Medical Fund

The medical fund has been created to enable our project partners, the monastic community at Huong Phuong village, to establish a medical centre. They will supply the qualified doctors and nurses. We will assist with technical advice from Australian medical professionals and raise funds for basic items. In August 2011 a storage building was cleaned out and renovated for a medical centre. Four sisters were posted there: a doctor with medical centre experience, a graduate doctor and two graduate nurses. The photo below shows the refurbished premises for the medical centre.

Preliminary planning meetings with the monastic community, pictured below, established the need for staged funding of the medical centre and for a special care unit beside the orphanage.

By October 2011 a cabinet with medicines, pictured, was the only piece of equipment at the medical centre.

Discussion with the Emergency Ward Registrar of Calvary Hospital at Canberra suggested 10 ground rules for the medical centre:

Ground rule	Description
1. Operating model	Local doctors and nurses need to weigh up best operating model for the centre. The “barefoot doctor model” has medical staff on a couple of scooters, going out to treat the poor in the surrounding area. The “medical centre model” has basic medical equipment and community health education facilities in one place to service a number of surrounding villages.
2. External funding to be staged	Funding must be in stages. Condition of each stage of funding must be successful use of previous stage of funds.
3. External funding to be transparent	Every dollar of sponsors’ money must be accounted for. No lump sums of cash to be provided. Better to purchase and supply items required by centre.
4. Staff training	Our scholarship program is creating more nurses, pharmacists and doctors. By 2015 the women’s scholarship program will have produced the additional people required to fully staff a medical centre. There must, however, be some continuing training of local staff. Local or overseas volunteer doctors could be engaged to do this. Specially trained assistants (doctors’ aides) are also very important in running the centre.
5. Staff retention – internships	Internships should be paid to staff, to encourage them to stay in service at the centre, and not move to cities where there is better paid employment.
6. Regular medication supply	There must be a regular monthly supply of medicines basic to any health centre. Regular money must be paid to a local supplier. A local pharmacy can be arranged to provide a monthly top-up of basics e.g. antibiotics, electrolytes, paracetamol.
7. Staff to know their limits	First rule of all medicine is “Do no harm”. Staff training should teach doctors and nurses to know their limits – there are treatments that are safer to be done at hospital. Staff may want to have all the latest hospital gadgets and do exciting operations, like the ones they have seen in hospitals. But the local centre should refer patients to hospital if any elaborate treatment is needed.
8. Charge something	We would all like treatment to be for free. But if people pay nothing then they do not value the treatment. A schedule of small charges should apply to medical services. These should be clearly displayed to patients, so they can see that the medical service is “worth something”.
9. Regular electricity supply	There must be an independent generator with stocks of spare fuel, so that the centre can operate during power cuts. Freezers and some other items of equipment require continuous power.
10. Prioritise equipment list	Staff may want to have all the latest hospital gadgets (some of which they will not know how to operate expertly, some of which are too difficult to maintain far from the city and some of which are only suitable for use in a hospital). Basic medical centre equipment should be a priority. See below.

An initial local “wish list” of hospital and centre equipment was broken down into 2 priority categories: A – Important; B – Maybe in future.

Item priority	Item	Cost (M VND)
Category A Important	Tertiary training – funded through scholarships	N/A
A	Internships – funded through scholarships	N/A
A	Continuing training – funded through future scholarships	N/A
A	Monthly supply of essential medications @ 1M/month	12
A	Electricity generator for power cuts	20
A	Máy ly tâm: centrifuge	3
A	Máy xét nghiệm nước tiểu: urine test machine.Optical spectrometer + urine dipsticks + pregnancy tests	31
A	Kính hiển vi: Microscope. + Glass slides DQ.(Diff quick = stain for examining cell samples)	17
A	Máy huyết áp: 3 blood pressure, Doppler device.Electronic device later (Category B)	2
A	Máy nội soi tai, mũi, họng: Ear, nose, throat scanner. Bộ đèn soi đáy mắt: lights to examine ears/eyes. Opthalmoscope + octoscope, AA battery operated.	5
A	10 giường inox bệnh nhân: 10 stainless steel sick beds	30
A	Tủ lạnh đựng hóa chất: Fridge and freezer for ice and medicines (once generator has been installed).	10
	TOTAL COST OF IMPORTANT ITEMS130M = $6,500A
Category B Maybe in future	Basic life support equipment. Face mask + ambibag.Gendels/NPA + suction+ oxygen cylinder	20
B	Máy huyết học: Hematological machine	240
B	Máy Xquang: X-ray (MODEL SHIMAZU) + LMA	525
B	Máy rửa film: film washer:	130
B	Máy sinh hóa tự động: Auto. biochemical machine	260
B	Đèn gù soi tiểu phẩu: minor surgery endoscope	2
B	Bàn tiểu phẩu: 1 Minor surgery table	6
B	Máy tính: computer, Máy in màu: 1 Color printer:	19
	TOTAL COST OF FUTURE ITEMS 1,200M = $60,000A

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