Recorded at the "center" of measles epidemic

(Baonghean) - ... Arriving in Tuong Duong, we received news that Pieng Coc village, Mai Son border commune, was having an outbreak of measles-like rash fever, with 48 children infected... Asking for directions to Pieng Coc, Deputy Director of Tuong Duong District Preventive Medicine Center - Mr. Tran Van Cong said that the only way was to rent a boat along the waterway of Ban Ve Hydropower Reservoir for about 4 hours; or go by road up to Ky Son and then down to Pieng Coc for more than 3 hours. To avoid loneliness, we chose to go by road...

Pieng Coc Night

At 1:30 p.m. on October 14, I set off with a veteran from Hoa Binh Town (Tuong Duong) who works as a motorbike taxi driver. We passed through Muong Xen Town, Ta Ca, Pha Danh, Huoi Tu, My Ly communes of Ky Son district, and then headed down to Mai Son. To get to the center of Mai Son commune, we had to take a boat across the Nam Non River at Nhon Mai Border Guard Station, located in Huoi Mun village. And to get to Pieng Coc, where 100% of the Mong people live, it took another hour. It was past 6 p.m., but it was already dark and freezing cold.

Doctors and nurses at the field hospital check the children's health.

To combat the rash epidemic in Pieng Coc, Tuong Duong district has set up a field hospital at the primary school. Here, in addition to 12 medical staff and doctors from the Preventive Medicine Center, Tuong Duong District General Hospital, Nhon Mai Commune Health Station, Mai Son Commune Health Station, there are also staff from the Provincial Maternity and Pediatrics Hospital and 2 medical communication staff. Pieng Coc villagers, commune officials and management board are all happy to have more staff and doctors from the province. The handshakes at night are so tight, as if sending wishes.

Monitor severe cases at night

Pieng Coc, like the entire Mai Son commune, currently has no electricity grid but uses mini hydroelectric generators that the locals have installed along the stream. Under the dim light, two doctors from the Obstetrics and Pediatrics Hospital, although tired from the long journey, quickly joined medical staff and doctors from Tuong Duong Hospital to check the condition of each child aged 1-14 who were arranged for treatment in two classrooms. One room had 7 seriously ill children, and the other room had 9 children who were basically stable. On the tiled floor where the children lay, there were only simple mats and woolen blankets. According to the Mong doctor Va Ba Tua - Head of the Nhon Mai Medical Station who was mobilized to help Mai Son, from October 10-12, there were 3 treatment rooms, because at that time there were 48 sick children. Currently, 32 children have completely improved and have been sent home for monitoring.

Milk support for children in Pieng Coc

On the night of October 14, the children were still very tired, but they were almost no longer in a state of lethargy. According to Dr. Tran Van Cuong, Deputy Director of the Obstetrics and Pediatrics Hospital, through clinical examination, the children were likely to have measles. With this type of disease, doctors and nurses must follow the treatment regimen of the medical sector. I took the opportunity to talk to the officer in charge of the field hospital in Pieng Coc, Dr. Lo Van Hung - Department of Pediatrics, Tuong Duong General Hospital. Dr. Hung said: At 9:00 a.m. on October 10, I received instructions from the district, gathered people, prepared some medicine and set off. At 9:00 p.m., we arrived in Pieng Coc. At this time, the children were in a state of lethargy, looking very anxious and examining them, while giving them medicine, the working group contacted the district to set up a field clinic at the Pieng Coc Primary School. On October 10, 38 children were sick, 11 of whom were very seriously ill. Early in the morning of October 11, we discovered 10 more children with high fever. After consulting and reporting to the Medical Center and District Hospital, although we had not yet examined or taken samples for testing, we diagnosed the children with measles and prescribed appropriate medication. After being here for 5 days, all members of the delegation were “3 together” with the children for 5 days. And tonight was the same...

Some children's illnesses improved and they were able to return home.

