Nguyen Thi Hoa from Thu Duc District, HCM City was advised to prepare to give birth to twins at Thu Duc General Hospital. Following the caesarean operation only one baby was born, leading her family to lodge a malpractice complaint with the hospital. An urgent investigation was carried out by the hospital and it was discovered that seven foetal ultrasound test results that showed Hoa carrying twins were wrong.

"I did seven ultrasound tests at Vu Thi Thu Private Clinic," the 27-year-old mother said. "And they all said I was expecting twins. I decided to ask for the caesarean operation at the hospital."

According to the director of Thu Duc General Hospital, Tran Vinh Hung, the investigation showed that the ultrasound machine at Vu Thi Thu Clinic was faulty.

Although there have been no detailed reports on the number of victims of substandard medical equipment at local hospitals, healthcare managers have realised the huge dangers posed.

Lax management and a weak legal framework have been blamed for the rampant import of out-dated second-hand medical equipment in Vietnam. Old ultrasound machines, CT scanners or auto-biochemistry analysers are among the most common items seized by local customs office.

In one of the biggest cases last year, Hanoi police found Chinese and Vietnamese-made parts including motors and cooling fans in six bio-chemical analysis devices imported from Germany which are being used at six district hospitals.

Police said they found forged state documents attached to six Greiner GA240 Auto-Biochemistry Analysers, which were imported and sold through several companies in Hanoi.

The machines were acquired through a programme designed to invest in medical equipment at district hospitals using government bonds. Participating hospitals included institutions in Hoai Duc, Thuong Tin, Van Dinh, Thanh Oai, Phu Xuyen and Quoc Oai districts.

The Minerals Import Export Joint Stock Company, located in Hanoi’s Hoan Kiem District, won the contract to supply the six devices for VND26.78 billion (USD1.26 million).

Despite the ban on importing old medical equipment by the Ministry of Health, some enterprises still import equipment by exploiting loopholes in the current laws and regulations.

Huynh Van Nam, director of a company in District 10, HCM City said that the circular on importing medical equipment issued by the Ministry of Health four years ago has many shortcomings, with no detailed instructions on the inspections of the imported products.

"Many hospitals and clinics prefer used devices as they’re cheaper, despite knowing that they were mostly discarded by hospitals in other countries," Nam added. "CT scanners, ultrasound machines, electrocardiograms and electroencephalogram machines are among the most common."

According to Nguyen Minh Tuan, head of the Ministry of Health's Department of Medical Equipment and Health Work, Vietnam imports some 4,000 healthcare devices every year, accounting for 70-80% of the equipment being used at local hospitals.

Tuan said this is a lucrative market and so the large number of import companies is one of the main causes of the problem.

"The number of companies specialising in importing medical equipment has sharply risen in recent years," Tuan said. "The Health Ministry alone can’t curb this problem, we need help from other ministries and agencies."

Tuan said there are now no health officials at local customs offices to inspect imported items, and this was a major shortcoming.

Patients to suffer

According to doctor Tran Cong Bay who is working at the Department of Radiology and Imaging at a public hospital in HCM City, the import of cheap medical equipment has increased since the government gave more autonomy to public hospitals to raise finance from the private sector.

“These old and out-dated machines can’t produce accurate testing results," Bay said. "This is why patients may receive different results when having medical check-ups at different hospitals. Many are even required to do unnecessary tests so as doctors can get commissions from companies who sell material used in such tests or provide device rental services."

While the authorities have yet to curb these problems, they are calling on customs officials to be more careful.

A survey of 1,493 hospitals across the country done by the Ministry of Science and Technology last year revealed that as many as 385 hospitals (25.8 per cent) were using substandard devices; and 3, 597 out of 13,437 devices (26.8 per cent) did not meet standards. Most of the violations were found at district level hospitals and Hanoi had the biggest number of violations.