Chad Hoyt and Tom Forsberg embarked on their first medical mission to Vietnam more than a decade ago, marking the beginning of an extraordinary journey. Motivated by their desire to increase access to health care worldwide, they sought guidance from their esteemed Vietnamese colleagues to determine the most effective way they could contribute. Their inquiry uncovered a profound reality: a lengthy queue of children and adults are awaiting life-saving cardiac surgery, which inspired the formation of Healing Hearts Vietnam. Our aim today is to delve deeper into the significance of this waiting list and shed light on some of the factors contributing to this phenomenon.
1 out of every 100 babies in Vietnam is born with congenital heart disease
There are only 20 pediatric cardiac surgeons in Vietnam to serve up to 50,000 children in need
In 2016, over 240,000 hours of life were lost prematurely from congenital heart disease
When a waiting list exists for such life-saving procedures, it usually signifies that there is an overwhelming demand for cardiovascular surgeries that surpasses the available resources and medical capacity. One crucial aspect to consider is the high prevalence of congenital heart disease (CHD). In a recent systematic review and meta-analysis of over 250 studies about global birth prevalence of congenital heart defects, researchers concluded that Asian countries reported the highest rates of congenital heart disease worldwide (1). Furthermore, a study published last year reported that the Da Nang region of Vietnam specifically shows a significantly elevated total CHD birth prevalence of 14.7 per 1,000 births (2). What this means is that for every one thousand children born in Da Nang, 15 of them will have a congenital heart defect.
In Vietnam, the prevalence of CHD is relatively high, and unfortunately, the resources available to address these disparities are severely lacking. Despite witnessing an increase in the number of pediatric hospitals in the last decade, there continues to be a shortage of essential medical personnel, including nurses, cardiac anesthetists, and other specialists. Per the most recent data, the entire country has only 50 pediatric cardiologists and 20 pediatric cardiovascular surgeons. Moreover, the scarcity of vital equipment required for life-saving cardiac procedures further compounds the challenges. The country is facing shortages of crucial resources such as ambulances for patient transfers, echo machines for comprehensive heart evaluations, ventilators, monitors, IV pumps, specialized beds, and even sufficient facilities for post-operative follow-up. The deficit in available resources is also compounded by the arduous process of accessing treatment. Patients diagnosed must follow a long-winded, stepwise sequence that involves transfer from district hospitals to provincial hospitals and finally to city hospitals. However, pediatric cardiologists are often only seen at the city hospital level, which leads to a delayed diagnosis and worse prognosis in many cases (3). These inadequacies pose significant hurdles in providing comprehensive care and treatment for children suffering from CHD in Vietnam, highlighting the urgent need for focused attention and support to bridge these gaps in the healthcare system.
In conclusion, the existence of waiting lists for life-saving cardiovascular procedures in Vietnam reflects the overwhelming demand that surpasses the available medical capacity. The high prevalence of congenital heart disease in the country, especially in regions like Da Nang, further exacerbates the situation. Despite an increase in pediatric hospitals, the shortage of essential medical personnel and vital equipment presents significant challenges in providing adequate care for children with CHD. Additionally, the complex and time-consuming process of accessing treatment adds further strain to the already burdened healthcare system. To improve the situation and ensure timely and effective care for CHD patients, it is imperative to prioritize the allocation of resources, enhance medical training and infrastructure, and implement more streamlined processes for diagnosis and treatment. Healing Hearts Vietnam is committed to helping address these critical issues in multiple domains. Over the next few weeks, stay tuned to learn more about HHV's specific initiatives in the realms of screening, fundraising, partnering, and teaching. For specific questions, please feel free to reach out!
Please consider giving to further our mission of seeing all Vietnamese children and their families receive life-saving heart surgery. Your contribution, no matter how big or how small, makes a significant difference!
Nick and Aaron
1) Liu Y, Chen S, Zühlke L, et al. Global birth prevalence of congenital heart defects 1970-2017: updated systematic review and meta-analysis of 260 studies. Int J Epidemiol. 2019;48(2):455-463. doi:10.1093/ije/dyz009
2) Giang HTN, Hai TT, Nguyen H, Vuong TK, Morton LW, Culbertson CB. Elevated congenital heart disease birth prevalence rates found in Central Vietnam and dioxin TCDD residuals from the use of 2, 4, 5-T herbicides (Agent Orange) in the Da Nang region. PLOS Glob Public Health. 2022;2(10):e0001050. Published 2022 Oct 12. doi:10.1371/journal.pgph.0001050
3) Phuc VM, Tin do N, Giang do TC. Challenges in the management of congenital heart disease in Vietnam: A single center experience. Ann Pediatr Cardiol. 2015;8(1):44-46. doi:10.4103/0974-2069.149517