Report health and wellbeing demand of expatriates in hcmc-3

Health and wellbeing demand
of expatriates in Ho Chi Minh
City
An empirical study
Rebecca Mayer
2014

Rebecca Mayer
2
Abstract
Author: Rebecca Mayer
Title: Health and wellbeing demand of expatriates in Ho Chi Minh City
There are few academic papers about the health care need of expatriates in South-East-Asia, and none
about expatriates in Vietnam. But health care institutions especially in larger cities like Ho Chi Minh City
are dependent on information about their clients to be able to improve health care services. This study
provides a first insight into health related issues of expatriates in Ho Chi Minh City.
A quantitative study, including an online and a telephone survey were conducted. Participants were
asked about their life in Ho Chi Minh City, their health care needs, their preferred health care providers
and the kind of treatments they are accessing. Furthermore, qualitative face-to-face interviews
completed the work and provided a deeper understanding of expatriates’ thoughts and emotions
regarding their health care experiences in Vietnam.
The results of the analysis show that health care and health related issues are major concerns of
expatriates while living in Vietnam. Preferred health care providers are private hospitals and clinics.
Public hospitals are unpopular, because of their bad reputation or bad experiences expatriates had
there. They are associated with low hygiene, crowdedness and staff lacking skill, as well as language
barriers and missing trust. Complains about private hospitals are mostly about high prices and the lack
of specialized care.
Even if most of the expatriates access regular medical care in Ho Chi Minh City, the analysis indicates
that for more complex treatments and dread diseases expatriates prefer to fly home or abroad.
The findings of the study suggest that improvements on specialized care in the private sector and
improvements on public medical care on the most basic level has to be done, to make expatriates feel
safe when accessing health care in Ho Chi Minh City.
Keywords: expatriation; expatriates in Ho Chi Minh City; health care need; wellbeing; health care
providers; quantitative study; qualitative study

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Table of Contents
1. Introduction ..........................................................................................................................................4
1.1. Background ...................................................................................................................................4
1.1. Objective.......................................................................................................................................4
1.2. Methods and procedures..............................................................................................................4
1.2.1. Online survey ........................................................................................................................4
1.2.2. Telephone survey..................................................................................................................4
1.2.3. Face-to-face interviews.........................................................................................................5
1.2.4. Procedures ............................................................................................................................5
2. Profile of the questioned expatriates ...................................................................................................5
2.1. Demographic characteristics.........................................................................................................5
2.1.1. Online Survey........................................................................................................................5
2.1.2. Telephone Survey..................................................................................................................6
2.1.3. Face-to-face interviews.........................................................................................................6
2.2. Income level..................................................................................................................................6
2.3. Annual spending on health care and sources of finance for health care .....................................6
3. Expatriates’ life in Ho Chi Minh City......................................................................................................7
3.1. Health and wellbeing ....................................................................................................................7
3.2. General concerns ..........................................................................................................................7
4. Health care need of expatriates in Ho Chi Minh City............................................................................8
4.1. Information about health care......................................................................................................8
4.2. Kind of treatments........................................................................................................................8
4.3. Preferred health care providers....................................................................................................9
4.4. Remarks about improvements....................................................................................................11
4.5. Limitations...................................................................................................................................12
5. Conclusion...........................................................................................................................................13
6. Appendix ...............................................................................................................................................A

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1. Introduction
1.1.Background
There are few papers about expatriates’ need on health care in Vietnam. Information is found only on
expatriates’ blogs and on health insurance websites, which are promoting their services.
For health care providers the knowledge about the health care need of expatriates is essential. They
need to know which services they can offer and how to address this target group.
With the right adjustment of their services to the needs of expatriates, improvements on health care
among the expatriates community can be done.
1.1.Objective
The goal of this survey is to identify the health and wellbeing demand of expatriates in Ho Chi Minh City.
Therefore expatriates’ choice of health care providers, the kind of treatments they are accessing in Ho
Chi Minh City, their general wellbeing and worries, their income level, as well as the amount of health
care expenses and their source of financing was examined.
1.2.Methods and procedures
1.2.1. Online survey
Since there is a lack of academic papers in this field an online survey based on the statements of
expatriates on various expatriates’ blogs and on the personal experiences of the author has been
created. The online survey was promoted through various social media, like facebook, expatriates’ blogs
and through personal contacts. Furthermore, English language schools, international sport clubs and
organizations in Ho Chi Minh City were contacted and asked to share the link to the survey with their
foreign staff. If not mentioned explicitly the numbers in this report will be taken from the online survey.
1.2.2. Telephone survey
With the results of the online survey another questionnaire was conducted. These questions were asked
via telephone to patients at Cao Thang Eye Hospital.
This second step guarantees that interviewees have had health care experiences in Ho Chi Minh City
already and therefore have a deeper understanding of the health care system in Vietnam and their own
health care needs.

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1.2.3. Face-to-face interviews
A third method, personal interviews, was chosen to discover the thoughts and emotions of participants
when speaking about their own personal experiences with health care in Ho Chi Minh City. Depending
on their stories, individual questions and focus points could be made.
Furthermore an expert interview with two representatives of a health care insurance consulting
company (IF-Consulting) was conducted.
1.2.4. Procedures
This paper has been divided into five parts. After the introduction, which contains the background of the
study, the objectives and the methods used, the second part deals with the profile of the respondents,
and is divided into the different interview methods. Chapter three presents the wellbeing and the
concerns of expatriates while living in Ho Chi Minh City. In the fourth section the health care need of
expatriates is discussed. It focuses on five key themes: Information procurement, types of treatments,
health care providers, health care concerns and remarks about improvements in the health care sector
in Vietnam. Finally, the conclusion gives a brief summary and critique of the findings.
2. Profile of the questioned expatriates
2.1.Demographic characteristics
2.1.1. Online Survey
55 individuals returned the questionnaire, from which 45 completed the whole form. This number is no
representative sample of the expatriates’ community in Ho Chi Minh City and therefore figures and
percentages need to be interpreted with caution. That means that the study just offers a small insight
into opinions and trends of expatriates regarding health care in Ho Chi Minh City. It gives the
opportunity to obtain a first idea, which subjects and issues are relevant.
The majority of people who participated in the online survey are between 25-44 years old.
The United States, United Kingdom, France and Germany are the countries where most of the
respondents come from (with seven or eight people from each country). Five expatriates are from
Australia. The rest splits up to other countries in Europe and Asia.
It was not possible to investigate significant relationships between demographic data and provided
answers to the survey, caused through the small sample size.

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2.1.2. Telephone Survey
The telephone survey was held with roughly 10% of the international patients at Cao Thang Eye
Hospital, which means a total of 20 patients. 15 people were male and five female. That correlates with
a derivation from just under 4% with the actual distribution of the international patients at Cao Thang
Eye Hospital. More than half of the respondents have been living in Ho Chi Minh City for more than
three years.
The patients questioned are between 28 and 73 years old, the mean is 42 years. 30% of the respondents
come from France, another 15% from the United Kingdom. The other respondents are from North
America, Asia and Australia. Respondents from both, the online and the telephone survey, mostly come
from Europe or the United States. Only a small number of those interviewed are from Australia or Asia.
This does not reflect the expatriate community in Ho Chi Minh City, in which quite a high percentage
comes from Japan, China and South Korea. This group could hardly be reached, because of the
researchers own origin (Europe) and the language barrier.
2.1.3. Face-to-face interviews
The personal interviews were conducted with one Australian, one Canadian and one Singaporean.
They are all working in different areas (Consulting, Education, and Tourism) and have stayed in Vietnam
for at least three years. This ensures that they have developed their own lifestyle and have a feeling for
their wellbeing in Vietnam and it increases the chance that they know about health care in Ho Chi Minh
City and that they have made health care experiences themselves.
The expert interview with If-Consulting was conducted with a Vietnamese woman, who is responsible
for French clients, and with a European staff, who is, among other tasks, responsible for Marketing.
2.2.Income level
The mean income of most of the expatriates, questioned in the online survey lies between $20.000 -
$39.999 a year. It must be noted, that a quarter of the respondents preferred not to disclose their
salary. The salary reflects the primary area of employment of expatriates: The education sector, in which
38% of the respondents work.
2.3.Annual spending on health care and sources of finance for health care
According to the answers in the online survey expatriates’ average spending on health care a year (in
US-Dollar) is $1284.
This corresponds with a number provided by If-consulting, which estimates that the average premium
for a health insurance for expatriates is $1300 a year (Interview If-consulting, line number 457).

