|Bassett neurologist Michael Miller says Vietnam's pediatric hospitals|
should focus less on technology, and more on old-fashioned physical exams.
Here, Miller examines a boy during a week-long humanitarian mission in March 2011.
ON CALL FOR CARE IN VIETNAM
Back to basics for Bassett neurologist in Southeast Asia
--Trang Ho, special correspondent
Source: Columbia Magazine March 2011
and the Columbia University College of Physicians and Surgeons website.
Confused, in pain, and unable to walk, a 14-year-old girl rides piggyback on her much smaller mother, who is carrying her to see Dr. Michael Miller.
For them, it is a godsend that the clinical professor of neurology from Columbia University’s College of Physicians and Surgeons and the Bassett Healthcare Network happens to be volunteering at Nhi Dong Hospital 1 in Ho Chi Minh City this week through the Project Vietnam Foundation, a non-profit that provides pediatric care to the country’s underserved populations.
Bassett neurologist Michael Miller says Vietnam's pediatric hospitals should focus less on technology, and more on old-fashioned physical exams. Here, Miller examines a boy during a week-long humanitarian mission in March 2011.
Doctors at Vietnam’s 1,200-bed national pediatric facility couldn’t diagnose the girl’s problem, even after doing an MRI scan and observing her for 10 days. But experienced eyes and ears managed to discover what had eluded technology.
After spending a half an hour with the girl – more time than any other doctor at Nhi Dong could spare – Miller diagnoses her with Brown-Sequard Syndrome. Unfortunately, the rare form of paralysis, caused by an injury to the spinal cord, can’t be cured. But Miller recommends physical therapy that could dramatically improve her quality of life.
After doing rounds with Nhi Dong’s doctors and teaching them about neurological treatments in the U.S., Miller recommends that the hospital adopt simple procedures like Apgar scores, an easy way to assess newborn health, and head circumference measurements. Such tasks merely require time – not expensive technology – yet could dramatically improve quality of care.
“They think technology is going to be the answer to their problems when really, getting a full history and doing a thorough physical exam is the most important thing,” Miller says.
Aside from providing goodwill, Miller wanted a chance to see, first-hand, diseases eradicated long ago in the Western world, such as polio, tetanus and botulism. Things he has only seen in textbooks. “This is like practicing neurology in Paris in the 1840s or London in the 1890s or New York in the 1930s,” he says. “There’s much to learn.”
Even though he had to pay for his own airfare and lodging to volunteer in Vietnam, Miller is willing to do it again. He is surprised at how much fun he’s having, even though he can’t understand the language.
“I simply find the people joyful and charming,” he says. “They’ve been very open and kind.” For those interested in donating to the Project Vietnam Foundation, even money for little things, like hand sanitizer in all the hospital rooms to prevent the spread of disease, can reap big benefits.
“It’s amazing how far a little bit money can go here,” Miller says. “People are doing wonderful things with a pittance.”