This Article appeared in the Washington Post:
Saturday, May 27, 1972 by Coleman McCarthy
WASHINGTON --The shambles that war has made of Vietnam in the past 25 years is easily measured by counting the millions of lives lost and the billions of dollars wasted. Less easily measured is the suffering that will go on among the survivors; in many cases, it will last as long as the victims live but in all cases for as long as the rage persists. The deepest cruelty in Vietnam is what the children have suffered, because they are the true innocents among those who started the chaos and then kept it going without great concern for the human suffering.
A year ago this spring, a French doctor named Marcel Diennet, 28, doing optional military service, left his Paris home to do general practice in Saigons large Gralle Hospital. What he has done during this time -in service to luckless orphans who are young, crippled and Vietnamese -is one of the eruptions of mercy that occasionally spring up no matter how heavy the cruelty of war.
Early in his stay in Saigon, Dr. Diennet happened to wander into a large building in a suburb called Phu-My where a group of Catholic Vietnamese sisters give refuge to 1,500 of the citys old, blind, poor and orphaned, all homeless. He looked through the wards and discovered that many -about 30 -of the children were crippled by polio. In medical school, Diennet had volunteered in Biafra and had worked in a jungle polio clinic. "I had an interest in the disease, so I proposed to the sisters in Saigon that if they would give me space at their refuge, I would come and work in my spare time to treat the polio orphans."
The sisters, overjoyed to get a doctor to work among their outcasts, made plenty of space. By May 1971, Dr. Diennet was pulling 40 hours a week at Gralle and at least another 20 hours, sometimes 40, at the Phu-My refuge. Word spread quickly that a doctor was present, and soon polio orphans appeared in large numbers.
Diennet worked at the refuge through the summer. By October, he had fashioned a small center of 100 beds for his patients. Much of it was improvised from the scraps of war, using discarded sandbags as leg weights, the straps of old parachutes to bind broken bones, throw-away beds from a nearby Navy camp, junk-pile bicycles that had no tires but were valuable as stationary exercisers. A group of American soldiers, volunteering help, built a needed therapy pool.
"Its touching," says Diennet, "to see the eagerness of some of the American soldiers who come around to help. Its as though they want to be sure of doing at least one thing in Vietnam that is worthwhile."
As with all doctors of perception in a foreign country, Diennet found that understanding and valuing the local culture is crucial. A major problem, he believes, "in treating the Vietnamese polio orphan is that the people have a special cultural view of children. Traditionally, Vietnamese parents and families are easygoing with their young, pampering them and not demanding much. But to treat them for polio requires that they must undergo painful therapy. A mother with a crippled child would prefer to treat him by just letting him sit alone, bring toys to him and never disturb his passivity lest he be pained. The mother reasons that hell never get better, so at least let him have some comfort.
"It was difficult to train the Catholic sisters -who come from this culture -to be strict and firm with the children, to give them orders about therapy schedules and exercising. The Vietnamese are not forceful by nature, but if the polio patient is to have half a chance he has to undergo painful and long therapy."
-->In talking to Americans, Diennet finds that nearly all of them are amazed that polio exists in Vietnam at all. "It is now a rare disease in their country, so they think it is rare everywhere. But polio is widespread in Vietnam -something like 100,000 victims. Another reaction of Americans, when you get this fact across, is the way they say: "Well, if theres a polio problem, lets just ship over enough vaccine to eliminate it." That"s fine, but it doesnt work that simple. First, theres the enormous com-
ting trained people to go into the provinces and find the people. And second, the vaccine -even if you could distribute it easily, which you cant -prevents the illness, not cures it. What about the 100,000 children who have it now. How do they get on?
A final reason that polio is common, Diennet believes, is that Vietnam has been a war country for 25 years, first the French coming and then the Americans. The country is devastated physically and the people are drained spiritually. "Base survival is now everything for so many people. Citizens are obsessed with ways to get money, legally or illegally. Money means survival. The people are so broken by all the war that a sense of civic responsibility is gone. How can you have high social thoughts when you have a daily struggle just to get by? This is not to criticize the Vietnamese people. It would be the same in America or France if we had a war on our soil for 25 years. Thus, sick children are easily cast aside. They are not important for survival."
Aside from the war and the corruption, Diennet also spoke of the high rates of cholera, typhus, malaria, even bubonic plague. With all this, polio is often put far down on the list, if on the list at all.
The Vietnamese culture has also figured in the expansion of Dr. Diennets center. Last October, the sisters gave him a five acre site on which to build if he wished or could. His plan is not to construct a western-style high rise hospital but a village for patients. In the center of it would be a low one-floor building for operations and therapy, surrounded by satellite homes where the orphans would live. A finished school is already up, plus a playground.
healthy, so why not when they are sick. He notes with sadness that the Americans have built many hospitals in the provinces, ones that were technically advanced and of superior construction. "But now the Americans are gone and the local people cannot manage the hospitals because they have few technical skills. The hospitals have been turned into hotels. The sick are as abandoned as before."
Diennets immediate goal is to treat as many polio patients as possible on the least amount of money. He says that the governments Ministry of Health is the poorest of the Vietnamese ministries. Even though the Phu-My polio camp is part of the governments hospital system, each patient receives the equivalent of 12 cents a day. The nursing sisters are paid $12 a month.
Having little money for treatment means that the polio children have no braces for their legs, often the way the disease is best treated. Without braces, the children have one of two choices -dont walk at all or learn to walk in a new way. Diennet is working for the second option in the classic tradition of third world medicine -making out by making do. This means that physical therapy process becomes essential, demanding a personal commitment from the patient and therapist.
"The goal is mobility -for the child to get around. I dont care if he doesnt look pretty. I receive a twisted body and its still twisted when Im through. But by grafting muscles, realigning bones and teaching the patient to shift his balance in new ways the treated polio child has a twisted body that works."
For now, the Phu-My polio camp is a going operation, caring for 100 orphans. But what is that, asks Diennet, compared to the need? Currently, the French doctor is in the United States going around to foundations, government agencies and among doctors, telling them of his work and his methods. "Certainly money is needed for these children," he says. "Can you imagine treating a major disease like polio on 10 cents a day?"
Diennet is planning a return to Saigon at the end of May, to complete construction of the polio camp. It is one-third finished now. His immediate goal, aside from trying to heal sick children, is to train the Vietnamese sisters so they can one day run his camp themselves. And begin their own in other places, for more of the 100,000 polio victims. They should run things, its their country, Diennet says; not Frances, not Americas. Theirs.
"A French Doctor"s Viet Battle for Orphans With Polio", by Colman McCarthy, published in the Pacific Stars and Stripes Saturday, May 27, 1972 and reprinted from European and Pacific Stars and Stripes, a Department of Defense publication copyright, 2002 European and Pacific Stars and Stripes.