The Children of Vietnam

The focus of this program is on the children of Vietnam. Was happening to them, what has being done for them, were voluntary organizations here, and abroad, can do for them, and what they would like to do for them. Mr. Pepper, you spent, ah, 5 or 6 weeks last spring in Vietnam. Could you begin by describing what you saw, the children in Vietnam? The various faiths available to the children of Vietnam who constitute a majority of the population. That country, there were, a hundred and, 15 and under in 1964 constituted 47 and a half percent of the population, as in 1966 it's, it was in excess of 50 percent, according to the Enesco representative there. Are varied, and, um, in many ways, I suppose, it equally devastating. Some more subtly than others. There were the massive numbers of children who have been injured, directly as a result of the conflict. And the injuries range across the entire spectrum of, of war injuries and casualties that you could find in any war situation. There are great numbers of children who are resident in shelters, in camps throughout the country. There are a 1,200,000

in these camps that stretch around along the coastal area from Da Nang down toward Cam Rahn Bay in semicircular fashion around Saigon (inaudible word) metropolitan area. Great, great numbers of children live in these areas, having come in from, from battle scenes. There are children risen in orphanages, good number of them. There are 77 orphanages when I was there, I suppose they're are closer to 80-, 85, 86, at this point. There are children who, um, are resident with mothers, or families, or relatives in dependent fashion, various sections of the country outlying on the metropolitan areas and the provincial towns and cities. Tens of thousands of children inhabit the streets of the provincial towns and cities of Vietnam. And they sort of live in packs, for the most part. Packs ranging in size perhaps from 5 to 10. I found interesting enough they have their own turf areas, and the own distinct ways of attempting to survive. Those ways range anywhere from flagging cars, washing cars, selling newspapers, shining shoes, soliciting for their mothers, selling their sisters. A whole

range of activities that were necessary for them to engage in in order to survive. They They do survive according, for the periods of time, according to their, their cleverness, their ability, their toughness. You can always tell when a kid's been on the streets for an extended period of time, not only by a distended belly, as a rule, by the shape of his clothing, but those parts of his clothing which he still has. There's a definite process of animalization that you can observe. They're various faiths, of course the Montangnard children in central Vietnam, central highlands, encountered the most brutal devastation of the war. This is a key military area in terms of the conflict, and the NLF know it, that they could separate this area from central highland area from northern I-Corp 5 provinces, they be in a key military strategic position. To some of the heaviest fighting the war has engage in there, the Montagnards have suffered, ah, greatly as a result of this, and Montagnard children have. So I, I think, you know, ah, to the point of imagination, one can

envision various sorts of tragedies and fates that are available. Particularly, ah, new, in terms of the consideration of children in Vietnam, and the fate, are they Amero-Asian and Afro-Asian children and, and what's going to happen to them, and what is happening to them. These are the children who are produced as a direct result of American involvement in Vietnam, and they're being abandoned, ah, quickly and rapidly. And I think of the fate of the Eurasian children who are now being removed by the French and by the end of 1967, the French will supposedly have every Eurasian child who has been abandoned placed in French foster home or institution. The fate of the Eurasian child in Vietnam is indicative, then, um, we get a picture of the, the, likelihood in the future of the Amero-Asian and Afro-Asian, ah, kids who are, of course, only infants at this point. Mr. Pepper, you particular concern with what's gone on since the war, but would it be fair from your trip to Vietnam to say that, what you had originally were the effects on children of an underdeveloped society and added to that, are the dislocations and horrors of war. There's no question

about that. I mean, the administration and public health program in a, in a rurally oriented emerging nation, third-world like Vietnam, are immensely difficult, there's no doubt about that. Immense problems, foundational problems, in terms of a public health program, were there, but these have been compounded immeasurably by the conflict and the war in the increase in the military activity in the country, to the point where, what was always a very difficult situation has now reach the point of unceasing horror. I mean, you know, the 101 hospitals and 25,000 odd hospital beds and, and the whole function of the hospital program being (?)open, ah at least, in my experience, and that of many others, has broken down. Doctor Barsky, you've just returned from a trip to Vietnam. Could you give us your impressions of the the situation there. Well, I think, perhaps (inaudible word) answered that question to the extent, that my mission was specifically to determine what can be done to help these children. That is the injured children, and the children who suffer from malformations in one kind or another, and those that

were injured in civilian accidents. So far as statistics are concerned, I'm sorry, I have no figures whatsoever. Perhaps Miss (?)Zoom can help us along those lines. Miss ?(Zoom)? Well, ah, excuse me, but, ah, their studies they got information do you wish to have them. Well.... I'm sorry. Mr. Pepper said something about 1,200,000 children being injured I believe, in the orphanages, is that correct? No, there are 1,200,000 people resident in shelters when I was there. These included, these included, you know, women and children, mostly women and children. These were in the refugee camps, the shelters, that figure, I think, today is closer to 2 million, if I'm not mistaken. Um, I, I, ah, it's a, I don't have any any official statistic on that, but about the children and women living in the camps, and they as the Communist refugees, they as living in the combats areas, ah, the areas, the the Com-, the Communist controlled areas, and they flee from that areas, and

