I visited a number of the existing medical institutions in South Vietnam, and there is no question that the problems of overcrowding, inadequate supplies and insufficient personnel are probably insurmountable. The Da Nang Surgical Hospital is probably as well off as any Vietnamese hospital outside Saigon—but it is for surgery only; there is also a Medical Hospital not so well equipped.
Even in the Surgical Hospital, there are a number of tests that can’t be done with the inadequate laboratory and X-ray equipment. Frequent power failure is a major problem (suction pumps are vital in surgery rooms; one child died in Da Nang, for instance, because during an operation he vomited and—with no suction pump to with-draw the stomach contents from his mouth—breathed them into his lungs). Though 100 burn patients every month reach Da Nang Surgical Hospital, McLanahan reported that while he was there, the hospital had only one half-pint jar of antibiotic cream—brought in privately by a surgeon—which was saved for “children who had a chance of recovery.” In Sancta Maria Orphanage, I frequently became involved in trying, with a small amount of soap and a jar of Noxzema, to alleviate the festering infections that grew around every minor bite and cut.
In the nearby Medical Hospital, there are frequent shortages of antibiotics, digitalis and other equipment. While the Surgical Hospital makes use of outdated blood from military hospitals, most Vietnamese hospitals are chronically short of blood. According to another medical student, Jeffrey Mast, a hospital at Quang Ngai (60 miles south of Da Nang) occasionally “solved” a shortage of intravenous fluids by sticking a tube into a coconut—a common practice in outlying areas and, reportedly, among the Viet Cong.
The Swiss organization Terre des Hommes, which is attempting to provide adequate medical care for Vietnamese children (they were responsible for transporting Doan Minh Luan and Tran Thi Thong to England, and a few other children to other European countries), issued a report last spring Which said in part that in Vietnam,
hospitals … show the frightening spectacle of an immense distress. To the extent that one finds children burned from head to foot who are treated only with vaseline, because of lack of a) ointment for burns, b) cotton, c) gauze, d) personnel. In places with the atmosphere of slaughter houses for people, where flies circulate freely on children who have been skinned alive, there are no facilities for hygiene, no fans, and no air conditioning …
In South Vietnam, approximately 100 hospitals provide approximately 25,000 beds to serve the ever growing needs of the civilian population. Bed occupancy by two or three patients is not uncommon (two to a bed is the rule at Da Nang). I can testify personally to the accuracy of Manchester Guardian writer Martha Gellhorn’s de-scription of the typical conditions at Qui Nhon.
In some wards the wounded also lie in stretchers on the floor and outside the operating room, and in the recovery room the floor is covered with them. Every-thing smells of dirt, the mattresses and pillows are old and stained; there are no sheets, of course, no hospital pajamas or gowns, no towels, no soap, nothing to eat on or drink from.
“Americans in Vietnam who accidentally suffer serious burn injuries from napalm are rushed aboard special hospital planes … and flown directly to Brook Army Hospital in Texas, one of the world’s leading centers for burn treatment and the extensive plastic surgery that must follow. But burnt Vietnamese children must fare for themselves…”
An abandoned child, his belly distended from malnutrition, sleeps on a doorstep in Saigon. Many of these children take their own lives.
“… virtually every injury that reaches the hospital at Da Nang is already complicated by serious injection … doctors are forced to stop during emergency operations to kill flies with their hands…”
After superficial emergency treatment, a child—face and eyes torn by American shrapnel—awaits surgery at Da Nang. A lack of suction equipment—which would have kept him from inhaling the contents of his own stomach—killed him.
“Any visitor to a hospital, an orphanage, a refugee camp, can plainly see the evidence of reliance on amputation as a surgical shortcut”
“Torn flesh, splintered bones, screaming agony are bad enough. perhaps most heart-rending of all are the tiny faces and bodies scorched and seared by fire.”
“What we are doing to Vietnam may become clearer if the same percentages are applied to the American population.
They mean that one out of every two American families with four children would be struck with the tragedy of having at least one child killed or maimed.
There is a good chance, too, that the father would be dead as well. At the very least, he is probably far from home.”
Inside a Saigon hospital—some beds take three.
SEARLE SPANGLER, OF TERRE DES HOMMES, Says that there are only about 250 Vietnamese doctors available to treat all the civilians in South Vietnam. My own information is that there are even fewer; Howard Rusk of the New York Times gave a figure of 200 in September, and I have been told that there are now about 160. Obviously the difference hardly matters when at least five times that many children die every week. Dr. Ba Kha, former Minister of Health, told me that there are about nine nurses, practical and otherwise, and about five midwives for every 100,000 persons. He also told me that his ministry, charged with administering the entire public health program for South Vietnam, is allocated an unbelievable two per cent of the national budget.
There are, of course, American and “free world” medical teams at work, and USAID is increasingly supplying the surgical hospitals (a new X-ray machine has been installed at Da Nang, which AID hopes to turn into a model training hospital), but while their contribution is vital and welcome, it is like a drop in the ocean of civilian pain and misery. To speak of any of this as medical care for the thousands of children seared by napalm and phosphorus is ridiculous; there is simply no time, nor are there facilities, for the months and possibly years of careful restorative surgery that such injuries require. Burn patients receive quick first aid treatment and are turned out to make room for other emergency cases.
