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Vietnam should tom-tom its medical prowess, achievements

March 10, 2022 | 04:47 pm PT
Nguyen Hong Ha Doctor
I have just received a notice from the European Journal of Oral and Maxillofacial Surgery.

They informed my colleagues and me that our study, "Classification of Complex Soft Tissue Injuries in the Maxillofacial Region," has been published.

For the first time, a medical classification in Reconstructive Oral and Maxillofacial Surgery by Vietnam was accepted by one of the field's most prestigious journals.

It is very difficult for Vietnam to come up with a definition or classification that is accepted by Western scientists. However, this recognition is not necessarily good news. We managed to achieve this partly because the number of traffic accidents in Vietnam is way too high. Every day, frontline hospitals receive 20-30 emergency surgery cases due to accidents, many of which involve large injuries in the craniofacial region.

Western doctors don't have to deal with so many cases since there are few motorbike accidents. The majority of craniofacial injuries in developed countries are caused by firearms, meaning they were shot or committed suicide using guns. Such injuries are completely different from complex craniofacial injuries, which the world has been struggling to classify.

A scientist once had to perform experiments by throwing skulls down on to the ground and noting down which areas of the skulls were broken in order to classify them. In the U.S., the medical community also had to experiment by dropping heavy dumbbells on the faces of dead bodies, observing the resulting injuries and thereby determining the types of injuries.

Vietnam meanwhile has countless cases of facial fractures, becoming the pain of doctors and patients. There are so many such accidents that our database has pictures of thousands of patients with major face injuries. By putting about 300 of such pictures side by side, we realized that the injuries have five basic shapes, which could be named after the letters they resemble for easy classification: O, X, A, I and C. Since this is a classification of maxillofacial injuries, we added M at the start and named our classification M.O.X.A.I.C.

The medical community badly wants to classify maxillofacial injuries because in science, communication would be very difficult without definitions and classifications. Figuring out the type of the injury could help determine the treatment direction, the prognosis and which specialties to coordinate with, so it is important for everything to be systematized.

The leading scientific journal easily accepted Vietnam's classification thanks to the way we comprehensively studied and summarized the research on a large sample size of patients.

Everyone who conducts research knows how important it is to have articles published in prestigious scientific journals. No published article means no scientific research done. For Vietnam, the medical field is the largest contributor, accounting for 16-18 percent of the total number of Vietnamese scientific articles that are published internationally in all fields.

However, there are very few Vietnamese research articles on preventive healthcare, public healthcare, in-depth studies of specific specialties and articles that can make real contributions to direct treatment of patients in clinical practice.

Meanwhile, Vietnamese doctors have to deal with a much larger number of patients than their international counterparts. International medical interns always want to come to Vietnam because of the richness and diversity of the cases. Vietnam is a "fertile land" for medical research.

At an international conference on laparoscopic surgery held in Vietnam, a foreign professor was among those who made presentations. On the sidelines of the event, when a Vietnamese doctor asked the foreign professor how many patients he had operated on using the method he had presented, the professor admitted that he had only operated on about 20 cases.

Meanwhile, my teacher had operated on more than 100 cases using a similar method but he'd never made reports or written articles about it anywhere. The skills of Vietnamese doctors in some fields are very high but barely anyone knows about them.

The fault also lies with us. Doctors at frontline hospitals are always busy, so they remain focused on their work and are not given to making it known. This apprehension about publicizing, toward interacting with the media, has caused even Vietnamese citizens to think that they need to look to the West for good treatment.

Overworked, poor foreign language skills and lack of attention to writing scientific articles are the reasons Vietnam's medical achievements are not well known to the world.

Professor Ton That Tung was once recognized by the international medical science community with a liver resection method named after him. There would certainly be more such recognitions if Vietnamese doctors could reduce their workload and are encouraged to publish scientific papers. The government's policy of recommending that doctors studying for a doctorate need to have internationally published scientific articles has helped make the medical field Vietnam's leading contributor of scientific articles in international publications.

The main purpose of publishing articles is not to attain academic titles, degrees or report on achievements. They have high practical value.

Research from Vietnam can help doctors around the world gain more experience in handling cases. Our classification of soft tissue injuries in the maxillofacial region will help many doctors in countries with traffic conditions similar to Vietnam easily diagnose and treat cases correctly. Just by seeing that the injury is A-shaped, doctors can predict the possibility of danger. Blood could flow through the patient's nose into their throat and then their airway. If blood enters their lungs, it could put them in a deep coma and cause cerebral edema, which can easily lead to death. Therefore, upon recognizing the A-shape, doctors must immediately consider performing tracheal intubation so the patient can breathe. It is a very simple intervention but has helped us save countless lives.

We have done more and talked less. But that is not always a good thing. We should talk more about what we've done.

*Nguyen Hong Ha is head of the Maxillofacial, Plastic and Aesthetic Surgery Department of Viet-Duc Hospital in Hanoi. The opinions expressed are his own.

 
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