A hospice is where you go to die. Too often, a hospital is the same thing. And it's by design! Where else do you see concentrated so many germ-infested people with weakened immune systems concentrate in one place coughing all over each other? I heard once that half of hospital deaths, probably moreso in developing countries, could be attributed to unclean water and subsequent diarrheal disease. One of the most effective things a doctor can do is wash his hands. But a number of doctors and other hospital staff can't even be bothered to use soap. Beyond that, what else sets one hospital apart from another?

One thing foreigners in Vietnam worry about is quality healthcare, especially if they are retirees or have families with children. The quality of hospitals in Vietnam is increasing as the country has been developing over the past two decades but it's far from the standards of developed countries, including Asian neighbors who were once provincial backwaters compared to Saigon. The Vietnamese and foreign doctors working in Vietnam are surely capable of most quotidian treatments and non-complex surgeries but for more serious treatment many expats opt to fly out of Vietnam. Bumangrad Hospital in Bangkok is the hospital of choice for many expats in Vietnam and they're used to accepting medical tourists. One day, the Vietnamese tourism industry will figure out that people, without wasting further money on marketing, will come back to your country if you provide them good service the first time.

The question is:

Where are the region's best hospitals?

And the follow-up question: How do you determine how good a hospital is?

Country Best Average top 10 Average top 5
Hong Kong5320061137
The above data was collected from's January 2012 world rankings of some 17000 hospitals. You can read more about their ranking there, which isn't necessarily directly scoring the quality of a hospital and requires that the hospital has some presence online. One can only make assumptions about the quality of any hospital that doesn't have even a basic website these days. While most of the best hospitals in the world are in the United States, many are also in Japan. And I don't think any eastern/oriental medicine clinics are included here.

Countries are sorted by the average score of their top 10 hospitals. A hospital's score is based on how much research they do. I guess research hospitals are good hospitals and unfortunately Vietnam does poorly when it comes to doing and encouraging scientific research. [Vietnam fails to pay salaries to professors based on academic output and Vietnamese students aren't taught by the researchers either. Vietnam fails to convince many researchers who go abroad to come back, partly to the poor environment for scientific research.] A good research hospital will have the state-of-the-art when it comes to diseases they specialize in. Sometimes they may be the only place in the world with knowledge and treatment for rare diseases, and sometimes that could all be in the hands and head of one doctor.

Surprisingly, Taiwan beats Japan. And Thailand beats Singapore.

So the Philippines has a good (low) score for their top hospital although a very poor score for their top 10 average. The Philippines seems attractive due to its best hospital being an eye hospital which probably conducts medical research on illnesses of the eye that has been published. Except for eye surgery, expats there might generally still fly abroad for significant medical treatment, Hong Kong or Bangkok.

This type of anomoly also affects Hong Kong.

Cambodia only has two listed hospitals so it's not possible to calculate an average top 5 or 10. From the rankings one could predict the inflow of many Cambodians traveling to Vietnam for medical treatment, or flying to Thailand. This appears to be the situation. FV Hospital in District 7 has staff that can speak Khmer in order to service Cambodian medical tourists. The order of magnitude difference between Singapore and Vietnam is akin to that between Vietnam and Cambodia.

The one hospital in Myanmar is one of the worst in the world. Remember, there were only 17000 hospitals listed. One can only hope with the recent opening up of Myanmar that we'll see some hospital services to support an increasingly demanding expat population.

The following is a Wikipedia list of wiki pages for hospitals all over Vietnam. It's not a complete listing, but it may be useful especially if you are traveling to smaller towns. List_of_hospitals_in_Vietnam

Recently, I discovered first hand what a Vietnamese emergency room is like.

As I was standing at the building's entrance between two never-closing sliding doors while trying to catch a breeze at midnight on a weekday, a Honda SH (a ludicrously expensive motorbike) pulled up right next to me - actually pulling right into the hospital's ER waiting room. Held up between the motorbike's driver and a passenger was an overweight, unconscious middle-aged Vietnamese man. He had drunk too much and was now too much drunk.

The first rule of the ER at a Vietnamese hospital was that if you couldn't get the patient onto a hospital bed yourself, the hospital staff would just watch, or not, and wait until you did. I suppose it's not in anyone's job description. Corollary: they don't really care if you drive your scooter into the hospital's waiting room.

