Stories and Case Studies
Tales of the Experiences of our Volunteers
Greetings from Vietnam
by Gary Arthur, FACPSEM
This account was written in September 2014. Gary completed this program in January 2015, and subsequently returned to Vietnam in May 2015 to take up another program and continue his work.
Hopefully many of you are aware of the Asia Pacific Special Interest Group of the ACPSEM and its fund raising events that are held from time to time. What you may not be aware of is that the ACPSEM is also what is called an “Australian Partner” (AP) for the Australian Volunteers for International Development (AVID) program run by the Australian Department for Foreign Affairs and Trade (DFAT). More specifically they are partners in a program to provide a ROMP trainer for the Ho Chi Minh City Oncology Hospital, and that ROMP is me.
I have been here now 5 months so it is probably a bit late for first impressions, but one thing that stands out is the sheer busyness of the place. They treat up to 120 patients a day per linac – yes, that was per linac. With 4 linacs and a cobalt unit that’s a lot of patients and waiting rooms for both linacs and clinics are packed out.
I was surprised to learn there are about 25 radiotherapy centres in Vietnam, still that’s not many between about 90 million residents. One thing that has struck me is the vast range of medical physics knowledge and skill among the centres.
There is of course no formal and practical training program – a situation not so dissimilar to Australia a few years ago. However when I reflect on my own training there was always plenty of textbooks or journal articles available and willing experienced senior physicists to pass on their knowledge. This is not the case in Vietnam.
In general I have found centres to be poorly resourced in terms of physics equipment and I have heard stories of centres where new equipment was donated, but sits idle as either it was unsuitable or no one knows what it is or knows how to use it. I should point out that I’ve only visited a few centres and much of my knowledge is from word of mouth.
I won’t bore you with what I have been up to, but it has involved a range of things related to linac QA, dosimetry, documentation, commissioning of various pieces of equipment etc. I have done a lot of teaching, both to the physics staff as a whole as well as to individuals including a university student. As compared to Australia I have learnt not to take for granted what a medical physicist may know, but with no formal training programs, Vietnamese textbooks or a good senior mentoring system I am no longer surprised.
I am however often surprised. Recently I was asked to present my work on measurement and use of electron virtual source distances at the hospitals annual conference, not a problem except that the full text of my talk had to be submitted in two days and there was still some measurements I wanted to perform. Also recently I discovered a Leipzig HDR skin applicator (in original packaging) and was immediately asked to commission it* Of course everything I do I do as a training exercise with other physicists.
There are lots of challenges: the language barrier, cultural norms that sometimes seem to work against progress and development, heat and humidity, missing family and friends, lack of equipment, stomach bugs, chaotic traffic …., but balancing all that are the rewards when a technique is improved, an error is corrected or someone’s face lights up because they finally understand something. The people are warm, generous and friendly and the food is great and cheap.
The Elekta Travel Award 2014
The 2014 Elekta Travel Award was given to Matrika Prasad Adhikari, a Medical Physicist from Nepal. Matrika works at the B.P. Koirala Memorial Cancer Hospital in Bharatpur, Chitwan.
During his visit to Australia, he was able to attend the Combined Scientific Meeting held in Melbourne in September 2014, and attended by 1,300 professionals working in radiology, radiation oncology, nuclear medicine and other associated professions. This event was jointly organised by RANZCR, AIR and ACPSEM.
Matrika also visited and studied The Alfred Hospital, including the William Buckland Radiation Therapy Centre, and the Peter Maccullum Cancer Centre.
Matrika completed and submitted a report for the Elekta Travel Award.