singapore

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
Taiwan1918999
Japan3719988
Thailand85630370
Singapore189705426
Hong Kong5320061137
Philippines21029591654
Vietnam225542102692
Cambodia12713*12992
Myanmar/Burma15396****
The above data was collected from hospitals.webometrics.info'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.

Vietnam has been labeled an "enemy of the Internet" by Reporters Without Borders. There have been a lot of cases of bloggers being targeted, harrassed, and arrested. But RSF (Reporters Sans Frontieres - French for Reporters Without Borders) are possibly speculating heavily on many of their other arguments such as banning Internet (gaming) cafes near schools, the real origins of DDoS attacks, Considering Internet penetration in this rather populous country, with Internet usage continuing to rise rapidly each year, and an explosion of Vietnamese businesses operating on the web, it might be a bit of hyperbole to say that Vietnam and the Internet are enemies, just like people mistakenly still think that Vietnam and America are still enemies. But censorship of websites is an issue here in Vietnam. It's an issue in all of Vietnam's neighbors in Southeast Asia.

First, to the north of Vietnam lies the vast Middle Kingdom of China (China isn't properly part of Southeast Asia but it does border many Southeast Asian countries). China has been labeled #1 Enemy of the Internet for implementing a technologically advanced firewall (the Great Firewall of China). In China, hundreds of popular American websites are blocked including Google, YouTube, Facebok and Twitter. Search queries are also monitored for keywords and then stopped if a person is searching about a sensitive topic like the Tiananmen Square massacre. Chinese are forced to use local versions of social media (like Sino Weibo) which are more easily controlled by the Chinese government. You could try to draw parallels to Facebook versus Zing Me and other social networks in Vietnam but the huge difference is that Facebook is still accessible and the one and only social media platform in Vietnam. TOR (The Onion Router, used for anonymously browsing the Internet and TOR .onion sites) is also blocked in China.

Malaysia isn't your typical enemy of the Internet. Its government (like Vietnam) encourages a digital ("multimedia", a term from the 1990s) economy with various initiatives like Cyberjaya and the Multimedia Super Corridor and when those initiatives started, just as the Internet was blowing up around the world, the government declared that the Internet was to remain free and uncensored. But Convervative Muslims in charge do want to limit certain cultural shortcomings by censoring scenes in movies with nudity or even just cleavage and sex or even just kissing.

Singapore - the country where chewing gum is banned and could get you caned. It's also a country with a rather long blacklist of blocked websites, mostly porn sites like YouPorn or Pussy.com. In Vietnam, pornography is illegal and you won't find Playboy or other girly mags being sold at magazine stands. But online, while ostensibly the Internet censorship laws are for blocking online porn, no porn sites are actually blocked (I've checked some of them - for research purposes). In Singapore, to a lesser extent, bloggers have been shut down and so has a random website about traveling while infected with HIV due to unfavorable portrayal of Singapore's policies towards HIV carriers. But no reports of bloggers being jailed unless they were also jaywalking, chewing gum, dancing in public places without a proper permit, bringing durian onto busses, or being a graffiti artist.

Thailand demonstrates a tactic that has been used in Vietnam, Cambodia, and probably many countries. Websites are not strictly speaking made illegal by the government. Rather, the government makes secret requests to ISPs to make certain websites unavailable. ISPs can decide to comply or ignore the request but ignoring the request comes at a high cost and so ISPs will generally block any website upon request. This means now over 100,000 websites are blocked in Thailand, putting it in the same league as China! Out of the rest of the countries in the region Thailand and Cambodia are the only kingdoms. Thailand has lese majeste laws making it illegal to insult the monarchy. This has led to arrests of people saying potentially offensive things about the king on social media sites like Facebook or even for liking or retweeting such statements.

Cambodia follows Thailand and Vietnam's leads when it comes to Internet censorship (Cambodia also gets their Internet connection from those two countries). When the government "requests" that certain websites are blocked the ISPs generally comply making it unnecessary to outright criminalize the websites in Cambodia. At the same time, governments deny censoring any websites and ISPs also release confusing messages regarding any block or whether it's an official block or just "technical difficulties". Like in Vietnam, certain blogs hosted by massive blogging platforms like Blogger and Bloghost have caused both entire platforms to be blocked by ISPs, not just the offending blogs. A certain controversial artists has had his website blocked, as has the NGO Global Witness, who fights againgst natural resource exploitation, corruption, and human rights abuses, probably for writing stuff like Cambodia should not stand for UN Security Council until land grabs and repression stop. Strangely, the prime minister of Cambodia briefly banned smartphones and 3G due to the potential of being able to view sexy streaming videos on one's mobile phone.

In Burma, the problem isn't just that some websites are blocked. Rather, all websites are slow and access can be unbearably limited to the point where they are functionally blocked. In general, Internet access is hard to subscribe to and then expensive to use, unaffordable for most Burmese. They also apparently have the same networking gear used for censorship as in China. With recent changes in attitudes towards the West and to media, with promises of no longer censoring newspapers, this is one country to watch in the future from any angle.

Laos, on the other hand, appears to not censor anything on the Internet.

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