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THE ESTABLISHMENT AND DEVELOPMENT PROCESS

The construction and development of the Institute of Malaria - Parasitology - Entomology in Ho Chi Minh City system, as well as special department of malaria control, parasites and insect is always associated with the historical stage of development of the country, at the same time associated with the fight against malaria, prevention of parasites disease, mainly malaria

Our country was in malaria circulation so malaria has been a threat to the health and the lives of of the people, especially in mountainous regions where people of ethnic minorities, the new economic community, the armed forced border guard living. In the past, malaria was one of the most common diseases in our country, the situation of suffering and dying from malaria was severe. Outbreaks of malaria was long, the outbreaks occurred in the middle of the plain, evirons. In the midland and mountainous regions, there was 40 % of population with malaria

In 1954, the resistance against the French won victory, the North was completely liberated. In the South, U.S enemy invaded and turn the South into new colony of American empire. General tasks of the revolution had to turn the North into firm rear to make the struggles to liberate the South, reunificating the whole country. In 1955 the North began investigating the malaria situation, the survey’s results showed that the rate of malaria parasites from 15 - 20%, somewhere 50%, the ratio of swelling spleen 50 - 60%. In many places, the rate was over 80%. In the South, due to the invasion of U.S, there was no data on the malaria situation.

Early 20th century, people have invented and produced DDT – effective chemical anti-mos and anumber of malaria medicine as acrikine, plasmocid. In 1955, the General Assembly of the World Health 8th through policy of malaria eradication in the world. The strategy was conducted in four phases: preparation phase, the attack phase, the consolidation phase, the strength and protection phase.

Facing with severe malaria and urgency of malaria control, in 1957 the Government established the first unit ofViet Nam to study the prevention of malaria, worm inflection, and the Institute of malaria research was built in Ha nghiên cứu phòng chống bệnh sốt rét và các bệnh giun, sán, đó là Viện nghiên cứu sốt rét đặt tại Hà Nội. From an Institute which was developed into three Institute (the Institute of Malaria, Parasitology and Entomonology (Central) , Institute of Malaria, Parasitology and Entomonology (Quy Nhơn), Institute of Malaria, Parasitology and Entomonology (HCM City)and malaia control network in locality such as Malaria Prevention Centre, preventive medicine Centre in city, provinces, districts, health communes, wards, village health in localities participated in controlling malaria and parasitic diseases.

The history and factors concerning to construction, development of the Institute of Malaria, Parasitology and Entomonology HCM City can be summarized as follow:

The period before Liberation and unification

In the first time from 1957 to 1964, this was the preparation stage to campaign for malaria eradication in the North. In this stage, malaria situation was very common and serious. With the interests of the Party and State, the great help of Soviet, the campaign of malaria eradication in the North has made great achievements. In the South, since 1963, Dr. Vo Hong An ( Ba An)- the Southern official under the direction of Health Ministry returned to build basis and conducting malaria prevention activities in the South battlefield.

After 1965, this was the period of most intense challenge, both consolidating the achievements of malaria eradication in the North in a fierce war condition and supporting aids, building malaria prevention facilities in the South battlefield. Many hardships, struggles and great sacrifices including the sacrifice of the Professor, Heroes, Martyrs, Director Dang Van Ngu and many colleagues. The war against the United State was more aggressively, the number of soldiers, youth, volunteers from North to South, from South to North was on the rise causing the spread of malaria. It was a major difficulty for the prevention of malaria.

Since 1968, to achieve the goal of malaria eradication, increasing aids, taking over the construction of initial malaria prevention facilities in the South, hundreds of officials from the Institute of Malaria, Parasite and Entomonology in the Northern provinces were trained and put into the battlefield B2, Region 5. Based on increasing staffs from the North and force development, a malaria group under the department of Germs (C34) with three officials was established and Dr. Vo Hong An was team leader. In 1969, the Board of Health B2 decided to establish Division of malaria in the South (C30) under the Board of Health B2, the Ministry of Health - Invalids -Social Affairs, Republic of South Viet nam (the separation C34 into C30 and C4 ), Dr. Vo Hong An was in charged of C30- precursor of The institute of Malaria, Parasitology and Entomonology HCM City. This was initial basis to build a network of specialized malaria in the South later.

In 1973, the Paria agreement on ending the war and restoring Peace in Vietnam was signed, the liberated areas were expanded but the economic and social conditions of the liberated areas were in diffcult, heath sector did not meet the requirement. Therefore, the Government decided to support for the South to limit and eliminate malaria in the liberated areas and the base.

