Name: Chi Woisetschlaeger

School: Howard University

ID #: 02585333

I was born in Vietnam, and in this paper I would like to review some of the health
issues facing Vietnam. I will also relate and compare those health issues to those seen
internationally and to the health issues seen in countries of differing economic status. In
the past most countries of high economic status have for the most part been isolated from
the health issues affecting the underdeveloped countries of the world. Today
globalization and the associated “interconnectedness” of countries provide a potential to
quickly spread communicable diseases, the vectors of disease, and even harmful food
products. The pace of that spread challenges the ability of even high economic status
countries to respond in a timely manner that allows for the prevention or minimization of
harm, and also challenges the surveillance capabilities that allow those countries to
identify and respond to these threats to our health. Global warming with its predicted
climate change and sea level rise has many negative implications for Vietnam in
particular as well as for the world at large. Because Vietnam has an extensive coastline
for a relatively small and narrow geographic footprint, low lying flood plains, and a
massive river delta systems (Red River delta near the northern tip of Vietnam that
empties into the Gulf of Tonkin and the Mekong Delta in the southern tip of Vietnam that
empties into the Pacific Ocean), a World Bank sponsored study on climate change
categorizes Vietnam as one of the top 5 countries to be negatively impacted by the
expected sea level rise. The magnitude of the impacts due to sea level rise will certainly
create unsanitary conditions that foster the re-emergence of communicable diseases
(CD’s) that are now under control and tax the resources of a low income country’s ability
to maintain the preventative and sureveillance programs that allowed Vietnam to
eliminate CD’s as some of the leading causes of morbidity there. Any discussion of
health issues in Vietnam with potential international health impacts, must also mention
the newly emerging and re-emerging diseases with the potential to become pandemic
such as bird flu or H5N1, swine flu, and SARS (Severe Acute Respiratory Syndrome).
These are all zoonotic diseases, or communicable diseases that originated in animals, but
also infect humans. Zoonotic diseases account for 75% of newly emerging diseases,
today they mostly impact the animals that they originated in and the impact is limited to
the economic costs associated with dead livestock and livestock culled to prevent the
spread of disease among animals. But viruses are always mutating and if they mutate to
allow for easy human-to-human transmission and high human mortality our next
pandemic will have been born.

Vietnam’s Top 10 leading causes of morbidity as reported by the World Health

Organization’s Western Pacific Region Health Databank for 2006. Total number of cases
referenced to General Statistics Office of Viet Nam [http://www.gso.gov.vn]:

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 Morbidity Causes Total # of Cases
1 Pneumonia 309,749
2 Acute Pharyngitis & Acute Tonsillitus 271,173
3 Acute Bronchitis & Acute Bronchiolitis 217,751
4 Essential (Primary) Hypertension 164,863
5 Transport Accident 124,196
6 Gastritis & Duodenitis 117,737
7 Influenza 99,940
8 Diseases of Appendix 79,933
9 Intracranial Injury 64,478
1 Urolithiasis 58,902
0

Historically, the leading causes of morbidity in Vietnam have been communicable

diseases. Although, there are no communicable diseases on the top10 morbidity listing
for Vietnam for 2006, the WHO’s statistics report 68,532 new cases of Dengue/Dengue
Haemorrhagic Fever (DHF) and 22,637 new cases of Malaria reported for 2006. Dengue
in particular is a resurgent health problem in Vietnam, the WHO reports that dengue/DHF
new cases rose to 96,451 for 2008.

Vietnam’s Top 10 leading causes of mortality as reported by the World Health

Organization’s Western Pacific Region Health Databank for 2006. Total number of
deaths referenced to Health Statistics Yearbook 2006: HSID. Planning and Finance
Department, Ministry of Health, Viet Nam:
Mortality causes total number of deaths
1 Intracranial Injury 2,521

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2 Pneumonia 1,179
3 Transport Accident 1,009
4 Intracerebral Haemorrhage 964
5 Acute Myocardial Infarction 749
6 HIV/AIDS 653
7 Heart Failure 630
8 Stroke (not specified as haemorrhage or 601
infarction)
9 Transient cerebral ischaemic attacks 586
1 Meningococcal Infection 519
0

The WHO also categorizes and lists the top 10 causes of worldwide mortality based on
broad income groups, specifying lower, middle, and high income countries. According to
the World Bank Vietnam is categorized as a lower income economy. The World Bank’s
main criteria for classifying economies is gross national income (GNI) per capita, with
lower income being $975 GNI or less, middle income being $976 to $11,905 GNI, and
high income being $11,906 GNI or more. As a comparison, the World Bank lists the
United States’s Gross Domestic Product (GDP) as $14,204.3 billion and GNI as $47,580
for the year of 2008, for the same year Vietnam’s GDP was $90.7 and GNI was $890.
Note that the GNI numbers here are based on the Atlas method and are in equivalent U.S.
dollars.

A comparison of the WHO’s top ten worldwide mortality causes to the top ten mortality
causes for low, middle and high income countries for 2008:

Cause of mortality WorlDwiDe vietnam LOW MIddle High

Coronary Heart Disease 1 5,7 * 2 2 1
Stroke & other 2 8 5 1 2
cerebrovascular diseases
Lower respiratory infections 3 2* 1 4 4
Chronic obstructive 4 NITT+ 6 3 5
pulmonary disease
Diarrhoeal diseases 5 NITT 3 NITT NITT
HIV/AIDS 6 6 4 NITT NITT
Tuberculosis 7 NITT 8 9 NITT
Trachea, Bronchus, and Lung 8 NITT NITT 5 3
Cancers
Road traffic accidents 9 3 NITT 6 NITT
Prematurity and Low Birth 10 NITT 10 NITT NITT
Weight

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* The Vietnam mortality listing does not have coronary heart disease, but lists acute
myocardial infarction and heart failure as the 5th and 7th leading causes of mortality,
respectively. + While nothing related to COPD appears in Vietnam’s mortality listing, the
morbidity listing ranks acute bronchitis as 3rd.Since we are referencing the mortality
ranking for different income categories to the worldwide mortality ranking, NITT here
means that the income category does Not Include the Top Ten mortality cause from the
worldwide list.

http://www-
wds.worldbank.org/external/default/WDSContentServer/WDSP/IB/2007/02/09/00001640
6_20070209161430/Rendered/PDF/wps4136.pdf

www.searo.who.int/LinkFiles/Dengue_Bulletins_c2.pdf

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