War Reparations

June 3, 2016
What is fifty years of suffering worth?  Forget about the millions of gallons of toxic Agent Orange herbicide and the tons of explosives dropped on Vietnam, a tiny country once considered by the World Bank to be one of the poorest in the world.  Forget about the millions of Vietnamese people killed in what Vietnamese call "The American War." Here is the result of one careless and malicious kick by an American soldier fifty years ago:
This is what results from 50 years of walking with a ruptured medial collateral ligament in your left knee--gross deformity of one's body plus excruciating pain in the opposite knee and the arms that are trying to compensate for the load that the injured leg cannot bear.  This poor woman, who is now in her eighties, has dragged herself around for fifty years like this.  She used to walk with crutches, but had to give them up as she kept falling down.  Most recently, she walked supporting much of her weight with her hands pressing down on a plastic stool.  When even that was becoming impossible due to the worsening arthritis in her "good" knee and in her arms, she came to the Traditional Medicine Hospital of Da Nang in a desperate quest for help.  At this point, her entire body appeared twisted from the decades of maladaptive ambulation to which she had been reduced.  There was no quick fix available for her.

And so we did two things:  first we assigned Vu, a young Vietnamese therapist who had recently completed a course in Myofascial Release therapy conducted by Joni and Roger Edmonds at our hospital, to help stretch out her tortured body so that she could sit and stand erect.

Then we asked Mr. Anh, a local orthotic technician, to fabricate a custom brace for her that would stabilize her injured knee so that she could bear weight upon it. 

And now, Vu and Hien, two of the young therapists that I have been training for the past two years, are working with this elderly woman in order to help her regain her ability to walk on two feet, with the support of her new brace and a walking frame.

What was the cost to Steady Footsteps, our organization?  One hundred US dollars for the custom brace and the sandals to go with it.  That works out to two dollars a year for fifty years of suffering.  There's a message in there, somewhere.

Photos From Our New Out-Patient Facility



A young Vietnamese banker who has suffered a stroke (CVA) works to regain functional use of his hand and arm under the care of American and Vietnamese therapists at the new out-patient facility of the Traditional Medicine Hospital of Da Nang, located at 342 Phan Chau Trinh Street. In addition to neuro-rehab and treatment of chronic and acute pain, this facility also provides effective and affordable treatment of heroin addiction via acupuncture and other traditional remedies.

 A motorbike taxi driver rejoices in regaining both the use of his right arm and his ability to balance on a two-wheeled vehicle with the help of Thuy, an American-trained Vietnamese physiotherapist. More info on physical therapy in Vietnam here.


Tea shop at the new out-patient facility of the Traditional Medicine Hopsital of Da Nang, located at 342 Phan Chau Trinh Street features the art work of disabled artist Nguyen Tan Hien.

Recipe for Success



I've been a physiotherapist in Vietnam, volunteering in four different hospitals, a school for disabled kids, and out in the community in Da Nang, Hoi An, and rural Quang Nam since 2005. And while my first years here were certainly educational for me and afforded me the opportunity to personally help countless disabled Vietnamese people, I--like every other foreign therapist I have spoken with--was unable to make any significant impact upon the way in which Vietnamese-trained physiotherapists practice physical therapy. As you can see from earlier blog posts, I had in fact given up on trying to change practice here and instead, since 2010, been focused solely on providing hands-on rehab for patients at the Traditional Medicine Hospital of Da Nang, a 140 bed non-acute facility that had an abundance of stroke patients, but not much to offer in terms of physiotherapy.

However, when Dr. Nguyen Van Anh became director of the facility a year ago, everything changed. Not only did he immediately begin renovating the sadly deteriorated hospital and grounds, he also initiated several new projects, including a widely acclaimed drug rehab program. And--of particular interest to me--he brought in a large number of newly graduated Vietnamese therapists on a probationary basis and told them that if they wanted to work in this hospital, they would be required to follow and learn from me. This has made all the difference in the world! Although neuro-rehabilitation is an especially challenging aspect of physical therapy and although their earlier training had left them without the ability to evaluate, plan and implement effective treatment regimes for individual stroke patients, our young therapists have been doing their very best under my guidance. I would not say that they are "world class" therapists at this point, but they are head and shoulders above any other therapists that I've encountered in the ten years I've been volunteering in Vietnam. And they continue to improve with each new patient that they treat. I am so very proud of them!

 
 Remarkably, word of mouth has already brought us an ever increasing number of patients from the city of Da Nang itself and also from Hoi An, Quang Nam, Quang Ngai, and Hue, as well as from the mountainous region to the west and the off-shore islands of Cham and Ly Son. In fact, in the days immediately following the Tet holiday this year, 45 stroke patients were admitted to our service while other nearby rehab facilities received but a few. Our patients now include not only those who had been frustrated by ineffective rehab treatment they had received elsewhere, but also new stroke patients, transfered to us directly following their initial acute stay at the General Hospital of Da Nang.