and that's why they, they live in camps, because the refugee camp and we try to help them very much, but, and, they are quite a number of camps around the country, but I don't have any figures. USAID has the figures, um, Marx who was the commissioner of refugees for USAID when I was there, told me there were a 1,200,000, this was an official USAID figure, ah, you know, this is no conjecture on my part. And, and you say that the issue figures regularly on the number of people who are being cared for in the camps. You know, this is no secret. I think it's probably closer to 2,000,000 million today. This is USAID. Uh, yes, about it, Communist refugee I can say that, that, that, there is about more than 1,000,000 who flee from the Communist control to go to the areas and we call them Communist refugees, and it's more than 1,000,000. I'm not labeling them anything, I'm saying that they're human beings, they're there, you know, the 1,2000,000 when I was there, maybe 2 million today. There in the, the camps are called New Life Hamlets, Strategic Hamlets, refugee camps, you know, they call them, they term them

different names at different stages of the conflict. Well, Miss Zoom, can you tell us, um, your impression of what the nature of the problem in Vietnam is? Well, you know, that the, the (?)suffering and (?)hazard of life are not always distributed by choice, and, ah, the children of Vietnam, as childrens in all countries, which is at war, as born in a war they do not make, and they is caught up in it's struggle, they do not start at all. I hope that we all agree on that. But, ah, despite the fact that they as the most suffering persons in that struggle, the government and all of us know that we as in debt for them, so we tried to do something for them and then, you mentioned that there's many orphans living in Vietnam. I know that there's about 10,430

childrens, and the government tried to offer it's shelters for them, and we have about 73 orphanage, but, ah, all we can offer is shelters and not love, and we need the the love and help from all the count-, all the people, too, and we as at war at the moment, so every facility as we needed and, ah, that's why the, um, private organization and the humanitarian organization come into pictures, such as the foster parents plans and care and there is some, um, come the pictures to help the childrens and, ah, I hope that, ah, in these programs, we're in, ah, try to find a way to help them, because they are the victims, and they are so helpless. Dr. Barsky, I know your mission to Vietnam recently was a limited one, but, at the same time, you had your eyes open, and you are professionally trained.

I must ask you, if, if, if you weary of figures, I understand that, because most people agree that getting figures on the extent of the problem is almost impossible. But can you give us an impression of, of what you saw? Well, i think to begin with, one must realize that the conditions in Vietnam differ in no way from those of an underdeveloped country anywhere in southeast Asia. Ah, they are, of course, compounded by the fact that this is a country at war, so the difficulties multiply immensely, but there's something else, too. This is a rural country, that is now entering the mechanical age, and it is faced with all those mechanical problems which any country is faced with. There is an increasing use of kerosene stoves, and similar things of that nature. This invariably results, anywhere in the world, in an increased number of burns, and this is exactly what has taken place there. Unquestionably, this country needs a great deal of help, and a

great many areas. I think that we are only beginning to attack that problem, and I personally feel that we will be able to make progress. Mr. Pepper, from what you saw, um, is the scope of aid being given to the children of Vietnam by the government of South Vietnam, and by the United States government sufficient? Well, no, it's it's not sufficient, but, you know, that's, that doesn't mean necessarily this is a condemnation of either, either programs. It means simply that the problems are immense and difficult, and that almost any concept of, of aid would be insufficient, and under these circumstances, and under the existing facilities. The government of Vietnam allocated when I was there two percent of its national budget for the conduct of public health program in Vietnam. Dr Bach, previously minister of health, who originally effected the agreement with Terre des Hommes for the removal of children, you know just couldn't couldn't

begin to administer a health program. He lamented to me how impossible it was to perform as a public health administrator in a country with 2% of the national budget, and with an increasing number of the supply of doctors being taken over for the military effort. There were about 160 actually when I was there, according to him, who were involved in treating the civilian population. And that may have been approved upon and it should be. And they're USAID rotational teams that serve admirably. And these men, doctors, do tremendous work in a two month period to stay in Vietnam in the various hospitals, but all of these things still are like sort of drops of water in an ocean of misery. There are an absence of basic supplies and utilities in most of the hospitals and Dr Barsky can attest that. Dave Mcclanahan has written of it, Martha Gelhorn, Dick Perry who served there has written of it. I mean David tells me of the one jar of salve that they had in Da Nang for... that they saved for only those whom they thought burn salve, and they thought could survive. And everywhere you can see an absence of basic supplies such as soap. You know, frankly, I

came back and organized a group of students to send 1,300 ponds of soap over there just because this one vital product was absent almost everywhere that I went. You know and so its not sufficient. Catholic Relief Services has been tremendous job in terms of relief assistance, they probably have among most effective, if not the most effective program. Vietnam Church World Service is doing a good job, administered by the Mennonites there. And there are programs like Foster Parents Plan which don't relate directly to the medical situation itself as such, but it's the Seventh Day Adventists have a hospital, and there are other medical missions, but its inadequate. There's no question about that in my mind at all. [Narrator]: Miss Sung? [Sung]: Well I don't need to remind you that we are at war, so all the national resources has absorbed for the national defense and that's why the - we have a shortage of, a lack of facilities in the medical field.

