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Vietnam - Health Service
The average life expectancy for women born today in Vietnam is 80.7 years, and 71.3 years for men, more than 50 percent of whom smoke. Whilst this is lower than predicted for US citizens, at 81.6 years for women and 76.9 years for men, it is a surprisingly positive statistic given how low the country’s GDP is and that the wage of the average worker is less than $150 per month. In addition, the country has a number of high-risk health issues.
Despite government programmes aiming to tackle tuberculosis in Vietnam, that disease remains a real and present danger. Since it is easily passed on by an infected person coughing near you, make sure all your TB jabs are up to date before arriving in Vietnam.
The Vietnam War, also known as the Second Indochina War or the Resistance War Against America, saw North Vietnam and South Vietnam in heavy conflict between 1955 and 1975. Other nations were active participants, most notably the US. In order to destroy the food resources of the guerilla fighters and the forest canopies which gave them cover, the US sprayed other 4.5 million acres of land with the herbicide known as Agent Orange, which contained dioxins. The effects of this carcinogen lead to cancer, health defects, immune deficiency, reproductive and developmental issues, and nervous system disorders. Even today, the dioxin levels of people living in the affected areas are much higher than other populations, because it continues to be present in the soil, local wildlife and locally grown food.
Human Immunodeficiency Virus (HIV) which, if left untreated, can cause a wide range of minor and serious illnesses and result in Acquired Immune Deficiency Syndrome (AIDS), has reached most areas of Vietnam, from major cities out to tiny rural villages. Thousands of new cases are diagnosed every year in the country. The stigma that people living with HIV and AIDS often have to face means they can be reluctant to access necessary treatment. Be aware of this risk, and avoid unprotected sex with men or women, using dirty needles, or any other contact with bodily fluids which can lead to infection.
Vietnam suffered major food shortages even as late as the 1980s. Today, some impoverished households still struggle with malnourishment. Vietnam, along with Bangladesh, has the lowest obesity rates in the world. However, researchers have identified an alarming increase in the number of overweight adults and children. There are a number of reasons for this. Sugary, fizzy drinks are popular, and Western fast food has recently arrived in the cities. Families were encouraged to give their children plenty of milk drinks each day, mixed with sugar-loaded flavouring powders. Meanwhile, exercise has yet to become a popular pastime, and facilities to enjoy sport are limited.
Smoking is still very common in Vietnam; most smokers are men and most men are smokers. There are no laws to prevent anyone from smoking in a public area, even indoors in a public place. One in five deaths in Vietnam is due to stroke, which is associated with the high blood pressure side effect caused by smoking.
Since the 1908s, all residents in Vietnam have been expected to pay for all medical services they receive. However, the government does subsidise some of these costs for lower income patients and target populations living in disadvantaged areas.
There are a lot of hospitals in Vietnam, but the ones in big cities have the best equipment and more highly trained medical staff. Even at the best hospitals, the services that can be offered are more limited than available elsewhere. As a result, people in rural areas travel great distances to receive treatment in overcrowded national hospitals, where occupancy is often more than 100 percent, whilst those who can afford it travel abroad. Medical services in the US earn more than $1 billion each year treating Vietnamese patients who have travelled there for private treatment.
Ambulance services are notoriously slow, and the staff will probably have limited English skills. In an emergency, you can call 115, but the reality is many that people prefer using a nearby taxi, as these are likely to get you to hospital faster.
The health care services in Vietnam have worked hard to reduce infant mortality rates. Immunisation programmes have protected babies and young children from a wide array of life threatening illnesses. However, in some areas, access to maternity services are very limited, especially in rural communities; data studies have confirmed infant mortality is much higher in these areas. Where ultrasound technology is available, pregnant women will be offered several scans to check the health of their unborn child.
Given the overcrowding in national hospitals, there is limited access to the latest, most effective medicines. Since treatment is limited, if you are going to live in Vietnam, you should prioritise private medical health insurance. The government aims to upgrade and overhaul the health service by 2020, but the priority will remain treating as many of the country’s poor and middle-income households as far as possible. It is probable that the private health sector in Vietnam will strive to keep its private customer base happy by upgrading and improving its own services further, which may ultimately reduce the need to travel abroad for treatment for some patients.
Unfortunately, mental illness carries a stigma in Vietnam. Attitudes are slowly changing as more people leave their families in the countryside and move to the cities, where more modern attitudes to mental health are developing. However, mental health services are underfunded and still based around committal to a facility. For expats, the long working hours in an unfamiliar environment far from friends and family can take its toll. With adequate private funds or access to health insurance, it is possible to be treated by psychologists and physiatrists who have moved to major Vietnam cities from Western countries. The services of these professionals are invaluable, as they can fluently speak English, understand and identify with cultural issues, and have training and attitudes which allow treatment on a par offered in the UK or US.
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