CURRENT HEALTH STATUS IN NORTH VIETNAM

• Document Type: FOIA
• Collection: FOIA Collection
• Document Number (FOIA) /ESDN (CREST): 0005647973
• Release Decision: RIPPUB
• Original Classification: U
• Document Page Count: 24
• Document Creation Date: June 24, 2015
• Document Release Date: May 27, 2011
• Case Number: F-2010-01312
• Publication Date: August 26, 1964

(b)(3)
Scientific
Intelligence
Report
. _ _ N? 119
Current Health Status
in North Vietnam
~U$LICATION~ FILE COPY
DQ N02 REMO_V~
.~f:~~~
OSI-SR/64-40
26 August 1964
Office of Scientific Intelligence
APPROVED FOR
RELEASES DATE:
16-May-2011
ti~
 Scientific Intelligence Report
CURRENT HEALTH STATUS IN NORTH VIETNAM
OSI-SR/64-40
26 August 1964
CENTRAL INTELLIGENCE AGENCY
~ Office of Scientific Intelligence
 PROJECT OFFICERS
Life Sciences Division
OSI/CIA
Interpretations of intelligence information in this pub-
lication represent immediate views which are subject
to modification in the light of further information or
analysis.
 SUMMARY AND CONCLUSIONS
DISCUSSION
Incidence of Diseases
Vietnamese Prophylactic and Therapeutic Measures .
Page
Shortage of Medical Supplies ... 3
Water and Food Problems 4
Organization and Facilities 5
Medical Personnel and Training .. 6
TABLES 8
ANNEX 18
 SUMMARY AND COItiCLU.510NS
When the. present Communist Government assumed control of .:..
North Vietnam .in 1954, it inheritedthe responsibility of meeting the
medical needs> of its approximately 16 million people, 90.percent
of whom lived in primitive crowded villages. Modern sanitation and
larger cities such as Hanoi. The long rainy seasons and lack of .:
adequate provision for food storage fomented furtherthewidespread
nutritional, infectious- and parasitic diseases. There was nocentral
public health group capable of effectively instructing thepeople and
instituting modern disease control measures.
A Ministry of Public Health was established in 1954 and patterned
after that in Red China. From its headquarters level, Hanoi, the
health organization extends down to interzonal andprovincial levels,
each having. its--~ own- hospital or health center, and its own medical
and provincial administrators. In addition, the Red Cross and Red
Crescent Societies' and some medical teams from Sino-Soviet bloc
countrie -operate in North Vietnam. -
Ambitious programs carried out by the Soviet bloc countries in-._
eluded building or rebuilding 6 general hospitals. Large scale mos-
quito control programs and immunizationprogramswere instituted,
and many new sanitary wells were dug and others improved. Better
training for. physicians and ancillary personnel was begun.
In spite : of `this, .the health problems of the country remain but
little 'improved, and the normal life expectancy is 30 to 35 years.
But the effort to. improve public health has made inroads into the
backward ways of the North Vietnamese. -The general health and
nutritional status of the country remains precarious and serves as
a continuing threat to the North Vietnamese.
 ?ISCUSSIOIV
A. Incidence of Diseases
Endemic diseases among the North Vietnamese are malaria, tu-
berculosis, trachoma, venereal diseases, smallpox, amebic and
bacillary dysentery, and dietary deficiency diseases. Malaria, tu-
berculosis and smallpox are the leading causes of death. Animal
diseases transmissable to man include rabies, anthrax, lep-
tospirosis, schistosomiasis and .parasitic diseases. A chart of
diseases of military importance is shown in Table 1. Disease vec-
tors generally are not under control although mosquito con-
trol measures have been ambitiously undertaken and the incidence
of malaria has been lessened.
The following diseases generally are prevalent during the sum-
mer in NorthVietnam and in the adjacent areas:
Typhoid fever, encephalitis, hog cholera, mumps, whooping
cough, and measles. In addition a cholera epidemic has been raging
in South Vietnam during the last three to four months. Cholera has
also been reported in Thailand (Bangkok), and Cambodia (Kohking
District), and plague was reported in South Vietnam (Saigon, Dalat,
Nhatrang).
B. Vietnamese Prophylactic and Therapeutic Measures
In 1964, the Council of Ministers summarized the current disease
control problem: North Vietnam must still make a major effort to
use public health, sanitation, and health-protection units to prevent
disease outbreaks; it has not yet extended hygiene and epidemic
prevention work to base-level productive establishments; it must
build public health and maternity stations in the highlands and in the
reclamation areas, and hygiene-epidemic-prevention stations in the
provincial cities, Excrement collection, untreated sewage and gar-
bage disposal .are problems which still have not been solved. Viet-
namese effort on specific diseases are given below:
Trachoma -- The Ophthalmology Institute has sent teams
of specialists into more than 1600 villages in the lowlands and
mountain areas to study effective measures to combat the disease.
