgrounds and to be on the management board of the Association,” continues Pham My. “They also needed to have some level of communication skills.”
Once trained, that group then went on to serve as the core training group for hundreds of community volunteers and local motorbike taxi drivers, known as Xe Om, giving them valuable skills in First Aid and injury prevention.
As Chairman of the District Red Cross Association in Hanoi’s Thanh Xuan District, Dr. Hang was among the core group of 12 medical professionals selected for the specialized skills training.
“There were three or four training courses, and each was ten days long,” Dr. Hang says. “I was trained in first aid techniques such as how to stop bleeding and how to deal with broken bones. I was also trained in how to teach others those techniques. We focused on skills like how to present information and how to listen to others.”
Once trained, Dr. Hang herself became a teacher, instructing over 200 local volunteers and Xe Om drivers in First Aid through the successful Safe Fleet Project. However, they did not just educate Vietnam’s taxi drivers; they also brought the training program to local youth and children.
“The Injury Prevention Program was also conducted in ten schools in the district, so I trained teachers from those schools,” says Dr. Hang. “Every year now I still provide training for teachers and students in injury prevention.”
For Dr. Hang, the skills she acquired during her training in 2006 have helped her become not only a better medical professional, but also a better teacher – skills she continues to use each year through her job at the Red Cross.
By educating youth and children about road safety and First Aid at a young age, the hope is that they will carry this knowledge with them and become safer drivers on Vietnam’s already crowded streets.
Though the actual project has ended, its impact continues to live on.
“It may be hard to measure if injury rates have gone down in a city like Hanoi, but with the additional training of medics and the assistance of the Xe Om Safe Fleet, the care that accident victims receive has certainly improved.”
By David Snyder
Calling Hanoi’s 115 Emergency Center for medical assistance five years ago turned out to be a sure way not to get emergency help. Today, Hanoi’s 115 Emergency Center receives up to 90 calls a day to help the city’s sick and injured – and it is able to manage most of them thanks in part to Counterpart’s Vietnam Injury Control Program.
When the program began in 2001, Vietnam’s Emergency Medical Services (EMS) were struggling throughout the country. With a presence in only 10 out of 64 provinces, they were generally understaffed, undertrained and underequipped to cope with the growing patient numbers.
Starting with a pilot program in Hanoi, one of the first issues addressed was staff training. There was a general lack of trauma care knowledge among the staff and EMS personnel were inadequately trained.
“The training focused on things like intubation and using a backboard to immobilize the spine, which was not available before Counterpart provided it,” says Dr. Nguyen Van Chanh, Vice Director of the Hanoi 115 Emergency Center. “We also learned the principles of ABC (airway, breathing, circulation), which helped us be systematic in our work. In the West, this may sound basic. But it was very helpful to us.”
Working through the University of Washington, and with initial funding from the U.S. Agency for International Development (USAID), a select group of Vietnamese doctors were taught how to train others in trauma care techniques used in the United States. The training sought to fill an existing gap in Vietnam, where medical students must specialize to receive the high level of training required for most emergency work, known there as pre-hospital care.
“In our medical education system we have subjects throughout the year where students are taught the basics of emergency care,” Dr. Chanh says. “But for those who want to pursue that field they have to take two more years of school. For pre-hospital care there is a vacuum.”
The doctors who took part in the U.S.-based training then used their new skills to educate the staff of medical facilities like the Hanoi 115 Emergency Center.
In addition to the specialized training, basic medical equipment – including backboards, cervical collars and medical kits – were provided. Perhaps most critical, however, was the provision of three new ambulances for the center. Their impact, explains Dr. Chanh, was immediate. “The ambulances allowed us to set up the first satellite center in the west of Hanoi. Before that it used to take very long for an ambulance to respond to an accident in that area,” says Dr. Chanh.
By 2009, with two more ambulances from Counterpart and additional funding from the Government of Vietnam, the 115 Center had opened four satellite centers in Hanoi. This allowed them to vastly expand their coverage area and improve their response times.
