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Cablegate: Border Province with China: Health, Environmental Concerns

VZCZCXRO5926
RR RUEHCHI RUEHCN RUEHDT RUEHHM RUEHLN RUEHMA RUEHPB RUEHPOD
DE RUEHHI #0398/01 0990742
ZNR UUUUU ZZH
R 080742Z APR 08
FM AMEMBASSY HANOI
TO RUEHC/SECSTATE WASHDC 7556
INFO RUEHHM/AMCONSUL HO CHI MINH 4542
RUEHZS/ASEAN REGIONAL FORUM COLLECTIVE
RUEHZN/ENVIRONMENT SCIENCE AND TECHNOLOGY COLLECTIVE
RUEHUL/AMEMBASSY SEOUL 3316
RUEHKO/AMEMBASSY TOKYO 5863
RUEHHK/AMCONSUL HONG KONG 1407
RUEHGZ/AMCONSUL GUANGZHOU 0888
RUEHCN/AMCONSUL CHENGDU 0352
RUEHIN/AIT TAIPEI 1592
RUEAIIA/CIA WASHINGTON DC
RUEHPH/CDC ATLANTA GA
RUEHRC/DEPT OF AGRICULTURE WASHINGTON DC
RUEAUSA/DEPT OF HHS WASHINGTON DC
RUEKJCS/SECDEF WASHINGTON DC//USDP/ISA/AP//
RHMFISS/CJCS WASHINGTON DC//J2/J3/J5//
RHEFDIA/DIA WASHINGTON DC//DHO-3//
RHMFIUU/CDR USPACOM HONOLULU HI//J00/J2/J3/J5//
RHEFAFM/DIRAFMIC FT DETRICK MD//MA-1A//
RUEHSUN/USUN ROME IT

UNCLAS SECTION 01 OF 04 HANOI 000398

SIPDIS

SENSITIVE
SIPDIS

STATE FOR EAP/MLS, EAP/EP, INR, OES/STC, OES/IHA, MED, OGAC
STATE PASS TO USAID FOR ANE AND GH
DEPARTMENT OF DEFENSE FOR OSD/ISA/AP (STERN)
HHS/OSSI/DSI PASS TO OGHA
(WSTIEGER/LVALDEZ/CHICKEY/DMILLER) AND
FIC/NIH (RGLASS) AND DIV-FLU (COX/MOHEN)
USAID FOR ANE (CJENNINGS, MWARD) AND GH (KYAMASHITA, KHILL)
CDC FOR COGH (SBLOUNT), CCID (SREDD) AND GAP (BIRX, SIMONDS)
USDA PASS TO APHIS, FAS (OSTA AND OCRA), FSIS
BANGKOK FOR RMO, CDC (MALISON), USAID (MACARTHUR/MBRADY/CBOWES)
BANGKOK FOR APHIS (NCARDENAS), REO (JWALLER)
BEIJING FOR HHS HEALTH ATTACHE (BROSS)
PHNOM PENH FOR CDC INFLUENZA COORDINATOR(BBRADY)
ROME FOR FAO
VIENTIANE FOR CDC INFLUENZA COORDINATOR (ACORWIN)

E.O. 12958: N/A
TAGS: TBIO AMED EAGR PINR KFLU VM
SUBJECT: BORDER PROVINCE WITH CHINA: HEALTH, ENVIRONMENTAL CONCERNS

REF: A) 06 HANOI 630 B) HANOI 90

HANOI 00000398 001.2 OF 004


1. (SBU) Summary: A small, mountainous province bordering China,
Lang Son's location is both a blessing and a curse. Its four border
gates with Vietnam's huge neighbor to the north have encouraged
trade and development, leading to increased economic growth.
However, local authorities also blame its close proximity to China
for several health and environmental problems, including the threat
of avian influenza outbreaks from chickens smuggled across the
border, high rates of HIV/AIDS due to the easy availability of
cheap narcotics, and silent forests robbed of wildlife sent to feed
Chinese appetites for exotic animals. Though local officials denied
extensive smuggling at the border posts, we observed huge stocks of
counterfeit electronics and apparel in local markets. End Summary.