 Dr. Anh has a new vision, and I'd like to help him achieve that as well. We would like to create an effective Early Intervention program for children with cerebral palsy and developmental delays. Existing child rehab programs in Da Nang attempt to deal piecemeal--with very minimal success--with older children who have already developed contractures and/or maladaptive movement patterns. We want to catch kids early and work together with the child's family to guide them on a developmental path which holds the best potential for their optimal development. Thanks to our open-minded therapists and to our supportive administration, we have a wonderful opportunity to do something great for the disabled children of Da Nang and their families. Now all we need is an experienced foreign paediatric physiotherapist to guide us in our efforts. If you know of anyone who might be interested in such a long-term volunteer opportunity, please send them our way!


Slow and Steady Wins the Race



By Thanh Nguyen, Thanh Nien News


An unusual journey from the US to Vietnam took physiotherapist Virginia Lockett and her artist husband David Lockett 11 years, but it is not one that they regret one bit.

In 2006, they sold their house in America and moved for good to a country they’d only visited twice earlier, the first time in 1995.

During the process of making this momentous decision, they’ve been helped by their ability to change the lives of many disadvantaged Vietnamese people for the better.

After settling down in the central city of Da Nang, Lockett started volunteering as a physiotherapist at several local hospitals.

Meanwhile, Steady Footsteps, a non-profit organization that they’d founded prior to their moving, has worked to provide walkers, canes and pump-action carts for poor patients. Funds for this work have come from their savings and donations from other individuals and charities.

Sometimes they provide more than just a piece of equipment.

For instance, a man who had his legs and part of his arm muscles weakened by a spinal cord tumor was helped to open a small grocery shop at home and given a used three-wheel motorbike.

They have also distributed 3,400 helmets for healthcare workers in Da Nang, winning recognition and praise from the city’s Department of Health.

Fateful encounter

Lockett said they first visited Vietnam to adopt children in 1995.

The trip not only helped them find a daughter and a son but also made her, a professional trained to work with physically impaired people, realize how “hopeless” the situation was for people with disabilities in Vietnam.

Upon learning of her expertise, a man who assisted them with adoption paperwork in the central resort town of Nha Trang took them to meet his 65-year-old father who had been bed-ridden for five years after a traffic accident and a stroke.

The old man’s circumstances would have been much different had he been in the US or Canada, where he would have undergone orthopedic surgery for his injury soon after the accident, and walked again with assisting devices and therapy in a few weeks, she said.

Therapy would have also helped him recover from the stroke, Lockett said.

It struck her then that “there must be thousands and thousands of disabled Vietnamese people, spending their lives on floors and in beds, simply because they lack the medical and rehabilitative care that we take for granted in the west.”

“I didn’t know what I could do about it, but it haunted me.”

Ten years later, in response to a call from a North American non-profit organization, Lockett flew to Da Nang as a volunteer clinical instructor at the Da Nang Orthopedic and Rehabilitation Center.

For the second trip, she packed a variety of devices that she knew was unavailable and unaffordable in Vietnam so that she could give them to her future patients. Many of pieces of equipment were adjusted by her husband, who was also travelling with her, to fit Vietnamese recipients.

Lockett said the trip was long enough for her to realize why physiotherapy in Vietnam was almost ineffective, even with the help of experts from international NGOs.

Instead of being instructed to do functional activities like getting out bed, patients were asked to perform “very simple passive exercises,” she explained, adding assistive devices were also insufficient.

Helping some patients “truly” recover during the time she worked convinced Lockett that she could use her skills and training to improve the lives of many people with disabilities in Vietnam.

Better work

Lockett said in an interview with Vietnam Television that in the US, a physiotherapist can get tied up with lots of administrative tasks including documentation and limitations related to insurance, but here in Vietnam, she is free to do the best she can to help her patients recover.

Her dedication has won her a lot of respect and admiration from her Vietnamese colleagues.

“Rain or shine, she always comes to work on time and is dedicated to treating her patients,” said Nguyen Van Anh, director of Da Nang Traditional Medicine Hospital, where Lockett has worked for over the past three years treated some 300 patients so far.

Dr. Nguyen Kim Dieu of hospital praised her treatment methods, saying that depending on each patient’s condition, she would design suitable exercises that can help the patient regain his or her ability to do particular, practical tasks.