“Previously it took us 20 minutes on average to reach an accident site. Now, it is 12 minutes,” says Dr. Chanh. “Up until 2001 we had about 17,000 responses every year. Now we have about 30,000.”
The Hanoi 115 Center keeps 14 medical teams on duty every day, whereas before they could only staff six such teams.
Through the Vietnam Injury Control Program, the Center now has the resources to continue training staff, a more streamlined response system, and the ability to provide top quality care for its patients.
After the success in Hanoi, the EMS training program expanded out to several provinces of the country, including Hai Phong, Hung Yen, and Da Nang.
In a country where as many as 11,000 injuries occur each day, the Hanoi 115 Emergency Center may be a modest success, but it continues to have a big impact on many people’s lives.
By David Snyder
Traffic accidents are theleading cause of injury and death among young people in Vietnam. In the country’s capital of Hanoi, an estimated 30 people die in road accidents each day. Injury rates on the country’s roadways have risen dramatically, as population growth continues to surpass the development of Vietnam’s infrastructure and public safety awareness.
“The situation is getting worse, especially with the young people,” says Nguyen Van Hai, a former participant in Counterpart’s Safe Fleet initiative. “They drive very fast and they don’t obey the law, so the driving is very dangerous.”
In 2001, Counterpart launched the Vietnam Injury Control Program (VICP), a series of planned activities aimed at reducing the number of injuries and accidents on the country’s streets. One of the most effective projects under the program was the Safe Fleet initiative where Hanoi’s motorbike taxi drivers, known asXe Om, were trained in First Aid techniques and road safety in collaboration with the Hanoi Red Cross.
Nguyen Ngoc Vinh is one of almost 500 Xe Om, who is now a safer driver and better equipped to help those injured in traffic accidents thanks to the training.
“I have been involved in about 100 incidents since the training, sometimes just scrapes and small injuries,” he explains. “Once I saw a motorbike accident where someone had a broken leg. Along with some other people I helped bandage the leg and I took them to the hospital.”
Participants are interviewed before being accepted into the program, ensuring that those taking part are physically fit, healthy and genuinely committed to helping make Hanoi’s streets safer.
“The Red Cross ward approached me,” says Vinh. “Before taking the training I underwent a health test to make sure I could do the job, and I was accepted. I was very happy to be included.”
After completing the course, each Xe Om driver is given a helmet, a uniform shirt, an identification card and a basic first aid kit, which allows him to act as a first responder at the scene of an accident.
Xe Om are perfectly suited to help improve Hanoi’s accident response infrastructure. The drivers are already driving on the streets, they know the city better than most and can travel to and from a scene more quickly than most ambulances.
“Before this training when I saw accidents I would stop and help, but I just did what I could,” says Hai. “Now, after the training, I’m more confident and I feel more professional.”
Their First Aid skills have also improved their own business and client turnover. Those looking for a taxi feel safer and have more confidence in someone who has taken part in Counterpart’s Injury Control Program.
The Project’s impact continues to be felt in Hanoi. Responding to an average of 300 accidents each year, Safe Fleet participants regularly get together with Red Cross staff at the district level to share their stories, statistics, refresh their first aid skills and make sure that they are maintaining their valuable knowledge.
Counterpart International has distributed relief supplies to flood-stricken villages in northern Georgia in cooperation with the U.S. Embassy and the Shida Kartli regional government.
Counterpart’s on-the-ground team assisted some 1,500 flood-affected households in the communities in Surami, Khashuri and Chumateleti on June 28. More than $500,000 worth of sleeping bags, bed sheets, blankets and boots from the U.S. State Department’s pre-positioned disaster packages, which are stored in Tbilisi, Georgia, were distributed. Additionally, UNHCR, UNICEF, Tbilisi Mayor’s Office and private contributors donated commodity items, such as cots, that were received by the flood-affected households.
