Sharing with those less fortunate.

(Baonghean) - This week, images depicting the somewhat disturbing lives of mental health patients at the Nghe An Social Welfare Center have appeared on social media, attracting public attention. However, few people know about the difficulties and hardships faced by the staff and employees of this Center behind the scenes…

Located in Hamlet 1, Giang Son Dong Commune (Do Luong District), the Nghe An Social Welfare Center was established by Decision No. 1962/QD-UB dated November 23, 1995, of the Provincial People's Committee, based on its predecessor, the 202 Social Welfare Camp established by the Nghe Tinh Provincial People's Committee by Decision No. 61/UB/XDCB dated January 7, 1977. The Center's initial function and nhiệm vụ was to manage, nurture, and care for the elderly, disabled, and orphaned disabled children without a place to live. On March 11, 2003, the Provincial People's Committee issued Decision No. 828/QD-UBVX on the establishment of a mental health care facility within the Social Welfare Center, and began admitting mental health patients in 2004. Currently, the Center manages, cares for, and nurtures 140 individuals, including 122 mentally ill patients, while the remainder are elderly, lonely, and without family support.

The staff at the patient care center.

The Center's Director, Mr. Nguyen Xuan Phu, stated: "The workload is immense, but the number of staff at the Center is very small compared to the requirements. Government Decree No. 68/2008/ND-CP, which regulates the conditions, procedures for establishment, organization, operation, and dissolution of social welfare facilities, clearly stipulates in point d, Article 13, "Staffing Norms": For severely mentally ill individuals (agitation, terminal decline): 1 staff member cares for 2 individuals; for mentally ill individuals whose condition has improved: 1 staff member cares for 3 to 4 individuals; for mentally ill individuals who have recovered: 1 staff member cares for 8 to 10 individuals. Furthermore, in section 2 of this article, it is stipulated that staff members working in nutrition, including food preparation and cooking: 1 staff member serves 20 individuals... However, as of now, the total number of staff, civil servants, and contract workers at the Center is only 27 people." Of these, 17 staff members regularly interact with patients, including 10 medical staff, 4 nutritionists, and 3 security guards. Furthermore, the center's grounds are very large, covering 6 hectares, with three scattered buildings (administrative, elderly care, and mental health care), making movement, cleaning, and supervision quite challenging.”

Despite the constant challenges, the staff here have strived to overcome them and perform their duties well. Of the 27 staff members at the Center, 12 are women working in the medical and nutritional care departments, most of whom have young children. Having worked for many years caring for mental health patients, Ms. Ho Thi Ai (born in 1962), from Nam Dan district, shared: “In 1983, I started working at the Center. Back then, the work was hard but not as stressful as it is now. Since 2004, when the Center started admitting severely mentally ill patients, we have faced many fears. I and some colleagues have been assaulted by patients, even having our clothes torn many times. Most of the women working here have to cut their hair short to avoid being grabbed and pulled by the patients when they become agitated. However, thinking about those less fortunate and because of our work, we motivate ourselves to overcome everything and fulfill our duties.”

Nguyen Thi Hang (born in 1985), a staff member in the nutrition care department, has a very difficult family situation. She started working at the Center in 2008. Her husband works as a factory worker in Thanh Hoa, and she single-handedly raises two young children – the eldest is 5 years old, the youngest is less than 2 – while her mother-in-law is bedridden due to a stroke. Hang confided: “Despite my family circumstances, I think I’m still luckier than many others because I’m healthy, I have a husband and children, and a warm family. Most of the patients being treated at the center are almost abandoned, rarely receiving attention from their relatives. Sometimes they have episodes, acting crazy, even hitting us, but normally they are very gentle, sometimes even shy and pitiful.”

Medical officer Nguyen Van Ba, Head of the Health Department of the Center, added: “The people with neurological disabilities here are all cases where families or local communities are powerless in managing and caring for them, and many are classified as potentially dangerous to society. For them, the line between good and evil is very thin. They can have a seizure at any time. Even I have been assaulted and injured by patients many times. Therefore, the staff at the Center always emphasize the importance of being approachable and friendly when interacting with patients to avoid provocation, but always remain vigilant to prevent incidents. When on night duty, when checking patient rooms, we must go in groups of 2-3 people to protect each other.” Yet, there have been many cases of injuries, even serious injuries, due to assaults by patients. In 2014, Mr. Nguyen Trong Hung, a security guard at the Center, was assaulted by 3-4 patients and had to be hospitalized with multiple injuries. The women still feel sorry when mentioning the case of Ms. Ng. T. Ch, a staff member in the nutrition care department, who suffered three miscarriages due to the excessive pressure of her job… Despite the hard work and dangers, many staff members here have low incomes, such as Mr. Bui Huu Tai and Ms. Nguyen Thi Nhung, who, despite having worked at the Center for 4-5 years, only earn a total income and allowances equivalent to a coefficient of 2.06, or just over 2.3 million VND.

Regarding the images of patients eating without clothes on, which have recently appeared on social media, Mr. Nguyen Van Ba ​​said: “For patients with particularly severe mental illnesses, not only do they lack control over their behavior, but they also have almost no sensation of the outside temperature. Even in the hot summer, and even in the biting cold winter, many patients will still remove or tear their clothes. As for the patients eating with their hands, the center used to have spoons and chopsticks, but the patients used those utensils as weapons to fight, and there have been cases of eye injuries, so we have to let them eat with their hands. The patients' bowls are thin, durable plastic bowls; we can't use ceramic or aluminum ones. The plastic bowls getting crushed, torn, or punctured happens all the time. In fact, we have to put some patients' meals in plastic bags because they might tear the bowl and scratch their faces…”

Director Nguyen Xuan Phu stated: “Currently, most of the residents at the Center receive a monthly allowance of 360,000 VND for elderly people who are lonely and without family support; and 450,000 VND per month for those with mental illnesses. Each resident receives three meals a day: breakfast, lunch, and dinner. Regarding the portions, breakfast typically consists of one sticky rice cake or a bowl of instant noodles; lunch and dinner mainly include rice, pork (or fish), vegetables, and soup. Those who are sick are given porridge or fresh milk as substitutes. With a standard of 6,000 VND per meal, the Center strives to ensure that residents have enough to eat. The implementation of the program for residents at the Center is meticulously planned and calculated according to specific principles.” To help staff members with difficult family circumstances, each year, the center's staff and employees donate one day's salary... With these efforts, along with the attention and support of the local government, agencies, and departments, the Center has successfully completed its tasks.

"However, the Center's workload is increasing year by year because the number of mentally ill patients admitted to the Center is growing, while the current staff, including contract workers, are all overworked. Therefore, we hope that the relevant authorities will pay attention to supplementing the Center's staff or allowing us to sign contracts with a salary fund. In addition, the Center currently lacks doctors and specialized psychiatric medical equipment. Therefore, to better care for mental patients, we need a mechanism to attract doctors to the Center and supplement the necessary medical equipment..." These were the aspirations of Director Nguyen Xuan Phu and the staff of the Social Welfare Center when they shared their thoughts with us.

Text and photos:Minh Quan