AN INTRODUCTION TO OPERATION OF AMERICAN NON-GOVERNMENTAL ORGANIZATIONS IN HEALTHCARE SECTOR IN DANANG FROM 2001-2011
114 Le Thi Phuong Loan AN INTRODUCTION TO OPERATION OF AMERICAN NON-GOVERNMENTAL ORGANIZATIONS IN HEALTHCARE SECTOR IN DANANG FROM 2001-2011 Le Thi Phuong Loan University of Foreign Language Studies, The University of Danang; loan.lephuong@hotmail.com Abstract - The operation of American non-governmental organizations (NGOs) in Danang in the first decade of the 21st century has been of great interest recently thanks to their considerable contributions to the city’s prosperity, particularly in improving people’s living standard and to the two target programs of Five Nos and Three Yes Employing methodologies in international relations such as meta-analysis, international relations analysis, observation and statistics with a Neo-Liberalism perspective of NGOs in international relations, the paper finds that American NGOs in Danang have been most interested in healthcare system This sector has received their most investment and financial assistance since the last decade in terms of the project number and financial aids Among the organisations, East Meets West Foundation took the lead Most financial assistance comes to constructing infrastructure and providing medical equipment Eye Hospital, along with other provincial hospitals, have received most assistance However, other lower level hospitals and medical units have not received much investment from American NGOs Also, those activities have not yet been expanded to medical staffs training Key words - American Non-governmental Organizations; operation; financial aid; humanitarian activities; Danang healthcare sector Introduction Globalization in the twenty-first century has paved the way for non-governmental organizations (NGOs) to thrive and achieve significant recognition worldwide In the last decades, there has been a sharp increase in the quantity and operation scale of NGOs in international relations from 1,250 in 1980 to 45,000 NGOs in 2000 Also, they have gradually become governments’ crucial partners in facilitating community development all over the world Consequently, the study of NGOs’ operation has attracted deeper attention in more diverse fields International NGOs first came to Vietnam long ago Initially, they worked mainly in the South of Vietnam Since 1975, yet, international NGOs have considerably assisted Vietnam in reconstructing the nation, gradually promoting economic growth, and improving people’s living standard The number of international NGOs, hence, steadily increased in accordance with the country’s development, from 200 to 600 in 1990 and 2006 respectively Impressively, at the end of 2011, this figure was already 800 Likewise, the total finance assistance in 2009 was nearly USD 270 million, which was nearly 17 times as much as that of the early 1990s [5] Danang, the fourth largest city in Vietnam, has become the biggest cultural, economic, educational, medical and scientific center of the Central Highlands This resulted from appropriate development policies, good management of the city authority, and support from its citizens, as well as foreign and domestic cooperates, enterprises and NGOs Indeed, since 2000, the total aids to Danang has reached VND 1,331.3 billion, contributing to the realization of a large number of major infrastructure facilities for the city, especially in healthcare system Particularly, Danang has been the only city in Vietnam to have built a number of hospitals out of limited allocated public budget, thanks to financial contributions of individuals and NGOs Accordingly, this paper examines the current status of American NGOs’ operation in the healthcare sector in Danang from 2001-2011, for these NGOs account for nearly 50% out of 110 foreign NGOs having partnerships with Danang city [2] Overview of American NGOs (ANGOs) 2.1 What are ANGOs? Currently, there are approximately 1.5 million NGOs operating in the U.S They undertake a wide range of activities, from political to social ones to represent almost every possible cause Even though they claim themselves as non-governmental, these NGOs receive finance from grants of federal, state or local governments, apart from donations from individuals, philanthropic foundations, and private sector for-profit companies For instance, World Vision U.S collected USD 55 million worth of goods in 1998 from the U.S government [1] More importantly, ANGOs embrace an important role that they themselves