WEEKEND IN HUE Kathryn L. O’Donnell, R.N. National AORN President

Editor’s note: Back in 1959, Kay O’Donnell was stationed in Saigon, with a Medico team, as a guest of the Vietnamese Government, teaching and demonstrating her techniques of OR nursing as an assistant to Dr. Richard H. Overholt, head of the team and of the Overholt Tho- racic Clinic of Boston, Massachusetts. Her letters home were always interesting and we print this not only because of her keen eye and zest for living, but because we also get a fascinating backward look at a country now so torn with strife that Vietnam has become a household word the world over.

Kay O’Donnell’s his t job in Saigon was to set up the surgery. She says, “The OR was a very large room with two small air conditioning units. A n overhead surgical light was purchased for us, and an intricate German-made anesthesia machine. Other than that, the OR had an ancient table, two wall shelves, and that was it. We had taken only special instruments and equipment with us since we had been assured that they had basic kits. They used long Kochers for hemostats, and large French scalpels, but I found some rusty blades which the coolie sharpened and polished for me. W e shopped for oxygen valves, copper and rubber tubing, had glass bottles blown, and rubber corks fashioned. Drapes were stitched according

On Thursday, May 14, 1959, Shirley Wolf (the other nurse) and I took a trip to the village of Hue, pronounced “Whay,” about 600 air miles from Saigon. To do this we had to get up at 4:3O a.m., taking off at ex- actly 7:OO a.m. on a once-a-week flight in an Army type of plane with bucket seats. A great part of the plane was filled with cargo. In all, we were four passengers and four crew men. As we took off, Shirley looked a little green and I remember wish-

to instructions, sponges cut and folded, cot- ton balls made. Everything was scrubbed down without hot water since there was none. Solutions such as saline had to be made and autoclaved. The autoclaves just went up and down-no exhaust. Linen was usually soggy but cultures rarely showed bacterial growth.”

After two and a half weeks, surgery was ready, and the first of many operations was scheduled. Fortunately, one weekend was available for travel to Hue, formerly capital of all Vietnam, now perched precariously only 50 miles from the Communist border, and rife with guerrillas. The beaches, temples and majestic Imperial tombs which Kay ODonnell enjoyed so much are now out of bounds to all foreigners, especially to Ameri- can military personnel stationed nearby.

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ing that I had never consented to make the trip. However, after we reached a height of several thousand feet I felt fine and settled back against a strap of canvas to be uncomfortable for three hours.

The captain invited us to sit in his seat for a while, next to the pilot. This was a wonderful experience as I could see a great deal of the heavily treed country and almost fancied I could see the wild animals below. At Hue, Anita Smith‘s Vietnamese male secretary met us and took us to stay at Anita’s home where we were to be guests. Anita is a Nurse Advisor to the town of Hue, employed by the U. S. Government, and we had become well acquainted with her in Saigon where she spent one or two weeks of each month.

The secretary, called Hue-just like the town-saw to our needs and went back to the hospital to pick up Anita. Her house is provided by the Government and is most attractive, with a large living room, dining room, two kitchens, two bedrooms, bath, sunporch, and large servant’s quarters. There is a male cook called Heihn, a female boyesse called Mink, and two Vietnamese girls age 11 and 14 whom Anita is fostering because the mother is so poor.

Besides having a secretary, Anita has Thuan, who is an interpreter, advisor and companion. Thuan is a lovely Vietnamese girl, a refugee from the North Vietnam capital of Hanoi. She has become very “American.” Her family was well-to-do but when the Communists came they were forced to flee with only the belongings they could carry. Her father had to start all over in Saigon. This is the usual story which we hear every day. Thuan lives in the house with Anita and has the use of all the servants. Without these interpreters, Americans would be lost here.

The hospital has its frontage along the Perfume River which flows through the center of Hue. I t gets its name from the

beds of lotus flowers which can be seen by the thousands in many parts of the river. In the slum areas, other things are also to be seen floating in the river which make me wonder if that is why it was named “Perfume.” At the hospital, we met Mr. Bough, a Vietnamese nurse and Director of Nurses who spent a year studying at the Massachusetts General Hospital and Bos- ton University.

