Narrator: In the mid-1980s, after decades of conflict left Viet Nam in ruins,
a massive political, economic, and social overhaul known as Doi Moi ushered in greater opportunities
for private investment and a loosening of the previous centrally controlled economy.
This began an explosion of commerce, a rapid increase in gross domestic product and a greater reliance
on the private sector as an engine of growth.
These changes had unintended side-effects,
among them a decline in an already basic low quality of health care for poor and rural Vietnamese.
By 1998, the Vietnamese government was spending less than 1% of its budget on health care,
compared to 37% in China and 14% in Thailand. With depleted budgets, the commune health centres
were unable to pay for basic equipment, medicine, training, or maintenance
which the rural poor relied on.
Higher education faced similar challenges
with crumbling infrastructure and an outdated system of learning in provincial and regional universities.
In 1998, Chuck Feeney visited Viet Nam for the first time.
He was greatly moved by what he saw and felt an obligation to do what he could to help.
Chuck Feeney: The world is full of a lot of people who have less than they need
and each time you can address their problem, you help them to move forward, and to feel that life can change and I can change it.
Narrator: By working locally, regionally, and nationally, Atlantic began to help transform
Viet Nam's higher education and health care systems.
Dr. Le Nhan Phuong: We're still an NGO working in a very large country of 90 million people.
And so the most that we can do is to show ... to establish a model, address a problem in an interventional model
to show that it can be addressed, and it can work, and hoping that others
will follow our lead -- specifically the government.
Narrator: Early grants went to both hospitals and universities, with the majority of grantmaking
between 1998 and 2005 focused on higher education.
The largest and most dramatic Atlantic investment in higher education
went to the creation of the first 100 per cent foreign-owned university in Viet Nam:
a branch of RMIT, the Royal Melbourne Institute of Technology, in Ho Chi Minh City.
Chuck Feeney: One of the first things we did in Viet Nam was a university.
And from a green field, we had 5,000 students walking in and out of the doors, and that has continued on
and the country has expanded the universities in other parts of Viet Nam.
Dr. Matthew Sukumaran: But it was fortuitous I think at the time, that we set up a campus
here in 2001 -- that was when the idea was conceived to come in and have a higher education
institution and university in Viet Nam -- Atlantic was around at the time, fortuitously, there to provide
the support that was required to really kickstart this whole project.
So that partnership in capacity-building has been wonderful, and we still see the fruits of that today.
Narrator: In Da Nang, Hue, Can Tho and Thai Nguyen Provinces, grants from Atlantic were
invested to improve higher education facilities.
A major focus was turning traditional libraries into Learning Resource Centers.
A Learning Resource Center is an expanded model of the university library, incorporating computer and telecommunication centres,
meeting and conference facilities, language labs, and other accommodations for advanced learning, teamwork, and research.
Christopher Oechsli: We put in about, I think, over $80 million to develop six key libraries,
driven in part by Chuck's interest in infrastructure, but ultimately they were about bringing access to knowledge
and student-initiated learning to the Vietnamese higher education system.
Dr. Le Nhan Phuong: I like to think what we did in higher education in Viet Nam,
with focusing with the Learning Resource Centers and local universities and our RMIT project,
has had a significant impact with the Viet Nam higher education sector.
Narrator: In the health care sector, the need for structural assistance made an immediate
impression on Chuck Feeney, as he was taken on a tour of hospitals in his first visit to the country.
Dr. Le Nhan Phuong: Chuck wants to really look at improving health care services in
hospitals because that's what he saw was needed at the time, especially these tertiary hospitals
where he sees overcrowding, he sees crumbling buildings, he sees lack
of equipment, he sees people sleeping on the ground, and just a whole mess.
Mark Conroy: There were 2 buildings -- one was German and the other was Dutch.
So we looked at that building, and then we came back to the meeting and the director of the hospital
and the hospital staff said, "Well, which one would you like to help us renovate,
and put back in good operating condition?" And he said "Why don't we do both of them?"
Narrator: As Atlantic learned more about the fundamentals of public health in Viet Nam,
it became clear that along with upgrading and building health care facilities, instilling
a culture of public health was critical as well.
Christopher Oechsli: The public health deans were telling us, if you're interested in improving health
and having an effective impact in a modest period of time, address injury prevention.
A bit of a surprise, especially if you're used to building hospitals to deliver hospital-type care.
You're probably seeing a lot of injuries coming into the emergency room,
but the root cause of that is traffic patterns, traffic safety. And prevention -- helmets --
would be a very important part of that. So we very quickly started working with some
manufacturers and designers of helmets as well as health authorities and education authorities
to try to change behaviour patterns. We were also involved in tobacco control.
