The Vietnam National Cancer Institute – better known as ‘K Hospital’ – is situated in the heart of Hanoi in an attractive French-colonial building with green shutters and neo-classical arches. A pediment with Roman lettering recalls the hospital’s Gallic heritage: Institvt Dv Radivm De L’Indochine. Its doors first opened in the 1920s, and it shows. Dark wooden card-catalogues line the main hallways. Slides of tissue samples are packed in ancient wooden trays piled up next to modern microscopes. Some of the equipment is still marked ‘Made in the USSR’. There are rooms that don’t appear to have changed much since the fifties and sixties. The luckier chemotherapy patients receive their treatment reclining in split-leather armchairs that spill foam through the cracks.
Every day, a swarm of scooters and motorbikes surrounds the hospital. Hundreds of patients crowd a courtyard. The wait is interminable. The relief when a patient’s name or number is called out over a tiny loudspeaker mounted on a pole is almost palpable. Some days as many as 700 or 1 000 people will push their way into the hospital. Doctors can average up to 100 patients a day. Many of them are from small rural villages and towns, and have scraped together what little they have to seek treatment. Often it is too late.
The wards in Vietnam’s cancer hospitals are hopelessly overcrowded. It is not uncommon to find three, even four people sharing a bed and a few more sleeping underneath it. In 2011, the hospital’s children’s ward was reported to have twenty-five beds for sixty-six patients. Beds are only for those who can afford them. The poor have to sleep on the floor or curled up on mats in the corridors and stairwells. Some sleep on the streets.
Rampant corruption affects almost every aspect of Vietnam’s tangled bureaucracy. And it extends to the heart of the country’s state hospitals, where underpaid doctors, nurses and administrators readily supplement their income with bribes. Their willingness to accept these supposed ‘tokens of thanks’ is unsurprising. A doctor with ten years’ experience earns a salary equivalent to about $200 a month. A chief nurse with fifteen years’ experience will probably earn $175 a month.
Patients know that to get proper treatment, a ‘tip’ is often required. Usually it is cash, sometimes the offer of an ‘opportunity’ to a medical doctor or nurse. The latter can involve anything from discounts in a shop owned by the patient’s family to enrolling a doctor’s children in expensive schools or arranging the purchase of an apartment for them at a greatly reduced ‘corporate price’. The practice is commonly referred to as tê nan phong bì or ‘envelope evil’.
A detailed survey published in September 2011 by corruption watchdog Transparency International found that large ‘envelope payments’ frequently accompanied operations where there was a ‘high chance of mortality’. The amount paid was usually based on the gravity of the illness.
Tran, my interpreter and guide through the hospital, is fatalistic. ‘The rich people get treatment outside Vietnam. If you are seriously sick in Vietnam and you can’t go to Thailand or Singapore, then you have to accept to die. A lot of people who go to Hanoi and Saigon for treatment are in the final stages and it is too late, because in the local areas they don’t have medical facilities. More and more people are getting cancer. There is a lot of pollution in Vietnam today. There are factories poisoning the water with chemicals. In the countryside the soil is polluted and it affects the food. People smoke a lot of cheap cigarettes. And there are chemicals like Agent Orange, which poisoned the soil during the war.’
‘It is a harrowing experience for patients,’ says Dr Scott Roberton, the Wildlife Conservation Society country rep. ‘In Vietnam, if you are diagnosed with cancer, you are going to die, and that’s how the doctors approach it. For them, there’s no point in trying to treat someone with cancer, and they make no effort to try and protect patients from infection. Often it is the untreated, opportunistic infections that kill them and not the cancer.’
Roberton has lived in Hanoi for more than a decade. His wife is Vietnamese. ‘My brother-in-law died of cancer and for eighteen months we went with him through hospitals here, in China and in Singapore. It opened so many doors. It was like being in another world and it helped me gain an understanding of the real challenges we face in tackling the use of rhino horn, tiger bones, bear bile and other animal parts. Radiation therapy makes you ill, so people here don’t trust it. This is faith-based medicine. The traditions have existed for thousands of years. People believe in them. You can’t dispel the myth of rhino horn’s curative properties with Western science, because it works like a placebo. And there’s such an interest here in alternative remedies. Patients will try everything and, if they can afford it, they will try rhino horn. It doesn’t matter if there is anything real behind it or not.’
