VietNamNet Bridge - Paediatrics has been an area of medicine slow to develop in Vietnam, but thanks to the efforts of one man and his collegues, hundreds of sick children can look forward to a healthy future.

Dr Nguyen Thanh Liem (centre)operates on a child with intestinal problem.

He is professor Dr Nguyen Thanh Liem, director of the National Hospital of Paediatrics (NHP): responsible for introducing the first organ transplants for child patients in Viet Nam.

Tragic start

Liem hadn’t always considered a career in medicine, in fact, growing up in the central province of Thanh Hoa, young Liem was more interested in studying literature. But when he turned 16, fate took a tragic turn. Liem’s mother started suffering terrible pains in her chest. She was diagnosed with lung cancer and died a week later.

“The memory of my mother’s painful death haunts me to this day,” the doctor says. The tragedy provoked him to turn away from the arts and seek a path in a more lucrative field – medicine. In September 1970 the teenager enrolled for the entrance exams at Ha Noi’s University of Health and passed the test with flying colours.

It wasn’t until Liem had completed his six years at the university that his fortune was to take another twist. The graduate was among several students picked to study a further three years under a special intern programme at the Viet-Duc (Viet Nam-German) Hospital. Initially, Liem wanted to study infectious diseases but the course wasn’t running that year so he opted for his second choice: to specialise as a paediatric surgeon. It was a life-changing decision.

Once fully-qualified in 1979, Liem was assigned to work at the Paediatrics Department in Bach Mai Hospital. The department at that time had only 6 surgeons. At 27, Liem was the youngest. “It was hard in the beginning,” the doctor says. “I didn’t know anyone in the city, I had nowhere to live so I stayed at the hospital.”

There Liem had to face the sufferings of the patients 24-hours a day. “It broke my heart when kids died under my care. I knew that because of Viet Nam’s then limited medical skills, our hospital lacked the knowledge and resources to help them.”

The bottom of it

In the 1980s, ailments that could be operated on relatively easily in developed countries often had low survivor rates in Viet Nam. Among these were intestinal problems like imperforate anus, a condition that is caused by birth abnormalities and can mean the patient having to use a colostomy bag.

Moved by the number of children dying post-surgery, Liem determined to do something about it. At that time, the amount of children with intestinal defects surviving surgery was 60 per cent in developed countries, while in Viet Nam it was only 6 per cent. Liem headed to Sweden for four more years of study in paediatrics to try and get to the bottom of the problem.

He discovered that many children were dying because of a drop in body temperature during and after surgery. “We learnt not to let patients’ body temperature drop below 34oC,” Liem said. The survival rate in Viet Nam is now almost 100 per cent.

Thanks giving

Dr Liem often receives well-wishes from his patients whose lives he has transformed. One of them is Nguyen Thanh Hai from the northern province of Bac Giang. Having suffered from a perforated anus at birth, he had to use a colostomy bag. At the age of 14, Hai was too embarrassed to go to class, his father said. “We decided to do something drastic to help our son. So we sent him to the hospital to get treatment.” After a successful operation, Hai was able to throw away the colostomy bag. He has since graduated from university.

“We’ve come to say thanks again. The operation really changed my son’s life,” Hai’s fathers said.

Organ transplants

Up until ten years ago, children with serious kidney or liver problems would most likely not recover. Means to carry out organ transplants were limited although demand was high. According to the doctor, there are around 1,000 children needing organ transplants per year.

In 2000, Dr Liem began to pursue the idea of conducting the operations at his hospital. Many of his peers scoffed at his plan. “One friend, an Australian doctor, said my idea could never work because sanitary conditions were so low at the NHP,” Liem said. But that wasn’t the only problem. The hospital also lacked funds and medical equipment. It seemed an impossible ambition, until the doctor became acquainted with staff at the Samsung hospital in South Korea through a patient whose case had to be referred to the hospital.

In 2005 a group of South Korean surgeons arrived at the NHP with modern medical equipment. With their help, the hospital was able to complete its first liver transplant on 14-year-old Hoang Anh Tuan from the northwestern province of Hoa Binh. The operation took 12 hours and was a success.

Since then the hospital has gone from strength to strength. Experts from Taiwan Veterans Hospital have joined in and on April 7 this year the team completed their fifth liver transplant. The successful surgery was on 16-year-old Ho Tuan Anh from the central province of Nghe An. Her uncle, a 42-year-old army officer, donated part of his liver for the operation.

“It took almost 14 hours for the surgeons to perform the operation because of abnormal blood vessels in the livers of both the donor and the recipient, so we had to use microsurgery,” Liem said. Both patient Tuan Anh and his donor are now in good health. The operation was free of charge.

Ten successful kidney transplants and five pancreas transplants have also been completed at the hospital so far by Dr Liem and his colleagues.

As well as being a pioneer in organ transplants in Viet Nam, Liem has performed thousands of endoscopic surgery on children since 1997 and operated on two sets of conjoined twins. In honour of his achievements, the doctor received the national Hero of Labour award earlier this year by the Government: a mark of respect for a man whose career has given hope to hundreds of children in Viet Nam.

(Source: VNS)