Cancer patient Mrs Nguyen Thi Nhan has been living in a narrow and dingy corridor at the Oncology Hospital in Ho Chi Minh City for the last four years.
The 60-year-old gets up at 4 o’clock every morning to help with menial tasks such as feeding and washing other patients to get money to pay for her treatment.
She is one of the surging numbers of cancer patients in Vietnam who are threatening to overwhelm health care provision in the country.
Experts say an alarming increase in the cancer rate is partly due to rising life expectancy but believe the extensive use of pesticides in the countryside and growing sales of adulterated food are also to blame.
Mrs Nhan has to ask for food from well-wishers and eats her meals out of boxes with other patients in the corridor.
“I have been alone at the hospital corridor for four years since my family sold our house and farm to pay for medical treatment for my breast cancer,” said Mrs Nhan, who is from Lam Dong province in central Vietnam.
Her husband abandoned her. Her two daughters work part time for a living and study at colleges in the city and she sent her youngest son to live with her brother.
Mrs Nhan has had to work at the hospital to pay for treatment ever since her health insurance ran out.
She blames her cancer on her exposure to insecticides and herbicides during work in the fields.
“I would regularly spray tea and coffee farms with pesticides and herbicides that got my body wet through,” she said, adding that she had been too poor to pay for protective clothing.
She was diagnosed with breast cancer six years ago and had one breast removed.
She believes that many of the patients she meets got cancer because they’ve led lives of poverty, worked in a polluted environment or ate contaminated food. Three of her neighbours recently died of lung and cervix cancer a short time after they were diagnosed.
She said many were forced to return and die at home because they could not afford to pay for treatment. She said many sufferers had only gone to hospital for checkups when the cancer was already terminal.
Recent research has indicated that Vietnam has a low survival rate for cancer sufferers even by the standards of other developing countries
The estimated cost of treatment for breast cancer starts at 80 million dong ($3,500) and can increase to ten times that figure – well beyond the ability of most people to pay in a country where the average income is $2,000.
Cancer experts estimate Vietnam has up to 150,000 new cancer cases a year and 70,000 deaths from the disease.
It’s the second leading cause of death after heart disease.
Men most commonly suffer from cancer of the lung, liver, rectum, stomach, and upper jaw, while for women, the most common areas are in the breast, cervix, lung, rectum, and thyroid gland. 30-50 percent of new cases are blamed on eating and drinking habits.
According to the World Health Organisation’s Globocan project (http://globocan.iarc.fr/Default.aspx) new cancer cases in Vietnam rose from an estimated 70,000 in 1998 to 150,000 in 2012, an increase of more than 100 per cent.
Dr. Dang Huy Quoc Thinh, deputy director of the Ho Chi Minh City Oncology Hospital, one of Vietnam’s leading cancer facilities, warned that the number of new cases was rocketing.
Last year 12,000 patients were treated at the hospital but as many as 13,000 cases were treated in the first five months of this year, Thinh said at a recent cancer conference. The hospital is overwhelmed by patients and three or four sometimes have to share one bed.
The illegal contamination of food with chemical substances is seen by experts as a significant cause of the increase.
Fruit artificially ripened by chemicals is seen on display at markets across the country, even though it is public knowledge that such chemicals are harmful to health.
A female farmer in the southern province of Ben Tre where fruit is produced said local farmers and sellers apply chemicals to keep fruit in a batch evenly ripe and attractive for better sales and profits. Most consumers are unable to distinguish between fruit ripened naturally and that treated with chemicals.
She said proscribed chemicals are easily found in local pesticide shops and the sellers disguise them as fertilizer to evade inspection by authorities. “If the authorities discover illegal chemicals they will turn a blind eye if they’re offered gifts or money,” she alleged.
Experts said acetylene and ethephon are often used to ripen fruit since they are cheap. Long term consumption of such chemicals can damage eyesight, the liver, gall bladder, heart and other internal organs.
The use of banned substances in the breeding of pigs has also become widespread, the Ministry of Agriculture and Rural Development warned.
On August 31, the Sub-Department of Veterinary based in Ho Chi Minh City announced that it examined 61 batches of pigs at 10 slaughterhouses and found that 10 tested positive for salbutamol, which is a lean-meat agent that helps pigs gain weight in a very short time.
The agency called on its counterparts in six southern provinces – Ba Ria-Vung Tau, Ben Tre, Dong Nai, Long An, Tien Giang and Vinh Long – that provide pigs to the city, to detect and eliminate the use of salbutamol in the breeding of pigs.
“It is really admitted that authorities and agencies have acted slowly and turned a blind eye to the use of banned chemicals at farms and slaughterhouses,” Nguyen Xuan Duong, the deputy head of the Department of Livestock Production, said at a press briefing held on August 31.
Nguyen Quoc, a senior veterinarian in Dong Nai province, said although 18 chemicals including salbutamol, clenbuterol and ractopamine are banned in pig breeding, farmers can easily buy them from markets and shops.
He said local farmers can raise from 50 pigs to hundreds each and some have them eat lean-meat chemicals for the month before they are sold to traders. “It is easy for you to find those pigs walking slowly, breathing heavily and even dying before they are sold,” he said.
“Farmers and owners of slaughterhouses offer authorities bribes and everything is ok,” Mr Quoc said.
Many banned chemicals used for fruits, vegetables, poultry and cattle, as well as pesticides, are imported from China, he said, questioning whether customs officers work effectively.
Contaminated food is openly sold at markets and shops and tends to be eaten by the poor who have no other choice. Richer people can afford to buy safer goods and food imported from North America and European countries
Mrs Nhan said she has no money to buy fruit and meat and so she eats any food, whatever the quality, given by other people.
“What concerns me most is where my body will be placed before burial. I hope the hospital will hold my funeral and cremate my body.”
(By Joseph Nguyen – freelance journalist focusing on social and religious issues in Vietnam.)