sometimes did not realize: doing public relations for the U.S government Andrew Natsios, Head of USAID even emphasizes that: “From now on, NGOs had to a better job of linking their humanitarian assistance to U.S foreign policy and making it clear that they are “an arm of the U.S government” [6] Huong and Tinh [1] define ANGOs as those who are big in terms of number, budgets, and expertise As the world wars gave way to the birth and thrive of many ANGOs as an internal correspondence to unprecedented disasters caused by traditional international relations, the beginning of the 21st century witnessed increasing advocacy for ANGOs with larger roles in collaborating with governments in such missions as: settling disputes, providing relief, exercising the protection of human rights and gender equality, facilitating human progress, tackling environmental issues, and so on 2.2 Development of ANGOs in Vietnam The collapse of former socialist countries in the late 1980s resulted in the decline of support for Vietnam, yet, initiated chances for international NGOs from the West to aid Vietnam In 1988, Catholic International Cooperation for Development and Solidarity (CIDSE) became the first NGO to have an official representative in Hanoi after the THE UNIVERSITY OF DANANG, JOURNAL OF SCIENCE AND TECHNOLOGY, NO 6(91).2015 war The two turning-points for Western donors to renew their efforts to come back to Vietnam were the 1986-DoiMoi Policy and the withdrawal of Vietnamese troops from Cambodia in 1989 However, it was not until 1995, when the normalization of diplomatic relations between Vietnam and the U.S was officially announced, that ANGOs increased their aids to Vietnam as well as developed economic and political relations between the two countries Since then, the U.S government has funded humanitarian activities, mostly conducted by ANGOs to support war victims, children with disabilities and orphans of Vietnam in a way that helps bring these disadvantaged groups better lives There are several types of ANGOs operating in Vietnam at present Huong and Tinh (2004) categorize them into three major types as Social – cultural NGOs or Foundations; Religious NGOs; and Humanitarian NGOs ANGOs’ activities in Vietnam are very diverse, covering almost all aspects of life and almost all over Vietnam Huong and Tinh (2004) summarize over thirty fields of ANGOs operation in Vietnam, ranging from natural resources, healthcare, education, human and social development, bomb disposal, to natural disaster relief, etc [1] 2.3 Development of American NGOs in Danang ANGOs came to Danang at the same time with their appearance in Vietnam, yet with a limited number Currently, ANGOs account for nearly 50% out of 121 international NGOs and FDI corporates operating in Danang, in which 13 ANGOs have representative offices within the city They mostly concentrate on the five fields namely healthcare, childcare, education, humanitarian assistance, and poverty alleviation There are a variety of reasons for the interest of ANGOs in Danang Firstly, Danang is among the five centrallycontrolled municipalities in Vietnam prioritized in investment and development policies of the country Secondly, Danang possesses advantaged geo-political and geo-economic positions Lying at one end of the EastWest Economic Corridor, linking Danang and Mawlamyaing – covering Laos, Thailand, Myanmar and Vietnam, has created favorable conditions for Danang to call for investment in industrial zones and infrastructure improvement to boost regional cooperation and development along the economic corridor Thirdly, Danang has great advantages in water and air transport The city has been the largest commercial seaport and airport systems in the Central and Highlands region, 115 and the third largest port systems in Vietnam In recent years, Danang seaport has been improved to accommodate cruise ships to attract thousands of tourists from all over the world, along with improvements in freight warehouse and commercial activities at the port Last but not least, Danang used to be a major battlefield in the U.S – Vietnam war in the last century Hence, the city authority has been making efforts in handling war aftermaths, including cooperating with the U.S government and NGOs to remediate dioxin contamination in Danang international airport soil and sediment to eliminate risks of dioxin exposure, develop capacity for implementing similar remediation activities in other sites of the country; or working with the U.S Joint