Anita’s work goes beyond that of a nurse. For instance, she met with the contractor to discuss some remodeling which was under way. Since the French built most of these old hospitals they have many separate one- story units. A single hospital may incliide 30 or more buildings, all enclosed by a high wall and all constructed of stone on cement, painted yellow. Properly kept up, they would present a beautiful sight but now they are so badly in need of repair that it would be cheaper to tear them down and rebuild.

First we went into the Obstetric build- ing. One half was empty as it was being remodeled. Even so, it was almost impos- sible to enter a lavatory because of the terrible stench. The workers were painting right over the dirt, and the water on the floors was two inches deep since the con- tractor had put in new sinks but had for- gotten to tell the workers that they should be connected to pipes. Screens were put in windows on the first floor but not in the second as they didn’t think flies went so high.

In the part of the building not under re- pair, the women lay on old iron beds, no spring, no sheets, no pillow. They lay fully clothed and the food which was brought from home was kept under the bed so that the flies were as thick as if a piece of fly vaper had been put there. The babies lay in a wire type of bassinet bv the mother’s bed. fully dressed, even to bonnets. Most of them were very cute. The mothers nurse their babies until they go home and then

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they supplement with anything the baby will take.

The medical and surgical wards are large and open, with about 40 beds each. Screens in the windows each have a small section which can be opened, so they always are, and the flies are everywhere. One woman’s body was covered with burns which had become infected. I doubt that she will ever get better. She had been burned trying to light an oil lamp which tipped over. It is a common occurrence among chil- dren, also.

The kitchens are at each end of the wards and how one can eat food from them, I’ll never know. Most of these patients are so poor that the only food they know or care about is rice and the hospital maintains each patient on about 12 piastres a day (about 18Q) so you see they can’t get much to eat. Their relatives are allowed to bring in food if they wish.

The worst is Pediatrics. From the out- side, one would think that it must have been condemned and that it is about to be torn down. Inside, it is worse. Along the outside corridor are many small room which house iron cribs for babies and children four to six years old. Again no mattress-only boards. Some of the sights I never want to see again. Most of the babies had big fat abdomens, a sure sign of worms, and one of the commonest symp- toms of the very poor. There were a great many cases of burns, Mongolism, rickets, hair lips, cleft palates. Everything was in- fected. In most instances the mothers and grandmothers were sitting in the crib along with the children, trying to stuff rice or pour tea into them. Flies were here too in appalling numbers.

The treatment rooms are small, with scanty equipment. It is almost impossible to carry out sterile technique. There is only one pediatric doctor. He works day and night to care for the children but it

1s a losing battle. These children and their mothers are all expressionless and there is very little noise as the children are too weak to cry.

One of the commonest operations on chil- dren is removal of a bladder stone. There were at least six of these cases in a small group and the flies were all over the in- cisions. I don’t have to describe the smell in these wards.

The nursing school is made up of two or three classrooms in one small building. A three-year nursing program is in force but until quite recently, only two years or less were required.

Nurses are housed in tin huts with bunk beds. These huts are kept reasonably clean but are so hot I don’t know how they sleep. The majority of nurses are male. A few who have shown promise have been sent to the U. S. for training but since so little money is available for that purpose nursing is still on a low level.

Thursday was the eve of Buddha’s birth- day so after a delicious steak dinner, we drove around the town to see the excite- ment. This year’s celebration, we under- stand, far outshone all others and we feel fortunate to have been there. For miles on the river banks, colorful lanterns were strung, each with a lighted candle. Numer- ous floats in the river were decorated with colored candles, looking very much like Christmas trees and birthday cakes. About 12 feet high, they floated up and down the river, their colorful reflections entrancing to the eye. All through the town the vil- lagers had strung lights and artificial lotus flowers in front of their homes and huts. Temporary little Buddha temples and pa- godas were to be seen everywhere along the countryside. Everybody was out on the crowded streets. Satiated at last with the beauty and pageantry-and the jostling- we went off to our comfortable, clean, un- crowded quarters, feeling fortunate in more