Although of course no one can talk about it openly, there are known to be cases in which pain is so great, and condition so hopeless, that the treatment consists of a merciful overdose. In an alarmingly large number of other cases, amputations—which can be performed relatively quickly—take the place of more complex or protracted treatment so that more patients can be reached in the fantastic rush that is taking place in every hospital. Any visitor to a hospital, an orphanage, a refugee camp, can plainly see the evidence of this reliance on amputation as a surgical shortcut. Dr. Hall has reported that hospitals allow terminal cases to be taken away by their families to die elsewhere, so that room can be made for more patients.
Then there are politics. A leading doctor and administrator in the I Corps area has found it difficult to get supplies for his hospital because he is suspected in Saigon of having been sympathetic to the Buddhist movement. In Hue, a 1500-bed hospital shockingly is allowed to operate under capacity because some of the faculty and students at the associated medical school expressed similar sympathies; apparently in punishment, the school and hospital receive absolutely no medical supplies from Saigon; only aid from the West German government keeps it operating at all. The dean of the medical school and some of his students were arrested last summer; a shipment of microscopes donated by West Germany was heavily taxed by Saigon. The harassment goes on.
At the present time, two groups are trying to do some-thing about the horror of burned and maimed Vietnamese children. They are the Swiss-based international group, Terre des Hommes, a nonpolitical humanitarian organization founded in 1960 to aid child victims of war; and a newly-formed American association with nationwide representation called the Committee of Responsibility. Their approaches are somewhat different, but they are cooperating with each other wherever it seems helpful.
IN THE AUTUMN OF 1965, Terre des Hommes arranged for about 400 hospital beds in Europe—like the two in England paid for by Lady Sainsbury—and fo
r surgeons to donate their services. They contacted North Vietnam, the NLF representative in Algiers and the government of South Vietnam. The first two turned down the offer, but the South Vietnamese government seemed willing to cooperate. Air fare from Saigon to Europe is about $1500, so Terre des Hommes asked for help from the United States government.
American soldiers in Vietnam who accidentally suffer serious burn injuries from napalm are rushed aboard special hospital planes—equipped to give immediate first aid treatment—and flown directly to Brook Army Hospital in Texas, one of the world’s leading centers for burn treatment and for the extensive plastic surgery that must follow. Burnt Vietnamese children must fare for themselves.
It was the use of such special hospital aircraft that Terre des Hommes was hoping for, though any air trans-portation would have been welcome. Although American authorities in Saigon at first seemed enthusiastic, the decision was referred to the White House. In January 1966, Chester L. Cooper—now in the State Department “working,” he says, “on peace”—wrote on White House stationery to issue a resounding NO.
… the most effective way of extending assistance [Cooper wrote] is on the scene in South Vietnam where children and others can be treated near their families and in familiar surroundings…. U.S. aircraft are definitely not available for this purpose.
Terre des Hommes wrote back to Cooper to argue the absurdity of the American position—there are, of course, no “familiar surroundings” in napalm-torn Vietnam, thousands of the children are displaced orphans, and in any case there are no medical facilities for the long and difficult rehabilitation of burned children. In November of this year, asked directly about the request, Cooper said:
A doctor in Switzerland, of apparently good intentions but somewhat fuzzy judgment, wanted planes to take these innocent Vietnamese kids to Switzerland for treatment. [Edmond Kaiser, founder of Terre des Hommes, is not a doctor.] … The problem, basically, is that Terre des Hommes—and the chap involved, I want to emphasize, is a well meaning man—when we looked into it—and I worry just as much about the injured kids as the next fellow, maybe more so—what they want to do, they want to be taking these frightened little kids halfway across the world and dump them there in a strange, alien society …
However much better a Swiss home or hospital might be, it cannot compensate for having their own families around them in familiar surroundings in their own country. Experienced social workers and hospital workers have described what happens when you take a child suddenly out of his environment: culture shock and trauma….
Either Cooper is grotesquely misinformed about medical facilities and family coherence in South Vietnam, or he would genuinely rather keep these horribly maimed children in the bosom of frequently nonexistent families, in the “familiar surroundings” of dirty fly-ridden hospitals or jammed refugee camps or burned-out villages, rather than subject them to the culture shock and trauma of clean hospital beds, relief from pain, and a chance for the kind of surgery that will give a Tran Thi Thong back her eyelids and enable a Doan Minh Luan to close his mouth.
In any case, while the argument was going on, Terre des Hommes turned to commercial airlines and asked them to donate whatever empty space they might have on flights from Saigon to Europe; they refused, possibly feeling that the experience might be psychologically difficult for their other passengers. Finally, in May, Terre des Hommes brought 32 children (including Luan and Thong) out of Vietnam at its own expense; they were both sick and wounded, and eight were burn victims. The tiny victims were brought out by arrangement with Dr. Ba Kha, the Saigon Minister of Health; when I visited Saigon, the doctor was extremely cooperative and seemed eager to implement any program that could benefit even a few of the people who, he acknowledged, are suffering terribly.