prisoners of war, missing in action (POW/MIA) Accounting Command (JPAC) to seek and transfer American remains back to the U.S All of the above reasons, along with the preferential treatment of Danang administration, have attracted more and more ANGOs to initiate and expand their operation within the city Operation of ANGOs in Danang from 2001-2011 in the sector of Healthcare 3.1 Current status As can be seen from the collected data from reports of Danang People’s Committee and Danang Department of Foreign Affairs, among many fields of interest, healthcare is ranked the first in terms of project numbers and financial aid.Particularly, East Meets West Foundation (EMW) has the most investment both financially (about VND 106 billion) and project quantity (18 projects – accounting for 25% of ANGOs’ total projects in this field) This indicates that healthcare is a major field of interest of ANGOs in Danang Most financial assistance comes to construction of infrastructure and purchase of medical equipment Danang Eye Hospital, along with other major provincial hospitals, including Danang General Hospital and Cancer Hospital, receive the most assistance Yet, other lower level hospitals and medical units have not received much investment from ANGOs, with only VND 8.600 million during the surveyed period This may be partly explained by more skilled health workers and advanced equipment of major hospitals, thus attracting more patients and investment Besides, ANGOs’ activities have not yet been expanded to medical staffs training Consequently, ANGOs should take into consideration the training of medical staffs, especially those at medical units of ward and village levels within the city Table ANGO’s aid projects in Healthcare in Danang (Source: Danang DOFA (2009, 2010, 2011, 2006)) No Spon-sor Project Name EMW Emergency Room - Danang Hospital Oncology Ward - Tropical Medicine Ward Danang Eye Hospital construction Substation construction in Danang Hospital Receiving/ Implementing Agency Total Committed Value (VND) Disbursement Value(VND) Year Danang Hospital 406,109,145 2003 Danang Hospital 5,586,436,635 2005 Danang Eye Hospital Department of Health (DOH) 6,864,712,725 2007 4,882,500,000 2009 4,882,500,000 116 Le Thi Phuong Loan Building and furnishing Tropical Medicine Ward and Oncology Ward Building and Furnishing Danang Eye Hospital phase 2, (add expense: $1,293,000) Annual Dental programs VVAF Multi-functioning Section construction Additional funding for Danang Eye Hospital, phase (source AP) Community-based mental healthcare model development + improvement Free wheelchairs GIBK Heart surgery VCF Newborn recovery support in Danang Women’s Hospital Construction CedarsSinai Center COV VNAH Medical Equipment for Cancer Hospital Heart surgery support for poor children and 01 container of foods, rice, porridge Functional Rehabilitation center construction at Hoà Sơn Medical Unit, Hoà Vang Dist Complete functional Rehabilitation modeling and socio-economic support for people with disabilities Interdisciplinary information management system of the handicapped UCPWFH Free wheelchairs and functional rehabilitation equipment Infants with disabilities Recognizing and care model coordinated in initial healthcare system in Danang Multi-functioning section construction for Danang Hospital AP Complete infrastructure and equipment investment for medical units at ward levels in Danang Building and Furnishing Danang Eye Hospital Danang Hospital 6,516,440,175 2009 Danang Eye Hospital 23,274,000,000 10,992,090,725 2009 DOH, Department of Education and Training (DOET) ~9,036,407,012 ~3,107,993,050 20092011 20,000,000,000 2009 34,996,832,500 2010 Danang Hospital DOH-Danang Eye Hospital 34,996,832,500 Danang Mental Hospital 10,618,816,500 Danang Charity Association Children and Mother Protection Association DOH Children and Mother Protection Association Children and Mother Protection Association, Cancer Hospital 3,527,180,000 20092011 3,527,180,000 1,800,000,000 2,437,500,000 2,437,500,000 20102011 20102014 2011 16,000,000,000 2007 150,518,625 20092011 Danang Charity Association 1,796,320,000 2,676,492,000 People’s Committee (PC) of Hoà Vang Dist 877,500,000 877,500,000 2011 DOH, DOLISA, Bình Dân Hospital 19,430,000,000 136,614,000 20102011 1,029,464,000 788,587,215 20112012 2,073,344,000 6,169,709,000 20092011 975,000,000 819,000,000 Department of Labor, War Invalids and Social Affairs (DOLISA) Danang RehabilitationSanatorium Hospital DOH DOH DOH 11,259,199,256 VND ~ USD 700,000 