Understaffed, underpaid: tough working conditions for HCMC Covid medical staff

Thach Hung was preparing medicines for new Covid-19 patients for the Ward 12 medical center in Binh Thanh District last Friday when the call came.

The nurse rushed with an emergency kit to help a man who'd just collapsed on No Trang Long Street, around 100 meters from the center.

Unfortunately, the man had died by the time Hung got there. After confirming the death, Hung transferred the case to the local police, and rushed back to the medical center.

While Hung was away to attend to the emergency, three other staff, nurses and pharmacists, did not have any time to rest. One prepared medicines for Covid-19 patients treated at home, another received new Covid-19 patients to guide them on what needed to be done next, and the other one tended to a patient who'd suffered another health problem.

Around the same time, Nguyen Hong Thien, a volunteer, drove a motorbike to the 60th family that had reported having Covid-19 suspects in the day. Thien would carry out tests and help the family with necessary procedures.

Member of a medical task force explains procedures on self-isolation to a newly-detected Covid-19 patient in Binh Thanh District, December 3, 2021. Photo by VnExpress/Thu Anh

Doctor Tran Thi Hoe, head of the Ward 12 medical center, said that since early November, the number of new Covid-19 cases in the ward of 39,000 residents has risen rapidly to 40-70 cases per day. The ward has around 700 Covid-19 patients being treated at home, Hoe said.

Since the city began implementing several months ago the policy of having Covid-19 patients self-isolate themselves and only hospitalizing severe cases, it has been relying on medical task forces with state-owned medical centers across wards and communes to take care of the former.

Hoe said for the new duty, the center has formed a mobile task force of four members, including two new staff and two that have worked at the center even before the pandemic.

In all, it now has eight staff in total – four mobile and the other four staying at the center.

During the peak of the latest outbreak in HCMC, the center used to receive over 100 patients a day but there were dozens of volunteers to share the workflow back then.

Since Oct. 1, when the outbreak was basically deemed under the control and the city resumed socio-economic activities, the volunteers returned to their normal lives, leaving all the work on the two teams of eight medical workers.

Apart from directly taking care of Covid-19 patients, the eight workers have to perform other tasks including completing procedures to start or finish quarantine, vaccinating children against Covid-19 and other diseases, having children take vitamin A as per the national program, vaccinating adults against Covid-19 and taking care of patients with health conditions other than Covid-19.

The situation is no different at the medical center in District 1’s Tan Dinh Ward.

Tran Hoai Phong, head of the center, said they also have just eight medical workers and the ward now has 300 Covid-19 patients being treated at home.

With Covid-19 patients far outnumbering medical workers, the team in Tan Dinh has to "work 200 percent of their normal capacity from morning to midnight every day.

"They are all worn out," Phong said.

More work, same money

Despite all the hard work that they do, medical workers at ward/commune medical center said they have not been given any raise to date.

Apart from the one-time allowance regulated at either VND4.5 million ($195) or VND10 million for frontline medics, they have been paid exactly the remuneration they received before the pandemic.

The head of the medical center, like Hoe and Phong, is paid VND6 million per month while nurses like Hung get a monthly salary of VND3.75 million.

Every quarter, they receive an additional income of about VND12 million dong, if they are on the official payroll.

Hoe and Phong said they have their spouses to share the household’s financial burdens and can cover daily expenses, but Hung said his salary was not enough for him to take care of his family of four, including two children aged four years and 3.5 months.

Personally, Hung still has to worry about tuition fees of almost VND50 million to study at a university after transiting from a community college.

Before the latest outbreak hit HCMC in May, Hung, 31, used to work part-time as a ride-hailing driver.

Since the outbreak, he has had no spare time to do the side job, which has cut his earnings.

His wife and kids returned to their hometown in the Mekong Delta several months ago to escape the pandemic and cut family expenses.

Staying alone in HCMC, Hung moved out of his rented apartment and stayed temporarily at the medical center but even without the monthly rent, the nurse said he has to rely on financial support from his parents.

"I did think about quitting this job several times, but put aside that thought as quickly as possible. I told myself that if I quit, I'm giving up my passion.

"I’m hoping that my salary will increase sometime in the future."

Nurse Thach Hung (in white shirt) works with his colleagues at the medical center of Ward 12 in HCMC's Binh Thanh District, December 2021. Photo by VnExpress/Thu Anh

In the first ten months this year, 968 staff at state-owned medical centers quit jobs compared to 597 last year, Nguyen Thi Huynh Mai, office chief of the city’s Department of Health, told the press last month.

A majority of those who quit were medical workers at ward/level medical centers, she said. Most cited their family’s financial problems or personal reasons in the resignation letters.

Hoe said there have been days when staff at the center she's in charge of in Binh Thanh District have burst into tears due to the work overload and other pressures.

A medical worker herself, Hoe said she has more than once felt sorry for herself, and every time that happened, she would think: "I will not let my children follow this career path."

Phong said the key to reducing overload at ward/commune medical centers is to add more staff to proportionally match the locality's population.

Besides, the city should have better allowance policies for medical workers so that they can completely focus on and be devoted to their work.

HCMC currently has just 2.3 medical workers per 10,000 residents, compared to the national average of 7.4, Nguyen Van Vinh Chau, deputy director of the city Department of Health, said last month.

He said there were 310 medical centers at commune and ward levels, with 52 having less than five employees, 173 having six to eight each and 64 having nine or 10.

He said there were many reasons for the staff shortage; and some of them are related to policies that fail to attract or retain workers.

Another reason is that private hospitals are developing rapidly and luring medics with more attractive working conditions.

In the ongoing Covid wave that hit Vietnam in April, HCMC has been the epicenter with more than 478,300 cases as of Sunday, almost half the national tally.

As of last Friday, the city had 66,857 Covid-19 patients isolated at home.