afpa and vietnam psychiatric association hold psychiatry-training course in ha noi

Asian Journal of Psychiatry 5 (2012) 206–207

Discussion

AFPA and Vietnam psychiatric association hold psychiatry-training coursein Ha Noi

M. Parameshvara Deva, Russell D’Souza

Vietnam is a large largely tropicalcountry of well over 90 million peoplein the heart of southeast Asia. Al-though its ancient history is well over2500 years old it is Vietnam’s recentpast that the world is more aware of.Few in modern times have heard of theancient Dong Son Drums or the ancientCham empire that ruled over parts ofneighbouring countries besides southVietnam Following World War II theVietnamese communist party underthe leadership of Ho Chi Minh opposedthe return of the French colonial powerwho had ruled French Indochina priorto the war. The guerilla war thatfollowed ended in the northern partof the country with the fall of the largeFrench base at Dien Bien Phu in 1954and the talks that followed led to thedivision of the country into a NorthVietnam and a South Vietnam belowthe 17th parallel. The south was ruledby the French and later a Vietnamesegovernment. The guerilla army contin-ued the struggle into the south whenthe French left Vietnam and this led toa huge intervention by the US and itsallies who were defeated in 1975.Vietnam was once again reunited inApril of 1975.

Since the reunion of Vietnam anddespite tremendous war damage, priva-tion and damage to infrastructure theunited country has re-built the countryalmost from scratch, and started to healthe wounds of over 30 years of war byJapan, France and the US. Today Viet-nam has the fastest growing economy insoutheast Asia and striving to developits war deprived social and health caretraining and services.

There were big differences in thehealth and mental health services in

the south and the north. While theNorth after the departure of the Frenchpatterned its mental health trainingand services on socialist modelslearned from China and Russia, theSouth depended on a more westernmodel of the 1950s. Thus in 1975 therewere in place 2 different systems ofmental health care – one for the Northand one for the South. The one in thenorth relied on 2 large mental hospitalsin Bien Hoa near Saigon (now renamedHo Chi Minh City) and one for thecentral provinces in Da Nang. Theconcept of Community care and dis-trict level mental health care andpsychiatric beds outside of the 2 largemental hospitals was very limited. Theproblems in the South were largely thatof very limited trained humanresources as French trained psychia-trists were scarce beyond the budget ofthe ministry of health. In the Northhowever a rough and ready systemtraining of new medical graduates withless than 1 year of training in psychia-try, training of Feldshers or Medicalassistants as front line mental healthworkers was put in place after 1954 bythe newly independent Vietnam. Itcovered cities, towns and villages.While the training was basic andavailable in the North, the serviceswere hospital based and specialisedbut largely unavailable to those outsideof the 2 large mental hospitals of theSouth.

Post-1975 the re-united governmentof Vietnam embarked on a two prongedapproach to enhance mental healthtraining and services. The mental healthservices were extended to most parts ofthe country up to subdistrict level. At thelevel of mental hospitals 35 were set up

with over 5000 beds including 3 underMinistry of Health. A further 6000 bedsare under ministry of Labour, Veteransaffairs and Social welfare. A further 21psychiatric wards are integrated intoprovincial level general hospitals inVietnam. The move to provide commu-nity care for the mentally ill covers 56 ofthe 64 provinces and some 1305 of the11500 subdistricts have subdistrict levelmental health services. Plans are underway to extend the provision of mentalhealth care to more centres at thesubdistrict level.

To train mental health humanresources a variety of training pro-grammes spearheaded by the Instituteof mental health and the First NationalPsychiatric Hospital in Hanoi have orga-nised an elaborate training system. Thepsychiatrists today number 850 ofwhich 400 are postgraduate level trainedmostly at the Institute of Mental Healthat the Bach Mai hospital in Ha Noi. TheInstitute of Mental Health with 50 staffincluding 20 psychiatrists and 165 inpa-tient beds has a busy training pro-gramme including training for over 500medical students, 200 nurses and tradi-tional medicine students. There are also15 PhD and 50 Masters students. Theinstitute works closely with the 500bedded First National Psychiatric Hospi-tal and the Armed forces medical collegein Hanoi.

With such an elaborate network ofmental health service centres there is aneed for quality assurance and trainingof human resources. In the past withindependence the only source of assis-tance from overseas was from socialistcountries and several of the senior staffwere trained in Russia, Germany, PRChina and Eastern Europe. In recent

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M.P. Deva, R. D’Souza / Asian Journal of Psychiatry 5 (2012) 206–207 207

years more psychiatrists from Australia,US and Europe have visited Hanoi andHo Chi Minh City and given lectures atthe institute. However a longer-termpractical assistance is needed especiallyto upgrade theoretical bases of modernpsychiatry and practical skills in diag-noses, treatment and rehabilitation.

AFPA with the WPA Section onPsychiatry in Developing Countriesjointly ran a 2-day course on Updatesin Psychiatry with an international teamof 5 psychiatrists from Australia, Indiaand Malaysia together with local Pro-fessors from Ha Noi University on 14 and15 April 2012 at the First NationalPsychiatric Hospital in Hanoi. Thepacked programme was attended byover 100 psychiatrists from Hanoi andprovinces from afar a field as theMekong Delta, to Da nang, Hue andDien Bien Phu near the Laotian border inthe north.

The AFPA team also discussed coop-eration with the Vietnam Psychiatric

Association and assistance for the VPAto join AFPA, WPA and ASEAN federa-tion for Psychiatry and Mental Health asa member association. The University ofHa Noi is to establish a UNESCO Bioeth-ics Unit of the Asia Pacific Bioethicsnetwork with AFPA’s support. The Viet-namese Psychiatric Association willaffiliate with the Asian Journal of Psy-chiatry and Plans for regional training inpsychiatry for psychiatrists and PrimaryHealth Care workers were discussed andfurther discussions will follow. Onepsychiatrist from Vietnam is already amember of the AFPA Earlier CareerPsychiatrists network

NEWS

The Asian Federation of PsychiatricAssociations takes great pleasure incongratulating Professor Shigeto Yama-waki the first Asian to be elected asthe President of the Collegium Interna-tionale Neuro-Psychopharmacologicum.

Dr. Shigeto Yamawaki is Professor andChairman of Psychiatry and Neuros-ciences, Hiroshima University, Japan.He has served as Councilor (2000–2004)and Secretary (2004–2006) of the CINP,and editorial board member of the IJNP.He served as President (2006–2008) of theInternational College of Geriatric Psycho-neuropharmacology (ICGP), and was afounding President (2008–2010) of theAsian College of Neuropsychopharma-cology (AsCNP). The major focus of hisresearch is on the neurobiology andclinical psychopharmacology of mooddisorders. His interest includes the mo-lecular basis of early adverse life eventson vulnerability for major depression,and the neuroimaging study on moodregulation using a visual emotion taskand a future reward prediction task. Hehas published more than 300 papers inthe high impact international journalssuch as Nature Neuroscience, BiologicalPsychiatry, Journal of Neuroscience aswell as IJNP.