While there is an interpreter to help with the language barrier, Lockett is also admired for her ability to communicate well with patients who suffer speech and brain disorders caused by strokes or traumatic brain injuries sustained in road accidents.

She first establishes eye contact with them, and then directly demonstrates what they should do instead of explaining it verbally.

“I love this work and what I’m doing now is what I wanted to do when I first came out of the physical therapy school,” Lockett said.

She said although it might seem “very noble and selfless” of them to leave an American lifestyle for living and working as volunteers in Vietnam, their life here is “so much less stressful and more meaningful” than it was in the US.

Artistic talents

The Locketts now also run the Da Nang Artists Company, which markets paintings and embroidery works made by people with disabilities that the wife meets during her volunteering work.

Lockett said they were inspired to establish the company after meeting Nguyen Tan Hien at the Da Nang Rehabilitation-Sanatorium Hospital in 2007.

Hien, who hails from the Central Highlands town of Buon Ma Thuot, had been in the hospital for three years then. His legs and part of his arms were paralyzed after he was hit by a bus.

The accident forced him to stop his university studies as a mathematics major, but it did not prevent him from pursuing his dream of getting into an art school and becoming a professional artist.

He asked Ho Viet Phuong, an architecture student who was paralyzed by a spinal cord tumor, to teach him to draw during free time, so that he could pass the school’s entrance tests.

However, to his dismay, Hien discovered that all drawing classes were on the school’s second floor, meaning that he could not access them on his wheelchair.

Lockett said her husband recognized Hien’s talent and told him that he could become a real artist without going to school, because many famous artists in the world were self-taught.

They asked him to draw pictures that they could use for printing postcards and greeting cards for Steady Footsteps. He was offered US$10 for each picture, and in the end he earned $100 for works that he drew with a pencil tied to his fingers with rubber bands.

Hien said that later, Lockett returned after a short visit to the US and told him two stories that he could illustrate for her.

“She kept encouraging me to continue drawing, and buying my paintings to hang them in her house or give as gifts to others,” he said.

With continuous support from the Locketts, Hien was slowly able to grow from drawing with pencils to doing water colors and even acrylic paintings.

The American couple helped market his paintings online and found buyers from different parts of the world like Canada, Hong Kong and Singapore.

Hien’s works have since been displayed at a couple of local and international exhibitions. The appreciation and acceptance that he received for his works have given the artist a lot of self-confidence and belief. He is now happily married and works as a consultant for other people with disabilities.

“Throughout my journey, Ms. Virginia and her husband are always by my side. I respect them and love them as my family,” Hien said.

“We’ve helped and worked with lots of people since we were in Vietnam, but Hien is very special to us,” Lockett told Vietnam Television.

“It’s a rare thing when you can have such a big impact on somebody’s life. It’s an honor.”

Yes, We're Still Here!



Well, it’s been over a year since my last post on the Steady Footsteps blog, though there’s quite a bit of new material on my other blog, A View from Vietnam. We’re still in Da Nang and we’re still busily engaged in trying to make life better for disabled folks in Central Vietnam.
 

 Trang, Huy, and I have been working together at the Traditional Medicine Hospital of Da Nang for more than a year now and hope to continue for the foreseeable future. The majority of our hospital patients have suffered strokes, though many at a younger age than I had been accustomed to seeing in the States. (Our most recent is only 17 years of age!) We’ve also worked with divers from Quang Ngai who sustained spinal cord damage due to decompression sickness (aka: “the bends”) and--of course--victims of traumatic brain injury due to motorbike accidents.
 

 Our work in the community has continued as well. In Dai Hiep, four year old Phuoc, who has cerebral palsy, has started to speak and continues to try valiantly to perfect his head control and gain functional use of his arms. Tiny ten-year-old Nhon, who has what appears to be a pituitary disorder, has transformed himself, with our help, from a weak and listless waif into a dynamo on wheels! Farther afield in Quy Son, Trang has been traveling an hour each way via motorbike to become, in essence, a Guardian Angel for Hoa, a head-injured young woman with coordination problems that I’ve been following intermittently for the past four years. Under Trang’s care, Hoa has started speaking, doing more and more activities of daily living independently in her home, and even getting out into the community for the first time in four years on the back of Trang’s three-wheeled motor bike.


 Finally, our efforts to promote the financial success of disabled artists of our acquaintance have led us to formalize a business called The Da Nang Artists Company. (A Vietnamese language version of the site can be seen here.) Through our efforts, paintings by Nguyen Tan Hien, our quadriplegic artist and friend, are now offered for sale not only by us, but also via another on-line gallery based in the UAE: liborius-xu.com Hien’s proudest, however, of two very different accomplishments this year. He and his wife Ly now have a baby son and a little one-bedroom house of their very own!