BY MICHAEL KARADJIS
HANOI — While the historic advances made by revolutionary Cuba in education, health, welfare and other fields have long made for impressive contrasts with the grinding poverty, illiteracy and death from preventable diseases that afflict most of the capitalist Third World, Communist-ruled Vietnam is often regarded — even among leftists — as the pauper surrounded by Asian capitalist "miracle" economies.
A closer look reveals the fallacy of this impression. The fact that Vietnam is far behind countries in the region in terms of per capita gross domestic product (GDP) is hardly surprising given that they had the opportunity to grow in peace for decades while Vietnam was being "bombed back into the stone age", to quote US President Lyndon Johnson.
However, a look at a number of key social indicators, rather than the often meaningless GDP figures, tells us that a socialist revolution even in conditions as adverse as those in Vietnam brings with it a considerably better spread of what wealth is created.
Vietnam's key indicators — a literacy rate of 94%, life expectancy at 68 years and an infant mortality rate of 29 per 1000 births — are roughly equivalent to those of Asian capitalist countries which have far higher per capita GDP levels.
Following the unique story of the original four "tigers" (South Korea, Taiwan, Singapore and Hong Kong), it was alleged — at least until the economic crisis of 1997-98 — that a second group were following in their footsteps, namely Malaysia, Thailand, the Philippines and Indonesia. While this is largely imaginary, it certainly is true that these countries have performed relatively well compared to most of the capitalist Third World in terms of GDP growth and industrial development.
These four countries boast per capita GDP's of US$4251, US$2593, US$1092 and US$972 respectively, compared to US$331 for Vietnam (United Nations Development Program 1998 figures). This puts Vietnam on the level of Bangladesh (US$348) and Haiti (US$370). Bangladesh has a literacy rate of 40%, life expectancy is 58 years and infant mortality is 79 per 1000 births.
When converted to parity purchasing power (PPP), which gives a better measure of what can actually be bought in these countries with this amount of dollars, the Vietnamese figure rises to US$1689, but this still puts it far behind the four South-East Asian capitalist countries whose figures rise to US$8137, US$5456, US$3555 and US$2651 respectively.
Vietnam's PPP per capita GDP figure puts it on roughly the same level as countries such as Ghana (US$1735), Pakistan (US$1715) and Guinea (US$1782).
In Guinea only 36% of adults are classed as literate, the life expectancy is 47 years and infant mortality stands at 124 per 1000 births, while in Ghana the literacy rate is 69% per cent, life expectancy is 60 years and infant mortality is 67 per 1000 births.
Even countries with considerably higher levels of PPP per capita than Vietnam have far lower social indicators. South Africa, for example, with a PPP per capita GDP of US$8488 in 1998 — five times larger than Vietnam's — had a literacy rate of 85%, average life expectancy of 53 years and an infant mortality rate of 60 per 1000 births.
Better
On some indicators Vietnam has done even better than the neighbouring capitalist countries. In Malaysia, for example, adult literacy is seven percentage points behind Vietnam, and female literacy is nearly nine points behind. Indeed, on literacy in particular, Vietnam's rates are higher than most Third World countries, reflecting the near universality of primary school enrolment.
As for Indonesia, a country with GDP per capita three times that of Vietnam, its literacy rate is eight points behind that of Vietnam, life expectancy three years behind and infant mortality is 47 per 1000 births — 18 points behind Vietnam.
In some respects, the contrasts are even greater. While Vietnam still suffers a maternal mortality rate of 105 per 100,000 births, the figure in Thailand and the Philippines is double (200 and 210) and in Indonesia it stands at 390 — nearly four times the Vietnamese rate.
One of Vietnam's worst statistics is its 33% child malnutrition rate, a continuing legacy of the decade-long US-led war against the country. However, the rate was 53% just five years ago.
The UN Development Assistance Framework has commended Vietnam on the success of its poverty alleviation program, claiming "the rate of poverty has registered one of the sharpest declines of any developing country on record, falling from a high 58 per cent in 1993 to around 37 per cent in 1998 according to the World Bank's poverty measure".
One of Vietnam's best indicators is its 96% child immunisation rate, against 10 major infectious diseases. This places it ahead not only of Thailand, Malaysia, Indonesia and the Philippines, but also South Korea, Hong Kong and Singapore — indeed, virtually the whole region except China and Japan.
"Vietnam's achievements are especially impressive", according to Morton Giersing, the United Nations Childrens Fund (UNICEF) representative in Vietnam. Since becoming the first country in Asia and the second in the world to ratify the UN Convention on the Rights of the Child 10 years ago, Vietnam has been "evaluated by the UN as a leading country in the implementation of the CRC".
