After the implementation of the 50-beds reference centre in Ho Chi Minh-City (HCMC), the project for adequately treating spinal cord injuries, rapidly moved into its decentralisation phase, developing 3 provincial ‘satellites’, in Khanh Hoa, Phu Yen and Da Nang provinces.
The main difficulty of this decentralisation was in fact assumed by the team of trainers from the HCMC spinal cord unit, combining training and a follow-up of the provincial institutions with the regular training process (as trainees) by international specialists.

A total of almost 400 people with spinal cord injuries have benefited from the project this year, including 32 % in the provincial units. These beneficiaries are young adults (average age 36, 21 % women), injured from traffic, domestic, or labour accidents (buildings). 41 % are quadriplegic, with partial or complete paralysis of the four limbs.

After ten years of economical reforms Vietnam finally joined the World Trade Organisation. The imposed liberalisation of public services made them less accessible to the poor. The “Rehab for All” project, part of the “Spinal Unit” project, aims to maintain that specialized services are accessible to the poorest as they should be. It is based on an ‘Equity Fund system’, consisting in deducting 15 % of the service fees, to be poured in a cashbox supporting part of the costs for the destitute categories of beneficiaries: 70%, 50% or 30%, according to social screening. This trial period was assessed by an international Health Economist, whose main findings confirm the positive impact of EF on access to health care for the poorest.

The HCM Centre for Care & Rehabilitation of Professional Diseases and Handicap International faced a triple challenge by implementing a polyvalent orthopaedic workshop meeting the large needs of many kinds of disabilities, being financially independent, and still accessible to the poorest beneficiaries.
Its guiding principle is free choice for the Disabled clients: those who wish to obtain a sophisticated device and are willing to pay extra for it should be satisfied, as well as the less fortunate beneficiaries, who should receive their necessary basic device at a discount price.

The recent improvement of the socio-economic conditions in Vietnam (especially in the large cities) has again significantly increased the number of motor vehicles and in particular the number of motorcycles, which represent over 90% of the traffic. As the road conditions do not improve as quickly as the motorbike market and as very few people wear helmets or are aware of road regulations, traffic accidents have become a national disaster in Vietnam, a new major cause of disability and mortality.
On average, 2 people are killed every day in Ho Chi Minh City, 26% of them in the 3 suburban districts crossed by the 22 km of national highway, and populated by economical migrants from the provinces.
The project includes 5 complementary fields of action, named the 5 E’s:
Education, Encouragement, Engineering, Enforcement, Emergency assistance.
In the 3 target districts, an important decrease in accidents, injuries and fatalities was observed immediately after implementing the measures. Since then the situation has tended to stabilize, despite the extremely high population growth of 15, 5 % every year in these suburbs.

In Vietnam, a high proportion of neurological disabilities (like cerebral palsy or epilepsy) are due to conditions during pregnancy and delivery. With no early detection in maternities, disabled children are actually left without any appropriate care before the parents themselves detect a problem, meaning at a late stage. To detect disabilities on newborn babies at an early stage, would fill the 2-3 year gap in services between birth and first care, and therefore make rehabilitation more efficient.


The general objective of the ‘Welcome to Life’ project is to improve childhood conditions in Khanh Hoa province. This year, 19.736 babies were born in Khanh Hoa, including 29 % in the upgraded General hospital, where 6 % of the babies were premature, and the perinatal mortality rate was 1, 7%.
26 disabilities were able to be detected immediately after birth, and therefore cared for at the earliest stage.
The provincial Rehabilitation Centre for Children received 112 children, now also including babies (62), referred by the General Maternity. 79 orthopaedic devices were produced and delivered.
Working side by side, the Community-Based network of 340 volunteers follow 1,145 disabled children at home, including the 497 who need rehabilitation services.