Saturday, July 20 spelled death for three newborn babies in Quang Tri Province, mere hours after their birth, and just minutes after their routine Hepatitis B vaccine shots, which all infants in Vietnam receive.

Pictures of the shattered, grieving parents weeping while holding their dead infants brought a pall of sadness and terror over the nation. The next day the Minister of Health, Nguyen Thi Kim Tien, traveled to Quang Tri — but not to meet the three grieving parents. Instead, she was there for the groundbreaking ceremony of a bell tower, and she chose to ignore the easy opportunity to pay the families a visit. Upon being questioned by reporters, the Minister excused herself by claiming a full schedule, and declined to provide a statement about the children’s deaths, claiming a commission had been assigned to speak to the media on the matter. No word of condolence or even regret for the incidents was reported. On the same day, 21 July, another neonate in Binh Thuan province died following yet another Hepatitis B vaccination.

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Source: http://tuoitrenews.vn

At this point, the previously amorphous gloom and anxiety over what appeared to be vaccine-induced infant deaths morphed into indignation and fury which now found a target: the Minister of Health.

An hours-long glance over forums and websites reveal that Vietnamese netizens’ reaction to the events of July 20-21 is downright querulous. Netizens find the Minister selfish, unsympathetic, and incompetent . Commenting on a news article reporting the Minister’s litany of excuses in Quang Tri, Trần Hoàn writes:

“After such an incident, wherever and however busy one is, if having a good conscience and the sense of responsibility when leading the sector that’s in direct relation with those tender souls’ deaths, you would supposedly spare some of your priceless time to come to the families and help ease their unjust pains. At the very least, send a telegram of condolence. If it was because you were afraid of missing your flight, we the people would be willing to put money together and fund a jet taking you home after you learn to do a charitable deed.

Another commenter, Trần Mai Sơn, remarks:

“Unacceptably cold-blooded. A visit, at the very most, would be just as long as the time it takes for her to put makeup on.”

Observations, like Sơn’s regarding the Minister’s mug have been picked up by many. Recall that not long ago, a staggering flock of teenage girls insisted that Dzohokhar Tsarnaevst, the accused Boston bomber, was “too beautiful to be a terrorist,” and it seems less vain and ludicrous when this time in Vietnam the Minister of Health’s trifling facial features became solid reasons for widespread hatred and judgments of personality:

“How can a person with that murderous mole have doctorly ethics?” – Tử Đinh Hương
“The minister is just ugly. With tattooed eyebrows, eyeliner and lips, she looks both ugly and malign.” – Ta Nhatanh

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Source: http://giaoduc.net.vn

While looks are clearly not on the minister’s side, it is her words and actions — or perceived lack of action — that have proved more problematic for many observers.

On 24 July, after a hastily-organized symposium between experts and the Ministry of Health’s senior officials, Tien said to the press: “Wherever the responsibility falls, we will resolve there. If it’s the vaccine’s fault, we’ll deal with the vaccine. If it’s the injector, we’ll deal with the injector. If it’s the technique, we’ll deal with the technique.

Delicate exigencies such as this require government officials to be articulate (to say nothing of tactful), a test that the Minister of Health seems to have failed. Her statement achieved little but to convince the public that she was an equivocator, a shirker, and the culprit behind every problem with the country’s public health sector. On the Minister’s now infamous statement, Facebook user Nguyen Thanh An writes:

“If it’s the vaccine’s fault, we’ll deal with the vaccine. What the heck is that? You’ll throw it away and things’ll be fine? Ridiculous. If your staff makes a mistake, as their senior, you have to admit to responsibility in front of the people. Whatever happens within your ministry, go home and deal internally.”

More laconic commenters threw in sarcastic remarks:

“Perfect how vaccine has no mouth to defend itself.” (Mứt Việt Quất)
“As long as the fault does not fall on the minister.” (Trương Minh Trí)

or:

“If that’s the patients’ fault, we’ll deal with the patients.” (Fata LError)

Apart from Minister Tien’s galling and much-ridiculed statement, the July 24 symposium did little to placate the public. It concluded that the three babies died from anaphylactic shock, the cause of which was unidentified. The public response was dissatisfied, to say the least. On the same day, July 24, it was reported in local newspapers that 20 children had died from what appeared to be faulty vaccinations within the past two years.

