Vietnam: Laura Barber, Pharmacist

In October 2010 a trainee pharmacist called Ngoc Anh came to the Chelsea and Westminster as part of the Vietnam Nurse and Pharmacist Exchange Programme funded by St Stephen’s AIDS Trust.   During her 2 week exchange programme Ngoc Anh shadowed members of the HIV multidisciplinary team including pharmacy.  It was interesting to see her reaction to the pharmacy robot  ‘its very complicated, I just take things off the shelf’.   I completely agreed with her sentiments as the robot can seem alarming!

Subsequently,  in February 2011,   I travelled to Soc trang where Ngoc Anh worked.   To help fund her university fees,  she is currently employed by the government to counsel clients prior to having a HIV test.  She works in an office that offers a walk-in HIV testing service, which is advertised on several billboards in the town. Ngoc Anh counsels patients on the risks of transmission and hands out free condoms, unfortunately the center does not offer STI testing and thus clients have to be directed to another part of town.

The rest of the week I spent at the hospital, where I met the chief pharmacist and the specialist HIV pharmacist.  

I sat in on paediatric and adult clinics and went on various ward rounds where I was able to compare treatment in the UK with Vietman, discuss cases and share online resources with physicians.

Outpatient appointments at the hospital are booked by the day, and there is an open door policy for patient appointments.  A doctor is seated in the clinic room and patients all sit in the same room, walking in and out during other patient consultations.  At one point there were four people having a consultation at one time! This was good opportunity to speak to patients about their medications, although through limited translation.  Nearly all the patients I talked to said they were 100% adherent taking their medications, and used mobiles or their watches for reminders, a large proportion of patients suffered side effects, but were able to tolerate them.

Antiretrovirals in Vietnam are provided by the Global Aids fund, first line treatment is Lamivudine, Stavudine and Nevirapine. When patients start ARVs they see the pharmacist who fills two weeks of Antiretrovirals in a medical compliance aid for each patient, to help them remember to take their medication. After this, patients get one months supply of medication at a time. This seemed such a shame especially for patients who lived in the countryside and have to travel some distance to visit the clinic and thus lose out on a days work. The hospital were not willing to provide drugs for more than a month as they believe these medicines may be sold by poorer patients.

What I found most rewarding about this experience was observing Ngoc Anh put into practice what she had learnt in the UK, comparing patients’ cases that she had seen in the UK to those in Vietnam, which is testament to the exchange programme.