But I hope that you don't overlook the fact that we tried to do our best in such a circumstances and we have worked at the moment about 800 Vietnamese doctors who tried to take care of the population and sixteen millions. It is from very small numbers of doctors. But the other friendly countries, well realized our difficulties, and they come in to help and [someone strikes a match] we have about fifteen foreign medical teams working in Vietnam and we are [male coughs] trying to do our best and they are trying to help [heavy breathing] us and I hope that you don't overlook the fact that....[heavy breathing]. [Pepper]: I'm not trying to overlook, I'm trying to point out that, I know its extremely difficult and its been compounded as a result of a war, and this is got to be emphasized, and most of the resources are being channeled into the into the defense

undertaking in Vietnam. There's no question about that. Of the eight hundred doctors, do you know how many are assigned to do treatment of military casualties? [Sung]: Well, five hundreds as in army, but that five hundred doctors even as an armys but that they don't make treatment in the evening for the civilians, especially if they are in the provinces. [Pepper]: You know it's a very difficult situation and I'm not underplaying the attempts and the efforts. I am concerned about certain aspects of administration of the public health program. Dr. Barsky? [Barsky]: The figures we were given are their figures, they say approximately one thousand doctors in all Vietnam, 800 in the army, and 200 left for civilian population. Now, even if you were to take all the doctors in Vietnam and put them to work taking care of civilian population, I doubt if you would have enough. I don't think a

thousand doctors for a population of sixteen million is sufficient. Now the question of supplies, I think it is a question of distribution rather than a question of supplies. A great deal is coming into Vietnam. Everything that comes in, the US public health AID program is given to the Vietnamese ministry of health. And there are immense stockpiles there I've have been informed, but the problem is one of distribution. Again, everything that happens there is compounded by the war and the problem has to be viewed from two aspects. One is they actual immediate care of the children and the adults who require care, whether they be civilians or military individuals, whether they're injured as a result of war action or civilian accidents, that's one problem - the immediate care. And the second problem is

the development of sufficient facilities to care for these people in Vietnam and the future self help program in other words. Now, we can't separate these two and really do a good job of it, so that we have to train the Vietnamese to help themselves, the specialists. Now even if you took these thousand doctors and sent them to work, you would not have, in that group, sufficient number of neurosurgeons, orthopedic surgeons, plastic and reconstructive surgeons, and so forth to take care of the children, so again I must emphasize that it must be a program to help the Vietnamese help themselves. These programs that have been taking place there now are simply wonderful. I think the doctors work with terrific enthusiasm and vigor, but I don't think its quite enough. Now, my purpose of going to Vietnam was to see what we could specifically do about this one problem - the children

of Vietnam who were injured in civilian accidents, domestic accidents, and even in war casualties, Now everyone speaks to the napalm injured. We made this an attempt to question the parents or relatives of every child that we saw that was burned. Now we came to that conclusion about 85% of the burns that we saw in children in Vietnam were due to civilian accidents and domestic actions, and approximately 15% were due to war injuries. Of this 15%, there were relatively few that we saw that had napalm burns. Now we have to admit, of course, that we didn't see all the children that were burned there, nor did we we visit all the centers but we went to from the north in Hue to Nang to Lot Trang and all the hospitals in the Saigon area and that's conclusion we came

to. [Narrator]: Well you've brought up one of the most emotionally charged issues and that is the napalm victims. Mr. Pepper, you claim that there are many more casualties due to napalm. [Pepper]: Yes, I do and I do not as a result of my own observations alone, solely. I came to the conclusion after having, when I returned from Vietnam in May of '66, I felt I was much too sort of emotionally involved with the whole problem of the effects of this war upon the children to write about it then, and I spent about six months talking to people, interviewing the widest number of doctors I possibly could, and compiling voluminous material, and I probably the largest file on this aspect of the Vietnamese problem of anyone in the world at this point, continually being called upon by European and other sources to give them cites and resource material. Just yesterday the New York Review of Books asked me to give them a whole list of sources for something they're doing on it. I wanted to treat the problem as objectively as I could, and I really didn't want to get taken off an

emotional kick about it because I didn't go originally to Vietnam to deal with the children. I was concerned about the effect the war on the civilian population, but not the children. It was only when I found out how large a number of the population they were, and how devastating the total effects of this war were upon them, that I dealt with the children. And on the basis of the interviews that I had and the basis of observations and some case histories that I did, I found that the portion considerably different. Now, it may have changed but I've talked with doctors who have served for two months in every section of that country, specifically Bernie Castleman who served in the Qui Nhon area and spent time there, Dave Mcclanahan and Warren Washburn who served in the Dah Nang hospital, Dr. Wade Eckert who served in the Cant Ho hospital. These are just three immediate examples who come to mind, who maintain the proportion of napalm burn kids and phosphorous burn kids is much, much higher than figures that have been recently coming to fore. Mcclanahan quoted,