The institute is studying a method of treatment by "oriental medi-
cine." The institute has treated over 432,000 people~and has claimed
cures in most cases.
Malaria -- Malaria is particularly prevalent in the lower moun-
tainous regions, and water conditions in the delta areas are such to
 provide excellent breeding grounds for its vector, the anopheles
mosquito. Vietnamese efforts in malaria control have been aided by
other bloc. countries but the control program has progressed slowly.
Soviet recommendations om `c o n t r o 1' procedures, based on
a pilot plant study in Thai Nguyen Provincewere turned over to -thee
Vietnamese in 1960. The Ministry of Public Health and the Malaria
Elimination Central Board (President: Pham Ngoc Thach, Minister
of Public Health)utilized Soviet and Rumanian experts to train more
than 509000 native workers `to combat malaria. The Soviet Union was
~ expected to furnish the necessary appliances and medicines.
Tuberculosis -- The Tuberculosis Institute has employed BCG
vaccination (orie million in 1960), serial X-ray identification, put
monary surgery and chemotherapy.
Health 1Vlirister Pham Ngoc Thach has reported successfuluse of
isoniazid iri the treatment of tuberculosis. In 1961 the country had
103 specialists in tuberculosis prevention, 3,220 hospital beds re-
served for tuberculosis patients, and 35 antituberculosis dis-
pensaries. ~ .
..
folio -`-`Poliomyelitis was epidemic in 1959 in North Vietnam;'
according to a Soviet physician: In 1961, sixmillion doses of Soviet
oral vaccine were given. in North Vietnam,
C. 'Shortage of Medical Supplies
Nediciiies'bf`all finds are in short supply in North Vietnam, Es-
sential Western drugs are obtained from foreign countries. Peni-
cillin is imported from China and other drugs are imported` from
East Germnay (Jenapharm), .China, USSR and possibly Czech-
oslovakia,
Two ` other steps are being taken to overcomer the shortage of
medical:::supples:~ 1) some native drugproduction and 2) the exploi-
tation, of `existing "oriental medicine," which utilizes "nature''
drugs and traditional remedies and practices. North Vietnam has
allegedly resolved 'to select all the best practices and drugs from
both Oriental. and Western medical cultures, blend the two and en-
joy the fruits of both.
Acute .drug shortages are probably the reason thata captured
military. medical document advocates medicinal plant cultivation and
use'by the` mittary`andthat.ehina was training seven .teams a~ Viex-
namese medical students in oriental medicine related to the treat-
 namese medical students in: Oriental medicine related to .the 'treat-
ment~ of tuberculpsis, leprosy., and 'other diseases.
Native;drug.manufacturing competence is meager but some effort
is under .way: The Tuberculosis Hospital (which. is directed by the
Health Minister) is attempting to manufacture TB culture:media.The?
Microbiology , Institute has prepared .some common vaccines for
pediatrics diseases, tetanus, typhoid, and cholera.
The claim has, been made that in 1961 the Microbiology Institute
(Directoro Nguyen Duc Khoi) produced antipolio vaccine according
to the Soviet method, with the assistance of the Soviet physician,
Chumakov. North,Vietnam asserts that it was the second country.
after. the .USSR to manufacture the product and administer it to mil-
lions pf children.
D. Water and Food Problems
Water, supplies, are generally taken ,from nearby streams, rivers,
canals. or shallow,wells. Deep wells are used in a few cases. For-
eigners must regard all water sources as contaminated: While some
of the larger cities may have potable municipal supplies, they are
occasionally contaminated and users _ may not be so informed.
During the. wet season, ground and surface water is ample. During,
the _dxy ; season .the flow of streams diminishes so that salt water
extends upstream and potability is decreased.
The water supply in Hanoi'is from wells. The water is pumped in-
to underground reservoirs where it is treated and then piped to pri-
vate. connections and public water taps. The water has to be boiled.
before ;Westerners can .use it. A modern, Western-style municipal
water ; .treating system, was projected for completion by 1966' but
probably ,will not be completed until ,1975-1980. The city has a
sewage disposal: system.. '
The sanitation problems in Hanoi are typical of other, Vietnamese
cities. Crowded conditions and thepresence of rats and vermin con-
tribute to the; spread of diseases.such as typhus, cholera, and dysen-
tery.. The present; system of waste water disposal is primitive 'and
consists of narrow,slightly..covered subterranean ditches, irife.sted
with rats.
The Vietnamese have had four consecutive years of severe agri-
cultural short falls. Rigid food rationing was established in 1961.
