By Grant McCool
HANOI, Oct 4 (Reuters) - Preventing disease in a developing and mostly rural country such as Vietnam can sometimes be as simple as frequently washing hands with soap.
One of the countries hardest-hit by avian flu, Vietnam is geared for another "avian flu season" with the approach of winter.
But amid the high-profile global threat of the H5N1 virus, the stretched Vietnamese public health system has had to fight many other diseases such as SARS (Severe Acute Respiratory Syndrome), blindness-causing trachoma and intestinal worms.
One of its main weapons against these potentially deadly or disabling diseases is teaching villagers and urban residents alike to wash hands with soap combined with good sanitation practices.
"Hygiene is a hot topic in Vietnam because it is linked to so many diseases," said Nguyen Kim Nga, coordinator of the National Handwashing Initiative.
Diseases that can be prevented with better hygiene include avian flu, SARS, trachoma, diarrhoea and respiratory tract infections. The programme, run by the World Bank and the Vietnam health ministry in partnership with soap companies, aims to reduce sickness and death among children under five from diarrhoeal diseases.
The U.S. Centers for Disease Control estimates 14,000 children die from diarrhoea every year in Vietnam.
Some of them could have been saved if washing of hands with soap was the norm in their households.
Nga said the programme, which is also being developed in other countries, does not recommend any soap brands.
"We want to make handwashing with soap so appealing to these consumers that it becomes a habit," Nga said. "Knowledge about hygiene in Vietnam is high, but handwashing with soap is rare."
She said researchers are monitoring actual handwashing with soap in households in eight provinces to assess how many use soap after defecating, after changing a baby's diaper, before preparing food and cooking.
They hope to obtain a better idea of what would motivate mothers in particular to use soap, which can prevent transmission of a variety of pathogens.
Handwashing is sometimes referred to as the "do it yourself vaccine" as research suggests that diarrhoeal, respiratory and intestinal infections can be cut by almost half with proper use of soap.
LONG DISEASE LIST
A U.N. World Health Organisation study found that 55 million of Vietnam's 83 million people had intestinal worms, which can cause weight loss and listlessness, leading to absences from work and school and malnutrition in children.
The list of diseases is long in the densely-populated tropical country where 75 percent of people still live in rural areas or are engaged in agriculture. It includes HIV and AIDS, tuberculosis, meningitis, malaria, dengue, encephalitis and more.
Hans Troedsson, WHO representative in Vietnam, links the battle to prevail over these diseases to the country's ambitions to develop the economy and lift people out of poverty.
"My constant advice to the government is that if you don't have a healthy population you can't compete economically," said Troedsson. "You not only have the burden of diseases, but also they can't function in production."
Malaria is far less prevalent in Vietnam than it used to be, partly due to a campaign to distribute mosquito nets and encourage their use.
Trachoma, a leading cause of blindness among rural poor but treatable by surgery, has also been reduced by Vietnam's participation in a global programme to fight the disease.
As Vietnam begins to successfully combat diseases, partly due to greater resources as a result of its developing economy, other health problems common in the West are becoming a concern.
The transition from abject poverty to more prosperity has changed eating habits to more fatty foods, causing a shift to non-communicable diseases. They include cardio-vascular diseases, diabetes and those related to weight gain and lack of exercise.
A study by the Vietnam Nutrition Institute released in September found obesity rates climbing to almost 30 percent in and around the southern commercial hub of Ho Chi Minh City.
"These rates should set off some serious alarm bells," institute head Nguyen Cong Khan was quoted as saying by Thanh Nien (Young People) newspaper.