you know, sort of astronomical figures. Everyone admits that most of the burned victims, most of the kids and the people who were the victims of attacks and support airways in the interior die immediately. No one denies that. In fact, the figure ninety percent is continually, was brought up, that ninety percent die instantly. And with the development of the new napalm-b, then we've got more going to die quickly because one of the great selling features of napalm-b is that is has greater adhesion. And this is a selling point that is continually mentioned. So, most of them die instantly. Neil Sheehan and others have recorded Peter Arnett and Charlie Moore and others have described the plight of those who have been injured in the interior and who can't make it to the hospitals, and who die along the way, and you don't know how many they are. Neil has mentioned this again and again. So those who you see in the hospital there only remnants of the total picture. And there are kerosene burned kids, and I do have case histories of some kerosene burned kids

where the stove is turned over and the kid is burned. But I find this this sort of incident to be definitely in the minority. Bernie Castleman described the decimation of a village of about thirty five hundred people right outside of Quin Yong, by phosphorous, not napalm. And there were four survivors brought in by military truck and they were all under eleven and they died in, on the floor. They were still smoking, those are his words as they were brought into the hospital and they died soon after on the floor. So I think that, you know, we can't do anything for these, they're gone. What we're talking about are the remnants and they're there and they can be helped. [Narrator]: Mr. Pepper, you claim that those who are there, those who are burned, are not being given sufficient help, that there isn't this skill and so on in the country, to give them help, the skill and the facilities. [Pepper]: Well, I don't think anyone denies that. Most of the hospitals are operating on an emergency basis. They have to operate on an emergency basis because of the tremendous pressure on the

facilities. There is no massive reconstructive surgery that is going on. The plastic surgery that I observed when I was there and that others have told me about that they observed, is in the nature of a hair lip operations, or cleft palate operations, things of that sort. Now they may have expanded to some graft procedures, but there's no massive reconstructive secondary, reconstructive surgery going on there, and that's the concern you know that that many of us have. To see that this work go forward, and that as Dr Barsky quite correctly points out I think, that facilities be developed there because this must be done wherever possible that the youngsters should be treated and the surgeries should be performed there, but where it will take time and where it can't be done, that they receive this help and that they receive this assistance elsewhere. Terre des Hommes has served the finest interests of humanitarianism by bringing only a few children out to receive this assistance and I've seen I've seen photographs of the transition of the badly burned kids whom you brought to, Terre des Hommes brought to England. And they're unrecognizable today compared

with what they were like when they originally went there. This is what must be done elsewhere and everywhere as possible. [Narrator]: Miss Song did you want to make a comment? [Song]: You mention about the ideas of bringing the childrens abroad for treatment is very welcomed by the government of Vietnam. But somehow we think that if they find doctors and nurses, can go to Vietnam. For to treat the childrens and at the same, it is more beneficial. Because of, there is many reasons for that, if you bringing any child abroad, the cost of that transportation and the cost for treatment, you can use that expenses to bring nurses and doctors over to Vietnam. The numbers of childrens can benefit from that treatment can be... there can be more childrens to benefit from the treatment and moreover there's a chance for the

Vietnamese to learn the new techniques and to be advised by the foreign doctors and nurses. So in that case you can help the Vietnamese who can help themselves, instead of just giving from charities. [Narrator]: Dr. Barsky. [Barsky]: Well I think I ought to begin at this point by saying that its not generally recognized that burns rank in the United States as number three in the cause of accidental deaths. I think that Mr Pepper has made a very accurate observation when he says that the sight of a burned child fills him with horror, it's an intense emotional reaction that I think every lay person has when he sees a deformed or burned child. One can't help feeling a very intense pity. Yet, the professional who sees these burns thinks beyond that stage. When we see a burned child

all the feeling of pity and horror is sublimated to the fact that we're thinking ahead. What is the percentage of burn? How can we treat this child? What's the prognosis? What should be done immediately and subsequently? We're way ahead of the problem. Now death from burns simply depends initially upon the extent of the body burned and the regular scales which can tell us, according to the age of the patient, the extent of the burn, what the prognosis is. So far as napalm is concerned, it causes a rather particular type of burn because its spatters and it sticks. But again it's the surface of the burn and the depth of the burn rather than the burn agent itself. Now, one must realize that the treatment of burns is an immensely complicated affair, and even in this country where we're again well organized and we have a tremendous amount of money, we have only a few burn centers where highly developed care is rendered. So, there's no question that what they need some burn centers there and other centers for the

treatment. Now, what is the best way of going about that? And I think Miss Soong put her finger on the problem when she said it will be far better to treat the children in Vietnam. For instance, if you had a unit there which was functioning, and had several operating rooms, you could take of a great many more children than you possibly could if you brought children out and actually at much less expense. I think the Vietnamese and, you correct me if I'm wrong in this impression, they live sort of as a family unit. In the hospitals we found that the mothers or perhaps the fathers were in constant attendance on the child. Even the families sometimes travel with the troops I believe, and the result is that the families and children are caught in the crossfire. This is just one of the unfortunate horrible things about war - the innocent victims all too often suffer. So that we come back to the problem of treating the children in

Vietnam, I think is the best way of doing it, and at the same time we must train the Vietnamese doctors to be able to take care of their own. Now I'm very pleased to be able to tell you now that we have proposed both to the minister of health and the US Public Health AID program that we establish a unit of reconstructive plastic surgery in the Saigon area. Everyone has been heartily in favor of this idea, both Vietnamese and American, and we are actually in the process now of concluding negotiations for a contract, grand contract with AID to carry out this. [Narrator]: Dr. Barsky you emphasize helping the children in Vietnam and you emphasize self help. Can you give us some estimate of how long this will take, how complicated the problem will be?