“Thanks to the generous support of the State Department, we were able to deliver assistance that will help them get through this difficult time,” says Rang Hee Kim, Director of Humanitarian Assistance at Counterpart. “Local authorities were very effective in the coordination and facilitation of the distribution.”
Flooding and landslides caused by severe rains have killed several people in the Shida Kartli region and blocked one of Georgia's most important highways. Storms in central Georgia caused the Mtiskhevi river to overflow, triggering avalanches and sweeping away vehicles and buildings in its path. About 1,500 houses in the area were damaged by the flooding. Rising water had reached a depth of 3 meters in some parts of the villages of Surami and Chumateleti.
The situation is critical in Chumateleti, where the river broke its banks and is still flowing into the yards of nearby houses. Georgian special brigades are working in Surami, Khashuri and Chumateleti to clean up roads and canals. According to an estimate provided by Prime Minister Nika Gilauri the damage has exceeded 10 million GEL (nearly $6 million USD).
The timely and efficient response to the flood is being made possible by close collaboration between the U.S. Department of State Office of the Coordinator for U.S. Assistance to Europe and Eurasia (EUR/ACE), the U.S. Embassy in Georgia and Counterpart. Through a U.S. Department of State EUR/ACE grant, Counterpart administers pre-positioned disaster packages that are reserved for natural or man-made disasters such as this. Similar packages are located and used for disaster relief in Armenia, the Kyrgyz Republic, and Tajikistan.
Counterpart has operated in Georgia since 1995. Through its network of 960 partner organizations, Counterpart has imported and distributed over $158 million worth of humanitarian assistance to nearly 2.5 million needy Georgians.
by Joan Parker, President and CEO
“Local ownership” is today’s hot topic in development and recognized as a key element to sustainable development results. Unfortunately, good strategies like this can come and go like fads or become empty slogans that many people employ but few skillfully implement.
How do we keep local ownership from suffering a similar fate?
At Counterpart, we are all about “locally-owned development.” Indeed, our mission is to empower people, communities and institutions to drive and sustain their own development.
So let me share three elements of how Counterpart partners with – and empowers – the local owners of the development process, which may be a useful guide to others pursuing this goal:
- We are catalysts and facilitators: Our role is to offer temporary guidance and resources that provide options and incentives for new ways of thinking and working. Re-aligned incentives determine whether people will try changing traditional behaviors; and they are even more essential for maintaining and spreading new behaviors.
- Link local partners to resources: Our task is to facilitate linkages that allow people, communities or institutions to access key resources (partnerships, information, markets, finance and more).
- Be the “angel investor”:Our resources are initial (and short-term) investments that generate proof of concept for the long-term investors. We work with local partners to identify where that ongoing investment will come from, whether public or private sector. And then we ensure that potential investors are at the table from the get-go.
I would like to share a small example of how we served as a catalyst, delivered a missing ingredient and identified mutual incentives for local stakeholders.
In the Azerbaijan municipality of Zarrab, citizens believed that the local budget was derived from local land sales and that the proceeds were being diverted for personal gain rather than community purposes. Distrust and unwillingness to pay taxes abounded.
To remedy the situation, Counterpart’s project provided a range of options to the local community and municipal leaders drawn from best practices in other settings. From these options, the local leaders decided to create a Budget Control Commission comprised of citizens and municipal officials. The Budget Control Commission prepared internal rules and controls, followed by public meetings and budget hearings. Simultaneously, Counterpart provided technical assistance to municipal officials on how to incorporate citizen input; and to civic groups on how to constructively engage government.
The new transparency and skills were put into action – and the results were immediate. More citizens paid their taxes, and they became increasingly aware of their own role in the successful delivery of municipal services. Increased tax revenues are now used to meet a variety of community priorities, such as road work, bridge repairs and the construction of a new water supply system.
I like the fact that those who made decisions on how to proceed were local. And those who institutionalized the change were local. We were catalysts and advisors – temporary players in their development process.
If local ownership is an interest of yours, keep an eye on this column in future issues of Counterpart Connections. We will explore government ownership, community ownership and combinations thereof.