LITMIR.BIZ

       CHAPTER TWO

      LIEN WAS WAITING for him when he arrived back after dropping Regan at the school. He’d obviously been nervous about leaving his son at the strange school in an unfamiliar city, but the place had given him good vibes. The nursery teacher had shown them into a bright, welcoming environment filled with a host of happy-looking children chattering in different languages.

      Regan had tugged at his hand after a few minutes, anxious to go and join in the fun, so Joe had left with reassurances that they would call the hospital if there were any concerns.

      By the time he got back to the hospital it was a few minutes before eight o’clock. Already the place was a hive of activity. The waiting room had only a few seats left. Lien was wearing a pale blue shirt and navy trousers, and her hair was in a ponytail again. There was no sign of the traditional white coat.

      He’d swithered for a few moments this morning over what to wear, before settling on a pair of dark trousers and a simple short-sleeved white shirt. The temperature here was much warmer than he was used to, and he wasn’t sure if the hospital had air-conditioning or not. He hadn’t noticed last night. He gave a sniff. He wasn’t quite used to the aroma of the insect repellent he’d covered both himself and Regan in this morning. Maybe he should have tried to drown it out with more aftershave?

      Lien gave him a brief nod as he walked back through the main entrance. ‘Good. Is Regan settled?’

      He gave a brief nod and she started speaking again straight away. ‘Come with me, and I’ll give you a walk around. I’ll show you our systems and our supplies and when Mai Ahn, our translator, gets here, I’ll assign her to you for the rest of the day.’ She walked him over to a sink and started washing her hands. He quickly followed suit. She’d already mentioned norovirus problems. Hand washing was one of the key practices to help prevent the spread.

      Joe barely had time to draw breath. ‘First thing,’ Lien said as she kept scrubbing her hands, ‘you should really wear long sleeves. If your shirts are too warm, I’ll show you a place where you can buy some lighter weight clothing. Do you have your insect repellent on?’

      He nodded and she kept talking. ‘With Khiem and Hoa away, we’re two doctors down. I can’t afford for our latest recruit to pick up something from a mosquito bite.’

      It felt like a bit of a reprimand and he wasn’t quite sure how to react, but Lien was already talking again. ‘Hoa covered antenatal and maternity care, so we’ll all have to pick up her role while she’s gone.’

      Joe didn’t miss the way that she’d phrased that. She hadn’t asked him about his experience, or if he was happy to cover this area. She was letting him know what was expected of him. It seemed her directness last night hadn’t been unusual but the norm.

      As they finished scrubbing their hands she kept talking while she dried hers. ‘Okay, I’m sure you’ve done some general reading on the health issues in Vietnam.’ She shot him a sideways glance. ‘Or at least I hope you have.’

      He nodded quickly. ‘Of course. Main issues are malaria, tuberculosis, HIV and AIDS, with some cases of dengue fever and ongoing issues with Agent Orange.’

      She gave an appreciative nod and held out her hands. ‘Biggest killer of kids in our area is malnutrition, coupled with diarrhoea and vomiting. They have no extra fat layers to fall back on. It hits hard and fast.’

      ‘So a norovirus outbreak is your worst nightmare?’

      ‘Pretty much.’

      She led him down one corridor and then up a set of stairs. ‘Okay, downstairs is basically our clinic area. Upstairs we have six four-bed rooms with a variety of patients. Children and adults.’ He could see how the layout of the traditional colonial house had been adapted to work as a hospital. There were a number of nursing staff upstairs to whom she introduced him quickly. The staff seemed friendly, and the patients well-cared-for. Most were on IVs. Lien caught his gaze.

      ‘We have a mixture of dehydration in both the young and the elderly. Lots of chest complaints too. Anyone suffering from diarrhoea is cared for separately in one of the single rooms at the other end of the corridor.’

      Joe nodded. He’d known whole hospital wards closed because of winter vomiting bugs. They couldn’t ignore, or not treat, people affected, but, because it was infectious, it had a real chance of being passed to other patients or staff. Hygiene issues had to be the top priority.

      ‘Anyone today that you’re worried about?’

      She gave him a half-smile. ‘I’ve already done a ward round this morning, but we’ll do another one later so you can familiarise yourself with the patients. Today we start downstairs at the clinic.’

      They washed their hands again, and moved back down the stairs.

      Downstairs was separated into four areas. One was a general waiting room, one was for children, one for pregnant women and a fourth for X-rays, with a plaster room next door. It was a real mixed bag. A kind of cross between a GP surgery and community hospital back in Scotland.

      Lien gave a little sigh as she showed him into an office and gestured for him to sit in the chair opposite her. ‘We have a real mixture of antenatal care. Only around sixty per cent of women in Vietnam attend antenatal care. Some women don’t present until late in pregnancy. Others present early, requesting their pregnancy be monitored all the way through for birth defects. It’s not unheard of for a pregnant woman in Vietnam to have up to twenty scans.’

      Joe’s eyebrows shot upwards. The norm for the UK was two, unless there were any concerns. Something clicked in his brain. ‘Agent Orange?’

      She nodded.

      ‘How often nowadays do women present with birth defects?’

      Lien’s face was serious. ‘It’s more prevalent now in the south of Vietnam, but forty years on there are still children affected here. The spray that was used to destroy the crops obviously went into the soil. Poverty is a major issue in Vietnam and some families are solely reliant on growing their own foods. They have no other option but to eat the food they grow—whether the soil is damaged or not.’

      She shook her head. ‘We have two other hospitals. One is in the outskirts of the city of Uông Bí city, in northeast Vietnam, and the other—the one Duc’s parents have just gone to—is in Trà Bồng District in the south of the country. At that one, we also take care of the kids in the nearby orphanage. A lot of them are affected. There’s poverty across Vietnam, just like there’s poverty in every country in the world, but it’s worse down in the south. Down there, families are reliant on farming. If their crops fail, it’s disaster for them. A lot of them rely on their kids to work alongside them. If their kids are affected by Agent Orange, or any other genetic or medical condition, often the family can’t afford to keep them.’

      ‘So they end up in the orphanage?’ Joe asked.

      ‘Exactly. We offer free medical care to the

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