Clinic Time at VCHAP-HCMC

After visiting the VCHAP office and learning about HIV strategy in Vietnam, we also were able to sit in on patient visits to the VCHAP clinic. We shadowed one of the Vietnamese doctors on staff as he saw the many patients who had come to have their HIV monitored and managed.

We sat in with Dr. Khoa, a young physician trained in Vietnam. Patients in Vietnam, like many other developing nations, approaches systematic record keeping by giving all patients a personal medical record that they take with them each time they see their doctor. Mirroring records are also kept on file at the medical institution.


Inside these medical records, physicians note the medications taken, and ostensibly also write in the diagnosis for any medical complaint. In our particular case, however, each patient was there primarily to renew prescriptions for their anti-retroviral regimen, so it the process was much more streamlined for that particular purpose. Dr. Khoa listened to the patients as they described any complaints, how they felt and how the drugs were affecting them. The WHO protocols lay out a particular timetable that describe how a patient should be responding to the medications after beginning the regimen and when the lab tests should be done to determine CD4 count. CD4 white blood cells are the particular cells affected by HIV and their count is used to determine the progression of the disease.


Nine times out of ten, this process resulted in the patient continuing to receive the front-line WHO ARV protocol, a result so common that each of the doctors in the clinic had a small stamp that listed the medications of the therapy. This facility was focused on management of HIV, but was also supposed to be able to hear about and refer patients that were suffering with other medical problems, whether or not those problems had to do with HIV. In practice, however, this clinic dealt almost entirely with the patient's responses to HIV medication.