SCIENTIFIC INTELLIGENCE DIGEST

• Document Type: FOIA
• Collection: FOIA Collection
• Document Number (FOIA) /ESDN (CREST): 0005647986
• Release Decision: RIPPUB
• Original Classification: U
• Document Page Count: 5
• Document Creation Date: June 24, 2015
• Document Release Date: May 27, 2011
• Case Number: F-2010-01312
• Publication Date: August 1, 1968

(b)(1)
(b)(3)
DIRECT+OR:ATE OF
SCIEN#E & TECHNOLOGY
~CI.E1~T'~"IFI~ I'I'EI.II ~-I~-E~'I~
APPROVED FOR
RELEASES DATE:
16-May-2011
USI-SDf 68-8
August 1968
 DISE~ISES IN VIETNkM
Life Sciences Division
OSI/CIA
SUMMARI'' ~-1ND CONCLUSIONS
The infectious disease .problems in
South Vietnam resemble. those in many
oilier developing tropical countries, but
the imposition.of a war, particularlyone
against guerrilla forties, has altered con-
ventional approaches to disease .control..
..Since 1963 difficulties in`implernenting
public health ,measures in areas under
only tenuous control,`the.dislocation and
relocation of large segments of thepopu-
Iation,. and the cumulative effects of
inadequate health .services have: contri-
bated to. arising incidence of several
diseases. Additional factors contributing
to this trend.iriclude: (a} increasing drug
resistance of. disease producing
organisms, for example, chloroqun-
r e s i s t-a n t falcparum malaria and
penicillin-resistant gonorrhea, (b} -the
underemphasis of. internal South
Vietnamese support of public health
efforts relative to support of other
phases of South '~ietnamese economic
-and military, =efforts as exemplified by
the lour :salary scale for public health.
workers; the :drafting of ;public health
workers., and: ;the low budgetary com-
mitment for public health. A recent
study ndieated that mph of the disease
is .preventable and'that after a necessary
first phase of meeting acute curative
medical needs,-the time has come to begizi
a .:major shift toward emphasis on public
health and preventive medicine. ,
In North Vietnam. the incidence of cer-
tain epidemic diseases, such as cholera,
in.aiara, and plague, is dower than in
South Vietnam, This is believed attrib-
utable in part to some. prior efforts that
-have been placed on preventing outbreaks
`rather than on cures and in part to the
fact that some diseases {e.g., plague}
have .never been naturally widespread.
in North Vietnam. However, the war is
leading to a deterioration of health pro-
grams there and this will significantly
increase the number of cases of acute
and chronic diseases. The impact of the
war in Vietnam, especially among the
refugees .and the malnourished, -will be
felt far many years after the war in
terms of increased susceptibility to
disease.
SID 68-8
Aug 68
 DISCUSSION
Although some, of ahe apparent increase
in disease .1,ncdence is due to improved.
reporting, a rising trend m disease inci-
dente has occurred, :primarily in South
Vietnam since 19,64. .SoutYi'Vietnam pro-
vides reports to the World Health Organi-
zaton on quararitinable ,:diseases and
there Have ; been several -field-trip re-
ports by international and free world
medical teams which give some measure
of the magnitude of the'' health situation.
By contrast, there is cry.little official
reporting -or unofficial accounts. from
North Vietnam describing the ,present
impact of the warondseasecontrolpro-
gram.s. Nonethel,ess,'ahere is evidence
that the health problems . in both. North
and South Vietnam are becoming in-
creasingly serious. An insight into the
prevalence of disease can be'gained from
the fact Ghat of all .admissions to medical
treatment facilities .from US forces in
South Vietnam, approximatelytwo-thirds
to three-fourths are for.diseases,.and the
remainder. are; equally distributed be-
tween, battle 'and non-battle injuries.
Fragmentary ,evidence indicates that
similar rates .exist among. the Viet Gong
and North Vietnamese Army units,
A recent appraisal noted thattubercu-
losis is the:prirne killer.and is rampant
in. South Vietnam (30 percent of all
Vietnamese ..are calcul-aced. to have ~pul-
monary X~ray changes compatible with
.active .tubercul;oeis, while aijout.l0 pez'-
cent have positive. sputa}. Malaria,
typhoid, typhus:, cholera, poliomyelitis,
plague, parasitic infestations and infer-
tious diarrhea, especially among
chi:ldren,.are common.