[Barsky]: This is an immensely complicated problem, it means setting up a facility, building a facility for this purpose, staffing it with Americans, doctors, nurses and technicians, a whole group anesthesiologists, possibly a pediatrician. To set up this unit is really a big undertaking and, again, I must emphasize in this programme we need the active participation of the Vietnamese doctors. Now how long will this take? I think it'll take at least six months to get the unit in operation and beyond that, we project at least a year, and probably will be set up on an indefinite basis. In other words, the program being renewed at the end of each year. Eventually, we hope that the Americans will phase out this program and leave the entire unit to the care of the Vietnamese. That would be the unit, all its equipment, and we hope those that are trained to carry on. [Narrator]: The estimates around this

table about the number of doctors available for civilian casualties have been from 160 to 200. A program such as the one you're talking about, I assume from what I've heard that you'd need more than one program... [Barsky]: This is in essence a pilot program, but this project is not only for the war injured but it's for all the children in Vietnam, for any child that we can help regardless of the condition. [Narrator] Is there also a place in your thinking for taking those children who can't be cared for in Vietnam out of the country? [Barsky]: If we feel that any child can't be taken care of to the best advantage in Vietnam we will recommend that he be sent to some other place where he can be taken care of. [Narrator]: Mr. Pepper, do you have any comment? [Pepper]: Well, only that my real major concern is that children be cared for, that they'd be treated and that there be facilities developed in Vietnam to do this. And that where it is not possible

in an immediate sense to do it that the children be taken from Vietnam, and that they be treated wherever they may be treated. I'm concerned that your children receive care. That's the basic basic thing and I'm really delighted that there is at this point concern to try to develop reconstructive facilities in Vietnam so that this care can go on and this treatment can be performed there. I think this is a wonderful undertaking. I harken back to the report of Terre des Hommes last spring that said at that time which I think is the single call for for the children in Vietnam at that time. It is not enough for us to say 'let there be a hospital'. Hospitals and treatments and programs that will be developed are gonna take care of tomorrow's burned for the most part. The children that are there and waiting have been there and have been waiting and Terre des Hommes has done it's work in attempting to remove numbers of them, has been moved, some of them, I

think six months is fine. Let's work and develop facilities internally. But in the meanwhile, let's also mount a program to do something for those children who are there and who have been there for many months and who need care and treatment now. It doesn't seem to me that this effort is mutually exclusive. It seems to me that they go hand in hand and they should be developed and parallel fashion. And what we're dealing with are emergency situations and emergency procedures are necessary. [Narrator]: You've repeatedly referred to Terre des Hommes which is a Swiss humanitarian organization. Terre des Hommes has attempted to bring some children out of Vietnam. Have they run into on a particular problems in doing that? Well, others around the table may be more familiar with the problems that Terre des Hommes have run into than I. Actually, Terre des Hommes did have an agreement with the government of Vietnam, and did remove some war injured and chronically ill children from Vietnam in Spring of last year. Removed some of chronically ill children in early Autumn,

September, which there were no the war injured or war burned children, and Terre des Hommes has been attempting to cooperate with the Vietnamese government in order to operate in this outbreak, this emergency program. It is no secret that aircraft facilities have been denied the Swiss organization by the American government in the past. And it's well well documented that they were denied. It was contrary to American policy at that time to provide such facilities for the organizations, as I understand it. The present status of Terre des Hommes's removal evacuation program is one of which I'm not familiar. As late as December, I believe, of 1966, children were brought out, were evacuated from Vietnam, and among the cargo were two burned children I believe at that time who're presently being treated in England. So this is the status of the Terre des Hommes program because the committee of

responsibility, the American organization that has been established for the purpose of attempting to just deal with removal of - specialty - deal with the removal of the war injured and the war burned, the children, has just begun to develop a program, is sending a team of doctors and a head of team, a layperson, to Vietnam in April for the purpose of beginning to survey the situation and make a selection with the blessing and the avowed espousal of cooperation of the United States State Department. This is another effort really, an independent effort. Dr. Barsky is quite right in terms of the difficulty of establishing facilities that can perform the complicated burn procedures, as far as I have been told by plastic surgeons, it's a very difficult thing to do. It's a very complicated procedures particularly when you're dealing with secondary stage burns. The [inaudbile] Center in England is treating the Vietnamese youngsters, is apparently such a center. We fly all of our own burned soldiers immediately to Brook Army Hospital in Texas when they receive the