Since 1973, C30 was supplemented a number of officials from the North to enhance the malaria control. C30 has developed the malaria control in T1 (Southeast area), T3 (southwest area), T6 (Lam Dong area); Tan Bien, Loc Ninh, Bu Đop.... In spite of difficulties, the staff of C30 has done good performance, technical assistance for localities in malaria eradication. In addition, the C30 also conducted baseline surveys on malaria, control the malaria outbreaks in the area. Dr. Bui Dinh Bai, Dr, Nguyen Long Giang from the South to the North for training, fostering knowledge of malaria were appointed to the South to direct malaria eradication in the new period. Thanks to enhancement and supplement of staffs, more equipment, means of malaria prevention, the malaria prevention in the South has achieved marked progress.

On April, 30th 1975, the South was completely liberated, the country’s unification, the revolutionary government took over of Public Health Department and arranged the organization, department, the union, units. The revolutionary government took over C30 and malaria eradication program of Public Health Department of the old regime and renamed the malaria Sub-Institute (16/9/1975) under the Ministry of Health, Invalids and Social Affairs, Republic of South Vietnam, the forces included the C30’s staffs, and some staffs from the former regime. Dr. Nguyen Long Giang was appointed head of the Institute, Dr. Le Van Hanh and Dr. Nguyen Van Nam were the Phó Phân viện trưởng. On June 1976, the Ministry of Health – Invalids and Social Affairs, Republic of South Vietnam merged two units into the Institute of Hygiene and Malaria under the Ministry of Health – Social and Invalids Republic of South Vietnam. Due to complicated malaria situation, the necessity of stabilizing the organization of ministries, branches localities, two units were separated as before.

The period after the liberation of the South (1976 – 1990

Peaceful country, malaria system was unified the malaria eradication was expanded in the country. Malaria situation came back and more serious due to population mobility, economic difficulties, the malaria parasite resistant to drugs, malaria mosquitoes resistant to DDT chemical. The malaria control system in this period developed quickly both quality and quantity.

In 1976, there was severe lack of specialized – malaria staffs, the malaria control units in the Central region, Highlands, Southern provinces were newly formed, not able to perform full functional tasks so this region needed the support of the Institute of Malaria, Parasitology and Entomonology (Central). After the liberation of the South a series of malaria cases occurred, the proportion of patients with malaria accounting for 60-70% of all cases. The purpose of malaria elimination in the country is rapidly reducing severe malaria situation in the South, protecting the achievement malaria elimination gained in the North.

In the process of malaria eradication, the possibility of total elimination of malaria in a limited time was very difficulty and impossible in the condition at that time. Therefore, the general Assembly of the World Health 31st proposed resolution to move malaria eradication strategy to strategy of indefinited malaria control with the aim to prevent and reduce death from malaria, reducing the morbidity and damage caused by malaria.

Since 1977 our country has shifted malaria eradication strategy to indefinited malaria elimination. Facing with severe malaria on national scale, especially in the Southern provinces, on June, 6th 1977, the Prime Minister instruct “ In the Southern provinces for 2 years from 1979 to 1980 malaria elimination had been controlled basically. For the Southern provinces, the consolidation and building specialized forces strong enough to set up malaria eradication system on national scale were important leading factors to to do good performance. Under the guidance and active support of the Ministry of Health, the organization ang building specialized forces were implemented quickly and smoothly.

On January 18th 1977, the Ministry of Health issued Decision recognizing and identifying the name of the business units at the former B2 Department of Health belonging to central health system, the Institute of Malaria, Parasitology and Entomonology was established. After a period of formation, construction, development in the war, and a period of consolidation and restructuring of the organization, on January 18th 1977, the Sub – Institute o f Malaria, Parasitology, and Entomonology HCM City – a medical unit under the Ministry of Health of the Socialist Republic of Viet nam was officially established.

In 1997, system of specialized network were established quickly and uniformly throughout the country under the direction of professional consensus of the Institute of Malaria, Parasitology, and Entomonology (Central). The areas which were responsibled by The Sub – Institute included provinces from Lam Dong to the South (former provinces B2), the Sub – Institute Director – Dr. Nguyen Long Giang, the Deputy Director of the Sub – Institute were Dr. Le Van Hanh, Dr. Pham Van Dan. The Institute was assisted by the administration department (including planning and materials…), the Organization and Personel (including security work), the Accounting department, the Professional Department (including Local Direction Department such as epidemiological, parasitological, malaria insects, training, propaganda, library…), The Research Department included insects, clinical research, practice and pharmacy).

From the newly-established days, the Sub-Institute of Malaria, Parasitology and Entomonology HCM City as well as institutes in other provinces, cities were lack of technical staffs. In the provinces there were some mobile teams for malaria control. Training for specialized staffs for the southern provinces was increasingly. Due to limited expenses, the Sub – Institute of Malaria, Parasitology and Entomonology HCM City has found effective method of training and refresh – training. The Sub – Institute assigned training task to health facilities after that the Sub- Institute fostered and organized examination for staffs. By this way, the expenses for training a class can implement 2 class. The Sub – Institute focused on developing Head of laboratory training from skilled technicians.