South Vietnam reported no case of
cholera to WHO for some years until
1964. During the past 4 years some
38,000 cases have been reported, of
which nearly one quarter have been con-
firmed by laboratory analysis. Plague
.has increased from 29 reported cases
in -1962 to over 4,500 clinically diagnosed
cases to 1967. Syphilis and gonorrhea
have- reached a high level as indicated by
a survey shoeing, that 8 to I4 percent of
pregnant woir,.en had syphilis in 1966, Ten
thousand eases of malaria were reported
in 1966, About 25,000 cases of leprosy
are registered and the total number of
cases is estimated at some 75,000. Two
measures of the prevalence of infectious
diseases are the overall death rate and
the infant mortality rate, The death rate
in. South Vietnam. (per I,000 population)
decreased from 7.5 in 1956 to a minimum
of 4.8 in 1963 from which it has since in-
creased to 6.4 in 1965. The infant
mortality rate decreased from 46.6 (per
1,000 births} in 1956 to a minimum of
29.4 in 1964 and has since increased
(36.7 in 1965). These figures illustrate
the breakdown in the effectiveness of
the public health services.
A US A.LD, survey pointed out that
the most important .disease preventive
measures include the development of a
clean water supply, more adequate
sewage disposal, immunization pro-
grams and eradication of mosquitoes
and rodents. Health education is essen-
SID 68-8
Aug 68
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~n~ar
 tial: The number of;hospital beds in South for propaganda purposes. Diseases have
Vietnam (.18,000," in September . 1967) been blamed on -the testing of biological
w6uld lie adequate if they .were not warfare weapons against the population,
occupied `by patients with these pre-
ventable diseases. Curative medicine,
though still deficient,. is. making 5"teady
progress and unfortunately appears .to
be of, greater .concern than .preventive
medicine to `the South Vietnamese
government .and -:physicians, Less than
one percent of the:Gross National Product
is spent for -healt3i services, an unusually
smaYl amount for a developing country.
Some. programs_ ,for mass immuniza-
tions and efforts to increase the number
and .competence. of `Yiealth workers have
been active in nec,ent years, Advances
have. been made in preventing outbreaks
,:from reaching: epidemic proportions, in
large part .due., to the. influx of assistance
from free-world..countries, . improved
technologies and. an increased national
awareness. On the other hand, refugee
problems, inadequate or nonexistent
.sanitary conditions {the water supply at
Saigon's Binhdan Hospital has been de-
s.cribed as "woefully inadequate,"
functioning primarily in the rainy
season); continual harassments, by the
Viet Gong; and, more important, the low
level of popular support for public health
p r o j,e c t. s. are.. overriding disruptive
factoxs which have increased the risk of
disease:'
The . N. ational Liberation Front (NLF)
and .'Hanoi ',Government have recognized
that medicine can;be,aprmary effective
toolao win the loyalty.of the Vietnamese
pegpie. They have exploited the'seasonal
rise of several diseases in South Vietnam
on the "irresponsible attitude of the
puppet authorities" whichpermittedepi-
demics to spread and on the direct action
of US military operations. The NFL has
given vaccines and other medical
assistance to people in the countryside.
This aid is at best. minimal, aithoul~?h the
.gesture is widely publicized. On the other
hand, a primary objective of the N3y.F is
the disruption of antimalaria programs
which tivere visibly doing some good for
the people, Since 196,, they have sys-
tematically killed or ~ terrorized field
workers in the program. This action as
well as a decline of support by South
Vietnam's Ministry of Health to carry'
ouY the .goal of malaria eradication has
resulted in the reversion of the eradica-
tion program to a "holding operation"
against this disease.
Preventive health measures in North
Vietnam, principally in heavily populated
areas, have been. practiced `for over 10
years with varying degrees of success
and failure. The main thrust of these
efforts, aided principally by the USSR
and East European countries has been
directed toward mass inoculations and
improvements of sanitary conditions and
vector controls: These efforts have made
the overall incidence of acute infectious
diseases Lower in comparison to South
Vietnam: However, +the exodus of people
from major populated cities iedtoacon-
comitant breakdown of health services.
Outside these areas:; hygiene is at a very
low level, and the vaunted government
health programs have scarcely begun to
SID 68-8
Aug 68
-3-
~r'+nt?m
 operate. References to choiexa outbreaks of sanitation or functionin reventive
and- a very high incidence of gastro- r o .rams.
intestinal disor.clers in the.-Hanoi area
attest to the lack of effective standards
SID. 68-$
dug 68
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