finest care. They're just whisked right out. Or there may be an intermediary stop, in some cases, at Clark in the Philippines. But anyway, the major treatment is done in Brook. And there are not many countries, developed countries as I understand it, in the world where the facilities are that have the type of expertise that this is necessary. This is what I'm told. [Narrator]: Miss Sung, do you have a comment? [Sung]: Yes, there's about 20 Vietnamese children was brought to Switzerland and Belgium and England in September '66, and they has the procedures to take care of because that is the pilot programs. But the Vietnamese government tried to encourage the Terre des Hommes to send doctors and nurses to Vietnam instead of bringing the children's abroad, because as I said before, that we have a very strong feelings about

families, and to bring the childrens abroud, they need adjustment to the new, and of the environment. And after that, after the treatment, you bring them back to the country again. And it mean that they need readjustment again, so for the benefit of the children, the government think that it is wiser to have them treat in Vietnam. And moreover, we have no discrimination against children's who need help, so that's why among the twenty children sent abroad, there's only two burned children and older children who need help we send to Terre des Hommes and and they had some conflicts of how they have complained about there's only two burned children, but because he have no discrimination against children who need help, so that's the reason, only two burned children. [Narrator]: Dr. Barsky? [Barsky]: Going back to the problem of where the children are best

treated, we spoke with a great many people in Vietnam, ministry of health, foreign minister, great many Vietnamese doctors and American doctors, and everyone expressed the opinion that it would be best to take care of the children in Vietnam if this can possibly be done. [Narrator]: We've mentioned, in the last ten minutes or so, two voluntary organizations that are trying to work in this area, one - Terre des Hommes- which is a foreign organization based in Switzerland, and the other, the Committee of Responsibility, which is a new organization based here in America. Are there others there are becoming involved in this problem? What are they trying to do and what kind of public support do they need? [Barsky]: Well there are a great many voluntary organizations that are working here as Mr. Pepper pointed out and there are quite a few American doctors that have been working quietly in Vietnam and doing excellent work in various fields. But the point is that these men are able to accomplish

a great deal but it's not enough. What we need a great many centers of the type that we propose. And again, ours is only a pilot program and when we work out the program, I'm sure it'll be possible to establish centers of similar nature in other specialties perhaps throughout Vietnam. And I think that that's the way the problem should be approached. Again, if there are cases that can't be treated there, perhaps we can find some way of bringing them out elsewhere. Mr. Pepper brought out an important point that patients are being flown out - military casualties, US military casualties. We visited one of the hospitals there, a naval hospital at Nha Treng. And I must confess that I felt quite thrilled as an American, one who served in the army, to see the speed and efficiency with which they functioned. [Narrator]: Those are military personnel you're just.. [Barsky]: Yes, I'm talking about the naval hospital there in a Nha Treng. [Narrator]: Mr. Pepper, can

you give us some idea, what is it, what is the length of time Dr. Barsky he mentions the speed and efficiency with which American military personnel are cared for? What was it for the civilians? [Pepper]: The consensus of doctors with whom I spoke, ranging over the time of their experience in Vietnam, is that they rarely received a patient who had been injured less than sixteen hours previously. It took it, the minimum period of time after initial trauma injury was sixteen hours. Sometimes they received them a day later, two days later, it would depend because of the the absence of the facilities and the ability to be immobile and to bring them. And sometimes they're brought on the backs of relatives and sometimes they are carried on stretchers and litters and sometimes they're on oxen or whatever they, whatever means they can. Sometimes they do hitch a ride with military trucks or Jeeps and are brought in that way. And, um, the evacuation procedures that have been developed by

American military operatives in Vietnam, quite correctly pointed out by Dr. Barsky, are immensely effective and perhaps never in the history of man, in the history of war, has have casualties been evacuated so swiftly and so efficiently and indeed so well. I would hope, I would like to see that some of these facilities be made available for the injured civilians and and at a much greater rate and much greater degree than they presently are. And they have not been, at least till the present time. It's not only my judgment, it's the judgment of numbers of people who have, and of course Dave McClannahan writes of it in this week's Saturday Review quite well. They have not been made available and I would hope that they would be, because this is an area of expertise that should be applied to their welfare as well. And with respect to the development of the burn center in Saigin, as the first of the pilot project, well, you know, hoping really that'll go ahead with all speed and haste. I would also hope that it would remain, very

frankly, not under the control of the Vietnamese officials, but that it would rather remain under the control of USAID or American officials. Because I didn't see a hospital. I didn't talk to anyone who served in any provincial hospital in Vietnam who maintained that they, who maintain that they could function and were functioning anywhere near the degree of efficiency that they could if they, if they had a measure of control over the hospital. And this is a horrible thing and it may be shocking to Vietnamese to think that such programs for efficiency are going to have to be maintained by those but the simple fact is this: Where the provincial chiefs and the district chiefs control the hospitals there is immeasurable corruption. And then there is immeasurable delay and interference with the conduct of operational procedures. And for this I cite doctors who have served in Qui Nhon and Dha Nang and Canto and Plah Ku. It's a very difficult thing for a hospital to function anyway under these conditions and circumstances, and when they're hindered with all of the bureaucratic red tape, and in many instances, corruption and inefficiency that grace the local civilian governments in provincial and district chiefs, and the

