Vietnam - Money talks in health, education

Two months ago, my pregnant cousin lay bleeding in a Ha Noi hospital and no one was paying attention. 

My mother and I tried desperately to alert the staff but they simply ignored us and hurried past. Then, as a last resort, my mother slipped some money into a nurse's pocket. She immediately rushed to help.

On Vietnamese Physician's Day this month, the Minister of Health urged the health industry to adopt an ethical code of conduct in the workplace that would include a ban on taking "envelopes" from patients. I have heard this message repeatedly on every special occasion of the health sector, but I have yet to see it applied in practice.

According to a recent survey of eight hospitals by the Research and Training Centre for Community Development and Boston University's School of Public Health, most patients said they gave bribes to ensure timely medical treatment.

In preparation for my cousin's obstetric surgery, my mother presented the doctor and nurses with VND6 million (US$285) to express her "gratitude". She kept handing out tips each time they arrived to bathe the baby or perform a routine check-up. She ended up spending a total of VND13 million ($619), after consulting with friends about their own hospital experiences.

I can't help but wonder: what happens to poor patients who can't afford to pay extra? Do they just have to beg for the attention of doctors and nurses? I don't even want to imagine the outcome.

Last September, five central hospitals in the city attempted to implement a policy that would require health workers to refuse tips from patients. The ministry's inspectors promised to enforce this pilot programme.

While no doctor or nurse has been caught red-handed demanding money from patients, the plan can hardly be called a success.

A leader of a central hospital said recently that it is ok to accept tips from patients after finishing their treatment. According to him, it is simply a way for people to express their thanks to doctors or nurses.

But what is the boundary between gratitude and bribery?

In a survey by Dan Tri online newspaper after the implementation of the pilot programme, 73 per cent of its 6,000 respondents said they still give tips to health staff before getting check-ups and treatments. Worse, 15 per cent of them reported being forced to pay by health workers. Only 7 per cent offered tips to express their gratitude.

Health workers blame their low salaries for the fact that they accept tips from patients. A nurse in a city hospital said her monthly salary of VND4 million ($190) did not appropriately reflect her skills and efforts.

With that kind of logic, taking "envelopes" from patients becomes simple common sense and people whose lives are in their hands become their direct debtors. I believe it is unreasonable for them to put their burden on the patients' shoulders. Didn't they choose their profession? Where are their morals? I thought it was called the Hippocratic Oath, not the Hypocritical Oath?

Unfortunately, bribery is not quarantined in a hospital ward. This social evil has spread to other sectors, including education.

Last week, my sister tried to register her three-year-old child at a State-owned kindergarten in Dong Da District and was told the school was full. She was then advised to give VND5 million ($238) to the headmaster to have her kid enrolled.

Bing! Everything was magically done after money was handed out.

The headmaster also reminded my sister to give a VND200,000 ($9.5) tip to the teacher on her son's first day of school. She emphasised that it was a rule.

When International Women's Day comes around, my sister started to worry about how much money she should give to each of her child's three teachers. What if other parents gave more?

I'm sure every household was having the same thought.

I suppose one could blame these parents for eroding teachers' work ethics, but their children are their most precious assets! How can they jeopardise their futures?

Next month, the Research and Training Centre for Community Development will begin an initiative to stop the proliferation of bribes in the health and education sectors. They believe, and I agree, that if all patients and parents refuse to give tips, the practice will cease. However, "all" is a necessary condition.

Let's hope that such initiatives will help end the exchange of "envelopes" in our society! It's better to have a ray of hope than nothing.

Thu Hien

VNS

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