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This number can widely vary depending on the expatriate’s health care need and if the expatriate has a
health care insurance or pays out of his own pocket. 80% of the online survey respondents equally split
up between financing health care expenses through an insurance and bearing the expenses themselves.
Emergency costs, which are only included in the calculation, if the expatriate has an insurance, could
increase the expenses for a single individual a lot, if he or she has to pay for it out of his or her own
pocket.
3. Expatriates’
life
in
Ho
Chi
Minh
City
3.1. Health and wellbeing
The online survey provides the evidence, that the expatriates’ community in Ho Chi Minh City is healthy.
Three quarters rated their overall health excellent (29%) or good (46%). This result cannot be seen as
surprising, if taken into account the young age of the expatriates participated in the survey.
The three expatriates personally interviewed summarized what they mainly need for feeling healthy and
good: Healthy food, the possibility of doing exercises and social contacts for the mental wellbeing
(Interview I, line number 74-75). All of them do not find it difficult to live a healthy life in Ho Chi Minh
City, as the access to fresh vegetables and fruit is easy (Interview III, line number 114), exercises can be
done in a serviced apartment (Interview I, line number 72-73) or in the gymnasium (Interview II, line
number 33) and the online survey proofs that the social life is no major concern for expatriates.
One interviewee mentioned that it is difficult to do outdoor activities in Ho Chi Minh City, as she was
used to in Australia (Interview II, line number 36-39). The online survey provides similar indications
through comments from respondents, in which they complain about the lack of opportunities for
outdoor activities and the environmental situation.
3.2. General concerns
Expatriates’ most common concerns are health care, food safety, road safety and hygiene standards.
Especially the general safety on the street was mentioned constantly. A connection between the fear of
a motorbike or car accident and the health care situation in Ho Chi Minh City is pointed out by an
interviewee during the telephone survey. He said that he worries most about having a car accident,
because he has no trust in Vietnamese hospitals and doctors (Telephone Survey, ID 16).
On the contrary, expatriates did not just state food as health concerning, but more than one third
believe that it is healthy and delicious as well. The interviewee from Singapore indicated:
“Food was a bit different, but it was not tremendously affecting ones wellbeing”

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(Interview I, line number 70-71)
and
“coming from Singapore you would say, you know, have the spoons and the chopsticks been washed
entirely before they are served to the next costumer, have the food that they are serving been kept
on a certain temperature, (…) reducing the risk of certain bacteria multiplying. These would be the
slightly kills that one would consider, but (…) you can feel comfortable with the fact that what you’re
eating it’s not going to cost you severe health poison.”
(Interview I, line number 82-88).
4. Health care need of expatriates in Ho Chi Minh City
4.1. Information about health care
The results of the online survey show, that just seven out of 48 people have been provided with
information about health care in Vietnam before their arrival. That number provided the fundament to
ask patients during the telephone survey, if and why health care was / was not an important issue for
them at the time they were thinking about moving to Vietnam. It could be confirmed, that just a small
number of patients (26%) were seeing health care as an important issue. Reasons for that, given during
the telephone survey, are: Expatriates feel healthy and have no medical history (43%), expatriates are
not worrying, because they are having a health insurance (29%) or because they are still young (29%).
21% are also mentioned, that they can easily access health care in Thailand, Singapore or their country
of origin.
Once expatriates are in Vietnam, most of them (60%) are provided with information about health care
and health care providers. The source they are using is the internet (42%) and they are asking other
expatriates for advice (58%). This shows that, in addition to modern technologies, word-to-mouth plays
a major role in passing information.
4.2.Kind of treatments
The online survey shows that over half (55%) of those interviewed and those who are accessing regular
medical care, access it in Vietnam. Another high percentage returns to their country of origin for regular
health checks. 65% of the patients, interviewed on the phone, affirmed when asked if they are doing
their regular health check in Ho Chi Minh City. One reason for the varying numbers might be the
different sample size, as well as the way the question was asked. In the online survey the respondents
had the opportunity to choose between different countries, whereas the interviewed people in the

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telephone survey could simply affirm or deny, whether they are doing their regular medical checks in Ho
Chi Minh City.
Over half of the expatriates (57%) of the online survey thought that it is possible to receive a wide range
of different treatments in Ho Chi Minh City. In contrary, just 22% thought the opposite. Even if the
treatments are not specified in this question, the difference to the results of the online survey and
especially to the personal interviews is surprising, because all personal questioned expatriates said they
would return to their home country for complex or severe treatments. The representatives of If-
Consulting confirmed that the basic insurance covers the evacuation of patients to Thailand or
Singapore (Interview If-Consulting, line number 351-352) and that many of their clients would not like to
go to a hospital in Ho Chi Minh City, in case of an accident, but instead prefer to be evacuated to
Thailand (Interview If-Consulting, line number 479-483).
There seems to be an obvious discrepancy between various treatments, which are in the expatriates’
opinion available in Ho Chi Minh City and the fact that in most cases they themselves do not want to
access more than regular and basic medical care in Vietnam. Following reasons might explain the
discrepancy: Support of the family, which one interviewee mentioned (Interview I, line number 145),
might be one reason, why expatriates choose to return to their country of origin. In some countries the
access to health care is totally free. This is another motive for returning back home (Interview II, line
number 89-90). Another interviewee explained it like this: “I would be scared, if I breake my knee (…) I
would trust more of the medical practices in the US and Canada. In Canada there is… people who does
it, they have accountability. So here [in Vietnam. A/N] they don’t.” (Interview III, line number 43-45).
The surveys and the interviews have proved that expatriates are more likely to access basic medical care
in Ho Chi Minh City than complex medical treatments or medical care in case of dread diseases.
Cosmetic surgeries or cosmetic dental care is not a common thing for expatriates to undertake in Ho Chi
Minh City, as the telephone survey and the personal interviews show. Just three out of twenty
respondents of the telephone survey ever accessed any cosmetic treatment in Ho Chi Minh City.
Nevertheless, expatriates are aware of health care providers in Ho Chi Minh City offering more and
more cosmetic surgeries. One respondent mentioned, that the cosmetic industry is “a booming industry
in Vietnam” (Interview II, line number 136).
4.3.Preferred health care providers
The regular health care provider of nearly half of the expatriates is the private hospital, followed by a
general practitioner (26%) and a health clinic (17%). Just 7% visit a public hospital.

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Confronting the expatriates in the online survey with different illnesses and tasking them to choose
which health care provider they would contact, shows that in case of skin rash and high fever over 55%
would go to a medical practice. In case of continuous pain in the stomach, diffuse discomfort or if the
ability to see is getting worse, between 41%-49% of the people would either contact a medical practice
or a private hospital. The public hospital plays a tangential role. In the highest case (diffuse discomfort)
just 15% of the expatriates would visit a public hospital.
These results show a clear tendency and preference for using a private practice, clinic or hospital, even
in minor medical cases. Reasons for that, according to comments from expatriates, are bad stories they
have heard about public hospitals or bad experiences they have made themselves in a public hospital.
They claimed about low hygiene standards, crowdedness (64% of the expatriates are thinking that public
hospitals are overcrowded) and about medical as well as management staff lacking skills. Expatriates
also mentioned the language barrier and that they do not trust public hospitals in general. This is also
reflected in the high disagreement of the statement, that public health care providers are reliable.
Another, but smaller group of expatriates expressed their critical opinion about private hospitals, by
mostly saying that private hospitals are too expensive. Some also mentioned a lack in specialized care,
which explains the phenomenon of expatriates flying to Bangkok, Singapore or their country of origin for
specialized care. One of the representatives at If-Consulting summarized it with following words: “Once
it’s more complicated better to fly somewhere. And that’s very normal. You have the building with ten
floor of (…) cardiac surgery. In Ho Chi Minh you have three. And on the 10th
floor you have 20 cardiac
surgeons. Of course you will have better care with that.” (Interview If-Consulting, line number 574-576).
Not clearly differenced in the study are foreign-owned hospitals (all private) and Vietnamese hospitals,
which can be public as well as private. Two of the personal interviewed persons mentioned that they
have visited a Vietnamese private hospital and were very satisfied with the service and the medical
treatment there: “When I went to the local hospital private clinic the results of the blood test,
everything was amazingly fast” (Interview III, line number 63-64).
It can be assumed that most of the expatriates questioned in the online survey are thinking about
foreign-owned hospitals, when commenting on private hospitals. One interviewee explained this fact:
“Many expatriates using, (…) FV [Franco Vietnamese Hospital. N/A] or Victoria, mainly because of the
portrayal, (…) the common use of English as a language and also the portrayal of having the medical
crew from around the world. This gives a bit of a counterbalance to just Vietnamese specific doctor.”
(Interview I, line number 95-98).