 A Vietnamese doctor has stated that the biggest-health problem of
the country in 1962 was malnutrition. The authorities included food
studies in the natio~~i's 66Medica.l 'pask" for 1962. In this; connection,
the aim of the Five-Year program was said to be to acquire an un-
derstanding of the composition and nutritive value of different foods
and the selection of a diet that.is most wholesome for the people.
Insects, diseases, and rats have caused serious and sometimes
permanent damage to North Vietnam crops and agriculturalproducts.
The annual loss of food from this problem is from 15 to 20 percent
of the total production, For rice alone it is from 600,0.00 to 700,000
tons.
E. Organization and Facilities
Public organization of medical affairs in North Vietnam was
modelled after those of other bloc countries. After the Democratic
Republic of Vietnam was established in 1954, the Ministry of Public
Health was organized and superimposed on the existing inadequate
public health service:
`Central : contz?ol of the public health system is exterted by the
1VInistry in Hanoi. This control is supplemented at interzonal and
provir?eal levels, each of which has its own hospital, agency
or health center, and medical and political administrations. Nortf~
Vietnam has two City Medical Services (Hanoi and Haiphong) and
three Zonal Medical Services (Hong-Quang, Thai-Meo, and Viet-
B~ac): All-public health services which are made available at zone,
pr~ivnce, cit;~ or village levels are under the jurisdiction of
tile` Ministry.
"'The Ministry is directed by Pham Ngoc Thach and has a few com=
petent arYd well trained individuals. (See annex) Vice Ministers are
Nguyen Duc Thang, Chief Political Officer; Dinh Thi Can, Political
Officer; and Vu Van Can, Senior Colonel, Chief of the Military Medi-
cal Bureau, The organizatior_ of the ministry is as follows:
`Administrative Bureau. (D.irector: Le Loi)
Experts Division (Chief: Cuong. Conducts liaison
with foreign medical experts.)
Preventive Medicine Division (Chief: Vo To)
1Vlecldal Treatment Division (Chief: ,Nguyen Van Tin)
-5~
 Pharmacy Division (Chief: Ha)
Training Division (Chief: Hoang Dinh Cau)
Research Institutes
Ophthalmology Institute (Chief: Nguyen Xuan Nguyen)
Antimalaria Research Institute (Chief: Dang Van Ngu)
Tuberculosis Institute (Chief: Pham Ngoc Thach)
Oriental Medicine Institute (Chief: Nguyen Van Huong
and Deputy Chief: Pho Duc Thanh)
Radium Instit~~te (Chief: Hoang Su)
Microbiology Institute (Chief:. Nguyen Duc Khoi)
Sanitation Institute (Chief: Nguyen Van Huong)
The country has 263 medical establishments (hospitals, dispen-
saries, convalescent houses), 25,000 hospital beds, 2,297 village
medical stations, and 8 tuberculosis sanatoriums. Hospitals about
which information is available are listed in Table 2.
Soviet bloc aid after 1954 consisted especially in material support
and assistance in the reconstruction and expansion of hospital facili-
ties. The USSR gave the largest bulk ofaid--refrigerators, hospital
instruments and ambulances=-and constructed the Vietnam-Soviet
Friendship Hospital in Hanoi around the existing Don-Thuy Hospital.
East Germany, Czechoslovakia, Poland, Bulgaria, Hungary, and
China also contributed amounts of badly needed aid.
F. Medical Personnel and Training
Adequate numbers of scientifically trained personnel do not exist
in Vietnam. Many competent people were lost when much of the Uni-
versity at Hanoi was moved to Saigon in 1954-55.
In 1959, North Vietnam had 1,900 doctors,probablynot more than
400 of whom could meet Western standards for the medical profes-
sion. To alleviate the shortage of technically trained personnel and
to acquire a large number of people who would be useful in auxiliary
medical jobs, intensive training courses were set up in 1961 by the
North Vietnam regime. -These programs are for training "second
grade doctors," nurses, midwives, pharmacist's assistants, and
 medical specialists and include a regular medical specialist pro-
gram, referesher training course, hospital-on-the-job-training, a
,pharmacist regular training program, pharmacist's assistant
training, and university education for physicians. Except for the uni-
versity program forphysicians, these courses represent accelerated
education. The existence of suchaprogramwiththe attendant danger
of superficial training is striking evidence of the shortage of com-
petent medical personnel, Since 1962, the provincial centers have
conducted their own medical specialist schools at existing hospitals.
The Hanoi College of Medicine and Pharmacy conducts afive-year
course to train physicians and pharmacists. Two additional years
in internship are required before the medical graduate is recog-
nized as a doctor. In 1960, graduates numbered 208.
In addition to.this regular training of physicians, a correspondence
course is also available from the college, The program lasts about
three years at the end of which the successful student become a
"physician." The internship is waived for on-the-job trainees.