In 1979, 1980, malaria elimination in our country was made in conditions of extraordinary difficulty. War in the Southwest and the North broke out, the big consequences of natural disaster in recent years, in many provinces, leading to a large number of officials, the people, students from plain to mountain to do business so the management and malaria prevention had difficulties; the new economic zones continued to expand; the farm, traffic works, irrigation works in many provinces were developed in difficulty circumstances. In this times, the expert teams from Soviet Union (former) and from the Institute of Malaria, Parasitology and Entomonology (Central) repeatedly came to work and assisting in professional technique, coordinative research, investigation and direction of malaria control.

From 1981 to 1988, sources of drugs, chemicals, equipment aided by foreign organizations for malaria control reduced gradually. Drug – resistance malaria parasites occured in many places, mosquitoes resistant to DDT. The local networks of health were downgraded and the malaria situation in our country started with the complex changes. Malaria has gradually increased over the whole country. The life of people were misery, the crowds spontaneously went for gold, aloe wood, etc.. throughout the midland and mountainous areas, making the management of patients faced with many obstacles. Meanwhile the health network was degraded, not having operating funds in many places. In this stage the Sub – Institute of Malaria, Parasitology and Entomonology HCM City was facing with difficulties to perform professional duties and ensuring the life of staff and pernonnel. In 1985, the Ministry of Health appointed Dr. Pham Thi Hoa as Deputy Director, Sub – IMPE to replace Dr. Le Van Hanh and Dr. Nguyen Van Nam retired.

Since 1989, malaria control program and malaria elimination were upgraded to priority national health program and being one of the important work of our country’s health sector. The end of 1989 early 1990, in spite of many attempts, the malaria situation remains serious. Due to major technical difficulties, DDT spraying in area with An.dirusAn.minimus in outdoor shelter has not cut off the spread of disease. In the treatment of malaria, malaria parasites resisted to drugs with hight rate (over 70%), there was wide spread of drug resistance and multi – drug resistance in several key areas such as Central, Central – Highlands, Southeastern regions. Meanwhile, the entire foreign aid seemed to run out, DDT chemical of little effectiveness was also out of. For lack of condition to maintain the achievements of malaria elimination, the malaria disease returned on a national scale.

The period from 1991 to now:

In 1991, the malaria situation in the country became very serious. There were more than 1 million people with malaria, 144 outbreaks occurred, 4646 people died from malaria. To meet the requirements of changing strategy, in 1991, the Ministry of Health decided to establish the Board of national program for malaria control by the Minister of Health as chairman. As a priority national health program, the national program for malaria control in 1991 - 1995 was implemented strongly, synchronized by several measures both technical measures and implementation: malaria drugs were provided fully and several drugs with highly effective, the preventive measures vecto such as spraying, bed nets with medical treatment were expanding increasingly. In 1995 the Ministry of Health appointed MA. Nguyen Quoc Hung and BA. Dinh Van Su to the post of Deputy Director, Sub- IMPE. In 1996, MA. Nguyen Quoc Hung was appointed Director, Sub- IMPE to replace Dr. Nguyen Long Giang retired, at the same time the Ministry of Health also appointed BA. Pham Xuan Dinh as Deputy Director, Sub- IMPE. In 1995, Dr. Pham Thi Hoa retired

From 1997 to 2000, the renovation of the country gained important achievements, the national program for malaria control with technical measures such as new treatment using artemisinin and bed nets with permethrin new chemicals have blocked the explosion of malaria epidemic, pushing back malaria and heading towards sustainability. Along with malaria control system throughout the country, the Sub – Institute of Malaria, Parasitology and Entomonology HCM City has entered the stage of quality development, improved operational efficiency. Many scientific research subjects and special direction, training and international cooperation have been performed.

On May 15th, 2003, the Government issued Decree on arraging business units under the Ministry of Health, under which the Ministry of Health issued Decision on upgrading and renaming the Sub-Institute of Malaria, Parasitology and Entomonology HCM City into the Institute of Malaria, Parasitology and Entomonology HCM City on June 18th, 2003 TP. HCM.

The leaders of the institute included Master Nguyen Quoc Hung, Director, the Deputy Director such as the Bachelor Dinh Van Su, the Master Pham Xuan Đinh. In 2008, the Ministry of Health appointed Master Luong Truong Son, Deputy Director of Quy Hoa Central Hospital Leprosy - Dermatology of Quy Hoa to the position of Deputy Director.