pettiness that goes on with that administration government at that level, they're hurt immensely and and inevitably the wounded, the injured, the sick, chronically ill suffer and the treatment and the standards of care suffer. So I would hope that in some way this could be mitigated in the development of the new center. [Narrator]: Miss Sung? [Sung]: You mentioned that the hospital must be run by foreigners and it would be unofficial if it is run by the Vietnamese. Well, I have no comment on that because you go there to help, not to run everything for us. And it must be a self-help program. You need the cooperation, you know, us to run the things. [Pepper]: I lamented the fact that a doctor at Qui Nhon provincial hospital told me that he had to go hat in hand himself into Saigon to grovel and scrabble around and get up vital material that he needed to conduct the program. And was told when he

got there by USAID officials, that the material and the equipment and supplies had been shipped out to the province for the conduct of that program and he never saw them. [Song]: Well... [Pepper]: I was appalled in Binh Dien when living in a shelter area and Qui Nhon when a priest, Father Schall, told me that you know he was having immense difficulty getting things like bulgar and wheat and yet the province rep said, 'well we gave this to the district chief and we advised him to give it to you.' I think its a basic problem. That's all I'm saying. And Dr. Barsky's pointed out quite correctly, I think, that there are available supplies. It really is a question of getting them to the people who want to do the job and I'm trying to put my finger on that aspect of the problem and hoping that it will not apply to any new programs that are developed in Vietnam. [Sung]: Well, there's procedures to follow, is everywhere. Even in this country, there's the red tape too. So I admit that in Vietnam there's some procedures and red tape. But I doubt if if deep down in any human being even who can deny

to a sick people or burnt child to go such a difficulties as you point out. [Pepper]: No, I know it has happened, I know there was a tax put on a shipment of microscopes that needed for medical school in Da Nang by the government of Siagon. And they were donated by the government of West Germany for the conduct of that program, and the only reason the tax was put on was because, according to officials around the hospital there, because there were political difficulties connect with Da Nang and the medical school. You know there's a hospital in Hue a wonderful hospital, a wonderful potential facility in Hue, and it's been reported again and again as being at least one third empty. And it's connected again with the political problems that are involved here that are having a direct effect on the conduct of medical problems. [Sung]: Such mistakes can happen but I think that maybe the person get the, have the contact, but the wrong authorities. I don't think that if he get in

touch with the right person, such a medical surprise and medical help can be taxed like that. I don't think that such things can you know really happens intentionally. It might be a mistake from some um, junior officers. [Narrator]: Dr. Barsky? [Barsky]: Mr. Pepper mentioned a moment ago about hospitals being half full. Our own observation was hospitals close to the scene of activity were full, hospitals remote from the scene of activity were only partly full. Mr. Pepper spoke moment ago too, the fact that microscope were held up and taxed, I believe he said. I think this is probably bureaucratic red tape that we have everywhere in the world, including our own country. Now I don't excuse it, I merely mention it, cause that's a fact. The USAID people, again, are working on a system of

distribution. They're trying to set up with the Vietnamese so that the material from the warehouses will flow out properly on demand. I have met a number of people engaged in this. I was quite impressed not only with their sincerity but with their capability and their efficiency. Now so far as the time of a lapse between the time of injury and treatment, I think it's very difficult to estimate that. I think sixteen hours is probably only a guess, and it would depend entirely on the facilities available.The sad fact is that there are no organized facilities for the evacuation of the injured, and this is one of the problems again that we have to face in setting up our unit. Mr. Pepper mentioned the fact that he hoped the unit would not be under control of Vietnamese. You know, we must realize that in the final analysis, we are foreigners that come in to help a country that desperately needs help and, for your information, our own unit in agreement with the

preliminary discussions with the minister of health, is to be completely autonomous. Yet it is to be located and is juxtapositioned to a general hospital where we will use only certain of their facilities, but we will run our own show and train the Vietnamese doctors. We are going to do it together and we have further gone into the matter of training to this extent: when we finish the Vietnamese doctor is to have a contract with the ministry of health, wherby he is to remain in the service of the ministry of health for this period of no less than three years. In other words, we won't simply train somebody and then have him go off into private practice or leave the country. But he must remain there to take care of the people. Uh, I think that's covers some of the points that were mentioned. [Narrator]: Alright now, this is very difficult to say, but

seems to me in the last 55 minutes or so, we've made several points that are worth making. First, that like many underdeveloped countries in this world, Vietnam has many problems in education and health services, etc., that have made the situation for children in Vietnam very, very difficult to horrible. We've also made the point that in addition to these basic problems, you have the dislocations of war and the horror of military injuries or injuries inflicted by military operations. We've also made the point that facilities in an undeveloped country are underdeveloped. And also that political administration is difficult. At this same time, I sit here and get the feeling that no one is being completely frank here because under all of this is the political problem of the war in Vietnam. And each of you is is very much aware of it, and you're also

aware that there is a propaganda problem here. Certainly in some of the efforts that Terre des Hommes has made to bringing children to European nations and to the United States. There has been the fear, on the part of the state department, that this would have an effect on the public opinion in this country and in the world which would in turn affect the military effort. You are sitting here and trying to say this is not a political situation, this is a matter of helping children. Well that's true. But I'm not sure that you can have it both ways. I'm not sure that you can get support for what you're doing without being completely frank about some of the problems that do affect some of the political and military problems that do affect the welfare of these children. I wonder if you'd like to comment on that, if you think I'm just all wet, go ahead and say so. [Barsky]: No, I think you have a point there, but the fact is this - that I happen to be a specialist, I happen to be a trained surgeon and I must help in the way that I can.

