AN INTRODUCTION TO OPERATION OF AMERICAN NON-GOVERNMENTAL ORGANIZATIONS IN HEALTHCARE SECTOR IN DANANG FROM 2001-2011

AN INTRODUCTION TO OPERATION OF AMERICAN NON-GOVERNMENTAL ORGANIZATIONS IN HEALTHCARE SECTOR IN DANANG FROM 2001-2011

114 Le Thi Phuong Loan

AN INTRODUCTION TO OPERATION OF AMERICAN NON-GOVERNMENTAL ORGANIZATIONS IN HEALTHCARE SECTOR IN DANANG FROM 2001-2011

Le Thi Phuong Loan

University of Foreign Language Studies, The University of Danang; loan.lephuong@hotmail.com

Abstract - The operation of American non-governmental

organizations (NGOs) in Danang in the first decade of the 21 st

century has been of great interest recently thanks to their

considerable contributions to the city’s prosperity, particularly in

improving people’s living standard and to the two target programs

of Five Nos and Three Yes Employing methodologies in

international relations such as meta-analysis, international

relations analysis, observation and statistics with a Neo-Liberalism

perspective of NGOs in international relations, the paper finds that

American NGOs in Danang have been most interested in

healthcare system This sector has received their most investment

and financial assistance since the last decade in terms of the

project number and financial aids Among the organisations, East

Meets West Foundation took the lead Most financial assistance

comes to constructing infrastructure and providing medical

equipment Eye Hospital, along with other provincial hospitals,

have received most assistance However, other lower level

hospitals and medical units have not received much investment

from American NGOs Also, those activities have not yet been

expanded to medical staffs training

Key words - American Non-governmental Organizations;

operation; financial aid; humanitarian activities; Danang healthcare

sector

1 Introduction

Globalization in the twenty-first century has paved the

way for non-governmental organizations (NGOs) to thrive

and achieve significant recognition worldwide In the last

decades, there has been a sharp increase in the quantity and

operation scale of NGOs in international relations from

1,250 in 1980 to 45,000 NGOs in 2000 Also, they have

gradually become governments’ crucial partners in

facilitating community development all over the world

Consequently, the study of NGOs’ operation has attracted

deeper attention in more diverse fields

International NGOs first came to Vietnam long ago

Initially, they worked mainly in the South of Vietnam

Since 1975, yet, international NGOs have considerably

assisted Vietnam in reconstructing the nation, gradually

promoting economic growth, and improving people’s

living standard The number of international NGOs, hence,

steadily increased in accordance with the country’s

development, from 200 to 600 in 1990 and 2006

respectively Impressively, at the end of 2011, this figure

was already 800 Likewise, the total finance assistance in

2009 was nearly USD 270 million, which was nearly 17

times as much as that of the early 1990s [5]

Danang, the fourth largest city in Vietnam, has become

the biggest cultural, economic, educational, medical and

scientific center of the Central Highlands This resulted

from appropriate development policies, good management

of the city authority, and support from its citizens, as well

as foreign and domestic cooperates, enterprises and NGOs

Indeed, since 2000, the total aids to Danang has reached

VND 1,331.3 billion, contributing to the realization of a large number of major infrastructure facilities for the city, especially in healthcare system Particularly, Danang has been the only city in Vietnam to have built a number of hospitals out of limited allocated public budget, thanks to financial contributions of individuals and NGOs Accordingly, this paper examines the current status of American NGOs’ operation in the healthcare sector in Danang from 2001-2011, for these NGOs account for nearly 50% out of 110 foreign NGOs having partnerships with Danang city [2]

2 Overview of American NGOs (ANGOs)

2.1 What are ANGOs?

Currently, there are approximately 1.5 million NGOs operating in the U.S They undertake a wide range of activities, from political to social ones to represent almost every possible cause Even though they claim themselves

as non-governmental, these NGOs receive finance from grants of federal, state or local governments, apart from donations from individuals, philanthropic foundations, and

private sector for-profit companies For instance, World

Vision U.S collected USD 55 million worth of goods in

1998 from the U.S government [1]

More importantly, ANGOs embrace an important role

that they themselves sometimes did not realize: doing

public relations for the U.S government Andrew Natsios,

Head of USAID even emphasizes that:

“From now on, NGOs had to do a better job of linking

their humanitarian assistance to U.S foreign policy and making it clear that they are “an arm of the U.S government” [6]