The second rule I learned is that once you fill out the paperwork for admission (you could be convulsing/dying - you'll still have to fill out all the forms before you can see anyone), there is no triage system. I watched a women pull herself into the treatment area, sit herself down on a hospital bed, and wait an hour before asking the head doctor when someone would attend to her. Hospital staff were only loosely aware of who was there, a system also known as "the squeaky wheel gets the oil" to see the patients who complained the most first. There's no formal triage, quick initial examinations to give priority to "time-sensitive" patients, something that would not only waste less time but perhaps save lives.

Third Observation: The emergency room is open all night. They expect you to go and buy your own drugs at their 24-hour pharmacy. Which is fine but at 3AM the sole pharmacist is busy getting her beauty sleep on while laid under covers (because her tiny office is the only place there with A/C and she has it on arctic blast) on a little folding cot and she will be really upset (directed at you) when you wake her up to fill your prescription. I'm not sure what else could be in her job description besides staying awake and filling prescriptions.

Result : Waiting around for 4 hours to get two shots and a prescription for various pills (which you should still Google and Wikipedia when you get home to see what they are and decide if they're necessary or even helpful). Not convinced that the treatment caused any more improvement than just laying around for a couple of hours.

I may be guilty of painting a less than spectacular picture of hospitals in Vietnam and even going so far as to suggesting that there may be room for improvement. But even Vietnamese people are voting with their dollars. They think that rhino horns and other horny appendages are a better cure for their illnesses than going to the hospital, at least a local Vietnamese hospital. But surely the newer hospitals, the international hospitals, are better, aren't they? What about the newish French Viet hospital in Phu My Hung? Next I'll talk about how the best Vietnamese hospitals stack up against hospitals around the region.

Rubbing my eyes, contact lenses still in, I slowly woke up to an orange sun just beginning its daily ascent. We were still on a bus, just about to arrive in Nha Trang after driving all night from Saigon, but waking up alive meant I'd survived seven consecutive days of being a vegetarian (coinciding with the start of a bicycle trek from Nha Trang to Saigon, an exercise in which I would need all the calories I could get, regardless of source - future blog post on that experience). Since then, in the name of science I did another one week stint as a vegetarian which led me to finish writing this post.

Vegetarian restaurants in Saigon

[ Above is a map I made of vegetarian restaurants mostly around Districts 1, 3, and Binh Thanh. Red Markers indicated closed restaurants. Google and other online resources for Vietnam/Ho Chi Minh City are useful sources too but I always find them to be both lacking, inaccurate and, out of date, which means I've wasted a lot of time looking for restaurants that no longer exist or have moved. Feel free to suggest additions in the comments or let me know if you want to be a collaborator on the map and I'll give you access. I will only list restaurants that I have verified or which you can vouch for. The map will be updated periodically.]

Why eat vegetables and not animals in Vietnam?

With any luck, you should actually enjoy eating a healthier diet and feel better for it, both physically and mentally or spiritually. If you do convert to vegetarianism you should do it for yourself before any other reason.

Not eating tons of meat has health benefits. It will lower your risk for various diseases while you'll be eating more of the good nutrients you probably aren't getting enough of. You'll avoid more of the poisons like pesticides and heavy metals that accumulate in higher concentrations in animals. Vegetarian restaurants in Vietnam often go an extra step and refrain from using MSG in their food. (Next time you eat out in Vietnam, you'll be praying that Ajinomoto is the worst of all the additives used in most other restaurants.) Being vegetarian can be good for your conscience too - less animal farming is better for the environment and uses less of our resources and not killing sentient beings is something they'll appreciate (although it's up for debate whether invertebrates feel pain). If you're Buddhist then you should be concerned about what Buddhism says about that last point. Otherwise, try not to let it bother you. Try not to think of a purple elephant while you're at it.

If you happen to meditate, you may be interested in knowing that vegetarians shoved in an fMRI machine show more empathy. Personally, I've found myself feeling a bit more compassion for animals. From an enlightenment perspective, this extra push in compassion may help with your concentration, as meditation on compassion leads to improved concentration. (Thus compassion, beyond or despite its altruism, also shapes us into better human beings.)

