Introduction on this project

1. Background and Necessity of the Project:

The effects by herbicides containing dioxins sprayed during the Vietnamese War are still found in Vietnam, although over forty years have passed since the end of the war. Phu Cat Prefecture, the target area of this project, is one of the most heavily dioxin-polluted areas (so called “hot spot”) in Vietnam. Although partially environmental remediation of dioxins has been conducted recently in this area, specific supports for maternal and child healthcare activities are still insufficient. Kanazawa University, Phu Cat District Health Center and the 10-80 Division in Hanoi Medical University have concretely made clear that dioxins levels of lactating milk of 58 mothers in heavily polluted area were 3-5 times higher than those in the non-polluted area, and dioxins affect steroid hormones of mothers and their children, and 12 % of low birth body weight infants in heavily polluted area were higher than 4 % of those in the non-polluted area. From these results, dioxins are strongly suspected the main cause of growth retardation of children in this polluted area. However, maternal and child healthcare activities considering effects of dioxins haven’t been conducted sufficiently in the area due to lack of skill and knowledge for local medical staff. The purpose of this project is to improve growth retardation of low weight infants under the dioxins’ effects. Through development of human resources (doctors, nurses, local healthcare staff and technicians) and establishment of a coordination mechanism among Phu Cat District Health Center, the 10-80 Division in Hanoi Medical University, NCEM and Vietnam National University, Hanoi, the Project aims to sustainably conduct the maternal and child healthcare activities considering effects of dioxins.

2. Project Purpose:

Maternal and child healthcare activities are sustainably conducted, considering the effects of dioxins in Phu Cat District, Binh Dinh Province.

Indicator

• Specify the mothers and their infants who need the intervention.
• From ninety percent of the specified mothers, breast milk and umbilical cord blood are collected to analyze dioxins.
• Seventy percent of the mothers and their infants who need the intervention in the target area are instructed on nutrition.

3. Expected Outcomes and Indicators:

Expected Outcomes

1. Coordination mechanism among Phu Cat District Health Center, the 10-80 Division in Hanoi Medical University, NCEM and Vietnam National University, Hanoi for implementation of the project is established.
2. As results of health check-ups and examinations conducted collaboratively by Phu Cat District Health Center, NCEM and Vietnam National University, Hanoi, low weight infants lactated by breast milk containing high dioxin concentration are specified.
3. Local medical staff (doctors, nurses and healthcare staff, etc), who can instruct countermeasures, based on the proper understanding of health hazards by herbicides, are trained.
4. Based on the results of health check-ups, the practice of early ablactation and nutritional guidance are provided to mothers and their infants who need the intervention.

Indicators

• 1-1 Meetings are regularly held among Phu Cat District Health Center, Phu Cat District Health Center, the 10-80 Division in Hanoi Medical University, NCEM and Vietnam National University, Hanoi. (Joint Coordinating Committee is held twice a year; contact person meeting is held four times a year.)
• 2-1 Training of five specialists who can precisely analyze steroid hormones and/or dioxins using LC/MS/MS or HRMS.
• 2-2 A workshop by technical professionals at Hanoi once a year to achieve the technique for probe assay is conducted.
• 2-3 Prepare reports on results of health check-up.
• 2-4 Prepare reports on results of laboratory findings.
• 3-1 Training of fifty local medical staff who achieve knowledge on health hazards by dioxins and preventive countermeasures.
• 4-1 Training sessions and individualized instruction are held for mothers and their infants who need the intervention.

4. Project Implementation Period:

from August, 2019 to July, 2022 (tentative)

5. Implementing Organizations:

– Japanese side: Kanazawa University
– Vietnamese side: Phu Cat District Health Center
– Cooperation agencies: 10-80 Division in Hanoi Medical University, NCEM, Vietnam National University, Hanoi
* The role of three cooperation agencies is clearly written down in the Agreement Letter provided from each agency.

6. Main Activities:

• 1-1 Hold Joint Coordinating Committee and contact person meeting regularly among Phu Cat District Health Center, the 10-80 Division in Hanoi Medical University, NCEM and Vietnam National University, Hanoi.
• 2-1 Conduct technical training in Japan and Vietnam for staff of NCEM, Vietnam National University, Hanoi and others to achieve skill of probe assay.
• 2-2 Prepare materials to implement the probe assay for steroid hormones in saliva and dioxins in breast milk or steroid hormones and dioxins in umbilical cord blood.
• 2-3 Phu Cat District Health Center conducts health check-ups for mothers and their infants to assess the condition of low weight infants (measurement of height, weight, head and chest circumference of infants, and the interview of their mothers).
• 2-4 Phu Cat District Health Center, NCEM and Vietnam National University, Hanoi collaboratively examine hormones in the saliva of infants and dioxins in breast milk of their mothers or steroid hormones and dioxins in umbilical cord blood.
• 3-1 Prepare materials for local medical staff (doctors, nurses and healthcare staff, etc.) in Phu Cat District to achieve knowledge of dioxins’ health hazards and countermeasures.
• 3-2 Based on the results of hormone and dioxin examinations (2-4), conduct training for local medical staff (doctors, nurses and healthcare staff) to demonstrate the health effects of dioxins, early ablactation and nutritional guidance, in order to promote the health of mothers and their infants.
• 4-1 Trained local medical staff conduct training sessions of early ablactation and nutritional guidance for mothers and their infants.
• 4-2 Trained local medical staff conduct individualized instruction of early ablactation and nutritional guidance for mothers and their infants.