Huong and Tinh [1] define ANGOs as those who are big in terms of number, budgets, and expertise As the world wars gave way to the birth and thrive of many ANGOs as an internal correspondence to unprecedented disasters caused by traditional international relations, the beginning of the 21st century witnessed increasing advocacy for ANGOs with larger roles in collaborating with governments in such missions as: settling disputes, providing relief, exercising the protection of human rights and gender equality, facilitating human progress, tackling environmental issues, and so on

2.2 Development of ANGOs in Vietnam

The collapse of former socialist countries in the late 1980s resulted in the decline of support for Vietnam, yet, initiated chances for international NGOs from the West to

aid Vietnam In 1988, Catholic International Cooperation

for Development and Solidarity (CIDSE) became the first

NGO to have an official representative in Hanoi after the

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war The two turning-points for Western donors to renew

their efforts to come back to Vietnam were the

1986-Doi-Moi Policy and the withdrawal of Vietnamese troops from

Cambodia in 1989

However, it was not until 1995, when the normalization

of diplomatic relations between Vietnam and the U.S was

officially announced, that ANGOs increased their aids to

Vietnam as well as developed economic and political

relations between the two countries Since then, the U.S

government has funded humanitarian activities, mostly

conducted by ANGOs to support war victims, children

with disabilities and orphans of Vietnam in a way that helps

bring these disadvantaged groups better lives

There are several types of ANGOs operating in Vietnam

at present Huong and Tinh (2004) categorize them into three

major types as Social – cultural NGOs or Foundations;

Religious NGOs; and Humanitarian NGOs ANGOs’

activities in Vietnam are very diverse, covering almost all

aspects of life and almost all over Vietnam Huong and Tinh

(2004) summarize over thirty fields of ANGOs operation in

Vietnam, ranging from natural resources, healthcare,

education, human and social development, bomb disposal,

to natural disaster relief, etc [1]

2.3 Development of American NGOs in Danang

ANGOs came to Danang at the same time with their

appearance in Vietnam, yet with a limited number

Currently, ANGOs account for nearly 50% out of 121

international NGOs and FDI corporates operating in

Danang, in which 13 ANGOs have representative offices

within the city They mostly concentrate on the five fields

namely healthcare, childcare, education, humanitarian

assistance, and poverty alleviation

There are a variety of reasons for the interest of ANGOs

in Danang Firstly, Danang is among the five

centrally-controlled municipalities in Vietnam prioritized in

investment and development policies of the country

Secondly, Danang possesses advantaged geo-political

and geo-economic positions Lying at one end of the

East-West Economic Corridor, linking Danang and

Mawlamyaing – covering Laos, Thailand, Myanmar and

Vietnam, has created favorable conditions for Danang to

call for investment in industrial zones and infrastructure

improvement to boost regional cooperation and

development along the economic corridor

Thirdly, Danang has great advantages in water and air

transport The city has been the largest commercial seaport

and airport systems in the Central and Highlands region,

and the third largest port systems in Vietnam In recent years, Danang seaport has been improved to accommodate cruise ships to attract thousands of tourists from all over the world, along with improvements in freight warehouse and commercial activities at the port

Last but not least, Danang used to be a major battlefield

in the U.S – Vietnam war in the last century Hence, the city authority has been making efforts in handling war aftermaths, including cooperating with the U.S government and NGOs to remediate dioxin contamination

in Danang international airport soil and sediment to eliminate risks of dioxin exposure, develop capacity for implementing similar remediation activities in other sites

of the country; or working with the U.S Joint prisoners of war, missing in action (POW/MIA) Accounting Command (JPAC) to seek and transfer American remains back to the U.S All of the above reasons, along with the preferential treatment of Danang administration, have attracted more and more ANGOs to initiate and expand their operation within the city

3 Operation of ANGOs in Danang from 2001-2011 in the sector of Healthcare

3.1 Current status

As can be seen from the collected data from reports of Danang People’s Committee and Danang Department of Foreign Affairs, among many fields of interest, healthcare

is ranked the first in terms of project numbers and financial

aid.Particularly, East Meets West Foundation (EMW) has

the most investment both financially (about VND 106 billion) and project quantity (18 projects – accounting for 25% of ANGOs’ total projects in this field) This indicates that healthcare is a major field of interest of ANGOs in Danang