8,640,000,000 VND ~ USD 540,000 DOH 53,798,740,444 Emergency Center construction, Danang Hospital DOH 3,691,120,960 Building Tropical Medicine Ward and Oncology Ward – Danang Hospital DOH 20,335,928,872 THE UNIVERSITY OF DANANG, JOURNAL OF SCIENCE AND TECHNOLOGY, NO 6(91).2015 10 TASC Injury Prevention for Children DOH 11 ORBIS 12 GCSF 2010 Flying Eye Hospital Nutritious medicine support for HIV/AIDS infected children 13 Hope Haven Danang Eye Hospital Social Protection Center Danang Charity Association Free wheelchair As shown in the above Table, in 2011, EMW funded nearly billion VND for building the Eye Hospital and eye care treatment and health workers training in Danang The figure was nearly VND 11 billion and VND 35 billion in 2009 and in 2010 respectively EMW is still supporting Danang Eye Hospital Besides, Danang General Hospital gained more than VND 40 billion to build and improve Emergency Center, Tropical Medicine Ward, Oncology Ward, Multi-functional Section, and other medical infrastructures Additionally, dental treatment has become a yearly program of EMW In particular, in 2010, the funding for this program was about VND 1.2 billion (in 2008 and 2009, the figure was a bit higher with over VND 2.9 billion and VND 1.3 billion respectively) Yet, in 2011, EMW committed to spend approximately VND 3.5 billion on this program but the disbursement value was only VND 890 million EMW also donated VND 139 million to free heart operations for poor patients When it comes to heart surgery, in 2001, Giving It Back to Kids (GIBK) donated VND 1.8 billion for children who suffered from heart diseases Remarkably, it was much higher than the two previous years when, in collaboration with VinaCapital Foundation, GIBK had funded about VND 249 million in heart surgery for poor children Children of Vietnam also contributed over VND 2.676 billion to helping poor children have healthy hearts again Moreover, handicapped patients in Danang fortunately obtained batches of wheelchairs with a total value of more than VND 7.4 billion from UCP-Wheels for Humanity, Hope Haven and Free Wheel Chair Mission Vietnam Assistance for the Handicapped (VNAH) supported this group with complete functional rehabilitation model and support their lives Nearly VND one billion was given to implement the interdisciplinary information system of handicapped management This helps manage database of the handicapped more easily and systematically ANGOs also spare their care to mental patients in Danang A typical example is that Vietnam Veterans of America Foundation (VVAF) funded VND 743 million to this target group with a hope that they would get proper treatment More importantly, the community-based mental healthcare model has been developed in the city with participation and donation (nearly VND 13 billion) of many ANGOs, including EMW, VVAF, and American National Health Institute (NHI) Infant and female healthcare were also taken into consideration by ANGOs Among prime examples is VinaCapital Foundation’s donation of VND 16 billion to the construction of Women’s Hospital in 2007 (Two years later, this hospital received VND 343 million as medical 117 2,885,398,020 5,070,000,000 5,070,000,000 116,980,000 58,490,000 3,128,580,000 3,128,580,000 support donated by VNAH) VinaCapital Foundation also spared VND 2.500 million to support newborn recovery activities Likewise, The Alliance for Safe Children (TASC) donated about VND 2.8 billion for injury prevention for children Atlantic Philanthropies donated nearly VND one billion to care and diagnose infants with disabilities Other areas of medical care like cornea donation, stroke prevention, orthopedic surgery, etc were also concerned by various American NGOs, such as GIBK, NHI, and ORBIS with a total funding of more than VND 2.5 billion Sexual health care is a newly arising area that has attracted the attention of ANGOs In 2011, Family Health International (FHI) funded VND 264 million to assist the city’s authorities with sex education for men Vets With a Mission (VWAM) spared VND 760 million for building technical room for medical services in reproductive healthcare to promote better health services in the areas of fertility Other projects such as giving away medicine or vitamins for HIV/AIDS infected children were also undertaken by Global Community Service Foundation and GIBK Patients who encounter poverty are guaranteed to have daily meals and travel expense thanks to GIBK’s donation worth over VND 55 million [2], [ 4] 3.2 The