There's nothing that I can do or say that would really stop the war or contribute in any way to that. You know, as we've been talking here, I've been thinking of what Adlai Stevenson said at the death of Eleanor Roosevelt. And he said she would rather light a candle then curse the darkness. And for my part, I think I speak for our group, we would rather find out the facts rather than to add one more strident voice to the clamor, the clamor that I feel will not solve the problem of war or peace. Nor will it help these children. This is a situation that requires careful study and help. And if each one of us, be he humble or talented, makes a contribution in his own way, I think that we may be able to get somewhere. But simply to protest means nothing. When this is the time for action, not simply for words. And action with

which we help the people of Vietnam and not try to exacerbate the condition. [Narrator]: Mr. Pepper? [Pepper]: Well, of course these problems are [unintelligible] and they're interrelated. Of course, the whole political military consideration of the conflict in Vietnam is wrapped up up in treatment of children, and the effects of the war upon the children are directly relevant to the political and military situation in Vietnam. As a torn person, really, in a number of ways, when I discuss the children I attempt to to be somewhat effective in terms of trying to help see that programs are developed that will care for them, and will treat them, either here or preferably, where ever possible, in their home country on their own soil. I tried to quite frankly stay away in a humanitarian sense from political considerations that will turn off whole segments of the community and whole segments of constituents really who are needed to

make a humanitarian effort of this sort effective. And try not to fall into the bag of using or leaving myself open for being claimed, of using the children for political ends, or goals. And sometimes perhaps I bend over too far backward in this regard frankly. But I mean it sincerely in my attempt. However, I'm fervently committed. I think that I recognize Dr. Barsky's point of individual contributions, individuals doing what they can, individuals acting upon her own commitment. And physicians and surgeons who serve there for two months are doing this in their own quiet way. And my effort and my realization of what's going on in Vietnam and my contributions are of a different sort, substantially. And that's why, for the most part, I have tried of late to divorce myself from the humanitarian efforts. Having once been a part of getting it going, now to stay away from it in the fear that my presence will hurt it. Because I am, as sure as I'm sitting here,

loathe to see the continuation of the dropping of two hundred tons of bombs a day upon the southern part of Vietnam, knowing that for all of those who can be saved and can be helped, that tomorrow, tomorrow night, there are going to be many, many others. And that this is the basic core of the problem. I talked with Vietnamese people, Vietnamese soldiers, officers in Vietnam, who privately told me they wish the bombing of the south would stop, not the north. They'd love to see the north bombed to the stone age, most of them, but the bombing of the south. Because it was making their job, the problem of pacification, more difficult. The bombing of the south was so alienating the people of Vietnam from any cause that the friendly forces espoused that it was politically and militarily counterproductive at this stage. They said, you know, it really is, the situation is such and our people are aware that you're making prostitutes of our women and beggars and deaths of our children and communists of our men. And this was

a concern that surprised me. But anyway, so I'm, I feel very strongly about the conduct of the war, and about all of the implications that are inherent here, and about the problems that revolve around children and with the treatment of children and the effects of the war upon the children. But I don't see any let up. Perhaps like Dr. Barsky, there is a there's a frustration that's connected with the effort of protest that is ineffective and I have seen only protest being ineffective and my concern is that now protest be combined with a degree of political sophistication that has not been effective before so that it can be effective and can bring this thing to a conclusion. [Narrator]: Miss Sung, ah, We're all aware of that you are in a very difficult position and also that you, this hurts you much more than it can hurt us really. Because you're a Vietnamese. But I want, before you give your answer, and you've been scribbling notes, but the point I was trying to make is that perhaps in skirting some of

these issues such as the fact that the war is hurting children, I mean that's the fact. And the fact that in certain cases there is a difficulty in administering South Vietnamese administration. I wonder if it might be better to come out and say yes there are all these problems and then go on and say well what can you do? Admitting all these problems, forgetting about the propaganda issue, what can you do for the children? [Sung]: Well, I admit that there are difficulties in Vietnam, in not only in every field, even in the in the programme of helping the people and the children's. But that I admit that as difficulties and we are facing a very complicated problems, But it seems to me as if there are so much discussions have been going on about the war because

of political motivation, because of publicities, because of sensation, and and people forget about the forgotten children. There as the most suffered and the victim of the war. So I wish that everyone, if we can, try to talk and try to find out what we can do to help the forgotten and the victims instead of getting into the very complicated discussion about the war itself because there is enough people who discuss about it already and let's try to find out what we can do to help childrens. There's difficulties to find a way to help them but if we have the wish and the will to help, we can find a way. [Narrator]: Miss Sung, thank you very much. Mr. Pepper, Dr. Barsky, thank you.