Most financial assistance comes to construction of infrastructure and purchase of medical equipment Danang Eye Hospital, along with other major provincial hospitals, including Danang General Hospital and Cancer Hospital, receive the most assistance Yet, other lower level hospitals and medical units have not received much investment from ANGOs, with only VND 8.600 million during the surveyed period This may be partly explained by more skilled health workers and advanced equipment of major hospitals, thus attracting more patients and investment Besides, ANGOs’ activities have not yet been expanded to medical staffs training Consequently, ANGOs should take into consideration the training of medical staffs, especially those

at medical units of ward and village levels within the city

Table 1 ANGO’s aid projects in Healthcare in Danang

(Source: Danang DOFA (2009, 2010, 2011, 2006))

Implementing Agency

Total Committed Value (VND)

Disbursement

Emergency Room - Danang

Oncology Ward - Tropical

Substation construction in Danang

Hospital

Department of Health

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Building and furnishing Tropical Medicine Ward and Oncology

Ward

Building and Furnishing Danang Eye Hospital phase 2, (add

expense: $1,293,000)

Annual Dental programs

DOH, Department of Education and Training (DOET)

2009-2011 Multi-functioning Section

Additional funding for Danang Eye Hospital, phase 2 (source AP)

DOH-Danang Eye

Community-based mental healthcare model development +

improvement

Danang Mental

2009-2011

2010-2011

2010-2014

Newborn recovery support in

5

Cedars-Sinai

Center

Medical Equipment for Cancer

Hospital

Children and Mother Protection Association, Cancer Hospital

2009-2011

Heart surgery support for poor children and 01 container of foods, rice, porridge

Danang Charity

Functional Rehabilitation center construction at Hoà Sơn Medical Unit, Hoà Vang Dist

People’s Committee

Complete functional Rehabilitation modeling and socio-economic support for people with disabilities

DOH, DOLISA, Bình

2010-2011

Interdisciplinary information management system of the handicapped

Department of Labor, War Invalids and Social Affairs (DOLISA)

2011-2012

UCP-WFH

Free wheelchairs and functional rehabilitation equipment

Danang

2009-2011

Infants with disabilities Recognizing and care model coordinated in initial healthcare system in Danang

Multi-functioning section

11,259,199,256 VND

~ USD 700,000 Complete infrastructure and

equipment investment for medical units at ward levels in Danang

DOH

8,640,000,000 VND ~ USD 540,000 Building and Furnishing Danang

Emergency Center construction,

Building Tropical Medicine Ward and Oncology Ward – Danang

Hospital

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HIV/AIDS infected children

Social Protection

Danang Charity

As shown in the above Table, in 2011, EMW funded

nearly 7 billion VND for building the Eye Hospital and eye

care treatment and health workers training in Danang The

figure was nearly VND 11 billion and VND 35 billion in 2009

and in 2010 respectively EMW is still supporting Danang Eye

Hospital Besides, Danang General Hospital gained more than

VND 40 billion to build and improve Emergency Center,

Tropical Medicine Ward, Oncology Ward, Multi-functional

Section, and other medical infrastructures

Additionally, dental treatment has become a yearly

program of EMW In particular, in 2010, the funding for

this program was about VND 1.2 billion (in 2008 and 2009,

the figure was a bit higher with over VND 2.9 billion and

VND 1.3 billion respectively) Yet, in 2011, EMW

committed to spend approximately VND 3.5 billion on this

program but the disbursement value was only VND 890

million EMW also donated VND 139 million to free heart

operations for poor patients

When it comes to heart surgery, in 2001, Giving It Back

to Kids (GIBK) donated VND 1.8 billion for children who

suffered from heart diseases Remarkably, it was much

higher than the two previous years when, in collaboration

with VinaCapital Foundation, GIBK had funded about

VND 249 million in heart surgery for poor children

Children of Vietnam also contributed over VND 2.676

billion to helping poor children have healthy hearts again

Moreover, handicapped patients in Danang fortunately

obtained batches of wheelchairs with a total value of more

than VND 7.4 billion from UCP-Wheels for Humanity,

Hope Haven and Free Wheel Chair Mission Vietnam

Assistance for the Handicapped (VNAH) supported this

group with complete functional rehabilitation model and

support their lives Nearly VND one billion was given to

implement the interdisciplinary information system of

handicapped management This helps manage database of

the handicapped more easily and systematically

ANGOs also spare their care to mental patients in

Danang A typical example is that Vietnam Veterans of

America Foundation (VVAF) funded VND 743 million to

this target group with a hope that they would get proper

treatment More importantly, the community-based mental

healthcare model has been developed in the city with

participation and donation (nearly VND 13 billion) of

many ANGOs, including EMW, VVAF, and American

National Health Institute (NHI)

