or if he was happy to cover this area. She was letting him know what was expected of him. It seemed her directness last night hadn’t been unusual but the norm.
As they finished scrubbing their hands she kept talking while she dried hers. ‘Okay, I’m sure you’ve done some general reading on the health issues in Vietnam.’ She shot him a sideways glance. ‘Or at least I hope you have.’
He nodded quickly. ‘Of course. Main issues are malaria, tuberculosis, HIV and AIDS, with some cases of dengue fever and ongoing issues with Agent Orange.’
She gave an appreciative nod and held out her hands. ‘Biggest killer of kids in our area is malnutrition, coupled with diarrhoea and vomiting. They have no extra fat layers to fall back on. It hits hard and fast.’
‘So a norovirus outbreak is your worst nightmare?’
‘Pretty much.’
She led him down one corridor and then up a set of stairs. ‘Okay, downstairs is basically our clinic area. Upstairs we have six four-bed rooms with a variety of patients. Children and adults.’ He could see how the layout of the traditional colonial house had been adapted to work as a hospital. There were a number of nursing staff upstairs to whom she introduced him quickly. The staff seemed friendly, and the patients well-cared-for. Most were on IVs. Lien caught his gaze.
‘We have a mixture of dehydration in both the young and the elderly. Lots of chest complaints too. Anyone suffering from diarrhoea is cared for separately in one of the single rooms at the other end of the corridor.’
Joe nodded. He’d known whole hospital wards closed because of winter vomiting bugs. They couldn’t ignore, or not treat, people affected, but, because it was infectious, it had a real chance of being passed to other patients or staff. Hygiene issues had to be the top priority.
‘Anyone today that you’re worried about?’
She gave him a half-smile. ‘I’ve already done a ward round this morning, but we’ll do another one later so you can familiarise yourself with the patients. Today we start downstairs at the clinic.’
They washed their hands again, and moved back down the stairs.
Downstairs was separated into four areas. One was a general waiting room, one was for children, one for pregnant women and a fourth for X-rays, with a plaster room next door. It was a real mixed bag. A kind of cross between a GP surgery and community hospital back in Scotland.
Lien gave a little sigh as she showed him into an office and gestured for him to sit in the chair opposite her. ‘We have a real mixture of antenatal care. Only around sixty per cent of women in Vietnam attend antenatal care. Some women don’t present until late in pregnancy. Others present early, requesting their pregnancy be monitored all the way through for birth defects. It’s not unheard of for a pregnant woman in Vietnam to have up to twenty scans.’
Joe’s eyebrows shot upwards. The norm for the UK was two, unless there were any concerns. Something clicked in his brain. ‘Agent Orange?’
She nodded.
‘How often nowadays do women present with birth defects?’
Lien’s face was serious. ‘It’s more prevalent now in the south of Vietnam, but forty years on there are still children affected here. The spray that was used to destroy the crops obviously went into the soil. Poverty is a major issue in Vietnam and some families are solely reliant on growing their own foods. They have no other option but to eat the food they grow—whether the soil is damaged or not.’
She shook her head. ‘We have two other hospitals. One is in the outskirts of the city of Uông Bí city, in northeast Vietnam, and the other—the one Duc’s parents have just gone to—is in Trà Bồng District in the south of the country. At that one, we also take care of the kids in the nearby orphanage. A lot of them are affected. There’s poverty across Vietnam, just like there’s poverty in every country in the world, but it’s worse down in the south. Down there, families are reliant on farming. If their crops fail, it’s disaster for them. A lot of them rely on their kids to work alongside them. If their kids are affected by Agent Orange, or any other genetic or medical condition, often the family can’t afford to keep them.’
‘So they end up in the orphanage?’ Joe asked.
‘Exactly. We offer free medical care to the orphanage. Things have improved in the last few years, but we still aren’t where we should be.’
‘Sometimes I forget how lucky we are in the UK. Yes, things aren’t perfect. But the healthcare part of the job generally always gets done.’ He gave a slow nod. ‘And the first hospital you mentioned?’
‘The other is in Uông Bí in Quang Ninh province, in northeast Vietnam, more towards the coast. We’ll cover both hospitals at some point in the next six months—generally just for a week or two to cover holidays.’
‘Okay.’ He was beginning to get a general feel for the place, for the sort of patients he’d be seeing, and the kind of responsibilities he’d have here. None of it seemed beyond his ability, though he’d have to do a bit more background reading on some treatments.
Lien ran through the paperwork they used, how to order tests and their prescribing arrangements. She handed him a pre-printed list with Vietnamese names for some of the more commonly used drugs. It was clear she’d familiarised foreign doctors with the clinic workings before.
Joe leaned on one hand. Everything seemed straightforward enough. ‘This place,’ he said, ‘it’s like a cross between a community clinic, a cottage hospital and an ER.’
Lien was watching him with careful eyes. He couldn’t quite work out what was going on in her mind. He was sure she was part vetting him, part examining his motives. It was only natural. She was looking for someone she could rely on. Having to check another doctor’s practices would be almost as bad as not having a colleague at all. ‘Let’s hope you don’t have to cover it all at once,’ she said softly.
He could see the flash of worry in her eyes. But the only way to earn the trust of a colleague was to prove himself. Joe was willing to do that. Back home everyone trusted him in his current role, but he wasn’t back home any more. He was in an entirely different country, and while some health needs would be the same, there were others he’d need to query, and Joe wasn’t too proud to do that. He would never put patients at risk.
‘Where do you want me?’
Lien’s eyes brightened at the question. Was that relief he’d just spotted? ‘What do you prefer?’ she asked. ‘I need someone to cover the children’s clinic, and someone to cover the adult clinic.’
He gave a nod. The clinic work, whether it was for children or adults, would be very much like his GP role back home. He shot her a smile. ‘Happy to do either.’ Then met her gaze. ‘Put me wherever I can be of most use.’
She shifted a little in her chair, caught off guard at his words. He almost let his smile broaden. She liked being straightforward and so did he. ‘I’m not here to be a hindrance, Lien, I’m here to be a help.’
She reached up and brushed an errant strand of brown hair behind her ear that had escaped her ponytail. She was close enough that he could see just how smooth her skin was. She wore very little make-up. But she didn’t need any, her dark hair and eyes complemented her appearance beautifully. In another life, in another place,
