With funds provided by the German NGO “Stiftung Wirtschaft Hilft Hungernden” (German Economic Foundation For Humanitarian Help) some hundred children with various forms of life-threatening congenital malformations of the heart have undergone open heart surgery in specialist hospitals in Ho Chi Minh City.

        Awareness of the miserable situation of children suffering from agent orange-ralated birth defects and other serious health problems was raised again on occasion of recent visit to Vietnam of a delegation from this German private foundation. Headed by its founder and president, Mr. Dipl. Ing. Claus-Werner Ruff, the delegation had talks with their Vietnamese partner organization and representatives of several social and health institutions involve in foundation-financed programs.
        The German aid foundation is active in Vietnam since 1996 supporting projects for handicapped children in Can Gio district, HCM-province, and has also initiated since mid-2004 an extensive heart operation program. With funds from German companies as well as private donors, the foundation supports projects in various Third World countries, building schools, hospitals, social centers and children`s - villages for Aids-orphans, war orphans and streetchildren, digging wells for clean drinking water, and organizing emergency program. The scope of the foundation`s engagement in Vietnam has been permanently broadened over the year so that today it constitutes their largest aid project worldwide.
        In 1996, the foundation`s attention was drawn to the huge problem of rising numbers of children with birth defects possibly related to agent orange, and acquired mental and physical disabilities. On application of the Social and Rehabilitation Centre Can Gio, two schools for handicapped children, dormitory for old people, dormitories and vocational training facilities for handicapped children and healthy youth were constructed and mobile service for ambulant care established with the foundation. In order to make the centre economically more and more independent from external assistance, a number of income-generating projects were created. Today, revenues from the centre`s fish sauce and oyster production, worshop and dockyard for the construction and repair of ships and boats cover a growing portion of the budget.
        Only in 2004 became the foundation aware of the large number of children with congenital heart disease in Vietnam waiting for proper treatment. Life expectancy in this serious disease is extremely low unless a heart operation is performed in time. Many of these children, however, are from very poor families who cannot even afford the cost of diagnosing the disease quite apart from meeting the expenses of operation and ralated intensive care.
        Mr. Claus Rufff who returned to Germany last year deeply shaken from visit to families of seriously ill children in Can Gio, immediately initiated a fund-raising campaign of his foundation specifically aimed at supporting a heat operation program for children from impoverished families. In the meantime, from a list of 235 children in urgent need of an operation, around 100 have successfully undergone heart surgery, further 24 are already scheduled for operation, and from the remaining children acute cases will be operated according to medical priority.
        This huge operation program funded by a foreign private organization is unique to date in Vietnam. There are some other private initiatives for heart sick children. They are, however, considerably smaller in term of number of children operated. More over, what is particularly remarkable here, is the fact that the foundation has not only provided part of the individual cost of operation but has in all cases shouldered the complete expenditure of surgery and intensive care.
        To organize and implement such an immense program was only possible because well-organized hospitals and well-trained teams of heart surgeons are available in Vietnam. In Ho Chi Minh city there are two hospitals, which can conduct even the most intricate heart operations, i.e. the Heart Institute and the Trieu An Hospital. During their stay in HCM City, the German delegation also had the chance to visit both institutions and talk to the management of the hospitals and the surgical teams. 
        Particularly impressed of the high quality of specialized equipment in operating theatres and ICUs as well as of the professional excellence of the surgeons were the delegates Prof.Dr.Wolfgang Hiller of Munich University, member of the foundation board, and Dr. Heinz Palla, medical consultant to the foundation. Said Dr. Palla “The Vietnamese colleagues kindly invited me to be present at some highly complicated interventions. What I have seen convinced me that the quality of their work is in every respect comparable to that of the best surgeons in Germany or elsewhere.” Prof. Dr. Hiller remarked upon the visible dedication of the medical personnel towards their work: “In our discussions you could fell how deeply concerned doctors and nurses were for their patients.”.
        In Hue, discussion with the management and the heart surgeons of the Medical College concentrated on the scope and implementation of heart operations. More than 20 heart operations have meanwhile been funded there by the foundation and will be conducted. 
        In view of thousand of heart sick children waiting in Vietnam for surgery, other hospitals are making efforts in establishing heart surgery departments and ralated facilities. In this respect, the German delegation also discusses with the management of Nha Trang Provincial Hospital to explore the foundation`s means in supporting the equipment needed in build up of a local heart surgery department. 
        One aspect that always sprang up in the discussions between German and Vietnamese participants was the relevance of agent orange and other toxic agents to the occurrence of birth defects and other diseases in Vietnam. It became evident that opinion is split on this topic and available epidemiological data seem insufficient to attribute with certainly all these ailments to the chemicals sprayed during war time.
        As far as malformations in general are concerned, there is a growing bulk of evidence for agent orange to play a decisive role, not least because of the close relation between the amount of chemicals sprayed in a particular region and the respective incidence of malformation. The district Can Gio for instance where the foundation has built up facilities for an unusually high number of handicapped children, due to its strategic situation at the mouth of the Saigon river, has suffered particularly heavily from repeated bombing and spray of agent orange and other toxic agents by the US Air Force.
        With regard to congenital heart disease, on the other hand, the relation to agent orange is not as clear cut. According to experts from the Heart Institute in HCM City, more epidemiological work has to be done to arrive at a safe conclusion here. Mr. Claus Ruff has his own opinion to this topic: “For me personally and for the foundation the final cause of the disease does not matter at all. It is the sick children we want to support suffering from a life-threatening illness of whatever reason”. He hope the publishing of this article may help generate local support for his program, particularly from foreign companies operating in Vietnam.

Dr. Heinz Palla