These are the kinds of things that really are game changers in people's health.
Narrator: Atlantic grantees worked for many years to get a national Helmet Law passed.
And AP-funded education campaigns were so successful that the day the law went into effect
more than 95% of the people on motorbikes were wearing helmets.
It has saved thousands of lives per year and reduced debilitating brain injuries significantly since 2007.
Atlantic also recognised that tobacco is one of the main causes of disability and deaths in Viet Nam.
Working with government and nongovernmental institutions, Atlantic has successfully funded
a comprehensive strategy to improve tobacco control through legislation and communication campaigns.
Narrator: Major grants also were approved to build capacities for important national institutions
such as The National Hospital of Pediatrics and the Ha Noi School of Public Health.
The plan for the National Hospital of Pediatrics
was to build an internationally recognised centre of excellence and a standard-setter
for pediatric care throughout the country.
Narrator: At Hue Central Hospital, Atlantic funded the creation of a new cardiology centre
that quickly moved to the forefront of heart surgery in Viet Nam.
Narrator: With this focus on national institutions for public health, a more unified national health care system was in development.
It was at this point that an opportunity to build upon this culture of unity emerged.
Christopher Oechsli: And the trick was to try to find a niche, a space, that Atlantic could fill
and contribute to a system-changing approach to health care in Viet Nam.
And that niche was really focusing on primary health care.
Dr. Le Nhan Phuong: You know, there are good people in the structures if you look hard enough.
And they're everywhere. And many of them toiling away without any attention from
the outside and they keep doing things that they've been doing, just trying to help their community.
It's those people that we're trying to help. Those are the people that we want
to empower, to unlock their potential, so that they can do better and to change the system from within.
Narrator: In the provinces, the emphasis on primary care took Atlantic into the commune health centres,
which was an important place of entry for health care.
There was a significant amount of work to be done because the structures were dilapidated.
Christopher Oechsli: It became clear to us, though, that to be effective in delivering health services
we were going to have to address the health system and emphasise opportunities
to get those health services out into the community and focus on primary care.
And so the development of community-based health centres in Viet Nam was kind of a marriage
of the two -- creating some facilities that would house the delivery of community-based
primary care services, a marriage of our predilection for bricks and mortar with our focus
on human resources and community-based primary care.
Dr. Le Nhan Phuong: When I first met with the provincial health care director in Khanh Hoa,
for instance -- Dr.Minh at that time -- we started to ask ourselves:
How do we address this problem — improving primary health care? Without a facility to work in, nothing can be done.
Narrator: Together with the provincial government, Atlantic helped to fund the construction
of more than 800 commune health centres, in 8 provinces, with a population of 8 million people
with a total investment of more than $80 million.
The goal was to create an integrated model -- from rural commune health centres to urban hospitals -- with
the hope that the government would implement this model in other provinces.
Narrator: With quality facilities and trained staff in place, Atlantic turned its attention
not only to tending the sick, but also to developing programmes to serve the most vulnerable
segments of the population. A key example was a programme for mothers and infants, which
brought together the best efforts of Atlantic, a partner NGO, or nongovernmental organisation,
and government at both the local and national levels.
Dr. Le Nhan Phuong: Once the first commune health centre was built, the next one
and the next one and the training took place — the successes came rapidly.
And before long, the whole province was covered and then other provinces started taking notice
and it just snowballed. And I think that was the best feeling, for me, to see all this taking place in real time.
Christopher Oechsli: Phuong and Quyen and Dr. Hau, and their team, are really unique individuals
and we've been lucky to be able to find them and for them to agree to be part of this undertaking.
Without that kind of staffing, without that kind of leadership, these programmes don't,
can't, take hold, can't be developed, can't be sustained.
Narrator: Since 1997, Atlantic Philanthropies has invested $381.8 million in improving higher education,
public health, and primary health care in Viet Nam.
Since 2003, the focus of the grants has been on improving the primary health care system, while instilling a culture
of public health nationwide. And what are some of the outcomes?
Fewer deaths due to motorbike accidents...
Better functioning hospitals with improved patient care... 6 modern collegiate libraries...
And, at a particular point in time, 800 community-based primary care centres...
10,000 open-heart surgeries... 15,000 cardiovascular interventions.
Dr. Le Nhan Phuong: And so we have been very successful up to now in many of the initiatives
that we started: injury prevention, primary health care, mental health, social work, tobacco control.
These are issues that our staff and our collaborators inside and outside the country
have been very successful in getting started and getting right the sustainability aspect of it.
We have this desire to continue to work, to help improve the Viet Nam health care system --
and we will.