The World Health Organisation (WHO) has declared polio eradicated in Vietnam; neonatal tetanus has been virtually eradicated, and other childhood diseases have dramatically declined.
In 1997, Vietnam became one of only two countries in the world to meet global targets for diagnosing more than 70% of tuberculosis infections and saving 85% of patients. Nevertheless, the disease still struck 189 per 100,000 people in 1997, but this still compared favourably to 307 per 100,000 in Thailand, 310 in the Philippines and 285 in Indonesia.
Malaria remains a major problem in Vietnam, but the incidence has fallen 22% in the last year. This month it was declared that leprosy had been eradicated in accordance with WHO criteria.
None of this is to say that the health and education situation in a poverty-stricken country like Vietnam is rosy. The situation is still dire compared to anywhere in the First World.
Furthermore, there is no question that universal health care and education have slipped since the introduction of user fees for schools and hospitals and the privatisation of pharmaceuticals in the late 1980s as concessions to the "market" demanded by the International Monetary Fund and World Bank. Growing inequality in these fields and society in general is the price Vietnam is being forced to pay for its necessary compromises with world capitalism.
Regional inequalities have also been exacerbated — in particular, ethnic minorities in mountainous areas have far worse health and education indicators.
A stark example of the decline of universal health care is that while in 1982, 100% of births were attended to by skilled medical staff, by 1997 this had fallen to 79%. However, this still put Vietnam ahead of Thailand, the Philippines and Indonesia — 71%, 53% and 36% respectively.
Health care
Vietnam's strengths in these areas reflect the continuation of an overall socialist framework, and a continuing commitment to redistribute the new wealth that the capitalist sector is helping to create. They further reflect Vietnam's far better health-care infrastructure than the richer countries of the region, something inherited from pre-economic reform days.
According to World Bank 1997 figures, there was one hospital bed for every 263 people in Vietnam, for every 500 people in Malaysia, for every 600 in Thailand, for every 910 in the Philippines and for every 1428 in Indonesia. In 1993 in Vietnam there were 1200 people per doctor, in Malaysia 2700, in Thailand 5000, in the Philippines 8300 and in Indonesia around 7000.
In 1999 Vietnam won the UN Population Award for its population and family planning efforts, conducted at a grassroots level largely by the Vietnam Women's Union. Some 75% of women aged 15-49 in Vietnam are estimated to use contraceptives, the third highest rate in the Third World (after China and Brazil). Women make up 26% of the members of the country's national legislature, the highest figure in Asia and the ninth highest in the world. Seventeen percent of the members of the country's legislature are from ethnic minorities, which make up 13% of Vietnam's population.
The UNDP produces an annual Human Development Index (HDI) which combines literacy rate, life expectancy and "income" to compare average quality of life across the world. Vietnam ranks 108 out of 174 countries — far ahead of its GDP per capita ranking of 132. If the dubious category of "income" were replaced by other social indicators, Vietnam's position would be even better.
In reality, even Vietnam's similar or superior quality of life indicators fail to tell the whole story. Many Vietnamese were shocked when the Philippine garbage dump landslide tragedy revealed that 80,000 people live on the dump outside Manila — something unimaginable in Vietnam.
Likewise, glitter can't hide the fact that Thailand's role in the "globalised" world has been transformed by its rulers and their foreign backers into the "global brothel". NGO sources in Thailand claim some 2 million women and 800,000 children have been driven into prostitution. While the "free market" in Vietnam has also led to significant growth of prostitution, the Thai situation dwarfs even the largest estimates.
Sex slavery in Thailand has also been one of the major causes of that country having a million people living with HIV, with some 30,000 dying from AIDS each year and just as many new cases appearing each year. In Vietnam, the problem has also been spreading, but whether government estimates of 30,000 or unofficial estimates of 160,000 are accepted, there remains a huge difference with Thailand.
Ultimately, what has led to hundreds of thousands of people engaging in prostitution, tens of thousands living on top of garbage dumps and millions living in wood and cardboard shacks and shanties surrounding cities (1.2 million on the periphery of Bangkok) is the driving of millions of peasants off the land, as plantation owners, banks and other parasites grab as much as they can. In Thailand, the peasantry has been locked out of half of all cultivable land, in what has been described as one of the greatest land grabs in history, as giant private plantations growing cash crops enrich a tiny minority and GDP figures.
By contrast, Vietnam's land reforms have remained more firmly entrenched. While there is no question that Vietnamese peasants are shackled by the same poverty that engulfs the entire peasantry in the Third World, the fact that the bulk of peasants maintain a small piece of land provides the necessary measure of dignity and subsistence to prevent them drifting to the garbage dumps and brothels in the cities, saving Hanoi from the fate of Bangkok and Manila.