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That day, the Internet also welcomed a new Facebook fanpage dubbed Resign, Minister of Health calling for signatures for an online petition. Their pronounced goal was to reach 15,000 signatures, at which point page administrators said they would forward the petition to the National Assembly. By 23 August the count of membership of the Facebook page had reached 20,774. The page’s mission has been received with a mix of sentiments, from eager commitment:

“If we need a ten thousand ‘likes’ for Tien to resign, I will stay up all night to give enough clicks.” (Trieu Son)


“She bought that chair (of power) for more than a thousand US dollars. Let us chip in and give that sum back to her, so she’ll resign without delay.” (Vo Tuan)

to cynicism:

“There is no culture of resignation in Vietnam, but just people who’d, by hook or by crook, cling to their seats of power.” (Mẹ Bống)

and hopefulness:

“I simply want the public to know about this message. They may not sign it (the petition) out of fear, but this will make them believe that change is already happening.” (Thiên Long)

While millions of parents across the country were legitimately worried about the truth behind the vaccine’s possible lethal side, the Ministry of Health’s next two moves poured gasoline on the controversy. On 26 July, Minister Tien sent an express dispatch to the Ministry of Public Security, requesting an investigation from this department. On 30 July, a consent form was reported to have emerged and be assigned to parents in a few hospitals, which read“After hearing the medical officials explain about the benefits and possible side effects of Hepatitis B vaccination, I agree for my child to be inoculated. My family and I pledge full responsibility to this decision.”

A few commenters attempted to calm the crowds, such as Jirayu Tran, who reasoned that consent forms are part of a common procedure universally practiced. Even if that’s the only explanation, the timing was disastrous. The public saw their appearance, in the midst of the controversy, as proof that the ministry was doing its best to dodge responsibility and to indemnify itself against any future fatalities.

With more vaccine-related infant deaths revealed and revisited while the ministry had yet to present a coherent plan for secure vaccination, Vietnam’s cyber world became increasingly engulfed in obloquy and memes of wrath, mostly aimed individually at the minister:

Let me ask you this: without me, how would funeral services thrive?

Let me ask you this: without me, how would funeral services thrive?

Will you go to bed now, or do I have to give you a vaccine shot? (A parodic twist on what parents say to kids to urge them to bed, except they typically use a boogeyman instead of a government minister.)

Will you go to bed now, or do I have to give you a vaccine shot? (A parodic twist on what parents say to kids to urge them to bed, except they typically use a boogeyman instead of a government minister.)

I use this anti-shame cream everyday on my face and the 502 super glue on my ass, so don’t you dream that I’d resign.

I use this anti-shame cream everyday on my face and the 502 super glue on my ass, so don’t you dream that I’d resign.

On August 3, the Deputy Minister of Health said in a television interview that the ministry’s investigation, after 15 days, still had not reached a conclusion on the cause of the deaths. Incidentally, on August 6, Vietnam’s conducted its first lethal injection on a inmate (which Amnesty International condemned, but that’s another story), two years after the ruling criminal law was put in effect in 2011. As preparation of poisons was referred to as one of the causes of two-year delay in this law enforcement, still hungover on the vaccine scandals, Vietnamese netizens began sharing a meme that quickly caught on like wildfire:

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Prisoner: Officer… when will I get to be injected?
Unseen guard: Poison’s not yet available!!!
Prisoner: Still not available? Then please give me a vaccine shot. It’d be just the same.

The infant deaths that appeared to be related to vaccinations caused an immediate disturbance  in the national consciousness, but it was just the first roll of thunder of a brewing tempest to come for public health services and that ministry. In the four weeks since the death of the three infants in July, a series of other dramatic scandals in the public health sector have gained public prominence, no doubt due in part to heightened public scrutiny in recent weeks:

  • At Hanoi Obstetrics Hospital on July 16, a trolley flipped on the way to the baby shower room, dropping five newborn babies on the floor from the height of over a metre. Though the case appeared an accident, according to VTC News, the babies’ parents suspected it was in relation to  a nurse’s dissatisfaction with the “thank-you” money they had given her;
  • On August 1 authorities reopened an investigation into a series of large-scale embezzlements between 2007-2012 of medical X-ray technicians and doctors at Ho Chi Minh’s Trauma Orthopaedic Hospital.
  • On August 4 a misdiagnosis at Quang Nam Province’s Obstetrics Hospital lead to an infant’s almost being buried alive;
  • A deliberate and organized duplication of blood test results in Hoai Duc General Hospital in Hanoi, which had been going on since July 2012, was exposed by a hospital staff on 7 August, open for investigation by Hanoi police on 20 August;
  • On August 11 a tardy and incorrect diagnosis and treatment caused the deaths of a woman and her infant at Can Tho Province’s National General Hospital;
  • The most arresting and hysterical of the recent scandals in the wake of the ongoing vaccine controversy was probably one in which a 7-month-old girl was diagnosed on August 8 with “foreskin swelling” at the National Hospital of Pediatrics in Hoai Duc district, Hanoi.