Cooperation of Local Authorities and Achievements When conducting health care projects in Danang city, ANGOs have gained enormous assistance from the Provincial Health Office, Department of Foreign Affairs, Danang Hospital, Danang Rehabilitation-Sanatorium Hospital and other local charity associations as well as charity centers They help ANGOs’ construction projects go smoothly and distribute aid resources to appropriate target groups Health officials of these hospitals and other medical units also positively take part in training courses This bilateral cooperation makes ANGOs’ projects in healthcare sector become more efficient [2], [5] Being first on the list of total projects funded by ANGOs which are categorized by sectors, Danang’s healthcare system has improved dramatically Many vulnerable and poor people who used to rarely have any access to basic healthcare are now fortunately leading healthy lives thanks to ANGOs’ healthcare projects including annual dental check-ups For instance, until the end of 2006, EMW’s dental project, which started in 1996, has helped to treat 38,000 poor children at schools for blinded students, including Hope Village and SOS Village This free treatment helps prevent those children from teeth-related diseases There are more and more professional health officials as well as facilities, which makes it easier to meet the need of Danang citizens and patients from neighboring provinces [4] 118 Le Thi Phuong Loan Conclusion Vietnam is undergoing rapid economic growth and impressive social changes facilitated partly by appropriate policies and institutional reforms, which have promoted foreign investment and assistance to Vietnam.Among foreign organisations, international NGOs is an important channel Since 1995, there has been a gradual warming in Vietnam-U.S bilateral relations This milestone has paved the way for the establishment of ANGOs around the country Danang, one of Vietnam’s five major socioeconomic centers, has made use of the financial aid, technological transfer, and capacity building provided by ANGOs, especially in healthcare sector EMW has financially supported Danang’s major hospitals most in the last ten years Other ANGOs have contributed greatly to such activities as offering medicines to HIV/AIDS children, training health workers, delivering service of Flying Eye Hospital, and providing sex education Hence, Danang healthcare system has attained considerable improvements However, most of the projects went to medical infrastructure but not staff training Moreover, while major provincial hospitals received the most assistance, other lower level hospitals and medical units have not received much investment, which remains a challenge for both ANGOs and the city authority to tackle In addition, ANGOs should take into consideration the localities’ demands to establish feasible projects to make use of the support and coordination from local people, the city government and beneficiaries REFERENCES [1] Nguyễn Thái Yên Hương, Lê Đình Tĩnh (2004), Các tổ chức phi phủ hoạt động đối ngoại Mỹ, Đề tài nghiên cứu khoa học cấp Viện, Học viện Quan hệ quốc tế [2] Sở Ngoại vụ thành phố Đà Nẵng (2008), Báo cáo mười năm công tác viện trợ phi phủ nước ngồi địa bàn thành phố Đà Nẵng [3] Sở Ngoại vụ thành phố Đà Nẵng (2009), Các dự án lớn triển khai từ 2006-2009 [4] Sở Ngoại vụ thành phố Đà Nẵng, (2009, 2010, 2011), Báo cáo số liệu viện trợ tổ chức phi phủ nước ngồi [5] Lovrekovic, M (2010), Assessment of International Development NGO Activities in Vietnam, retrieved 14 November 2012 from: http://www.ncnk.org/resources/publications/Assessment%20for%2 0international%20Development%20NGO%20Activities%20in%20 Veitnam.pdf/at_download/file [6] Klein, N Bush to NGOs: Watch your mouths, The Globe and Mail, June 20, 2003—Page A15, http://www.theglobeandmail.com (The Board of Editors received the paper on 15/02/2015, its review was completed on 24/03/2015) ... more and more ANGOs to initiate and expand their operation within the city Operation of ANGOs in Danang from 2001-2011 in the sector of Healthcare 3.1 Current status As can be seen from the collected... data from reports of Danang People’s Committee and Danang Department of Foreign Affairs, among many fields of interest, healthcare is ranked the first in terms of project numbers and financial... field of interest of ANGOs in Danang Most financial assistance comes to construction of infrastructure and purchase of medical equipment Danang Eye Hospital, along with other major provincial