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Another indication therefore is the fact, that all participants who were interviewed on the telephone,
except of one patient, thought about foreign-owned hospitals, like Franco Vietnamese Hospital, Family
Medical Practice or Centre Medical International in the first place.
As mentioned before, this strong tendency towards foreign-owned hospital can be explained, among
other aspects, mainly by the wish to speak the native language (French people questioned in the
telephone survey were instantly thinking about hospitals, which have French-speaking doctors).
Patients interviewed on the telephone were asked about criteria they require from a health care
provider. Quality of care stands on first place with 75%, followed by hygiene, which 55% of the patients
require, and no language barrier, which 45% of the patients prefer. This proves the drift towards
foreign-owned hospitals. As long as public hospitals have the reputation, for doctors, who are not well
trained,
“And from my knowledge none of the Vietnamese doctors would be qualified to practice medicine
outside of Vietnam. (…) So, that probably tells me something is wrong with the medical schools here,
the quality of the medical schools here. So I would not want to… take the risk.”
(Interview III, line number 96-100),
for low hygiene standards, which respondents note in the online survey, as well as in the telephone
survey and for having nurses and doctors, who cannot converse in English,
“But most… even the local clinics, or even the [Vietnamese-owned. A/N] private clinics, they don’t
speak English much, (…) even the doctors hardly speaks English.”
(Interview III, line number 70-71)
expatriates will hardly choose to go there.
The telephone survey also asked about further demands on health care providers. The results show,
that expatriates in 80% of the cases prefer better facilities to a better accessibility and a health care
provider with more years experiences (65%) to the one which has a greater variety of treatments.
4.4. Remarks about improvements
Whereas the online and telephone survey concentrated only on the current situation of expatriates’
health care need, the face-to-face interviews gave more room for expatriates to compare the current
health care situation to the past or even have a look into the future. The respondents mentioned
improvements of health care in Vietnam.
One interviewee commented: “I think health care comparing to (…) my impression to first time (…) I was
in Ho Chi Minh City, it’s improving drastically.” (Interview III, line number 153-154). This view is

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supported by a participant of the online survey, who connects the improvement with the opening of
foreign clinics (Online Survey, ID 91). Interviewed expatriates confirmed that these improvements
happen in private institutions, accessible and affordable for foreigners and rich Vietnamese, but not for
the mass of poor or low income citizens:
“Health care is only improving for the rich people. Not for the poor people, not for the general
public. So the general public still has to go through the crude medical system you have in Ho Chi
Minh City versus major hospitals like FV hospital only caters to the rich and the middle class,
upper and the rich people in Vietnam, which is not a fair system.”
(Interview III, line number 156-159)
One individual listed different criteria, which are needed to undertake improvements. Among them on
first place she mentioned reforms that the government has to implement (Interview II, line number 125)
and that great effort from the politicians is essential for a change. Furthermore, it needs awareness from
the public and a better health care education. (Interview II, line number 152, 160-161).
4.5. Limitations
As this paper is the result of only two months work of a single individual, it gives just a small insight into
the health care demand of expatriates in Ho Chi Minh City. The results of this study will also not be
compared to the findings of other works, because of the lack of existing literature in that field. That
leads to the necessity of further representative studies to proof the results.
Due to language barriers with some expatriates in Ho Chi Minh City, who are not able to speak and
understand English and therefore could not participate in the surveys and the small sample size in the
online survey, the results of the research may not have been representative for the whole expatriates’
community in Ho Chi Minh City. However, this paper can be the basis for further studies, as well as for
health care providers, who want to proof the health care needs of their own international patients
resident in Ho Chi Minh City.

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5. Conclusion
This paper has investigated the health and wellbeing demand of expatriates in Ho Chi Minh City. It
concentrated on the current situation and how expatriates are feeling in Ho Chi Minh City, what types of
medical treatments they are accessing and where they are accessing them.
This study has found out that generally expatriates are accessing basic medical care in Ho Chi Minh City,
but are more likely to leave the country in complex and dread cases. The majority of expatriates prefer
to use foreign-owned private hospitals and clinics, followed by Vietnamese private hospitals. Public
hospitals have a bad reputation and are shaping the negative image of health care in Vietnam.
Mostly criticized was the bad quality of treatments, the low hygiene standards, medical staff lacking
skills and the bad equipment, as well as the language barrier, which presents a major dread for
expatriates.
The findings of the study suggest that improvements on specialized care in the private sector and
improvements on public medical care on the most basic level has to be done, to make expatriates
feeling safer when accessing health care in Ho Chi Minh City.
The study has furthermore found out that a way for health care providers to address and reach
expatriates is the internet. Even more important than that is the personal contact with patients and the
necessity to create a good brand image. Satisfied patients will then recommend the hospital or clinic and
word of mouth is the most important source of information for other expatriates.
Finally a number of limitations need to be considered. First, the lack of information on official statistic
numbers about expatriates in Vietnam and Ho Chi Minh City as well as of other scientific papers on that
topic. That means that a comparison of the results with other studies was not possible.
Second, the sample size of the online survey was too small to be representative, so that caution must be
applied, as the findings might not be transferable to all expatriates’ communities in Ho Chi Minh City.

6. Appendix
Appendix 1 Online questionnaire……………………………………………………………………………………….……. B
Appendix 2 Telephone questionnaire…………………………………………………………………………………….…. L
Appendix 3 Interview I – Transcript………………………………………………………………………………………….. R
Appendix 4 Interview II – Transcript…………………………………………………………………………………………. X
Appendix 5 Interview III - Transcript…………………………………………………………………….…………………... CC
Appendix 6 Interview If-Consulting – Transcript………………………………………………………………………. II
Appendix 7 Business cards interview partner If-Consulting…………………………………………………….… AAA

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Appendix 1: Online questionnaire
Health and wellbeing demand of expatriates in Ho Chi Minh City
Thank you for taking the time to complete this survey.
My name is Rebecca Mayer, I am a "Nonprofit-, Social- & Health Care Management" student and I am
currently doing an internship in the health care sector in Ho Chi Minh City.
The goal of this survey is to identify the health and wellbeing demand of expatriates in Ho Chi Minh City.
With the results improvements on medical services can be done and health care can be adjusted to your
need.
To take part in the survey, you must be from another country than Vietnam and you have to have your
current residence in Ho Chi Minh City. That ensures that the data collected is valid for the survey.
The information collected from you in this survey will remain anonymous. Your name and contact
information will not be collected for the survey.
Answering all questions will take approximately 10 minutes.
Please answer each question to the best of your ability.
You can skip questions if you don’t want to answer them.
Any questions marked with an asterisk (*) require an answer in order to progress through the survey.
If you have any questions, please contact me via email (rs.mayer@mci4me.at).
Click the Next button to continue to the next page.
Click the Submit button to submit your survey.
Welcome to the survey!
Thank you for taking part in it.
There are 22 questions in this survey

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General questions about your life in Ho Chi Minh City
In this part of the survey you will be asked about your descision to move to Ho Chi Minh City and about
the general view you have from the city.
1 [g1]What was your motivation to go to HCMC?
Please choose all that apply:
Work
Good environment
Healthy lifestyle
New experience
Studying a new language
Partner/spouse is living/working in HCMC
Access to good health care
Well-developed infrastructure
Good schools
Other:
2 [g2]What are your major concerns/worries while living in Ho Chi Minh City at the moment? Please tick
your top four concerns.
Please select at most 4 answers
Work
Food safety
Hygiene standards
Housing
Leisure activities
Health care
Income
Social life
Freedom of religion
Language barriers
Child education
Other:

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3 [g3]What do you think about Ho Chi Minh City (HCMC) as your current place of residence?
HCMC is a very convenient city
The food in HCMC is delicious & healthy
HCMC has an active nightlife
Food security is a major issue
Spa treatment is part of the lifestyle
The health care situation in HCMC is bad
People in HCMC are very friendly and helpful
In HCMC are plenty of good doctors and hospitals to go to
Other:
Health care in Ho Chi Minh City
4 [hc-hcmc1]In general, how would you rate your overall health?
Please choose only one of the following:
Excellent
Good
Fair
Poor
Very poor
5 [hc-hcmc2a]Did you get any information about Health Care in Vietnam / Ho Chi Minh City before you
arrived in Vietnam?
Yes
No

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6 [hc-hcmc2b]What was your source of information about health care in Vietnam / Ho Chi Minh City
(before you arrived in Vietnam)?
Only answer this question if the following conditions are met:
° ((hc-hcmc2a.NAOK == "Y"))
Internet research
Social media (Facebook, Twitter, Blogs, etc.)
From my employer
Travel agency
Embassy of the country of origin
Vietnamese embassy
Friends or family
Newspapers or magazines
Television or radio
Family physician / GP
Other expats, who are living in HCMC
Other:
7 [hc-hcmc3]
Are you currently looking for information about health care and health care providers in Ho Chi Minh
City? If the answer is yes, please mark the source(s) from that you are trying to get these information.
No
Yes, through other expats
Yes, through local people
Yes, through family or friends
Yes, through my employer
Yes, through health care providers in Ho Chi Minh City
Yes, through internet research
Yes, through social media (Facebook, Twitter, Blogs etc.)
Yes, through newspapers or magazines
Yes, through television or radio

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Yes, through my embassy (of the country of origin)
Yes, through the Vietnamese embassy
Yes, through a travel agency
Other:
8 [hc-hcmc4]In which country do you access regular medical care?
Country of origin
Singapore
Thailand
Vietnam
I never accessed regular medical care so far
Other
9 [hc-hcmc5]In which country do you access emergency medical care?
Country of origin
Singapore
Thailand
Vietnam
I never accessed emergency medical care so far
Other
10 [hc-hcmc6]What is your regular health care provider? Please choose the one you use most often.
Personal doctor/General practitioner
Public hospital
Private hospital
Health Clinic
Rehabilitation Clinic
Other

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11 [hc-hcmc7]
Which source of care in Ho Chi Minh City would you prefer if you had following health issues?
If I suffered from xy, I would prefer going to a...
Please choose the appropriate response for each item:
Public hospital Private hospital Medical practice
Diffuse
discomfort
Ability to
see / vision
is getting
worse
Continuous
pain in the
stomach
Skin rash
High fever
12 [hc-hcmc8]
Is there any reason why you would not be able to use any of the health care providers mentioned in the
last question?
Please tick the box with the source of medical care you would not be able to use and explain in short
words why you would not be able to use this health care provider.
Please choose all that apply and provide a comment:
I would not be able to go to a public hospital because...
I would not be able to go to a private hospital because...
I would not be able to go to a medical practice because...

