Taking family
medicine to
Vietnam
I
BY STEPHEN F. CUMMINGS, M.D. (PIMS ’76)
government corruption, mismanagement and oppression of the people.
To save face and keep the peace, the government let her remain as director
of an institute for pediatric health.
During our day together, we talked about our parallel experiences. The
conversation rekindled my interest in a health-care project in Vietnam. I
tried several times to reconnect with Dr. Hoa afterward, without success.
She died a few years later. So I came home to resume emergency medicine
and raise a young family.
In 1995 opportunity knocked again. In addition to full-time emergency
medicine, I was active in the family medicine program at Brown, largely with
international projects. A former residency partner suggested introducing
came to Florida State in 1972 as a 32-year-old, fed-up,
midlevel bureaucrat. I visited Paul Elliott, director of the
Program in Medical Sciences, on a preposterous mission to
find a way into medical school. (PIMS students completed Year 1
of medical school at FSU, then typically transferred to the University of
Florida to finish up. FSU didn’t have its own medical school until 2000.)
At Brown University I’d graduated with a B.A. in
international relations and French. My experience included
five years in Vietnam as a refugee advisor, five years there as a
special advisor to the minister of health and welfare, and three
years in Washington at the Department of Health, Education and Welfare.
Medicine was my long-dormant dream kept alive by inspiring physicians.
One was Pat Smith. Beginning in 1957, she operated a hospital in Kontum
Province, Vietnam. It was an oasis of caring in an area of savage fighting.
I thought about becoming a doctor and joining her work.
Elliott, who had a long beard and Afro and generally wore an African
dashiki to work, had sympathy for oddballs. He suggested I apply to FSU
for a second undergraduate degree in biology, take the premed courses and
family medicine in Vietnam. We wrote a grant proposal to the McKnight
Foundation of Minneapolis and were awarded $150,000 to get started.
Over several years we organized conferences/workshops in Vietnam.
We also sponsored Vietnamese midlevel faculty physicians to come to
the U.S. for academic fellowships to prepare curriculum and organize
family medicine departments. In 2001 the Vietnamese Ministry of Health
formally established family medicine as a specialty and approved family
medicine training at all medical schools. This became the biggest privately
funded international family medicine development project in the world.
I continue to serve as senior consultant. I have been active in similar
projects in Cambodia, Laos and Myanmar.
I thank the PIMS program for the supremely fulfilling opportunity to
convert wartime humanitarian work into peacetime development and
reconciliation.
In 2015 Cummings received the Gabriel Smilkstein Memorial Award from
the Society of Teachers of Family Medicine for furthering the development of
family medicine education throughout the world.
apply as an undergraduate to PIMS. I wouldn’t need to get the degree –
just score top grades – and he’d consider my application.
That part worked out fine but, by the time I graduated from medical
school, Pat Smith had been chased out of Vietnam. Waiting for another
chance, I chose a family medicine residency, then spent five years in
emergency medicine before returning to the Foreign Service in 1988.
In 1990 I transferred to the Philippines. Displaced Vietnamese “boat
people” still populated refugee camps throughout Southeast Asia, and
I was advising them to return to the land they had fled. It wasn’t quite
“legal” for Americans to travel to Vietnam, but my job afforded me
diplomatic and tourist passports. I returned to get a firsthand view of the
country to which I was advising economic migrants to return.
Saigon, capital of the South, was a forlorn shadow of its former self.
South Vietnam was firmly in the grip of North Vietnamese carpetbaggers.
People were friendly to an American who could speak Vietnamese but
clearly nervous about the police interview that could follow.
I set out to visit pediatrician Duong Quyen Hoa, in her mid-70s. During
much of the war, she’d been a well-respected pediatrician in Saigon. At
the same time, unknown to us, she was a founding member of the Viet
Cong. From 1968 to 1975, she was the Viet Cong minister of health. By
1990, however, she had quit the ruling Communist Party and denounced
26
Cummings at a family medicine faculty-resident precepting session at the
Hue Medical University in Vietnam.