In 1962, 107 doctors graduated from the college first corre-
spondence course.
Vietnamese physicians have received grants and scholarships
from bloc countries to do graduate work or to take special training
abroad.
A three-year course for "Medical Specialists" conducted in a
regular full-time hospital program followed by 18 months of on-the-
job experience is required before a Medical Specialist's Certificate
is awarded.
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 ANNEX
THACH, Pham Ngoc--Minister of Health, since 1958, Vice Minis-
ter of Health, 1954, Member, National Scientific Research Board.
Director, Vietnamese Tuberculosis Institute, May 1958. Attended
Hanoi School of Medicine. Received M.D, in France and interned at
the Hautville Sanatarium iri; Jura, returning to Vietnam in 1936.
E stablished a clinic in Saigon. One of Indochina's pre-World War II
most prosperous physicians. A lung specialist, credited with de-
velopment of new treatments for tuberculosis. President, Vietnam
Youth Federation and long a leader in youth activities. Reportedly
Communist Party member. Not believed influential in the formula-
tion of policy. Has visited USSR, Communist China, North Korea,
European satellites, Indonesia, India, and France. Born 1909. Speaks
French, some English,
TUNG, Ton That--Director, Vietnam-Germany Friendship Hos-
pital. Former Vice-Minister of Health, Professor of Surgery, Hanoi
University, Former President, Vietnamese Red Cross Society. Re-
elected to the National Assembly, April 64. Reportedly one of the
outstanding medical men in North Vietnam. Performed the first
heart operation in North Vietnam reputedly. Experimented with
Filatov metYaod of treating wounds, Published on pancreatism. Sur-
geon in charge of all military hospitals in the Thai Nguyen area in
1947; in 1948 writing for the medical service of the Vietminh army.
Born 1912.
KHOI, Nguyen Duc--Director, Microbiological Institute of the
Ministry of Health. Director, Hanoi Municipal Public Health Service,'
1955-56. Member, Preventive Medicine Association of NorthViet-
nam. Engaged in bacteriological research since 1951, specializing
in parasitology, especially Leptospira. Supporter of Ho Chi Minh.
HUONG, Nguyen Van--Director, Oriental Medicine Institute of the
Ministry of Health. Vice President, Oriental Medicine Association
of Vietnam, Specializes in utilization of indigenous herbs and plants
for medicinal purposes. Studied Oriental medicine in China, 1958.
SU, Hoang--Director, Radium Institute of the Ministry of the Pub-
. lic Health, Head, provincial medical department, Thanh Hoa Pro-
vince, 1946-50. Director, medical service, Fourth Interzone, subse-
quent to 1950. Specializes in irradiation treatment, specially of
cancer.
THANG, Nguyen Duc--Political vice minister, Ministry of Public
Health. Member, Scientific and Technical Council of the Ministry,
1959. Member, Department of Medical Science, Vietnam National
Science ;Commission. ':
- 18 ~-
 CAN, Vu Van--Vice Minister of Public Health, since 1960. Chief,
Military Medical Bureau, Vientam~ People's Army, since 1950. Senior
Colonel. Reportedly, member, Vietnam Medical Association.
NGU, Dang Van--Director, Antimalaria Research Institute and
Member, Central Executive Committee and Technological Subcom-
mittee, Vietnam Medical Association. Research Director, College
of Medicine and Pharmacy of the People's University of Vietnam.
Outstanding personality in medical research; currently working on
plan to eliminate malaria, Produced the first "Vietnamese" peni-
cillin; developed "Betlein," an antibiotic said to be comparable to
penicillin; grew streptomycin, recommended use of tapioca roots
to make alchohol for army. Educated in Hanoi, France, and Japan.
Visited USSR, 1955. Born 1910.
BAO, Nhu The--Director, Vietnamese-Soviet Friendship Jiospital
(reptedly used almost exclusively by military personnel) since
1958. Ho Chi Minh's personal physician. Member, Executive
Committee, Vietnam Medical Association, 1957.Vfce-Chairman, In-
ternal Medicine Association of Vietnam.
DI, Ho Dac--Rector, College of Medicine and Pharmacy, since
1945. Head, Department of Higher and Vocational Education of the
Ministry of Education. Member, National Scientific Research Board,
since 1958, Director of all medical activities including the training
of military doctors for the Communist forces, 1946.One of the best
surgeons in Vietnam and author of a number of medical works..
Studied at the Faculty of Medicine in Paris, 1923-27. Visited USSR
and France. Born 1901.
 REFERENCES
The source references supporting this paper are identified in a
list published separately. Copies of the list are available to
authorized personnel and may be obtained from the originating
office through regular channels. Requests for the list of references
should include the publication number and date of this report.