STUDY ON HEALTH QUARANTINE CAPACITIES AT SOME KEY BORDER GATES, AIRPORTS AND SEAPORTS
Khương Anh Tuấn, Trịnh Ngọc Thành, Nguyễn Thị Minh Hiếu et al.
Place of publication: Ministry of Health
Year of publication: 2011
The dangerous diseases pattern in the world has been experiencing great changes. Previously controlled epidemics have re-emerged with more severity. It has created favorable conditions for international and dangerous epidemics to penetrate in Vietnam and vice versa. Health quarantine aims at proactively prevent and limit epidemic trespassing, spreading and ensure national security, health care for the people. In general, this is an important duty, which becomes more urgent to contribute confirming that Vietnam is a safe destination for tourism, investment and economic development in the region and the world.
Conducting a comprehensive study on contents of health quarantine at some border gates, airports and large seaports in Vietnam, evaluate the current situation and recommend measures to develop and strengthen international quarantine is of utmost importance, helping to identify orientations for developing Vietnam’s international quarantine network, making it operate effectively and be capable to respond to the new context.
· Describe the current situation of health quarantine at border gates, airports and large seaports in Vietnam.
· Evaluate the operational effectiveness and recommend solutions for health quarantine.
Study design: Cross-sectional survey using quantitative in combination with qualitative analysis method.
Target group: Available documents, data and reports from all health quarantine centers and preventive medicine centers, management staff and central and provincial levels, management staffs at border gate, staff directly involved in border quarantine at border gates.
Location: 05 provinces representing 3 regions having border gate, airport and seaport, including Hochiminh city (HCMC) (airport, seaport), Lang Son (road and railway) and Da Nang (airport, seaport), and Tay Ninh and Quang Tri (road).
Current situation of health quarantine in Vietnam
There is no centre with ventilation systems at regulated standard. The infrastructure design has yet to ensure the operational functions of health quarantine centers. In terms of working facilities, most health quarantine centers have difficulties. According to regulations, all border gates must have rooms for separating disease suspects however at the moment only 11 of 46 (24%) border gates under the health quarantine network and 2 of 54 (4%) others under health quarantine department have separate rooms for disease suspects. There are border gates with health treatment areas. Only 10 of 46 (22%) border gates of health quarantine centers and 4 of 54 (8%) other of health quarantine departments are provided with health treatment areas.
The lab at health quarantine centers cannot operation according to functions due to lack of necessary equipment and personnel. Therefore, health quarantine centers rarely perform test as regulated and if yes, it is not frequent. Necessary equipment and devices for health treatment are not sufficient. In terms of quality, provided equipment are not synchronized with lack of maintenance budget. Protective equipment are limited and insufficient as requirements.
Only HCMC health quarantine center has personnel structure according to regulations with 4 departments and 2 function divisions. The remaining health quarantine centers often have 2-3 technical department, including lab, quarantine cum health treatment or three technical department integrated in one. There is always lack of personnel. When carrying out technical duties, one staff working on rotation at border gate must implement multiple jobs – epidemic detection, handling people, facilities and even sampling. At health quarantine centers quarantine staff may be in charge of several tasks due to the requirement of personnel arrangement. Presently only 2 of 11 health quarantine centers and 14 of 20 health quarantine departments (70%) have sufficient staff as regulated. Health quarantine centers face great challenges of being unable to recruit staff, especially medical doctors and university-level staffs graduated from related majors. Moreover, training facilities do not have health quarantine training contents and after recruiting, health quarantine centers must organize technical training for their new recruits.
Large border gates under international health quarantine centers have carried out quarantine for people, dead bodies, facilities, commodities and vectors. However some have not deployed other activities, for example health product quarantine and immunization (06 centers), posts (03 centers) and lab (02 centers). There are many obstacles in multisectoral collaboration, especially lack of information sharing mechanism and compliance with immigration procedures at border gate.
The number and types of technical services are not sufficiently delivered at border gates and health quarantine centers and departments as regulated.
· Infrastructure cannot respond to technical requirements.
· Insufficient equipment and yet to meet working requirements.
· Severe lack of health quarantine personnel at levels.
· No training curriculum and practice on health quarantine at training facilities.
· Lack of regulations, specific guidance on task assignment, cooperation and accountabilities of each member at border gate.
Develop master planning project on health quarantine with principle of one responsible quarantine unit, one focal points for technical activities at border gate
· Develop training curriculum on knowledge and skills of health quarantine.
· Policy and measures to recruit health quarantine staffs, taking into account factors of disadvantaged areas and extra duty hours.
More multi-sectoral legal documents to specify technical activity implementation scope.