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13 [hc-hcmc9]
In the following questions you can find statements about health care in Ho Chi Minh City (HCMC) in
general and about public and private health care in particular.
Please mark on a scale from "strongly disagree" to "strongly agree" how strong you agree to each of the
following statement.
Please read carefully.
Please choose the appropriate response for each item:
Strongly
disagree
Disagree
Neither disagree
nor agree
Agree Strongly Agree
Public health
care providers
in HCMC are
reliable…
Private health
care in HCMC is
patient-
oriented…
Public health
care providers
in HCMC are
overcrowded…
Private health
care in HCMC is
shabby…
You can receive
a wide range of
different
treatments in
HCMC...
Private hospitals

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Strongly
disagree
Disagree
Neither disagree
nor agree
Agree Strongly Agree
in HCMC are
providing good
specialized
care…
The quality of
health care in
HCMC is
excellent…
Health care financing
14 [hc-f1]How much money, in U.S. dollars, do you spend on healthcare in a typical month? (Count all
healthcare-related costs, including health insurance premiums, deductibles, copays, co-insurance fees,
and any other out-of-pocket expenses for medical, dental, or vision services and medications.)
Please write your answer here:
If you don't know the exact number, roughly estimate the costs.
15 [hc-f2]How do you primarily finance health care expenses?
Health insurance
Private / out of my own pocket
My employer pays for occurring health care costs
Other

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Demographic Questions
16 [sex]What is your sex? *
Male
Female
Other
17 [age]What is your age? *
18-24
25-34
35-44
45-54
55-64
65 or older
18 [nationality]What is your nationality?
19 [duration-living]For how long have you been living in Ho Chi Minh City?
Less than 1 month
1-3 months
4-6 months
7-11 months
1-3 years
Over 3 years

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20 [employment]
Which of the following categories best describes your primarily area of employment (regardless of your
actual position)?
Education
Economy / Commerce
Health Care
Homemaker
Retired
Services
Student
Tourism
Unemployed
Other
21 [income]What is your current annual income before taxes (gross salary) in U.S. dollars? *
Less than 10.000$
10.000$ - 19.999$
20.000$ - 39.999$
40.000$ - 79.999$
80.000$ or more
Prefer not to say
22 [end]
Thank you for taking part in this survey and answering the questions!
If you have anything to add about health care in Ho Chi Minh City or you want to give any feedback
about the questionnaire, please use the following box.
Thank you for taking part in the survey and filling out the questionnaire.
Please share this link with other expatriates in Ho Chi Minh City!

Rebecca Mayer
L
It will help me to get a representative sample.
Here is the link: http://mci-students.limequery.com/56946/lang-en
Appendix 2: Telephone questionnaire
Health and wellbeing demand of expatriates in Ho Chi Minh City
Interviewer:
Date:
ID number:
General Introduction:
Hello / Good afternoon / Good morning.
I am Rebecca Mayer from Cao Thang Eye Hospital in Ho Chi Minh City.
Am I speaking to Mr / Mrs _____________?
I have your phone number, because you are a patient at Cao Thang Eye Hospital.
We are currently working on a study to identify the health and wellbeing demand of expatriates in Ho
Chi Minh City.
We’re therefore doing a survey and asking questions about our patients’ health care demand. With the
results we can adjust our health care services to our patients need.
May I ask you five questions, which will take approximately 5 to 10 minutes?
If no: “All right. Thank you and goodbye.”
No time now: “Could I call you back later? What day and time would be good for you?” ______________
If yes: “That’s great.” (CONTINUE WITH INTRODUCTION SURVEY)
Introduction to the survey:
I will tell you a couple things before we start. All your answers are completely confidential, and you are
free to skip any question or to end the survey at any point. Cao Thang Eye Hospital will not release
personally identifying information and your answers in the survey will not be related to your name.

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Questions:
1. What is your current place of residence?
a. Ho Chi Minh City (CONTINUE WITH QUESTION 2)
b. Other (POLITELY EXPLAIN, THAT WE ARE LOOKING FOR EXPATS WHO
ARE CURRENTLY LIVING IN HCMC & SAY GOODBYE)
2. What kind of health treatments are you accessing in Ho Chi Minh City?
I will now read a list of different treatments to you and you can tell me if you are
accessing them or not.
Are you accessing … in Ho Chi Minh City?
a. Regular health checks
b. Basic dental care
c. Cosmetic surgeries / cosmetic dental care
d. Emergency medical care
e. Vaccinations
f. (Preventive) Cancer screening
g. For women: Gynaecologist visits
3. What are the three most important requirements for you to choose a health care
provider?
I will now read out a list of different aspects. Please let me know which ones are most
important for you. You can also add other aspects to the list.
a. Affordability
b. Accessibility
c. No language barrier
d. Hygiene
e. Quality of care
f. Good reputation
g. Needs to be covered by my health insurance
h. Other

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4. Let’s assume that you have two health care providers which are both meeting the
requirements you mentioned in the question before.
If you need to make a final decision, which one you would you choose for your
long term treatment?
I will now read different cases to you. Please let me know which health care provider you
would choose.
a. Would you choose the health care provider which is …?
a1. More convenient to reach
or the one with the
a2. Better facilities
b. Would you choose the health care provider with (the)…?
b1. Better price
or the one with
b2. Doctors who are trained oversea
c. Would you choose the health care provider with …?
c1. More years experiences
or the one with the
c2. Greater variety of treatments offered
d. Would you choose the health care provider with …?
d1. Special offers (Health care packages etc.)
or the one with
d2. More flexible opening hours (late in the evening, Saturdays &
Sundays)

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5. What general hospital or clinic instantly comes to your mind when you think about
health care in Ho Chi Minh City?
(DON’T READ THE ANSWERS)
a. Cho Ray Hospital
b. Franco Vietnamese Hospital (FV Hospital)
c. Victoria Health Care International Clinic
d. Family Medical Practice
e. Columbia Asia Hospital
f.
g. None
6. Was health care an important issue for you at the time you were thinking about
moving to Vietnam?
a. Yes
b. No
Please explain in short words why / why not:

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Demographic questions
1. For how long have you been living in Ho Chi Minh City?
(DON’T READ THE ANSWERS)
a. Under 3 months
b. 4-6 months
c. 7-11 months
d. 1-3 years
e. Over 3 years
2. What is your Nationality?
____________________________________
THIS PART CAN BE FILLED OUT BY THE INTERVIEWER:
3. How old is the interviewee? ___________________
4. What sex has the interviewee?
a. Male
b. Female
- END -

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Part for the interviewer to fill out
1. Did you have the impression, that the interviewee answered the question
truthfully?
a. Yes
b. No
2. Did you have the feeling that the interviewee was in a hurry when you asked the
questions?
a. Yes
b. No
3. Did you have the feeling that the interviewee was annoyed or bothered by your
questions?
a. Yes
b. No
4. Did you have the feeling that the interviewee fully understood all the questions?
a. Yes
b. No  Which question might not be understood completely? __________

