Sunday, 14 January 2024

Clinical teaching and lecturing at HCMC Pediatric Hospital #1... and heading home to the US

Pediatric Hospital #1 in HCMC is the largest of 3 pediatric hospitals. They are a destination for kids and families throughout the entire country for diagnosis, treatment, and surgeries. They are a teaching hospital for clinicians from universities and other hospitals and clinics across the country. 

The hospital site is huge, with 3 more buildings in the planning stages for this year.


Inside the hospital grounds-- lots of outdoor waiting areas and places to buy food and medicine (families are usually responsible for purchasing all supplies for the child's hospital stay).

Play areas on the hospital grounds


Heading to the physiotherapy-rehabilitation department!

A mini shuttle bus travels between buildings

Hưng, physical therapist, grabbing my backpack to hustle me
into the rehab department. 

It's been interesting to track how the hospitals in the two different parts of southern Vietnam continue to grow and change. Where the emphasis in Can Tho was refining their diagnostic frameworks and processes for developmental challenges, the focus of my time in Ho Chi Minh City was on "We know how to diagnose. How do we treat?" 

Many of the clinicians in HCMC have completed certifications and Master's degree coursework in speech and language therapy through a collaboration between the largest medical school in Vietnam and an Australian non-profit organization. These clinicians are now training other clinicians in smaller provinces throughout the country. Their professional knowledge continues to grow, and they are so committed to providing this much-needed service. 

This year, I was asked to lecture on AAC use for autistic children, Evaluating social communication for young autistic children, and Therapy for social communication for young autistic children. I was joined by the hospital speech therapy clinicians, pediatricians, and speech therapists in training from the medical school for my 3 action-packed days. 

In addition to lecturing each afternoon, mornings were devoted to clinical supervision, feedback, and treatment planning. Similiar to my clinical education work at Northwestern, I observe a clinician in a session and then review the session with her and the other session attendees. 

To my right is Mr. Giao Le, head of the physiotherapy department. Giao makes my entire visit happen-- including translation, clearing the significant bureaucratic hurdles, and determining my areas of focus for lectures and discussion. 





Discussion about how to provide opportunities for a child to practice using AAC to say "eat."

In addition to the pre-planned lectures, we often end up in long discussions and brainstorming related to how different support systems for children are set up in the US, and what might apply to systems in Vietnam. We had long discussions about US laws and policies related to Early Intervention/Birth-3 services and to Special Education services in the schools. Some parallel systems are in the very early stages in Vietnam, but there are many, many legal, policy, and cultural hurdles to account for. 


Following an observation of a therapy session, we discussed what the next steps in clinical planning could be. This is always a hot topic-- what are different ways that a therapist can help a child learn and practice a targeted skill? 
Ms. Yen is an ST emeritus at the hospital and was my first contact there 20 years ago. She continues to practice as an ST privately, doing Auditory-Verbal Therapy with children receiving cochlear implants in Vietnam. We caught each other via Zalo videochat in between our sessions in HCMC!






Good conversations this year about how to help children be more active participants in therapy sessions. The clinicians are learning about how to share the balance between adult and child in sessions.
Custard apples are a good quick snack in between sessions.


Sold in the hospital "can tin (canteen)," a coconut is essential to
the success of any lecture.

The department runs group ST/OT sessions and uses pictures to show the children the group's schedule.We had good discussions about how children can also use the pictures to share their ideas and interests.




I got fantastic advice from my sister, who conducts a lot of workshops and trainings internationally, to provide a small gift to everyone to commemorate our work together. I gave everyone an "infinity" pin, which is often used as a marker for "autism acceptance" and "autism rights."

As a group, we had great discussions about how the clinical conversation can move from pathologizing developmental differences to advocating for and developing necessary supports.

Thanks to Karen and Robert for nudging me to buy these pins,
they were a big hit!





Mr. Giao and Ms. Tam have guided and supported me across a lot of my visits to HCMC. We had a terrific dinner together after my last day of lecturing where they shared their big picture vision for clinical training opportunities over the next 5 years. Can't wait!




After a lot of goodbye hugs, more gift exchanges, and many "see you soon's", I packed the black hole bag to its absolute max and headed to the airport for the next 24 hours of traveling home. 
The trip's MVP

In the HCMC airport. I will advocate for both "Kiddy delights" and "Sleep boxes" as universal airport features!

A highlight of the trip home is the layover in the Taipei airport. Each gate is themed, from "Taiwan's national parks", to "Taiwan cinema," to "Hello Kitty/Sanrio." It's really fun to walk around (and around and around and around, as I try to exhaust myself before the 15-hour flight to Chicago). There was a new-to-me vegetarian food hall, so I had to have one last bowl of noodles before coming home:


And with that final food photo, I'll close out the blog for this trip. Thanks again to all of you for your interest, encouragement, and support! Please let me know what questions you might have, I'm always happy to talk more about this trip :) !

















ALL XE OM, all the time

Every time I am in Vietnam, I post photos of different xe om (scooter) configurations. Ho Chi Minh City is very stylish, this year I wanted to record some of the different styles and accessories on the scooter drivers. 

There are a couple of different Vietnamese ride-share apps. You can get a ride on this scooter through the Be app. Spiffy jacket, right?

Ride shares with the green jackets and helmets
are through the Grab app.

People regularly sit, sleep, eat, and work
while sitting on their parked scooters.





I think this person was transporting cotton balls.

People regularly wear gloves and arm coverings to protect from the sun, and put aprons over their lower half to protect their clothes while driving.



High heels and super fashionable.


Lots of curbside coffee and snack vendors that you pull up to on your scooter. This vendor is selling a sweet corn + rice combo
and sticky rice snacks.


From my Grab car ride back to the hotel one afternoon.


My mask is hiding my big goofy grin-- this was my xe om ride to the HCMC Pediatric Hospital each morning. The driver is one of the hospital physical therapists, who I've known for 10 years. Here is our exchange getting things set up over Zalo, with all safety assurances 😁: 


I had a lot of practice using Zalo, the Vietnamese texting platform, this year-- families, doctors, drivers, therapists were communicating with me over Zalo.  

Next up, working at HCMC Pediatric Hospital #1, the largest teaching and research pediatric hospital in the city.