By Nancy Kelly, MHS
Nancy Kelly, MHS served as HVO’s executive director from 1986 to 2023.
In 1992, HVO received a grant from USAID for a national rehabilitation training project in Vietnam. This was well before relations between the U.S. and Vietnam were normalized by President Clinton in 1995. The U.S. trade embargo, imposed in 1975, was still in effect until 1994, adding additional layers of complication to an already challenging situation.
To work in Vietnam at the time, HVO had to have a “License to Trade with the Enemy” issued by the Department of the Treasury. This license was key to HVO’s ability to implement the grant, send volunteers, and otherwise conduct programs in Vietnam. To wire funds to a bank account we had set up in Hanoi, we had to demonstrate to our U.S. bank that we had this license. In fact, the vice-president of Riggs Bank was so skeptical that he personally called the Department of the Treasury to verify that the license was legitimate. Once confirmed, he initiated the transfer, and I was invited into the back office to witness the transfer. We were joined by almost all the bank staff given the historic nature of this transfer.
Not surprisingly, the project did not start as quickly as had been anticipated, due in part to bureaucratic delays in Vietnam. The U.S. had no diplomatic relations with Vietnam, and dialogue was difficult until the appropriate intermediaries were found. As a result, the initial assessment team was not able to enter the country until nearly six months after the grant was awarded. However, once the team visited in March of 1993, progress was more steady. We quickly determined that the project would be based in Hanoi and the Ministry of Health (MOH) would serve as the lead ministry for the grant. Both decisions were well received by our Vietnamese hosts. In fact, HVO proved to be the first American NGO to establish such ties with the MOH, since other American NGOs usually worked with the Ministry of Labor, Invalids, and Social Affairs (MOLISA).
But being first, of course, meant that there were challenges. Many of the initial problems had to do with the Ministry of Health having never worked with a USAID-funded American organization. US government grants come with lots of rules and regulation – many of which necessitated a great deal of explanation on the part of HVO.
The MOH was not familiar with the U.S. government grant process and frequently tried to get assurances that certain percentages of the funds would be spent in Vietnam. Ironically, the grant required that we “buy American” whenever possible, even if costs were higher. Airfares were a prime example – volunteers had to fly on U.S. carriers even if significantly cheaper options were available on other carriers. The MOH was not aware of the requirement to return unused funds, nor did they understand the concept of overhead expenditures. As a result, there remained an element of skepticism throughout the entire agreement. Much of this attitude stemmed from their vastly different worldview and experience.
A few years into the project, I recall arriving in Hanoi where a senior official proposed that the Ministry of Health take over handling the remaining funds. It would relieve HVO of a considerable amount of work (quarterly financial and narrative reports, for example) and they would only charge HVO a 10% management fee for this service. I think he was quite surprised when I responded by telling him that I could go to jail for that.
Despite these challenges on both sides, the opportunity to design and implement a national program designed to improve the quality of rehabilitation care in Vietnam was truly exciting on many levels. The fact that we had a grant to support our project meant that we could set up a small office in-country, we had funds to support a variety of workshops across the country, and we had the ability to support nascent professional associations.
We never went flashy in Vietnam – no cars emblazoned with the HVO logo driving around the countryside. A staff, small in number, but competent and dedicated, handled interactions with MOH officials and colleagues and supported volunteers.
Over the years, trust was built on both sides, and, when the project finally wound down in the fall of 2007, I think it would be fair to say that we accomplished a great deal in terms of expanding and improving rehabilitation care on a national scale in Vietnam. Equally important, we also developed deep and long-lasting professional and personal relationships with many colleagues around the country.
And today, the work continues. Currently, HVO has fifteen active projects in Vietnam in anesthesia, dermatology, nursing, obstetrics and gynecology, oral health, oncology, and rehabilitation.
Vietnam is now considered a middle-income country – well on its way to a bright future.
To read the story of one nurse educator’s 30 years of experience with this project, click here.