Patients pay the price as hospitals struggle with supplies

Pham Hue Tom’s father died of cancer a few weeks ago.

Despite the terminal nature of his condition, she believes the death was premature for a strange, painful reason – lack of morphine at the HCMC hospital that he was staying.

“His cancer could not be cured but the morphine could have eased the pain. He could have felt better and been able to enjoy food and lived longer,” she said.

Tom, a resident of Dong Nai Province, had her father admitted to the Military Hospital 175 in neighboring HCMC.

The hospital used to give cancer patients two to three morphine pills a day for VND3,000-7,000 (13-30 U.S. cents) apiece. Later, it ran out of the pills and patients’ families had to look for them at private hospitals or other places that charged up to VND150,000 a pill.

“My family is not that rich,” Tom said.

Hospitals across Vietnam, not just major cities like HCMC and Hanoi, have been hit by a severe shortage of medicines and medical equipment in recent months, delivering more trauma than relief to patients and their families.

Hue, who took care of her father at the Thai Binh General Hospital in the northern eponymous province, said she was asked to buy everything outside, from needles to bandages, as the hospital did not have them.

“They asked me to go around and buy from the most basic things. We (patients’ families) were very upset about it.”

Hue said the problem has been going on since early this year. She had not encountered it last year.

She recently transferred her father to Hanoi and had to deal with the same problem.

“The hospital kept asking me to go to this and that center for medicine, where they were more expensive.”

Hanoi’s K Hospital, a major cancer facility, has been asking patients to purchase certain medical equipment such as catheters and IV needles on their own.

The Dong Anh General Hospital in the eponymous Hanoi district lacks certain essential chemicals and other biological products. Therefore, it has to send samples to other facilities to determine a patient’s condition, even something like a myocardial infarction (heart attack). It also lacks supplies for less invasive kidney stone removal procedures.

In HCMC, which is dealing with its most serious dengue fever outbreak in many years, many hospitals now lack important medicines for treating the disease.

Nguyen Minh Tien, deputy director of the HCMC Children’s Hospital, said they’ve run out of Dextran transfusion fluid for dengue patients, and new supplies are only due in December.

In many cases, doctors have had to resort to alternatives that are less effective, or to some that are not covered by public health insurance, meaning higher treatment costs for patients.

Dengue fever patients and their family members at HCMC Hospital for Tropical Diseases, June 2022. Photo by VnExpress/Quynh Tran

For the last three months, the Can Tho General Hospital in the Mekong Delta has been short of different kinds of medicine, including those needed for surgeries and special treatments. These become very expensive if patients have to buy them at pharmacies or private hospitals.

“We are struggling with medical supplies on a daily basis,” a hospital leader said, adding that the number of patients coming to the hospital since early June has dropped 20-30 percent from previous months because of the current situation.

The problem is also common in Hau Giang Province which borders Can Tho.

For months, the province’s general hospital has lacked anticoagulants, antibiotics and medicines for hepatitis, cancer, diabetes, high blood pressure and mental health problems.

“We have been calling for donations and asking patients to buy medicines that are cheap on their own. But the situation is very stressful,” said another hospital leader who did not want to be named.

Under regulations, the hospital needs to store enough medicine for two to three months, or worth VND6-10 billion. But the value of medicines at the hospital in early June was just VND1 billion.

Bidding troubles

Several health officials and hospital leaders said complicated bidding procedures and low financial capacity after two years of Covid-19 were major reasons for the poor medical supply situation.

A Hanoi hospital representative said the shortage was caused by “complicated legal bidding procedures.” Units have to double-check everything carefully to make sure they don’t break any law, slowing down the process considerably.

The Covid-19 pandemic has also plunged several hospitals into financial difficulties, forcing them to curtail purchases. Since most medical supplies are imported, the fact that businesses have not fully recovered from the pandemic means supply chains are not functioning smoothly. Certain drugs and other medical products also require lengthy bidding processes.

Pham Khanh Phong Lan, Deputy Chairwoman of the Vietnamese Pharmaceutical Association, said current bidding regulations require health departments to find the cheapest products for public hospitals, which makes it hard for them to find supplies or settle for poorer quality.

Lan suggested that the government removes the bidding requirement for generic medicines.

She said: “Hospitals should be authorized to buy their own products. Private hospitals do not have to go through a bidding process.”