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ways than one. On the holiday we got up at 5 a.m., had

breakfast and walked about a mile to the big pagoda on the hill. We walked be- cause it was impossible to get through the crowd any other way. The police let us through and into the front lines where we stood, armed with cameras, from dawn until 10:30 a.m. watching the parade of handmade floats and pagodas. Many of them were in the shape of temples, made of braided bamboo and flowers strung to- gether to trim the edge. I never did see such color. Buddhists were dressed in brightly colored silk robes. Men, women, and children all marched in the parade, or I should say, shuffled. There were about 100 groups in all. Balloons bobbed on every side. Vendors sold bowls of rice, sugar cane on sticks, popcorn, and fruit. Presents of food were left at the temple for Buddha. By 10:30 we were so hot and sunburned we had to leave but I was glad we went even if it had meant getting up so early.

Friday evening we went to a nearby beach, putting the car on a ferry with the driver and crossing the river in a sampan. This boat is manned by two women, one at either end, rowing in Vietnamese fash- ion. It cost us two piastres each for the ride, and there were about 20 in the sam- pan. A group of people had just arrived from the market with their produce. With the produce and the people, it’s a wonder we made it across safely, but we did. On the other side, we drove a mile to the beach where I had my first swim in the China Sea. The water was disappointingly tepid.

As we sat on the beach a little girl came along selling bananas and peanuts. The bananas, only 2y3 inches long, are de- licious but the peanuts are boiled in the shell so I didn’t like them. Afterward, we had a 7-course Vietnamese dinner at Anita’s which was excellent.

Saturday morning we again rolled out at 5:30 a.m. for another day of sight- seeing. I t sounds like a ridiculous hour but it gets very hot by 8 o’clock so it’s necessary to get an early start. We drove in a jeep for a distance of 60-70 miles to Marble Mountain and the Tourane beach. Anita has her own car but it was easy to realize why she chose the jeep. The chauf- feur had to exercise the utmost caution as he drove over the narrow, twisting country roads, through soggy rice fields and over the high mountain pass. How the road was ever cut through I’ll never know. It re- minded me somewhat of Capte Breton in Nova Scotia as the cars are allowed through the pass only one way at a time. There is a certain schedule so if one is late he must wait an hour.

Finally, we made it to the foot of Marble Mountain where we were faced with at least 200 steps-almost straight up! When told that to see anything we had to go to the top, Shirley, Hue and I decided to climb despite the broiling heat.

We rested every few steps but finally made it-soaking wet. At the top stood a Buddha temple where we were met by three priests with shaved heads, maroon cassocks, and bare feet. They were so dirty I pre- sumed that they never left their mountain- top. They led us into various caves where the images of Buddha are carved by hand from the local marble. In situ, I believe is the term. In the largest cave, reached by a long tunnel, were four Buddha altars, each flanked by burning candles and bearing offerings of food for the Buddha.

The cave was easily 200 feet high. Through a hole in the top, which was edged by yard- long icicles, I could see the blue sky above -an astonishing sight considering the heat which I knew existed just outside that hole. The cave itself was refrigerator-like and in one rock wall a piece had been chiseled out for a small spring. A glass is always kept

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there to catch the water and the belief is that if you drink some of it you always remain pure and free from evil spirits. Tak- ing one look at the glass and another at the priest, I decided to take chances on the evil spirits, which at least were not as apparent to my eye as were the dangers lurking in that dirty glass.

As we neared the steps to begin our climb down, the Buddhist guide pointed first to still another rising stairway and then to a cave dug deep into the ground, indicating that the stairs led to heaven and the hole to hell, or its equivalent. We thanked him, gave him a little money since he requested it, and chose the third alternative, to descend Marble Mountain from the opposite side. The descent was easier and gave us a SUC-

cession of wonderful views of the China Sea. I took pictures here.