Infant and female healthcare were also taken into

consideration by ANGOs Among prime examples is

VinaCapital Foundation’s donation of VND 16 billion to

the construction of Women’s Hospital in 2007 (Two years

later, this hospital received VND 343 million as medical

support donated by VNAH) VinaCapital Foundation also

spared VND 2.500 million to support newborn recovery

activities Likewise, The Alliance for Safe Children (TASC)

donated about VND 2.8 billion for injury prevention for

children Atlantic Philanthropies donated nearly VND one

billion to care and diagnose infants with disabilities Other areas of medical care like cornea donation, stroke prevention, orthopedic surgery, etc were also concerned

by various American NGOs, such as GIBK, NHI, and

ORBIS with a total funding of more than VND 2.5 billion

Sexual health care is a newly arising area that has

attracted the attention of ANGOs In 2011, Family Health

International (FHI) funded VND 264 million to assist the

city’s authorities with sex education for men Vets With a

Mission (VWAM) spared VND 760 million for building

technical room for medical services in reproductive healthcare to promote better health services in the areas of fertility Other projects such as giving away medicine or vitamins for HIV/AIDS infected children were also

undertaken by Global Community Service Foundation and

GIBK Patients who encounter poverty are guaranteed to

have daily meals and travel expense thanks to GIBK’s

donation worth over VND 55 million [2], [ 4]

3.2 The Cooperation of Local Authorities and Achievements

When conducting health care projects in Danang city, ANGOs have gained enormous assistance from the Provincial Health Office, Department of Foreign Affairs, Danang Hospital, Danang Rehabilitation-Sanatorium Hospital and other local charity associations as well as charity centers They help ANGOs’ construction projects

go smoothly and distribute aid resources to appropriate target groups Health officials of these hospitals and other medical units also positively take part in training courses This bilateral cooperation makes ANGOs’ projects in healthcare sector become more efficient [2], [5]

Being first on the list of total projects funded by ANGOs which are categorized by sectors, Danang’s healthcare system has improved dramatically Many vulnerable and poor people who used to rarely have any access to basic healthcare are now fortunately leading healthy lives thanks

to ANGOs’ healthcare projects including annual dental

check-ups For instance, until the end of 2006, EMW’s dental

project, which started in 1996, has helped to treat 38,000 poor children at schools for blinded students, including Hope Village and SOS Village This free treatment helps prevent those children from teeth-related diseases There are more and more professional health officials as well as facilities, which makes it easier to meet the need of Danang citizens and patients from neighboring provinces [4]

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4 Conclusion

Vietnam is undergoing rapid economic growth and

impressive social changes facilitated partly by appropriate

policies and institutional reforms, which have promoted

foreign investment and assistance to Vietnam.Among

foreign organisations, international NGOs is an important

channel Since 1995, there has been a gradual warming in

Vietnam-U.S bilateral relations This milestone has paved

the way for the establishment of ANGOs around the

country Danang, one of Vietnam’s five major

socio-economic centers, has made use of the financial aid,

technological transfer, and capacity building provided by

ANGOs, especially in healthcare sector EMW has

financially supported Danang’s major hospitals most in the

last ten years Other ANGOs have contributed greatly to

such activities as offering medicines to HIV/AIDS

children, training health workers, delivering service of

Flying Eye Hospital, and providing sex education Hence,

Danang healthcare system has attained considerable

improvements However, most of the projects went to

medical infrastructure but not staff training Moreover,

while major provincial hospitals received the most

assistance, other lower level hospitals and medical units

have not received much investment, which remains a challenge for both ANGOs and the city authority to tackle

In addition, ANGOs should take into consideration the localities’ demands to establish feasible projects to make use of the support and coordination from local people, the city government and beneficiaries

REFERENCES

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học cấp Viện, Học viện Quan hệ quốc tế

[2] Sở Ngoại vụ thành phố Đà Nẵng (2008), Báo cáo mười năm về công tác viện trợ phi chính phủ nước ngoài trên địa bàn thành phố Đà Nẵng

[3] Sở Ngoại vụ thành phố Đà Nẵng (2009), Các dự án lớn đã và đang triển khai từ 2006-2009

[4] Sở Ngoại vụ thành phố Đà Nẵng, (2009, 2010, 2011), Báo cáo số liệu viện trợ của các tổ chức phi chính phủ nước ngoài

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(The Board of Editors received the paper on 15/02/2015, its review was completed on 24/03/2015)