IN SEPTEMBER, Terre des Hommes arranged for another 26 children to be flown to Europe, and one of their representatives in South Vietnam chose the children. But when the planeload arrived in Geneva, the people waiting received a terrible shock. It contained no war-wounded children at all. All 26 were polio, cardiac and cerebral spastic victims, chronically ill children. Dr. Paul Lowinger of Wayne State University’s medical school was on hand when Terre des Hommes officials learned what had happened, and described them to me as “disappointed and frustrated” over the violation of the terms of the agreement.
So far, no one has been able to determine what happened to the burned and other war-wounded children who were chosen by Terre des Hommes but somehow didn’t arrive on the plane in Geneva. They have, seemingly, disappeared—or died. I have letters in my possession indicating that physicians who have been to Vietnam since my return fear that wounded and burned children are being hidden or kept out of sight of visiting doctors.
In the meantime, Dr. Ba Kha had been replaced, apparently for his actions in attempting to get the burned children out of the country, and his successor has demonstrated much less concern for the Terre des Hommes project. Most officials of the Swiss organization are convinced, though they cannot of course say so publicly, that the firing of Ba Kha and the substitution of the children was directly related to the fact that in England and else-where in Europe, the arrival of the first group of children had caused a tremendous stir about the cruel effect of the bombing. The arrival of Luan and Thong in Great Britain stimulated a large, spontaneous flow of gifts and contributions—and not a small amount of indignation about their condition.
Incidentally, Canadian reporter Jane Armstrong, who visited the Sussex hospital where the two children are being treated, wrote that “the hospital staff have been astonished by their happy dispositions,” and notes that “no one can say what will happen to Luan,” who has no known relatives. The culture shock and unfamiliar surroundings don’t seem to be bothering the children.
In any case, Searle Spangler, Terre des Hommes representative in New York, seems firmly to believe in “spy-like hanky panky” by the South Vietnamese government, including the secreting of badly injured children in order to play down the problem. He also said that “some of our Vietnamese workers have been mistreated, and we have reason to fear for them.” On the adequacy of medical care in Vietnam, Spangler notes that Terre des Hommes operates the only children’s hospital in the country—600 patients for 220 beds, with many of the children lying on newspapers—and that in other hospitals, some news-papers and wrapping paper are commonly used as dressings for burns, being the only material available.
THE AMERICAN GROUP, the Committee of Responsibility, has only recently been formed. Its concern is specifically with children burned by American napalm and white phosphorus.
Its national coordinator and moving spirit, Helen Frumin, a housewife from Scarsdale, New York, became interested in the problem last spring when she encountered some Terre des Hommes material. Later, in Lausanne, she met Kaiser and learned more, about the, problem. She. became convinced that Americans have a special responsibility toward the burned children of Vietnam.
“Napalm is an American product,” Mrs. Frumin says. “The tragedy that is befalling children in Vietnam is all the more our responsibility where children burned by napalm are concerned; only the United States is using this weapon, and it is fitting that we should provide the care for the mutilated children.”
The Committee backs up its position by citing such sources as a story in Chemical and Engineering News, last March, about a government contract for 100 million pounds of Napalm B, an “improved” product. The older forms of napalm, the article goes on to say, left “much to be desired, particularly in adhesion.”
This, of course, refers to the ability of the hateful substance to cling to the flesh of the hamlet dwellers on whom it is usually dropped, insuring a near perfect job of human destruction after prolonged agony. It is because American tax dollars are behind every phase of the process, from manufacture to delivery and use, that the citizens of the Committee of Responsibility (who include prominent doctors throughout the country) feel that American dollars might best be
spent in relieving the suffering they buy.
The Committee hopes at first to bring 100 napalmed children to America for extensive treatment. Hospital beds are being arranged, 300 physicians are ready to donate their services, homes have been found. But the cost for treating each child is still between $15,000 and $20,000, not including transportation from Vietnam to the United States.
The fantasy of the position that “adequate” care can be provided within South Vietnam and that “culture shock” might result from displacing a child, was pointed up in a report prepared for the Committee by Dr. Robert Gold-wyn, a noted Boston plastic surgeon. He said in part:
The children of Vietnam are the hardest struck by malnutrition, by infectious disease, and by the impact of terror and social chaos. They begin with the disadvantages implicit in a colonial society after nearly 25 years of continuing war, economic backwardness, inadequate food and medical facilities. Particularly helpless under such conditions is the burned child …
A burn is especially critical in a child because the area of destruction relative to total body surface is proportionately greater than that of an adult. And in the present real world of Vietnam, his nutritional status and resistance to infection is lower than that of an adult.
The acute phase of burn demands immediate and complex attention involving physicians, nurses, dressings, intravenous foods, plasma, often blood, antibiotics, and after the first week, wound debridement and skin grafting. Unless evacuation is simple and immediate and well-supervised, these early burns are best treated at or near the scene of injury.
The Plot to Kill King Page 45