In a hospital in China where his brother-in-law, like many other financially well-off Vietnamese, went for treatment, Roberton was astonished at what he saw. ‘People openly showed us their rhino horns, although there were quite a lot of fakes. There was a Taiwanese bloke, a famous architect, and someone had gifted him an adult stuffed tiger. You’d walk into this big fancy hospital room and there was this tiger, which was meant to give him strength in his fight.’ There were similar scenes in Singapore in a hospital popular with Vietnamese patients. In the oncology ward, ‘every single Vietnamese person had rhino horn’, Roberton says.
Medical doctors in state hospitals often promote the use of rhino horn to their patients. ‘I’ve tried everything, including rhino horn powder every day,’ a businessman in his eighties told the news agency AFP in May 2012. ‘Now the doctors have told me I’m in a stable condition. I have lots of money, I am old [and] I just love to live. I have no reason not to spend money on buying the expensive rhino horns and drinking its powder if it helps me.’
At ‘K Hospital’ there is a thriving department of traditional medicine, where I was told that medical staff regularly encouraged patients to use rhino horn in conjunction with standard cancer treatments. And a doctor at Bach Mai hospital – Hanoi’s largest – has been secretly filmed in his office grinding up rhino horn in one of the Bat Trang dishes and sharing the mixture with a visitor.
‘I use this every day,’ the doctor can be heard saying. ‘Look at me. Can you believe I’m sixty? The more the better, I say.’
Cong’s claim to have used rhino horn to help ameliorate the after-effects of too much rice wine seemed scarcely credible, at first. But the further I travelled, the more frequently I heard the story. And in the months that followed, there was increasing evidence of a disturbing shift in the Vietnamese consumer market.
It has been dubbed the ‘Ferrari factor’.
‘The new rich want luxury goods that are rare, exotic and expensive as indicators of their success,’ says Doug Hendrie, an advisor to ENV. ‘These values, in addition to the fact that rhino horn is supposed to be good for you, may be driving the surge here in Vietnam.’
Popular Vietnamese websites, including one linked to an official government newspaper, carry articles touting rhino horn’s supposed ability to ‘improve concentration and cure hangovers’. ‘Rhino horn with wine is the alcoholic drink of millionaires,’ proclaims an article on the website viet-bao.com. Another describes rhino horn as ‘like a luxury car’.
Vietnam’s nouveau riche are monied, trendy and ostentatious. It is not uncommon to see a bright yellow Ferrari or a Porsche lumbering cautiously through the chaotic crowds of bicycles and scooters in Hanoi’s Old Quarter. Designer labels and stores crowd the air-conditioned frenzy of the Vincom Towers shopping mall in the centre of the city: Prada, Valentino, Hugo Boss, Givenchy, Armani, Pierre Cardin, Dr. Martens and Longines. There’s even an Ecko Unltd store with its distinctive red-and-black rhino logo. The centre-piece of the shop is a plastic rhino. But unlike in South Africa – where the company has put up giant billboards cashing in on the poaching crisis – not a word of protest is evident here.
In Vietnam, rhino horn has been elevated to a status symbol. It is hugely expensive and, theoretically, illegal. Tho
se with money want it, not only for its perceived health benefits, but also because it has such an illicit appeal. Displaying a horn on a shelf or a table is both an overt statement of wealth and one of untouchability. There are stories of businessmen and government officials drinking brandy from carved rhino horn cups or whole horns being displayed in homes on the altars that families use to pay respect to their ancestors.
Nguyen Huong Giang is one of the new wealthy. The twenty-four-year-old lives in a modern high-rise with wooden floors and expensive furnishings. She carries an iPhone and wears tastefully extravagant jewellery. In March 2012, she openly discussed her use of rhino horn in an interview with an Associated Press stringer, Mike Ives. Unlike many others, she had no qualms about being identified and was clearly unconcerned about possible repercussions. She even agreed to be photographed preparing a rhino horn elixir.