Indeed, this can be measured in the figures for "extreme poverty", which the UNDP defines as "indigence and destitution, the inability to satisfy even minimum food needs", as opposed to "overall poverty". In Vietnam, only 4% of the population still suffered from extreme poverty in 1996, according to the UNDP's global survey; in Thailand it stood at 13.7%, and in Indonesia 11.2%, even before the Asian economic crisis hit.
This greater ability of Vietnamese peasants to hold onto land despite the pressures of debt, corruption, "the market" and so on is, ironically, due to the fact that they don't own the land outright. The Vietnamese constitution declares all land the property of the state; peasants lease agricultural land for 20 years at a time, these leases being instantly renewable and inheritable. While an indebted peasant may sell or mortgage the land, and the "market" certainly has resulted in a degree of landlessness and land concentration in some regions, the process is limited because the sale is limited to the period of the lease, following which the land reverts to the state, which then re-leases it to peasants.
It is scandalous that one condition raised by the World Bank and the Asian Development Bank (ADB) that would result in Vietnam allegedly getting more loans is "further liberalisation" of land, i.e., full-scale privatisation and the resulting land concentration which these organisations claim is necessary for greater "efficiency" and technological application. The Vietnamese government has to date wisely ignored such "advice".
While the miserable state of poverty and corresponding low health and education standards afflicting the Third World are due to imperialist exploitation through unequal exchange ("free trade"), debt slavery, resource looting and other mechanisms, the difference between Vietnam and capitalist countries is the degree of social control over its economy that the former has established since its socialist revolution. One example is the land policy, but another is the ruling Communist Party's determination to maintain dominant state ownership over the "key sectors" of the economy, despite a very liberal policy on both domestic and foreign capitalist intervention in many sectors of the economy.
The major proposal in a recent paper jointly published by the World Bank, ADB and the United Nations Development Project (UNDP) is that Vietnam scrap this state "monopoly" (as public ownership is referred to), pointing out that it is "inconsistent with WTO [World Trade Organisation] accession". Yet maintaining such control over key sectors through the State Owned Enterprises (SOE's), and in general Vietnam's relatively cautious pace of market reform, is what allows the degree of wealth redistribution that produces such good social indicators, which the World Bank and UNDP claim to be interested in promoting.
The dominant role of the state sector in its economy is also what allowed Vietnam to largely withstand the Asian economic crisis. According to Vietnam watcher Adam Forde from the National University of Singapore: "Vietnam delivered by far the best performance in ASEAN during 1998. This has been spectacularly ignored by the world, especially organisations such as the World Bank and the IMF. This is because Vietnam's still protected and 'unreformed' economy was her major source of protection. Not having followed some advisers and opened up her capital markets to foreign investors, there were no major opportunities for speculative positions to be taken against the dong, nor for capital flight."
Vietnam has grown impressively in the last 10 years, doubling its per capita GDP. Given this is largely the period since the introduction of the doi moi economic liberalisation reforms in the late 1980s, the growth is generally held up as the result of "the market", the suggestion being that further economic growth can only come for further marketisation. There is no question that Vietnam's formerly highly centralised command economy, resulting from decades of running a war economy, alongside Soviet and Chinese influences, needed a significant compromise with the market (though the state sector has maintained its lead in industrial development).
It is rarely noted, however, that it is only since 1989 that Vietnam has been able to develop at all without wars and trade embargoes. In that year, Vietnamese troops were able to withdraw from Cambodia, after a decade of protecting the Cambodian people from the genocidal US-backed Khmer Rouge, freely operating from Thailand. For this service to humanity, Vietnam, still suffering from its own devastation by the US, was punished by being embargoed by the US, the European Community, the ASEAN nations, Australia and China. Only after 1989 were these criminal trade embargoes lifted.
Moreover, the effects of the US war are still being felt and Vietnam never saw a cent of the reparations the US promised to induce the Vietnamese to sign the 1973 peace accords.
The Hanoi-based Resource Centre NGO claims that about 10% of the population — 7 million people — are disabled. This is an incalculable economic burden on a poor and devastated country. Many hundreds of thousands are estimated to be suffering from the effects of the Agent Orange US chemical warfare, and 84,000 people have been killed by unexploded ordinance left by the US since the end of the war — it is estimated that 150,000 tonnes of ordinance remains buried in fields and forests.
Despite the hype of President Clinton's visit last year, no significant money was promised to help clear this ordinance, while the US is still "researching" whether Agent Orange had any effect on its victims!
Such a drastic situation inherited from one of history's most barbaric and destructive cases of foreign aggression makes Vietnam's achievements all the more remarkable.