Vietnam is a country in southeastern Asia that borders China, Laos, and Cambodia by land the Gulf of Thailand, Gulf of Tonkin, and South China Sea by water. The north and south are a flat delta; it also has central highlands and mountainous terrain in the far north and northwest. The climate makes it susceptible to natural disasters such as monsoons.
Besides the Vietnam War and some culinary dishes, I knew very little about Vietnam. Because I am Korean, I am interested in learning more about other Asians and their cultures. This assignment was a good opportunity to do so.
Background
-Government:
Vietnam became part of French Indochina in 1887, following the French conquest from 1858-1884. France continued to rule even though Vietnam declared independence after World War II. In 1954 communist forces under Ho Chi Minh defeated the French. The country then divided into the communist North and the anti-communist South, starting the Vietnam War. The United States sent economic and military aid to South Vietnam through the 1960s, but withdrew after the 1973 cease-fire agreement. Two years later, North Vietnam overran the South and reunited the country under communist rule. “Hundreds of thousands tried to flee the country, creating an international humanitarian crisis.” In 2006, President Bush attended an APEC leaders’ meeting and pledged help for health problems caused by dioxins, from Agent Orange, an herbicide and defoliant used in the Vietnam War. [5] Although communist leaders maintain control on political expression, they have made modest steps towards better protection of human rights. [2]
-Population:
The total population of Vietnam is 96,160,163 (2017). [2]
-Key religious & ethnic groups:
The largest ethnic group in Vietnam is the Kinh, making up 85.7% of the population. The Tay, Thai, Muong, Khmer, Mong, Nung, and Hoa make up the rest, with 4.3% including other ethnic groups. A total of 54 ethnic groups are recognized by the Vietnamese government. Within the ethnic minority, children make up more than 60% of all poor children. The majority at 81.8% are not religious. Buddhists make up the largest religious group at 7.9%, followed by Catholics, Hoa Hao, Cao Dai, Protestants, and Muslims. [2]
-Languages commonly spoken:
Vietnamese is the official language of Vietnam. English is gaining popularity as a second language. There is also some French, Chinese, and Khmer spoken. [2]
-Life expectancy for males/females/both sexes:
Life expectancy for males is 70.9 years, while life expectancy for females is 76.2 years. Life expectancy for the total population is 73.4 years. [2]
-Under age 5/adult/maternal mortality:
The under age 5 mortality rate is 21.7 (2015), while the adult mortality is 5.9 deaths/1,000 (2017). Maternal mortality is 54 deaths/100,000 live births (2015). “The maternal mortality ratios are much higher in mountainous and remote areas, such as the Central Highlands and northern mountains.” [4]
-Income & expenditure:
The Gross National Income per capita (constant 2010 US$) in Vietnam is 1658.046 dollars (2016). [3] The total expenditure on health care per capita is 390. [1]
-Adult literacy rate:
94.5% of the total population are literate. Literacy is defined as age 15 and over who can read and write. [2]
-Major health conditions, health practices, & problems contributing to mortality/morbidity
The degree of risk for major infectious diseases is very high. Food and waterborne diseases include bacterial diarrhea, hepatitis A, and typhoid fever. Other, vector borne diseases include dengue fever, malaria, and Japanese encephalitis (2016). However, polio and maternal and neonatal tetanus were eradicated with high immunization coverage. Measles incidence significantly decreased but 2008 and 2009 saw a resurgence. 14.1% of children under the age of 5 are underweight. “Unsafe water and sanitation accounts for half of most of the communicable diseases.” [4]
“One-third of Vietnamese children under the age of 5 are stunted and one-third are anemic, from poorly balanced diets, low exclusive breastfeeding rates, poor complementary feeding, worms and infections.” Only 20% of mothers breastfeed early and exclusively for six months – the lowest rate in South East Asia, and are the lowest in middle class and urban settings. [4]
Despite improvements at the national level, only 39% of people in rural areas have adequate sanitation, with half of the children under the age of 5 not able to access improved sanitation and 20% unable to access improved water supplies. [4]
-Common food and nutrition beliefs, dietary practices & problems
Agriculture is the leading sector of the Vietnamese economy. In the early 2000s, the principal crops were rice, sugarcane, cassava, corn, fruits, vegetables, and melons, as well as sweet potatoes. Livestock included pigs, cattle, goats, and poultry. [5]
Rice is the main staple and is consumed in almost every meal. Vegetables and/or fish or meat are often steamed or stir-fried and eaten with rice. Fish is the most common protein. Dairy and soy are not part of the diet so many lack calcium and are lactose intolerant. Because fish sauce (made from salted and fermented anchovies) is the most common condiment, the diet can be high in sodium, and low in fiber (with its lack of whole grains). [6]
“Many Vietnamese – especially of the older generation – believe in the Chinese yin/yang categorization of food, in which foods are considered either yin – ‘cold’ or yang – ‘hot.’” Consuming “Hot” foods is believed to lead to an excess of heat in the body and cause ailments
such as pimples, nosebleeds, or rashes. On the other hand, consuming “cold” foods is believed to lead to chilliness, abdominal pain, or diarrhea. With this system, it is believed that sickness arises when the body’s yin/yang balance is off, so they will try to remedy the imbalance by eating the appropriate hot or cold food. Some also believe that specific foods have medicinal value. For example, some believe that bitter melon is helpful for controlling high blood pressure. [6]
In August 2016, the government of Vietnam issued the National Guidelines for the Management of Severe Acute Malnutrition (SAM) among children under age 6. These guidelines are in line with the 2013 recommendations from the World Health Organization. Malnutrition is a significant public health concern. There are about 200,000 children under age 5 who are severe acute malnourished. The new guidelines place protocols for the provision of quality treatment and management of children with SAM within the broader range of interventions/approaches addressing all forms of malnutrition including protection, promotion and support for breastfeeding, appropriate complementary feeding, behavior change communication for mothers and child caregivers on Infant and Young Child Feeding Practices, multiple micronutrient supplementation for pregnant women, support health staff to better diagnose and treat SAM. [4]
Cultural Encounter
Cultural Encounter cont.
Cultural Encounter cont.
Summary
Finding someone to interview for this assignment was difficult. I realized that I did not know the cultural background of many of my Asian friends. I tried connecting with a few through social media, asking if they themselves or someone they knew would be able to answer my questions and be willing to answer them. Only one of them responded and was not able to answer my questions or refer me to someone who could. I contacted multiple multicultural centers including the one at KUMC and even the one at my undergraduate university. I didn’t get a response from any of them either. My mother happened to remember a friend of a friend and got their contact information from that friend. This is the person who I was able to interview. This process helped me to be more culturally sensitive of others. I thought that after determining who was Vietnamese out of my Asian friends, one of them would be willing to be interviewed, not initially understanding that this may be a sensitive subject.
Despite not being able to find someone to interview, I learned a lot from this assignment that I can apply in the future. I learned that, even someone who speaks the same language may communicate differently than the way I do or the way that I think they will. When I am a professional I will need to learn how to communicate with my clients/patients in a way that they feel comfortable talking to me and understand what I have to say. As I mentioned above, I learned that I need to be more culturally sensitive of others. I believe that educating myself and being intentional about not being insensitive even though I do not mean to be. That may include thinking through what I say and how I say it, which ties back to communication. I also learned that there is still so much more that needs to be done and more that I can do to eliminate and prevent hunger, malnutrition, and other nutrition related issues.