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Appendix 3: Interview I – Transcript
Interview with Jin S. – 20th of March 2014
R: Rebecca – interviewer ; J: Jin - interviewee
R: So. For the beginning you can just tell me a little bit about yourself like – just for recording – like
what’s your name and since when you’re here, since when you are in Ho Chi Minh City and what you’re
doing here and why you came here.
J: Ja. So, my nationality is Singaporian. 37 years old. My name is Jin S. and I resided from Ho Chi Minh
from 2007 to 2011. Last held the position as a chief representative of the Singapore Tourism Board
based in Vietnam.
R: Alright. And that’s why you came here? That was the reason?
J: Yes.
R: So when you moved to Vietnam. Was it like a quick decision or did you have time to prepare?
J: We had time to prepare. It was a cured plan six months in advance.
R: Okay, alright. And did you have any worries at that time. Did you worry about something or..?
J: No, not really because for cooperate relocation I think it’s quite comprehensive. They would put
forward some sort of a package including housing, medical, education – if you have kids – and your
taxation issues. So these would have been communicated to you six months before and then you would
take up a post thing upon the agreement of the terms that you have then shed with, so by a large
relocation basis with a company that has looked into these factors, the individual does not have to
worry that much. But if you are coming here as an entrepreneur, you’re coming here to look for a job
then it’s different. Because these are areas that you may not have considered or you may not even know
if you are back, if you are here in Vietnam.
R: Okay, so you felt safe because you had the feeling you were well prepared from working site. They
prepared you with all kind of information and…
J: I think it’s not just that they prepared but they also executed many of these things, so for example
taxation issues: Do I pay tax in Singapore or do I pay tax in Vietnam. I don’t have to worry about that
because the office would have taken care about the tax in Vietnam. So they would have a separate team
asking me for my documents and then working separately with the authorities here to make sure that I
will pay tax in Vietnam, but I just pay the tax in Singapore. I would also have the support of the
organization saying: Choose three houses that you think you wanna stay and then put the one that
you’re recommending and we will approve that. So it’s a really, ehm… pre plan. So you don’t have any
surprises.

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R: Alright. And how did you expect it to be different to Singapore? Like: Did you have any idea what
would be different for you when you move here?
J: I think on two fronts there would always be difference. But I think these differences would not be
overwhelming. The first front is of course workwise… you have a different culture to work with and I
think that can be resolved very quickly through establishing what you need to do and stuff. The second
one is on a personal front. On a personal front being a single individual, I did not have any relocation
issues with my family, because I was here by myself and given the earlier four points I mentioned: You
know, the taxation, the housing, the health care: These have been really taken care of, so there was not
much of a readjustment. It’s quite straight forward.
R: Alright. I see. And have been living outside of Singapore before or was it your first time?
J: It would have been my first time.
R: Okay, alright. And what was your first impression of Vietnam or of Ho Chi Minh City?
J: I think most Asian cities would have a similar view. I think Vietnam was similar in that sense. So it
would be a traditional South-East-Asian emerging economy city… eh… feeling. It would not have been
very different from Thailand, it would not have been very different from Malaysia, it would
eh…Indonesia, it would not have been very different from Myanmar. So, I think, they are all quite
consistent in the way they portrait the image.
R: Okay. When you remember back to your first weeks and your first month, maybe your first half of a
year. Can you describe a little bit of your personal life, feelings you had during that time. Would you…
You said already like, that it was not so much difference to other cities, but like your lifestyle. Did it
change to before? Did you have to build up something or..?
J: Lifestyle would change in a better ply. Because it is like going to a new job, or going to a new school.
So your sense of home is not… eh… your sense of space and neighborhood and home is quite different.
So I think the first weeks you focus more on settling into your home, looking for the kind of food and
trying different kinds of food, so that you feel comfortable with. Concurrently you would be engaging on
different level of networking with, you know, eh… your professional groups as well as your country
groups, specific groups. So, I think this would be what happens in your first month or so. You would be
meeting up with a lot of individuals, you will be meeting up a lot, you will trying different experiences.
So I think this is quite consistent for any relocation you will go through, even I think if you’re in a school,
or in company you do the same thing, you try to meet as many people, understand the company, many
students understand the curriculum, so quite consistent.
R: Do you have or had any problem with feeling healthy, with feeling like… or having a good wellbeing or
was it something which came naturally and I would also be interest what you do for feeling healthy, for
being healthy?
J: I think food wise was one key to gonna beat the minon to your wellbeing. I think for food here. The
initial difference would have been the fact that the food here tends to be a little bit like worth in South-

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East-Asia, meaning Thailand, Malaysia, Indonesia, Singapore. We have very strong curry base, spice base
ingredients, which is absent from Vietnamese food. They tend to be a bit more brooke base, they tend
to be sauce based. But all these are very like sauce; they are not cream, heavy, bavy-heavy. So that food
was a bit different, but it was not tremendously affecting ones wellbeing. I think in terms of the other
aspects like access to recreational facilities, it does have its … Because I’m staying in a service
apartment, which has a pool, a gym and a tennis court, so it would not make me feel, that I had a lack of
access to recreational facilities. I think your mental wellbeing would have to be evolving sequence of
how you meet people and engage with people and again because working here on a professional basis, I
was able to join and engage people very quickly. So again that was not an issue. So I think overall
relocating to a country or city that is like Vietnam, maybe Ho Chi Minh to be specific, did not pause great
challenge to ones wellbeing.
R: Okay. Alright. I just one more time to be a little bit more detailed, a little bit more concrete. So was
there anything you had the feeling, is missing, what you think would be good for your overall wellbeing?
J: The short answer is no. The more elaborated answer would be: There are these certain areas of
cleanliness that you would pay specific attention to. Coming from Singapore you would say, you know,
have the spoons and the chopsticks been washed entirely before they are served to the next costumer,
have the food that they are serving been kept on a certain temperature, that’s warm and hence you
know, reducing the risk of certain bacteria multiplying. These would be the slightly kills that one would
consider, but the short answer is still no, because you would feel that after trying it once, twice or three
times you can feel comfortable with the fact that what you’re eating it’s not going to cost you severe
health poison.
R: Alright. And what was or what is your impression of health care providers in Vietnam or especially in
Ho Chi Minh City?
J: I have had different experiences in my time here. I think as I start to understand the… the market
better… there are two very distinguished groups: The international hospitals as well as then the local
based hospitals. I think that health care here for expatriates in the initial status is the unfamiliarity of the
language and the perceive inferior, you know technical skills that the hospitals or the staff may have
here, which will lead to many expatriates using, you know, FV or Victoria, mainly because of the
portrayal, you know the common use of English as a language and also the portrayal of having the
medical crew from around the world. This gives a bit of a counterbalance to just Vietnamese specific
doctor.
But overtime I think you realize that the medical procedure as well as the medical knowledge and the
equipment is not… in the local hospitals… is not anywhere worse stuff than what you have seen in FV or
Victoria. In fact on most cases some of the non critical treatments would have… FV or Victoria sort of
leveraging, existing equipment from local hospitals to do the initial diagnostic.
So the bottom line is, when you look at both, the local hospital and a foreign-run-one, the only
difference is actually the language and the other aspects of you know the technical skills that’s are more
or less similar.

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R: May I ask where you accessed your medical treatment and how you found it there. What was your
experience there?
J: I think in… I mean I went for, you know, medical treatment both in local and I think it was FV or Family
Medical, I can’t remember.
Quite honestly I enjoyed the local hospital a lot more, because I think the experience of having with and
paying an extremely high premium at Family Medical or Victoria was unnecessary. The only benefit they
brought of the table was an English speaking doctor. But when I went to the local hospital I surely
realized that many of their senior consultants are able to converse in English. And if they continue to
maintain not just a conversation in English, but a diagnostic in a bilingual, Vietnamese and English
report, I don’t think it would be very far factual for foreigner to choose the local hospital or FV or
Victoria or Family Medical.
R: Okay. So your health care experiences here were not so much different from what you experienced in
Singapore? Or was there any difference you saw?
J: There is of course a difference when you compare to your home country. I think the comfort of the
language would be a big difference, so even though you are talking about FV, I mean you could be, you
could be speaking to a doctor, that can speak English, but… or it could be an international crew, but will
have very little understanding of you know maybe local issues or Asian-based symptoms and stuff like
that.
Where else Singapore doctors would already be very familiar with the kinds of medical trends, medical
characteristics that you will have. If you say, that you have pain in your, in your… in certain parts of your
body, it could be a country specific risk, a country specific, you know, issue, maybe too much xyxyxy
causes gout in a specific country like Singapore. There may be not such an issue in Vietnam, due to the
dietary differences. So, there is a difference…ehm… on the consultation side. In terms of the cost
structure there is also a difference. In Singapore when we are… we are subsidies by our government. So
the costs that we pay is relatively low, compared to what we will pay in FV hospital or Family Medical. It
would be about the same price as what you pay in Vietnam in a local hospital. The difference is actually
the consultation time as well as the access to…eh… equipment. So taking a MRI as an example – in
Singapore I would have to wait for two to three months. In Vietnam I only needed to wait for one day at
the local hospital. And the panel of the… the reviews the medical MRI in Singapore would have been a
medical officer, which means an entry level doctor, but here I’m getting, you know, the panel surgeons.
So the quality of the software, in terms of the diagnostic aspects is a lot better in Vietnam for me, in my
experience at the local hospitals, not necessarily at the foreign hospitals, then in Singapore, but this is a
system related… full of events, it’s because of the fact that Singapore health care requires you to first
get your diagnosis done by a medical officer before it is escalated to a panel of surgeons if you are there.
Where else here they would have already the surgeons on standby, to advice almost immediately after
the medical report is in release.
R: Okay, alright. Is there any, any illness or anything you would go back or you went back to Singapore to
get the treatment done there?