At the foot of the mountain, marble statues were being sold. Here I bought two hard-carved tigers and two elephants, all of the local marble. We were very thirsty so we bought cocoanuts, had holes cut in the tops and drank the milk. Since we had no straws we had to tip the cocoanuts close to our mouths to drink. Nothing could have been more refreshing.

We next drove to the village, parked the jeep, and walked over a rocky ledge to the beach where we wanted to swim. Even with shoes on we could scarcely stand the heat in the sand. One of the boys cooked an egg on it to prove that he could.

We had been told that the beach had fa- cilities for undressing. These “facilities” proved to be a wooden V-shaped device, stuck in the sand on stilts, which barely covered us from neck to knees! The fourth side offered an unobstructed view. Anyone could walk behind us and get the full panorama. To get dressed and undressed in Times Square and retain one’s modesty would have been simpler. Anyway, the water and the swim made it all worthwhile.

Afterward, we drove into the center of Tourane for a delicious Chinese dinner such as no one gets in the US. Chop suey and chow mein are unheard of. We re- traced our 60 or 70 miles and arrived back in Hue in time to get dressed and go to a cocktail party for an hour.

Between cocktails and dinner we heard singing outside. We went out and saw at least 300 Catholic Vietnamese marching down the road, each bearing a lighted candle. A priest marched in the center, flanked by six men carrying a small altar on which rested a picture of the Blessed Virgin with lighted candles on either side. It was an unusual procession. All were singing, in unison, hymns to the Blessed Virgin. A church band brought up the rear.

Dinner was a party, held at the hotel as guests of the Army boys. I stayed until 11 p.m. and then left. It had been a big day.

On Sunday I went to Mass with one of the little Vietnamese girls. The 5 a.m. Mass was still going on when we got there at 6 o’clock. The church was packed and so was the church yard. About 6:15 the Mass was over and we were able to go inside. The seats were long, narrow benches with no kneelers but the sexton came with a straight chair and insisted that I sit down. The priest talked almost a full hour in Viet- namese and I fomd it very interesting.

After Mass we had breakfast, at 8 a.m., and then took off in the jeep for more temples. The temples are those of the former kings. They depicts his likes and dislikes by the various articles left as a shrine. At one, the surrounding moat was literally covered with half-opened lotus flowers-a truly beau- tiful sight. The temples were most unusual and colorful and here again, one had to climb many steps. The tombs, in back of the temples, are usually closed to the public.

After visiting the temples we went to Wall City, the site of the Imperial Palace, all within the confines of Hue. The Palace

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had been bombed during the Indo-Chinese War and a great part of it destroyed. Within the very high walls, the Queen Mother had two homes, one Oriental and the other Western. The oriental house had six dining rooms-all lavishly furnished. A roomful of Oriental china vases was almost be- wildering in its variety.

That evening Anita gave a dinner for us at her home. Sixteen invited guests were served buffet style-really American. We were all more than ready for bed when the time came.

Monday morning we again didn’t dare to sleep late. There was more to see. Rising at 6 a.m. we hurried through breakfast to get to the hospital as quickly as possible. There we met Dr. Binh-head of the Blood Bank in Hue. He had the most efficient set- up I had seen so far. Dr. Binh is a very eager, up and corning doctor who is anxious

to give good service and maintain the high- est standards. The Bank was almost empty as donors are hard to find and each person gives only 250 c.c’s in comparison to our 500 c.c’s. Equipment was scanty but ade- quate. The place was spotless, which made us realize that with proper training and teaching it could be done, right here in the relatively remote areas of Vietnam.

We also met the head of the hospital who told us some of the problems with which he is confronted in trying to run such an institution. The biggest problem is the fami- liar one of inadequate funds.

On Monday afternoon we came back to Saigon via Air Vietnam. We arrived at 6 p.m. and found that we were to attend a dinner at 8 O ~ C I O C ~ but I was so stiff from walking and climbing that I decided to go to bed instead. It took me three days to recover but I’ll never forget Buddha’s birthday in Hue.

88 AORN Journal