‘Nguyen Huong Giang loves to party,’ Ives later wrote, ‘but loathes hangovers, so she ends her whiskey benders by tossing back shots of rhino horn ground with water on a special ceramic plate. Her father gave her the 10-centimetre brown horn as a gift, claiming it cures everything from headaches to cancer. Vietnam has become so obsessed with the fingernail-like substance that it now sells for more than cocaine.
‘“I don’t know how much it costs,” said Giang, twenty-four, after showing off the horn in her high-rise apartment overlooking the capital, Hanoi. “I only know it’s very expensive …” [S]he estimates her horn will last another ten to fifteen years. But once her stash is depleted, there may not be any rhinos left on earth to satisfy her craving.’
Vietnam is one of Asia’s ‘rising dragons’, a ‘communist capitalist playground’ that has a seen a dramatic economic transformation in recent decades. On the surface, it is a country reborn – one that has defied the odds and prevailed despite decades of war, the loss of Soviet financial support and a series of crippling economic crises. It has been hailed as a model of economic liberalisation. The country’s first stock exchange was opened in 2000, and seven years later it joined the World Trade Organization (WTO).
Prior to the 2008 global recession, Vietnam had been averaging a remarkable 7 per cent annual growth in its gross domestic product. And, until it finally hit a wall of financial instability brought on by a combination of high inflation, large trade deficits and a weak currency, it was one of Asia’s fastest-growing economies.
But Vietnam is also a country in the grip of a paranoid and authoritarian political regime that seems determined to cling to power. Bill Hayton, a BBC reporter and producer who was expelled from the country for his reporting, has described Vietnam as a place where ‘the trappings of freedom are apparent on every street, but from the economy to the media, the Communist Party is determined to remain the sole source of authority’.
Their presence is felt from the flags outside shops to the phalanxes of green-uniformed soldiers and the tinny loudspeakers on street corners that once warned of air raids and now continue to pump out party messages and propaganda. State-owned enterprises still dominate the economy and account for 40 per cent of the total GDP. In the pages of the newspapers there are reports of crackdowns on government opponents.
A few days after my arrival, Viet Nam News, the English-language daily, carried an article about a seventy-one-year-old Buddhist activist, Nguyen Van Lia, who had been sentenced to five years’ imprisonment. His crime: ‘Abusing democratic freedoms to infringe upon the interests of the state’. It was not an unusual occurrence. Dozens of other dissidents have received similar jail terms for opaque crimes like distributing ‘anti-state’ leaflets or collaborating with ‘reactionary’ groups.
Vietnam’s spectacular economic growth has come at a price. The impact on the country’s environment has been devastating. Hayton – in his book Vietnam: Rising Dragon – refers to the ‘dogmatic Marxist-derived belief that the environment is just another resource to be used up in the service of humanity’. Scott Roberton says Vietnam’s economic model is, at its heart, driven by a desire ‘to make money, no matter what the cost’.
Increasing affluence has led to a growing demand for rare meats and exotic animals to be eaten or used in traditional medicines. Across Vietnam, restaurants advertising dac san or ‘speciality dishes’ abound. Anything from pangolins and civets to snakes, monitor lizards, turtles and deer can be served up. The rarer the animal, the more its flesh is prized. Newspapers have carried lurid tales about the new rich and their wild parties with ‘processions of supercars and sexy music shows by long-legged girls’ at which ‘the meat of endangered animals such as anteater, deer, muntjac, bear and snakes’ is consumed.
Surveys conducted in Hanoi in 2007 and Ho Chi Minh City in 2011 reveal disturbing trends where ‘affluent and highly educated people are more likely to use wild animal products than those with less money and education’. Businessmen and government officials are the most profligate, dining out and treating guests to an array of exotic dishes as a means of enhancing their status.
In Vietnam, the greatest threat to wildlife is human consumption. Estimates suggest that up to 4 500 tons of wild fauna, excluding fish and insects, are used each year as food, medicines and ornaments. Law enforcement efforts have a negligible impact, intercepting between 2 and 5 per cent of the illegal wildlife trade. According to the Hanoi survey, many people found that the consumption of wildlife was ‘appealing despite, or even because of, [its] illegality’. Disconcertingly, the survey found that ‘non-consumers [of wildlife] will potentially become consumers if their standard of living and disposable income increases’.