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J: I think.... I have not done so. But if you are to ask me, the operation related unites where you will need
rehabilitative period of either occ… eh physiotherapy or, you know, support of your family. Those I
would go back to Singapore, you know. That is one a psychological side from a practical aspect of
looking for help, getting help, you know.
For quick surgery, I mean not surgery, but quick diagnostic and stuff like that I can get it in Vietnam. I
think one of the things that one might need to consider is also the insurance coverage. So for example in
Singapore we have already existing insurance coverage. It does mean that inpatient or inhospitalisation
related costs would be bound by the insurance. So even Vietnam relatively cheaper, but I might not be
paying anything, if I do it in Singapore. So then I would choose Singapore, for the reason that I be closer
to my support system and not having to pay anything.
R: But here you also, you have the insurance through your employer, right?
J: Yes, correct. But I think one would have to examine very quick, ah very quickly and very carefully
whether or not the insurance that is covered by your employer covers simply outpatient or does it cover
hospitalization? Does it cover, you know... physiotherapy related post-hospitalization kind of treatments
or does it cover in hospitalization just the hospital state or does it covers the surgeons fees as well. So I
think there is a categorization of costs, that you need to be cognizant of, so that you are not hot up to
say that the insurance is sort of like a black head cover for all, you know, the insurance just covers
outpatient, it may not cover medical evacuations, so and so far…
R: Alright. Just to…like… ask more specifically: Did you ever go to another country for medical
treatment? Primarily for medical treatment as a medical tourist?
J: No, I don’t think I’ve done that as an individual. Although these would be common phenomenal into
days context, where cross border travel and cross border treatment is so accessible.
R: You mentioned many… you mentioned a few things which are, which you can better access in
Singapore: Medical treatments. And you mentioned a few things which might be even better in
Vietnam. Is there anything you want to add which could be… like… medical treatment, in a general view,
which could be better in Vietnam than in Singapore?
J: I can only share from my experience, what I would say is, not quite better, but objectively either
cheaper because of the costs, so that would be like your MRI or your ultrasound. This sort of diagnostic,
which requires equipment is relatively cheaper in Vietnam for the injuries that I have had, likewise for
consultation fees of the doctors as well as appointments, these are a lot faster and cheaper in Vietnam
compared to Singapore. To whether or not the operation would be better, to whether or not the
diagnostic is going to be more accurate in Singapore… I think there is bit pre-mucher for me to
comment, but at least the first opinion; it would have given me a lot of comfort in, in… with the
Vietnamese hospitals, for them they would have sent a senior doctor to look at some of these injuries
and give the diagnostic. So all I know, I think, diet is cheaper in Vietnam, access to equipment,
diagnostic, access to senior doctors… is also faster. But Singapore gives the comfort of being closer to
home and if you need further treatments, if you need further health support there is the family network
as well as the hospital network that you know, you can get access to very quickly as well.

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R: Okay, alright. At the end I want… maybe you can share one experience with me, one very concrete
experience you had in a hospital here. For example, I would be very interested; you said you visited
both, private and public hospitals or health care providers. So I would be interested if you can tell a little
bit more concrete the experience you had in the public hospital compared to the private hospital, in
terms of like language barrier or language in general, in terms of cleanliness, in terms of the treatment
itself. So what was your impression in terms of friendliness of the staff?
J: I don’t think there is a… I don’t think there is a lot of significant difference but I will point out some,
which I felt in a personal, made a difference. Eh… In public hospitals I think the language used continues
to be Vietnamese. These would be the main state, who I expected to change. Where else in private
hospitals or the foreign-owned hospitals the language used, quite from the onset, is English. So, if you
are unable to converse basic Vietnamese, you will find the public hospitals a little bit daunting, to even
get your first treatment, so that means that people in their first or second year in Vietnam may not
consider public hospitals, but people who are staying here after four to five years, who are speaking
basic level of Vietnamese, would consider public hospitals, simply because they are getting the same
stuff, but at a much reasonable price. In terms of cleanliness, I think it’s a subjective assessment. So I
would not think that there are significant differences between both the public and a private. I mean not
private, but the foreign-owned one. I think that is function of number of people in a hospital, so
obviously, if you go to a hospital which has higher public visitation, there will be a lot more noise and
perceive untidiness, but to a private hospital you will see a bit more exclusivity, because of the higher
price range which means only a limited people can go there. Does it mean that it is much cleaner? No.
Does it mean it’s much more sterile, in terms of its process? I don’t think so.
In terms of treatment again, my point is, I do not find a significant value at on from the foreign hospitals,
mainly because I think they charge a premium for the language but not necessarily for the technical
expertise. Many of the technical expertise in terms of diagnostic treatments and diagnostic inventory
still goes back to the government hospital, which really has purchased equipment.
So the three points I mentioned, I think captures the fact that, the Vietnamese hospitals to someone
who has stayed in Vietnam for about four, five years, is a very attractive option and one does not have
to go towards a, you know, a foreign hospital to actually get the treatment as well as the valuable.
R: Did you ever considered – because I’ve heard like that Ho Chi Minh City should be good for like dental
treatment or now I’m working in an eye hospital, so is quite popular for eye treatments, did you ever
consider like to get any cosmetic surgery, cosmetic dental care or if you need cosmetic like eye care here
in Ho Chi Minh City?
J: The short answer is no and the reason is because I think this is very much typed to individual
preferences, especially if it’s cosmetic. For dental, the short answer is yes, I would have considered that,
because the dental treatment is, technical treatment that you need, regular, you know, checkups, so
those are very much possible in Ho Chi Minh and I think that’s what I actively considered.
R: But you’re talking about the basic dental care now or cosmetic dental care?

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J: Basic dental care. I think area specific to cosmetics that becomes a personal preference. So the first
other question is would you ever consider cosmetic surgery or cosmetic enhancements. And if the
answer is no, than whether is Vietnam, Singapore or Thailand it does not matter. So my point is that my
first other question is would I ever consider cosmetic enhancements. My answer is no.
R: Okay, that would be my question. So if you have like anything to add about health care, about health
care providers, then say it know.
J: No, I don’t think I have anything else to add on to the earlier points I’ve made.
R: Okay, thank you!
Appendix 4: Interview II - Transcript
Interview with Trang N. – 24th of March 2014
R: Rebecca – interviewer ; T: Trang - interviewee
R: All right, so let’s start. First of all I would like to ask you to introduce yourself, tell a little bit about
yourself and why you came to Vietnam and what you’re doing here.
T: My name is Trang N.. I came to Vietnam about five years ago, five years ago, yes and I work as a
consultant here in Vietnam. Yeah.
R: Okay, all right. When you decided to move to Vietnam was that a quick decision or did you have time
to prepare? Can you tell me a little bit about that?
T: I didn’t have time to prepare. It was a… yeah, a very quick decision actually. I didn’t think too much
about it, because initially I only planned to stay for about year or two years.
R: Okay. The first time you came here was just for like a…
T: A short period of time.
R: Okay. All right. Did you have any worry about anything at that time?
T: Ehm… How do I gonna fit in, what Vietnam is like, you know culture life, business, environment, that’s
about it.
R: And when you arrived… you arrived in Ho Chi Minh City, right?
T: Yeah.
R: What was your first impression?

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T: Eh… Too many people, very busy city… eh… many motorbikes. And yeah, how to say, the… how would
I say that, it is a developing country, it’s just… it’s different because I came from Sydney, so…
R: What was the biggest challenge?
T: Business culture, I think. Assimilate into the business culture here.
R: Alright. And… ehm… So I think for a good balance it’s important do something for your wellbeing. So I
would like to know what you’re doing to feel healthy, to have a good wellbeing.
T: Eh… Well, I suppose to go on exercise, which I don’t do enough. Off. Recently. Ehm… But, that’s about
it. Eat healthy, but try to anyway.
R: Did you find that difficult in your first weeks, in your first month?
T: Eh… No, it was okay. Because company is taking care of my… when I move here they took care of my
first few weeks, in terms of accommodations. And I came here, because I already have a job offer, right,
so everything is taken care of, including my first few weeks, in terms of accommodation, I had health
insurance already, so that was not a big deal.
R: May I ask where you’re doing the exercise? Are you going somewhere, or are you have it..?
T: Typically it’s just… I just run around where I live or at the gym.
R: Okay, alright. Ehm… Is there anything you would like to do to feel healthier but you cannot, for any
reason?
T: Cycle is not a lot to do. Full stop. I mean I came from a place, where there is a lot of outdoor activities,
you can just go away, there is parks, there is beaches, there is things to do and see. And you can just
walk around. Can’t do that in Saigon. Well you can do it. Walk around the park here, but even the park
here there is too many people, there is just a lot of people. Ehm… And in Saigon, unless you try to get
out, like Bumthan, there is not a lot to do here.
R: Alright. Okay. And I would also like to know what was your first impression of health care in Ho Chi
Minh or in Vietnam in general?
T: Eh… If you talk about private health care, I think it’s pretty good. Public health care is different. Public
health care is…. Probably… I don’t wanna get sick here and don’t have a private health insurance.
R: Have you ever been to a private health care provider?
T: Yeah, that’s all I go here.
R: And to a public health care provider?
T: Yeah, hospital, local hospital. My mum was sick.
R: Okay.