In Vietnam, we should be especially concerned about what poisons may be going into our foods because when hearing reported seizures of rotten meat for sale to consumers (40 tons of rotten meat seized in Thu Duc District in the first half of 2012) we know it's just the tip of the iceberg. Fear of death due to eating rotten chicken may be reason enough to vegetarianize yourself, when chicken is often undercooked here, not to mention Vietnam's own various raw meat dishes including the raw beef thrown in pho. Lack of refrigeration is common at the numerous informal restaurants and carts in Vietnam despite the tropical weather and, whereas vegetable dishes can go unrefrigerated for awhile, meat dishes will spoil quickly despite being cooked possibly hours before being served to and eaten by customers, with leftover lunch being kept in the afternoon heat to be served for dinner.

Meat in Vietnam is often served with skin and fat included, making it even less healthy (although it can also be more delicious this way). And sinewy Vietnamese beef doesn't even taste good, does it?! This is why beef imported from Australia or the US is available for a markup here, for even minimally discerning tastes. I would honestly not miss eating Vietnamese beef. But Vietnamese people enjoy gnawing on chewy stuff, apparently.

Buddhists in Vietnam are also supposed to eat vegetarian once or twice a month, based on the lunar calendar, and can eat free vegetarian meals at pagodas on those days. The world is a better place for it on those days at least.

Vegetarians become aware of protein alternatives (e.g. broccoli, soy, beans, etc. although most beans are actually quite rare) and Vietnamese vegetarian restaurants have numerous mock meat dishes, some of which are rather convincing. How could you live in the south of Vietnam without eating "cơm tấm", broken rice served with grilled pork, shredded pork skin, and a slab of pork meatloaf? Thankfully, vegetarian restaurants in Saigon can do a convincing faux meat version (pictured above) of this signature dish and other Vietnamese favorites of mine like chả giò and canh khổ qua. Besides soy-based "meat", Vietnamese use wheat gluten (mì căn) to make mock meats. I'm impressed by what Vietnam has done with vegetarian (generally vegan) cuisine and want to encourage even more conversion of the low hanging fruit of Vietnamese cuisine into meatless versions.

Generally, meals at Vietnamese restaurants might come with fresh herbs but lack vegetables beyond a measly slice of unripe tomato and cucumber. We all know we should be eating more vegetables and eating at a vegetarian restaurant is an easy way to inject some vitamins into our diets.


Vietnamese Vegetarian Restaurants

Saigon has vegetarian restaurants sprinkled throughout the city, from cheap (under a dollar per meal) to fancy (e.g. Hoa Dang a.k.a. Loving Hut). But if you like to stay up late and eat late meals it can be harder to find your favorite veggie spot still serving - often the normal vegetarian "com chay" quans, like most restaurants in Vietnam, stop selling after lunch around 2:00 PM and start back up around 4:00, but then after 8:00 close for the day. I work late at night which is normally not a big problem for food in Saigon where late night joints can be found throughout town. So a late night vegetarian restaurants would have at least one customer!

There are basically two types of vegetarian restaurants in Vietnam. The most common is a "quan com chay" and they are easy to find all around the city. Just make sure it says "cơm chay" and not "cơm cháy" because the latter is a kind of crispy rice wafer., which may not be vegetarian at all. A quan com chay will generally have a cart in front with a buffet of a dozen or so vegetarian dishes such as tofu, mock meats, sauteed vegetables, greens, etc. to be eaten with rice.

The other kind of vegetarian restaurant is the proper restaurant with non-plastic chairs for seating, with air conditioning, where you will be shown a proper menu from which you will order dishes. This is where you'd take guests whereas the former is where you'd stop in for a quick meal.

Won't it suck?

Issues that might come up:

Hunger: Do you find regular Vietnamese portions to be too small, even after eating in Vietnam for awhile? Then it won't be better when eating vegetarian. I was used to it, and was already eating several vegetarian meals a week, but still felt hungry sometimes. But at most buffets you can choose to order more side dishes and even more rice. But Quan Thien Tam at 152 Ban Co, right off Dien Bien Phu in District 3, a 15000 VND rice plate is enough to satiate almost anyone's appetite.

Craving for animal flesh: I recently quit smoking. Thinking about a specific meal containing meat sometimes does not compare to the desire to smoke a cigarette after you've just quit.

Availability: It's available all over Saigon as long as you don't need to eat after 9 PM or so! I did not restrict myself to a vegan diet so eggs and milk products were "on the menu" so it was possible to eat at many normal restaurants too.

