Friday, 14 November 2008

Extra Blog - Home Visiting in Hoi An, Vietnam

Home Visits in Vietnam – insurance required?
The last home visit I took part in was in inner-city Manchester (UK). Conducted solely by myself, I set off from the concreted car park in the comfort of my Ford Fiesta, contemplating what the future in Vietnam would have in store for me? After leaving my community base, I made it no more than five seconds before hitting my first, of several sets of traffic lights. After driving past the 24 hour supermarket complete with McDonalds, past the endless construction of several storey high rise flights, seeing students with their Ipods and laptops waiting for the next bus, I faced the same dilemma as always, was there space to park the car? I stood outside my client’s home, and as usual I waited for the intercom response to come... I always hated waiting for that terrible buzzing sound that offers you a split-second opportunity to yank the door open, before repeating the performance four times, until finally gaining access... My last visit was now over, and the uncertainty and excitement of working in a ‘new world’ could begin.
Wednesday, this week, May 2008, and my first experience of a home visit, Vietnamese style. Myself, and three colleagues (physiotherapist, interpreter, & medical director), set off from the office on two motorcycles, with a set of weighing scales being wedged between me and my driver. With almost no cars in sight, but bicycles and scooters as far as the eye could see, I began wondering how this visit would go. Total compliance is not necessarily used here, so after a short ride from the office to the boat, via a crowded market place and too many ambling tourists (something you don’t see too much in Manchester), we arrived at the river! I was pretty sure no one mentioned swimming anywhere and I was relieved to see the girls loading their motorbikes on the boat. A short ten minute boat journey ensued, (so much for waiting 20 minutes for the number 86 bus!), with my watchful eye placed on the motorbikes, as I was sure they could simply fall off the boat at any time. Despite my fears, we arrived safely on the other side of the river to continue our journey into the unknown, (known to the locals as the DX province). Once back on the motorbikes, we journeyed through a rural landscape of rice fields at fair speeds, on ‘roads’ that were wide enough for one bicycle and a chicken, whilst local children continually shouted out ‘hello’ in English, making me feel like I was on some kind of regal visit!
Once arriving at our first destination, almost the entire village came see what we were doing, and there was not an intercom in sight! This open fronted home, now housed the four staff members from CHIA, the family, and almost the entire village, who I was beginning to suspect just found us very amusing! Especially with my pasty white English skin! The local people are so inventive with the possessions they have and this first family had attached a baby’s cradle to a hook from the ceiling, which was ingenious as the child’s basket could be swivelled or tilted in any direction, which assisted the feeding of the baby who had a cleft pallet.
Our second destination, again an open fronted house offered a warm welcome and a family gathering to meet a 13 year old boy who was unable to walk, and had to be carried to a toilet by his parents. I hear you cry “get a commode”, ah not so simple... due to cultural differences, and the boy’s personal preferences, but could we allow access with either aids or adaptations? With three different levels of flooring, an old wheelchair and no local ‘disabled living centre’ nearby, it was going to be a challenge! After taking some measurements and discussing the situation with the family, we agreed to return to discuss options.
The journey home was just as eventful, Van (my driver) carried out a serious of wild evasive manoeuvres to avoid suicidal chickens, cows and ducks that clearly needed more purpose in their lives, other than acting as road blocks! After the return boat trip and with my feet on solid ground again, I felt exhilarated at the prospect of facing these obstacles again, on future home visits.
To end on a more reflective note, as my profession demands, I wanted to share with the reader the striking and powerful scenes and experiences I was exposed to on this single visit, and how it has allowed me to consider the environmental ‘challenges’ that are faced here by many people. Travel if affordable, is best achieved on a motorcycle with relatively large journeys required to reach children, and for children to reach us. As many families do not have the money to afford a motorcycle, many children cannot reach schools and many parents can not work far from home, limiting their employability. On a more positive note, the style of these houses, with open fronts, (no doors, windows etc) encourages support and trust of one’s neighbours which is perhaps something that in western culture, has been lost due to the mindset of enclosing ourselves in houses with walls, doors and windows with curtains! Thinking about this issue and the western societal pressures to increase personal ‘wealth’ with materialistic items and money, it is perhaps an area in life where the Vietnamese people can remind us that in the face of adversity and financially uncertainty ‘wealth’ is not simply a concept that relates to objects and possessions, but to people and the coming together of a community.

Dan Johnson
Occupational Therapist
CHIA (Childrens Hope In Action), Hoi An, Vietnam

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