With health scandals following one upon the other in recent weeks, the question of who or what went wrong with the Hepatitis B vaccine last month is no longer the chief question for many online commenters. It is now the question of how to radically transform Vietnam’s entire public health sector, which seems to be collapsing like a house of cards. Despite a joint statement from WHO and UNICEF that read: “Whilst one such incident is still one too many, it’s important to remember that immunization is generally safe, and provides vital life-saving protection for children,”laments of disappointment and anxiety are voiced all over the Internet:

“I’ve lost all faith in doctors in our country. All the money under the table, all those kids dying from vaccines, all the kids that plop on the floor… Who can be sure what else’s gonna happen next? Where’s their conscience?” (Mai Hà)

“I have a newborn baby. I am determined not to have her get the Hepatitis B shot. I am afraid she would be the 21st baby. We’d rather deal with whatever happen to her in the future than let her die an unjust death.” (Vân Phạm Thảo)

That the public places all of their contempt and indignation upon the Minister of Health is an understandable reaction. Anger is an energy that needs discharging at some tangible target. Yet, the failure of an entire system is rarely a single individual’s fault. Among the furious online crowd, some commenters expressed opinions along this systematic view, albeit despondent and cynical:

“Replacing a person is not hard. But more importantly, changing the methodology and mentality of an organization, of a country, is hard. If after this minister resigns, others will take over and no changes will be made. All of this’ll just come to naught.” (Hoang Duy)

“Whoever sits in the ministerial chair, the society remains the same, and we must learn to live with it.” (Thuy Anh)

“A country of the people, for the people, despite the people.” (Kenken Lc)

A month has now passed since the three infant deaths that kicked off the recent conflagration; in that time, the public health service and its ministry have yet to score a single point to their favor in the public eye. To make matters worse, on August 19, local media exposed a dispatch sent from the Health Ministry to the Public Security Department in Dong Da District, Hanoi, which suggested the police department hand over an ongoing investigation into corruption at National Hospital of Endocrinology so they could “handle the case internally.”

On August 20, the Health Minister made her first comment on the recent serial public health scandals, stating: “The Ministry’s responsibility is to issue legal documents, design policies and strategies, and propel the regulation enforcement. But the actual execution of these policies is the responsibility of local authorities,” a statement that once again convinced the public that the Health Ministry had no interest in anything but passing the buck.

Meanwhile, more items in the public health system’s dirty laundry basket have been and will probably continue to come to light, the latest of which was the August 16 arrest of the Director of Tien Giang’s Psychiatric Hospital for embezzlement of billions of dong. In July and August, local media outlets, known more for defending authorities than going after them, published reports with such critical headlines as “Group Interests in Public Health Sector” and “Scandals Corroding Faith in Public Health.” In July the BBC also discussedWhy do Vietnam’s Patients Bribe Their Doctors,” bringing the nation’s public health defects into the international spotlight. It seems what the Ministry of Health is facing is not only isolated unfortunate incidents, but the kind of rough weather that can crucially shake their boat and challenge the hands at the wheel.

Among Vietnam’s online communities, a popular joke has been spreading, accompanied with a visual illustration:

“To honor the merits of the country’s ministers in the work of building the country, a special collection of stamps was printed featuring the ministers’ portraits. Not long after, complaints were heard that the Minister of Health stamps in this series wouldn’t stick. Instantly, an investigation commission was created and got to work. They soon discovered the problem. It turned out that instead of licking the stamps’ backs, people had been spitting on their fronts.”

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Four senior government officials who’ve all been implicated in scandals:
Top left: Nguyen Thi Kim Tien (Minister of Health)
Top right: Nguyen Van Binh (Governor of States Bank)
Bottom left: Dinh La Thang (Transport Minister)
Bottom right: Pham Vu Luan (Minister of Education)

According to Transparency International’s 2013 Global Corruption Barometer, Vietnam’s medical and public health services are perceived by the people as the third most affected by corruption out of all sectors. In the face of deterioration of public trust, how the Ministry of Health handle this nationwide crisis will be a bellwether of how government bodies and their leaders can (or cannot) resurrect and rebuild from scraps the faith that the people of Vietnam are seemingly withdrawing from them.

The Facebook page administrators declined to reveal their identities, but they claimed the online petition calling for the Health Minister’s resignation has reached 9,246 signatures, more than halfway to its 15,000 target, with the next National Assembly Conference less than two months away. Additionally, with Facebook page Resign, Minister of Health going strong and steady, regularly pressing for the petition success, it is an interesting time to watch and measure the power that social media place in the hands of the common men — not so much in the way a petition can lead to real changes in this country as in how social media facilitate the public in challenging entrenched systems, ideas, and power holders.

That said, as we speak of a national healthcare system, whatever change may occur to or from the Ministry of Health, at the heart of this matter is the lives of millions of people awaiting to be assured of their right to health.

Mai Huyen Chi