This is bún chả giò, rice noodles tossed with fried spring rolls and some bean sprouts and herbs, like salad with fish sauce as the dressing. Except the fish sauce here isn't made from fish and the spring rolls have tubers and other plans as ingredients instead of pork. It's delicious aka "ngon" in Vietnamese.


We were only just going to a cafe, just a two minute drive away. I pulled onto a wide one-way street, a stretch of road which connected four major throughways, and drove along the straightaway while doing my best to not hit anyone in front of me - the only rule of the Vietnamese road. But out of nowhere another bike came in on my right, leaning into me, tangling our bikes together like knotted headphone cables.

When I first learned to ride a motorbike, I was a foreigner who came from an extremely car-based culture to Vietnam, a country which shows how a society can be built to work around motorbikes rather than cars. I wasn't used to seeing so many bikes and so few cars on the roads, nor was I used to riding a motorbike yet. But living in Vietnam the Vietnamese way means eating with chopsticks (for noodles, but using hands to eat chicken feet) and getting around via scooter.

After several years of riding a Honda motorbike in Vietnam, including a fantastic voyage from Saigon to Hoi An via the central highlands, I finally got into my first accident. If you ride in Vietnam long enough, it will happen to you too. It's like cancer - survive everything else long enough and cancer will kill you. You can lead a safer life and reduce your odds but the odds aren't great. Cut out bad habits like texting while riding, rubbernecking at Vietnamese girls. But if you live long enough without anything else killing you you'll wreck your bike.

Each year some 11,000 Vietnamese, and a handful of foreigners, die in motorbike accidents. For those who like gruesome soundbites, that's 1.5 deaths every hour. The number of non-fatal accidents is clearly orders of magnitude higher as they occur more often. In the middle are the statistics who sustain serious injuries and who will not be able to work to pay for their own medical bills. Sometimes the dead ones are the lucky ones.

You can drive slow. You can ride a 50cc Honda Cub that can only ride slow at its maximum speed anyways. You can concentrate on avoiding hitting anyone in front of you, as you must trust everyone behind you also does. You can be the minority who uses turn signals and stops at red lights. But you can't do a damn thing about someone running a red light or quickly passing you and then pulling into you well before they've cleared you (which is what happened to me). You can't get out of the way when a drunk-driving car fails to stop at a red light and smashes through rows of stopped bikes.

If you ever do "put your bike down" while you're moving, your two options are to stop suddenly or to skid. Both have their downsides. Stopping suddenly can lead to death (unless your bike is equipped with an airbag), while skidding can cause road rashes (unless you're wearing elbow pads and knee pads and some protective gloves).

"Sorry, I couldn't see anything because of my hood and I was running late to class!"

In my case, either the impact or my bike getting twisted up with the other person brought my bike down quickly and I slid down the street for what seemed like a while and I mangled my fingers and slid on my arms, elbows, and knees and somehow tore my pants at the hips and crushed my chest, while keeping my passenger (and the laptop I'm writing this on) protected. In hindsight, I should have leaned away from the ground as much as I could including taking my right hand off the handlebar.

I have advice for both cases. If you die, I'd love to hear from you - please leave a comment. If you get road rashes, after cleaning out the wounds (you should go to the hospital if you see bones or anything more than the first few layers of skin), you should apply generic Neosporin, which you should go find right now, before you ever need it, under the generic name of the 3 drugs it contains. What you find may include a topical anaesthetic as a bonus. It's actually quite hard to find so you want to have it on hand before you get into an accident. If you get nothing else from reading this post, just go out and buy a bunch of bottles of that stuff and give them away to your friends and loved ones.

Face it, Saigon is a hot and dirty city. You want to keep the wound moist, but not sweaty. Once you venture out you'll see how many different ways that germs could get into your wound from the dust blowing in the air off the street. You'll stare at all the people nearby not washing their hands, sneezing and coughing at you. You might think how if there was another plague we would be so screwed.

General hygiene aside, if you do get a road rash, expect it to hurt fairly constantly for a few days. This is where basic painkillers like ibuprofen (ibu in "Vietnamese") and topical analgesics help a lot. Until they scab over, try to not let the wounds get infected.

I just wrote about how to ride a motorbike. It's not hard but fairly necessary in Saigon, but that also means you're sharing the road with a lot of people who shouldn't be on motorbikes (or cars). Until Vietnam starts taking public transportation seriously though you will have to choose whether to take the risks in choosing how you want to join and be a part of Vietnamese traffic.

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