As stipulated in the Regulaions on organization, the Institute has 12 departments, centre including Department of Epidemiology, Department of Parasitology, Department of Entomonology, Department of Molecular Biology and Immunology, Department of General Planning, Department of Organization - Addministration, Department of Accounting, Department of Science Management and Training, Department of clinic research, and special examination, centre of training, centre of service and technical centre.

By 2008, 2009, the Institute was in great difficulty by Master Nguyen Quoc Hung suddenly passed away, the Deputy Diirector Đinh Van Su, Pham Xuan Đinh were retired, so the Ministry of Health appointed Dr. Le Thanh Dong from the Ministry of Health as Director, Deputy Director as Master Luong Truong Son.

Regarding achievements in malaria control and great efforts of the health sector, especially the staffs in the system of national malaria control, the fight against malaria has the great results. Compared with the peak of the disease in 1991, from 144 outbreaks up to now there has not occurred any outbreak in many years. The number of malaria patients from over a million people in 1991 up to now there are only about 50,000, particularly in Southern region – Lam Đong provinces from 1991 to 1993 there were over 300,000 every year. In 1994-1997, there was annually from 100,000 to more than 200,000 cases of malaria. From 1998, the number of malaria cases was only tens of thousands and from 2007 to now there was under tens of thousands of malaria annually. The number of deaths due to malaria decreased from 4646 people in 1991 to now only dozens; particularly in the Southern region – Lam Đong provinces, from 1991 to 1993, the annual deaths from malaria were 300 people to more than 800 people. In 1997, there were 26 people died from malaria. From 1998 the deaths from malaria were a few dozen people. The scope of malaria circulation has narrowed, mainly in the provinces of Central region, Central Highlands and Southeastern provinces, border areas, remote areas. However, the malaria situation in recent times in the area tends to increase again, malaria parasites, malaria deaths are unstable and showing an upward tendency in 2009, 2010 and six month of the year 2011, especially in the area where malaria parasites resistance to drug were found (artesunate – resistant P. falciparum).

The prevention of diseases caused by other parasites has also been invested, the Institute has conducted some surveys of helminth in several key areas, preparing the overall survey partition epidemiological cysticercosis and other parasitic diseases, constructing and implementing the prevention of helminth program for children, students, community sector, and protect peope’s health.

Regarding external parasites, from 2010, the Institute has consolidated organization and directed the activities of sciencetific research, investigation, assessment of external parasites in the area. The Institute determined species composition, distribution of external parasites, especially the identified external parasites play a role in disease transmission to guide further research and make scientific basis and advise the Ministry of Health on directing operation against diseases transmitted from animals to humans, emerging diseases of animal origin.

In 2009, the Institute and other Institute in Southern region – Lam Dong as assigned by the Ministry of Health has coordinated in the prevention of dengue in the region, the Institute has received and deployed dengue insects monitoring activity, killing vector, handling the outbreak at the local.

Regarding training, the Institute has organized many specialized supplementary classes, refesh training, advanced training for the region. From 2011, under the Ministry of Health’s permission, the Institute in collaboration with Đang Van Ngu Medicine school has opened 2ndfaculty training test technician. Firstly, the Institute has trained technicians of testing malaria parasite and insects, then will train general medical examination.

With the implementation of functions and assigned tasks, disease situation and actual needs of the region, the risk of malaria can break out again the parasites and diseases caused by insects, external parasites have not been satisfactorily resolved, the implementaion of construction and units development is limited; therefore to maintain the full implementaion of the functions, duties, promoting the achievements, developing new tasks. In 2009, the Ministry of Health approved the Project of Planning and Development Institute 2020 and the vision of 2030. In 2010, the Ministry of Health continued to approve the “consolidation of the organization and operation of the Institute” project, under which the Institute has 15 departments, offices, centers.

Inheriting the organizational structure, available experience, and a team of enthusiastic staffs with the fight against malaria, parasites and insects, the Institute constantly maintains and accelerates the implementation of research, direction and the professional duties of the Institute. Currently, many staffs of the Institute continue to study bachelor, master and doctoral degrees in the field relevant to the tasks of the Institute, many research subjects are developed and implemented, the life of staffs are improving.

Over 35 years of development, the Institute conducted the fight against malaria in parallel with the prevention of parasitic diseases, insects. The tasks of the Institute is firmly attached with health guidelines of Party, career served construction and national defense. The achievements of the Institute has made in malaria control, the prevention of parasitic diseases and insect transmitted diseases are major contributor to the Health sector and the country contributing significantly to protect people’s health. These results are due to the deep concern of the Party and State, the direct guidance of the Ministry of Health. It is a struggle process, sacrifices and hardships of many generation of civil servants, workers of Institute, which is the first important factor contributing to ensure the implement of all tasks successfully.

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