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T: So she was staying in a hospital in Vietnam for about three months. And she was in intensive care
pretty much, for like half that time. So I experienced the health care here.
R: Okay, can you describe me a little more about that. Like… Maybe like quite concrete. When you
entered the hospital what did you feel?
T: Is… if I compare, is coming from… The biggest shock was that the family members had to take care of
the patients. From turning them for example, cause some patients, if they’re in a coma or they cannot
move, you have to turn them, right? So pretty much everything from feeding them, changing their
diapers, if they are unconscious… the family members had to take care of it.
In developed markets, in our countries, everything is going to taken care of. The health staff they would
take care of everything, they wouldn’t allow patients, like family members to touch the patient, right?
Here in Vietnam is different. If you don’t have money, that’s it. So is all like… What shocked me is, I have
to pay for an IV-tube, I have to pay for my, they washed my mum’s clothes, the clothes she wear, as a
patient I have to pay for that, for the washing of that clothes.
So coming from a country where health care is free and I mean it’s just world class, that was a big shock.
And you basically as family members, and you sit outside, the intensive care unit, and you had to sit
there 24/7 just in case they need something from you. They need you to buy blood, I mean what the
hell? Is that ….
You need to buy a blade, so they can shave your relative’s head, so they can have an operation. Right,
that’s just… Put it this way: Very simple. Life is cheap in Vietnam, if you don’t have money. You go to
hospital, and I’ve seen it, patients going in, who had a stroke or a car accident and they can tell you:
Well, this person has 30% chance of surviving, you wanna ask continue, taking care and have surgery or
you can take that patient home and let that person die, because the chance of survival, or the chance of
surviving is 30%. I mean you put family or relatives in a very difficult position, because what is if they
don’t have money. Alright, then, what… Do I pay or not pay? I meant, it’s putting the question to the
family and the relatives is a very difficult situation. And… yeah. What is if you don’t have money? The
good chance to die, cause they don’t… And the bill they give you is that long [shows with her hand],
maximizes everything. Ah, jeah.
R: Okay. Maybe in comparison, if you go to a private hospital here: What are your feelings when you go
to your regular health care or…?
T: I mean health care is layout, I mean I haven’t been to hospital yet, private hospital, but I’ve been to
clinic, right, health care clinic. And it’s clean, it’s up to the world standard. You know, you have doctors,
and the room and everything, it’s just like what you’ve seen in Australia or the US.
But you have to pay a lot of money for it right? I mean if you stay overnight, it’s 500$, just staying
overnight. Those facility. Later on you have to pay for all the medication as well.
R: So you are accessing all your health care treatments here in Vietnam or is there any health
treatments, you are accessing abroad?
T: Ehm… I haven’t touched.... I haven’t come across that situation. I mean here it’s just mainly health
check. Eh… That’s it. I haven’t. I think some of the tests, they have to send it to Singapore, so the health

Rebecca Mayer
AA
clinic I got to, they send the test to Singapore, to collect the test, because they don’t have the facility.
But, I think for everything else I might probably go back home, that’s probably cheaper and safer and… I
would go back home.
R: Ehm… And for me like… that might be a little bit weird question, but did you ever consider if you find
a job somewhere else, to move if the health care would be better there, or why would you consider
that?
T: Ehm… No. I think when you have family or children or when I’m a bit older that view might change,
especially if I have children, that view would change, because there is more need to access health care,
so typically it’s the age where, yeah, you gonna get sick more frequently and you have, you know,
children, again. But if there is no need, yeah, it’s okay.
R: Another question is: Did you ever consider or… no not consider, but did you ever go to another
country to just have your health care treatments there, so like as a medical tourist?
T: No.
R: Ehm… Okay, I think, that’s it already. If there is anything you want to add about like health care,
health care treatments in Ho Chi Minh City, your impression of the health care system. Anything you
would like to say.
T: I think in Australia that’s not new. Everybody knows that, proper health care here is not necessarily
this good. If you have money, if you have private health care, it’s good. If you need specialists, if you
need specialist treatment, Vietnam might not be the place. You might need to go to Singapore or
elsewhere. Just because you can’t get the doctors. And health care in Vietnam is not big enough. Eh… In
term of private hospital to deal with many cases, right? Ehm… Public hospital is a different story. Public
hospital there is huge, huge need.
You know reform. The question is when. Because the demand is there, the need is there, but the policy,
the mechanism in terms of government encouraging foreign investors and make it better. It’s still a long
way. That’s reality. In fact some of… you know, we have good doctors here… ehm… but again, it doesn’t
matter how good a doctor is you have, if you don’t have the equipment, you don’t have… you know.
Even if you go, you send the doctors to oversea training and they come back and the equipment is very
outdated there is no way the doctors here can utilize the skills that they learned abroad. So, first it’s to
improve, it’s, you know, it’s an effort within the government, as well as the people itself. And again, this
is not new, but you know, if you go to a good hospital, you have money then, they take good care of
you. The doctor gets paid so low, that everyone has a clinic at home because they make more money at
home. So it’s also a question of ethics as well. You read more about it, you will see there are many,
many issues about, you know, ethical standards of doctors, you know health care, like health service
staff in Vietnam, like I said to you, like you know, a nurse in Vietnam would not take care of a patient.
They just go and they just, you know, give a shot to the patient, but they would not clean the patient,
they would not bath the patient, they would not do what a nurse is supposed to do, simply because
officially the salary, the wage is crap, very, very low. Right? And it’s a very pressure job. All the stress,

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right? So, yeah there is huge need, huge reform is required. When it’s gonna happen? Be questionmark,
right?
R: Okay, so, since I’m here I learned or heard many times that Ho Chi Minh City might be famous for,
like… because I’m working in a eye hospital, might be famous for some eye treatments, LASIK
treatments, that Ho Chi Minh City is also famous for dental treatments and maybe cosmetic dental
treatments and cosmetic surgeries. So, I would like to know if you heard about that as well and if you
consider doing such treatments here instead of going back to Australia and do it there?
T: Dental, yeah. I mean dental is known. And the reason it is cheap, is that labour is cheap. Again but you
have to do it. It’s cheap relatively compared to developed countries because I think, the… professional
indemnity cost is lower, right? So, again, cosmetic surgery you have to have money. It’s cheaper, but it’s
not cheap for local. But it is relatively cheap and it’s not high risk. Cosmetic surgery is a popular thing,
because everybody feel, you know lack of confidence or they wanna look better they wanna… So, is a
boom. It’s a booming industry in Vietnam. And in fact… it’s a booming industry, because the rich people
here, the rich Vietnamese want to access that, the same with health care, is that only the rich
Vietnamese that can access that sort of service. Is not that at all about middle income, low. No.
So, investors who come to Vietnam… I know a friend who come to Vietnam as an investor and at the
end of the day he tried to open a clinic, a serial clinic, provide you know affordable health care to middle
income earner, you know. And there is so many right tay, you know so many… and the return of
investment is so low. Later on he decided maybe to go into cosmetic surgery as a business. Because
again it’s always about making money. So the rich people would take. Or he just… I think, recently he
just bought another hospital, to get into the market, right? So, yeah, I mean is know. And dental is
developed. Is know, is cheap and it’s relatively safe. Do it here and yes it’s fine. There is no issues there.
But again, if it’s coming out, even if you say, it’s famous here, it’s famous because because… is not
necessarily affordable for the local. It’s affordable for the expats and rich Vietnamese. Yeah, it’s still
relatively cheaper than if they do it in their home country.
R: Could you imagine that in the next 5, 10 years, that health care improves a lot in Vietnam?
T: I hope so. I think, of government is willing to change and compromise and listen to the private
invest…like the… If they make the policy more attractive to foreigner. If they willing to reform the
industry: Yes. That takes a lot of effort. But the government is the key. They have to set the standard,
they have to set the standard, they have to enforce that standard. Vietnam is many virigoul in laying
down the standard, right, if you looked at standard they have everything. Enforcement is the problem.
Right? So, go out and you actually vigorously checking and making sure that the clinic out there, you
know, is providing proper health care.
You know, not sure if you heard about the doctors case, where he didn’t have his license, but he bought
his license to do cosmetic surgery and basically he killed someone and throw that body into the river
and till now they cannot find it, right? So, in Vietnam they need to… and I think also people awareness
here and it takes education, right? Because here the Vietnamese is when it comes to health care, is very
easy. Oh yeah, I know that doctor, I don’t need to know if he is good or not. Just gets word-mouth, he is
really good and they blindly believe it. They don’t think of service, health care service. Classic example is:

Rebecca Mayer
CC
They get a prescription or I feel sick and get a prescription and you know self diagnose. Next time I get
sick with the same symptoms, instead of going to the doctors I will use the same prescription and go to
the pharmacy and purchase the same. Same kind of medication. So self-medicate themselves. So,
awareness also. And to do that, is the government is also asked xyxyx. Is the minister of health is doing
that. So, ehm… And then reform and pay the doctors probably. You know a doctor, I think a graduate
doctor, after studying for six years, I think they get paid maybe 200$ a month, in terms of official salary,
how can?
I mean average in Australia a doctor would get, fresh graduate, not even specialist yet, he works in a
hospital, the salary at least 60.000$ / 70.000$ a year. You imagine that? Yeah, so there is a lot to be
done in the next five years, I hope so, because there is demand, but it need to change from the
government perspective, in terms of policy making. Hope so, I hope so.
R: Okay, alright. Thank you very much for answering the questions.
T: You are welcome!
Appendix 5: Interview III – Transcript
Interview with Chamira E. – 28th of March 2014
R: Rebecca – interviewer ; C: Chamira - interviewee
R: First of all I would like you to introduce yourself, tell a little bit about yourself, what you’re doing here
in Vietnam, since when are you living here?
C: Chamira E. I’ve been living here for the last, almost last three years. Working first as an RMIT Student
and then as a teacher at a high school.
R: And how old are you?
C: Me? Eh… Older than 25 [laughing].
R: Okay, so when you decided to move to Vietnam. Was that a quick decision or did you have time to
prepare before you came to Vietnam?
C: It was actually a quick decision. Because if I prepared, I would never have made it here. I mean
coming to Vietnam is not economically a rational decision. It took a lot of income. So, it’s yeah more of a
quick decision, but I know it was probably the right one to make.
R: Okay, at that time when you started or decided to move to Vietnam. Did you worry about anything,
about your life here or about anything?

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C: No, no, not at all. No, because Vietnam… I had been in Ho Chi Minh City before, so I know the life
here is pretty easy going. But yes, I was always worried about the unknowns like, see, what will I do after
I finish school, will I get a job, will I stay, and all that information. But things usually work out, so on and
so on.
R: Okay, alright. And when you arrived in Ho Chi Minh, it was not your first time, but it’s maybe your first
time you live here for longer, right? So, what was your first impression of Ho Chi Minh City, of living here
as a long term resident?
C: I think Ho Chi Minh City is a great place to live on a short term residence, but long term residence I’m
not quite sold on that idea, so I think it’s a great place for a short term.
R: What do you think, why is it not good to stay here for longer?
C: Ehm… Healthcare, job safety, political situation. Those things doesn’t have… and especially the rule of
law, right? It’s a different system to what I’m used to, so yeah, so I don’t see myself here in a long run.
But in the short run it’s an awesome place. It’s an awesome place in a short time.
R: In which aspects?
C: The life itself. You gonna get to enjoy your life, go out. Even your work, but you don’t have to work so
hard, so at the same time you balance it with the social life here.
R: So, it’s easy to have a social life here and the work-life-balance in general is very easy?
C: Correct.
R: Okay, so I want to go a little bit deeper into health care. You said it might be a problem here or it
might be a problem for a long term stay.
C: Exactly.
R: Can you please explain me why?
C: In Canada health care is free, so I’m a health conscious person. So, I usually go for medical checkups
and everything and I do it according to the book. But here there is no accountability if you go to any
hospital or any doctors. There is no accountability. So you’re not quite sure, whether are you getting the
right advice, because they don’t have accountability. If they give you wrong advice or they treat you
define, if they make a mistake. So that aspect… for example I would be scared, if I brake my knee,
because the process of getting a surgery, recovery, I would trust more of the medical practices in the US
and Canada. In Canada there is… people who does it, they have accountability. So here they don’t. But
here health care cost is much cheaper than in Canada. I mean that would be in the US, because in
Canada it’s free.
R: To what kind of health care provider are you going here in Ho Chi Minh City?

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C: Usually just go to a normal doctor, if I get sick. And, so…
R: So to a local hospital or is it a private doctor or the clinic?
C: Actually, the last time I went to a local clinic, but had to wait too long, so then they opened up the
private clinic, so I had to spend a whole lot of money. Close to more than 1.000.000.
R: So was it a Vietnamese private clinic or a foreign-owned one?
C: Yes, it is. It’s a Vietnamese private clinic, yes. Not the FV hospital. I have been to FV hospital to get
some... FV hospital has good products for injuries, like if you have safety items. You can buy at FV
hospital. Then a local place.
R: Could you… Because now you like… you have seen three health care providers already: The public
hospital, the Vietnamese private hospital and the foreign private hospital. So for me it would be very
interesting if you could compare them a little bit, like what you experienced there, what your feelings
were.
C: If you go to a local clinic, the cost is quite low. But you have to wait for long. You have to wait in the
line for much longer, but even in the local clinics if you pay certain additional fee, you can cut in front of
the line and… but… the results of your blood tests and those things takes longer. But when I went to the
local hospital private clinic the results of the blood test, everything was amazingly fast. I think it came
back within 30 minutes or something like that. But if you have gone to a local clinic, it would have been
the next day, but I wanted the results right away, because I was worried it was dengue fever. So if it was
dengue fever I didn’t want to pay the chance, so… I am a cost conscious person, but at that time I wasn’t
cost conscious because I was more worried about my health and to make sure I’m safe versus taking the
risk of waiting another day or two, if I’ve gone to a local clinic. And…
But most… even the local clinics, or even the private clinics, they don’t speak English much, they had
these… even the doctors hardly speaks English.
R: Did you find that was a barrier to go there?
C: Not at all, because I went with my Vietnamese friends, who speaks English fluently. So they helped
me out on the translation part.
R: And if you would have to go there alone. Would you choose another hospital or would you choose
the same?
C: Just the same hospital, because through my experience here, language has never been a problem for
me, even if they don’t speak English, I just find a way to communicate with them what I want and then
they would still help me out. But that would have taken longer, longer time to let them know what I
want. If I had a friend it’s much faster.
R: Since you’re living here in Vietnam, did you ever access health care abroad?
C: No, no, no.

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R: Okay, so you access all your health care needs here in Ho Chi Minh City.
C: Yes, yes.
R: Would there be any reason… would you consider to access health care abroad, if there would be
certain reason?
C: Ehm… The only time… Like if I had a major surgery or something. I would not do it in Vietnam. I
probably would go back to do the surgeries.
R: To Canada?
C: Yes. If I would break my knee and I need a knee surgery I probably would go back home to do it,
although it’s quite cheap here. The surgery is quite last. But I would rather have somebody who is
responsible, something was wrong.
R: Can you like tell me some of the aspects why you would go back to Canada. You said already the
responsibility you have, maybe in Canada is better, maybe is cheaper. Are there any other aspects?
C: Oh, I think it’s a better quality. Like, I wouldn’t trust somebody with my body, cutting and chopping
unless I know they are well qualified for that position. And from my knowledge none of the Vietnamese
doctors would be qualified to practice medicine outside of Vietnam. So, I mean except in Cambodia and
Lao. I think those are the only places where Vietnam’s qualifications are accepted. So, if they would go
anywhere outside, their qualifications are accepted. So, that probably tells me something is wrong with
the medical schools here, the quality of the medical schools here. So I would not want to… take the risk.
R: In general what are you doing to stay in a good health condition, to feel well and good?
C: Eat healthy, exercise, watch how much sweets I eat, be careful with the sweats I consume because I
have a… one of my weaknesses is sweet. So I try to limit that. Replace that with more vegetables and
with healthier alternatives.
R: Did you find that easy or difficult in Vietnam?
C: Eh… About the same, it’s about the same. Yes. Because, actually I would say the cakes are better in
Viet… ah in Canada. The cakes are much better in Canada that in Vietnam. Like chocolate cake, cheese
cake.
R: Ah, okay, so you think maybe here you have the risk to eat more sweets? Or in Canada?
C: In Canada is higher risk. Because the cakes are… I find the quality of the cakes are much better. The
bakery is much better in Canada, so you would have a higher rate of craving for that than in Vietnam
because the quality of the sweets, the bakeries are not so high as in Canada. So then it’s easier to
remain healthy. And also… One of the biggest advantages, when it comes to eating healthy here is, the
access to fresh vegetables here is amazing, is amazing. Like in Canada, like unless you go to the local

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