Near midnight, the field hospital staff arranged for us to rest in a classroom next to the room of the seriously ill children. The place to rest was a thin mat on a brick floor, with a few thin blankets. Doctor Va Ba Tua and physician Kha Van Dau lay next to us, covering their faces with blankets to ward off mosquitoes and explaining the "difficulty" of this remote place: "You guys try to sleep, we can only lie here. We have to get up to check on the children later." The later it got, the colder Pieng Coc became. In the next room, the children occasionally coughed and cried. Every time like that, Doctor Tua and physician Dau got up...

The delegation of the Central Institute of Hygiene and Epidemiology consulted

Difficult in every way

Since the field hospital was established, the order to "no one goes out, no one comes in" has been given within Pieng Coc village. Children from Pieng Coc village who study at the commune center must stay in the dormitory, and those who have already returned home cannot go to school. Pieng Coc primary school is also closed to prevent the spread of the disease to other villages.

One issue that everyone is very concerned about is, where did the epidemic originate? According to Dr. Va Ba Tua, it came from Laos. Since around August 2014, two villages Pha Danh and Pom Bai in Laos have had a rash epidemic. In Pha Danh village, 4 children died; in Pom Bai village, 17 children. These two villages are only a mountain away from Pieng Coc, a nearly 3-hour walk. When there is sadness in Pha Danh village in Laos, Pieng Coc families often carry their children to visit relatives. On September 22, a couple in Pha Danh village brought their two sick children to Nhon Mai to be treated by Dr. Va Ba Tua. To get to Nhon Mai, the couple slept in Pieng Coc. "I think the fever epidemic in Pieng Coc originated from that," said Dr. Tua.

Pieng Coc village medical officer, Mr. Va Ba Xeng, also agreed with the reason Doctor Va Ba Tua mentioned. According to Va Ba Xeng, because there were many sick people in Pha Danh, he went to examine and treat some patients...

Pieng Coc has 52 households, 375 people located on high mountains, isolated, transportation is very difficult, the climate is harsh, hot and cold irregularly. The life of the people here is very poor, all activities are simple, environmental hygiene is not guaranteed. For example, young children with high fever need to wear enough warm clothes, but most of them only wear thin clothes. Meals other than rice are beans dipped in salt and boiled bean water, so they are often malnourished, have low resistance. During our time in Pieng Coc, we had a meal at the house of the village chief Va Xai Cho, so we understood this. Although he is the village chief, Va Xai Cho's house is just like other families in the village. In the house with dirt floor, black wooden roof typical of the Mong people, there are no valuable items, the way of living and environmental hygiene is still inadequate. Doctor Va Ba Tua said: “It is too difficult. Medical equipment and human resources are limited. Pieng Coc people are too poor, and their awareness is limited. Their way of living has not changed. The overall hygiene of the village is poor. Personal hygiene is also poor. Therefore, the work of preventing and fighting all kinds of epidemics is very difficult..."

At 12:30 on October 15, Pieng Coc was welcomed by a delegation from the Central Institute of Hygiene and Epidemiology. At this time, of the 16 children still in the field hospital, only 3 had a high fever. The remaining children were conscious. Mr. Nguyen Van Dan, Head of the Epidemiology Department of the Provincial Center for Preventive Medicine, said: Since the outbreak of Pieng Coc, he and the staff of the Provincial Center for Preventive Medicine collected 16 samples to bring back for testing. And so far, the results have been released, 12/16 samples were positive. This means that Pieng Coc is the epicenter of the measles epidemic. Therefore, the delegation from the Central Institute of Hygiene and Epidemiology, in addition to participating in professional issues, requested the Tuong Duong Medical Center to take all measures to prevent the epidemic from spreading to other places; not only the villages in Mai Son commune, but also the communes in the area...

After 20 hours of staying, at 1:30 p.m. on October 15, we left Pieng Coc with mixed emotions. Happy because the epidemic control work has made a lot of progress, the health of the children has had many positive changes... Worried and anxious because here, people's awareness is still limited, while medical facilities and human resources are still too difficult. The lingering question: What should be done to take good care of people's health?!.

Article and photos:Nhat Lan