In May 2011, wildlife inspectors conducted a raid on a restaurant run by the matriarchal ‘kingpin’ of a wildlife trafficking ring in Da Lat, a popular tourist destination in southern Vietnam. Minutes after they left, the woman, Mrs Tu Loan – a matronly sixty-year-old – was back in business and offering to sell rhino horn to an undercover journalist from Thanh Nien news.
‘One hundred million [$5 000] for 100 grams. No bargain,’ she reportedly said. ‘I just want to help you. Let me ask a friend of mine to bring the rhino horn here. I used to trade in it, but it has become scarce in the past three years.’ The director of the local forest protection department, Tran Thanh Binh, later told the reporter that Loan was the ‘most infamous wildlife kingpin … in Da Lat’ and ‘any rhino horn [sold in her restaurant] must have been sourced from her, not anyone else’.
Investigations by Roberton and his colleagues at the Wildlife Conservation Society turned up evidence that she ran a zoo in addition to the restaurant and allegedly used it to ‘launder protected species’. The raid was not the first. In August 2010, officials confiscated 300 kilograms of illegal game meat from her restaurant. But despite the raids and mounting evidence, Tu Loan remained in business and untouchable.
You only need to travel to Ha Long Bay, probably one of the most spectacularly beautiful places in the world, to see the damage wrought by rampant development, crass commercialism and uncontrolled tourism. A UNESCO World Heritage site, it consists of hundreds of limestone islets and pillars rising dramatically out of the South China Sea. The bay, with its hundreds of fake Chinese-style junks and cruise boats, attracts close to 2 million tourists a year.
But it is dying. Mangrove forests that once lined the shores and protected the bay by filtering out the soil and pollutants being carried into the sea by rivers and streams have long been stripped. In their place is the ugly concrete of Ha Long City. Just north of Ha Long Bay is Cam Pha, the heart of Vietnam’s coal-mining industry. Coal dust blights the sea. The sludge has become so thick, it can be mined. The tourist boats leak diesel into the water. You can smell it on the sea air as you drift between the islands and see the oily iridescence on the water’s surface.
The cruise lines all boast that their boats are fitted with septic tanks. Many of them are, but few are equipped to process the raw waste, and the onshore facilities are inadequate. The result, as Hayton bluntly puts it, is that ‘the shit of a million and a half boat p
assengers a year [now closer to two million] is being dumped directly into Ha Long Bay’.
About a thousand people live in four traditional floating villages sheltered by massive limestone karst pillars. Once upon a time, the waters teemed with fish. But years of overfishing, some of it involving the use of poison, explosives and electric current, has decimated the fish stocks. Most of the fishermen living there now eke out a living from whatever fish they can farm in polluted net pens and from tourism.
Vietnam is a signatory to more international environmental conventions and agreements than most other Southeast Asian countries. But in reality, this has more to do with projecting a favourable image of the country, and saving face, than protecting the environment.
In September 2011, South Africa and Vietnam held bilateral talks in Johannesburg. A media release announced that the countries had ‘agreed on a process towards the finalisition [sic] of [a] Memorandum of Understanding (MOU) to collaborate among others on natural resource management, wildlife protection and law enforcement’. At a press conference – in which the Vietnamese delegation had grudgingly agreed to participate – I asked Ha Cong Tuan, the then deputy director of Vietnam’s forestry administration, about the persistent myth that rhino horn could cure cancer and rumours that its use had been endorsed by a senior Vietnamese government official.
His response was telling. ‘I can publicly declare that it is a rumour in Vietnam,’ he said through an interpreter. ‘Me, myself personally, and others as well, hear that rhino horn can cure cancer. Personally I don’t believe in that statement or rumour and we already requested that a medical research institution … verify if rhino horn can cure cancer and make [the findings] public’.
Killing for Profit: Exposing the Illegal Rhino Horn Trade Page 33
