Authorities in Son La Province, a northern border province infamous for drug smuggling and the HIV/AIDS epidemic, decided to lay off all non-permanent medical workers at methadone centres in the area.

A medical staffer gives methadone to an HIV-positive man in northern mountainous Son La Province's Moc Chau District.

According to Decision 93 issued by the municipal People's Committee, medical staff who work at local methadone centres on a yearly contract will lose their jobs next Friday.

It means that seven out of 10 employees of the Thuan Chau District's methadone centre, which provides the treatment drug to about 124 local people with drug addictions every morning, will be out of work. The other three are permanent employees, including the centre's director.

Lo Thi Tinh, 23, a contract employee at the centre, said everyone thinks the work she does – giving the patients the right dose of methadone - is easy and requires little effort.

"But in fact I have to work every day, even on the weekend with every morning spent with the patients while doing the paperwork - for example, the treatment report for the patients in the afternoon," Tinh said.

She receives a monthly wage of VND2.139 million (US$95), with neither social insurance nor bonus for her work on weekends.

Tinh said she struggles to raise her family of three on such a paltry sum of money, but added that she was still grateful for the position because it was difficult to find a job relevant to her pharmaceutical degree in the area.

The reason behind the furlough was not clearly stated in the Decision's document, but Son La HIV/AIDS Prevention Centre Director Dam Van Huong said that financial reasons likely triggered the decision to downsize.

Luong Minh Tuan, director of the Thuan Chau Health Centre, said the job cuts are expected to create problems for the health system, which already has a shortage of employees.

He said the three remaining staff would not be able to consult and provide treatment and follow-up health checks to the 100-plus patients who come to the methadone centre every day.

"So far we have no choice but to ask two employees from the two communal health stations to pick up the job here at the methadone centre," Tuan said. "Those two will share their time between the heath station and the centre."

Permanent staff frozen

The health stations affected by Decision 93 currently have five staff each to provide health services to a dozen thousand local people, and are already overloaded with their daily tasks.

One of the two, Tong Lanh Communal Health Station, which also provided ARV (antiretroviral) drugs to 50 HIV-positive patients, was spread thin due to a shortage of health workers, said head of the station Bac Thi Thuan.

"Freezing the number of permanent employees is making our work really hard," she said.

Keeping the number of permanent state employees stagnant, or going further by making additional staff cuts, has been a national priority policy in recent years.

Both the Government and residents have repeatedly called for action regarding the issue.

The Chieng Son commune's health station is located about 25km south of the abandoned villa of notorious drug ringleader Giang A Tang, who smuggled drugs worth millions of dollars from Laos to Viet Nam via Son La. At the same time, the region struggles to help people facing drug addiction.

The methadone centre, built next to the health station, expects to see staff cuts similar to Thuan Chau District's, and staff are bracing themselves for their 10 employees to be reduced to just three at the beginning of January.

Two workers of the station will be sent to the centre to help care for the 131 patients being treated with methadone, said health station head Tran Thi Van.

"But the hitch is that we are already strained with the current workload," she said.

Her health station is supposed to cover health services for about 9,000 residents with only seven workers available.

The lack of employees is posing a serious risk to the newly adopted pivot plan by the Government - the 90-90-90, said Son La HIV/AIDS Prevention Centre Director Dam Van Huong.

The plan, first initiated by UNAIDS last year, aims to make 90 per cent of all people living with HIV aware of their HIV status. In addition, it aims for 90 per cent of all people diagnosed with HIV to receive sustained antiretroviral therapy.

Son La, which has nearly 8,000 people facing drug addiction and 7,722 people with HIV, according to the provincial police, was chosen to be one of five pilot localities to carry out the plan that is due to reach the three targets in 2017.

The other four are also hot spots of HIV infection, including Dien Bien, Thanh Hoa, Nghe An and HCM City.

Huong warned that the current employee shortage, worsened by the latest downsize, is likely to make the fight against HIV "a mess" in just three months.