Lang Son is Growing
-------------------

2. (U) Late last month, ESTH personnel visited Lan Son province,
Vietnam's province bordering China's Guangdong province. In a March
31 meeting with ESTH Officer and ESTH Assistant, Lan Son provincial
officials reported strong economic growth for the province; 10.4
percent from 2001-05, followed by 10.3 percent in 2006, and 11.6
percent in 2007. Traditionally dependent on forestry and
agriculture, industry/construction and trade/services increasingly
play a large role in provincial development, with both seeing
double-digit expansion over the past few years. Lang Son has yet to
attract significant foreign direct investment, instead relying on
local exploitation of its natural resources, including iron,
bauxite, and limestone, together with agricultural and forestry
processing, and limited manufacturing and assembly of mechanical
products. In 2007, total trade equaled USD 985 million, most of
which passed into or out of China. Officials worry about Lang Son's
ability to sustain its growth, given its limited infrastructure and
few competitive goods, but hope to continue the province's
transition from agriculture to industry.

Lack of Infrastructure Limits
Public Health Improvements
-----------------------------

3. (U) Local officials proudly note that every village in the
province has a public health clinic, 70 percent of which are staffed
by doctors. Over 300,000 underprivileged residents have access to
health insurance and the province has a solid record of response to
disease outbreaks. At the same time, only 79 percent of people in
Lang Son meet national health care standards. The province's four
hospitals lack necessary equipment (only 40-50 percent of required
equipment per Ministry of Health lists) and have little funding for
improvements and no money for new facilities. Health officials
stated that a major outbreak could overwhelm their limited
capacity.

Avian Influenza Preparations
----------------------------


HANOI 00000398 002.2 OF 004


4. (SBU) Though Lang Son has only suffered one animal outbreak (in
February 2004) and has yet to report a human infection, animal and
human health officials highlighted their preparatory efforts. A
provincial steering committee, including human and animal health
experts, guides policy, which includes response plans down to the
village level for possible human victims. In 2007, officials
carried out a province-wide training exercise to improve
capabilities to respond to human infections. As a high-priorty
border province, Lang Son actively participates in the GVN animal
vaccination program, with over 2.6 million vaccinations administered
in 2007. Per local officials, Lang Son used nearly seven tons of
sterilization liquid in 2007. Human health officials closely
monitor the border gates for persons possibly suffering from
influenza, tuberculosis or HIV/AIDS (note: the international border
post at Dong Dang recently received a thermal imaging device to
detect high temperatures in persons entering Vietnam). Border
officials have the ability to separate suspected infected persons
and reported one instance in which an individual was quarantined and
then sent to the National Institute of Infectious and Tropical
Diseases for further testing.

Long Border With China Tempts Smugglers . . .
---------------------------------------------

5. (U) Lang Son's over 200 kilometer border with China contains two
international border crossings, two national border gates (where
local Chinese and Vietnamese can cross without formal documentation)
and numerous paths in the mountainous and well-forested areas where
smugglers can bring goods back and forth across the frontier.
National and provincial authorities do not have the resources to
police the border beyond the formally recognized border posts.

. . . Leading to Large Numbers of Illicit Chickens
--------------------------------------------- -----

6. (SBU) In a sense, Lang Son is a victim of the success of
Vietnam's efforts to combat AI. According to local health
officials, over the past five years, Vietnam has culled 60 million
poultry, which has caused sharp increases in prices. Sensing a
market opportunity, smugglers quickly moved to spirit Chinese
chickens, a similar breed to their more expensive Vietnamese
counterparts, across the border (Ref A). Though local customs
officials denied that any birds made it through the border gates,
all local officials acknowledged wide-spread smuggling across the
thousands of local crossing points. Though much of the smuggling
remains disorganized and small-scale, the overall numbers are quite
large. In 2007, customs and market control officials seized 160
tons of illicit poultry (mostly live) and 300,000 eggs. In the
first three months of 2008, they have confiscated 82 tons of poultry
and 30,000 eggs - which all agreed represented a fraction of the
total numbers crossing the border. Other border provinces,
particularly Quang Ninh to the east, have also reported poultry
seizures.

. . . And an Increased Threat of Avian Influenza
--------------------------------------------- ---

HANOI 00000398 003.2 OF 004

7. (U) Aside from economic impacts, Lang Son fears smuggled chickens
may spread AI. An EU/Japanese-funded project to increase Vietnamese
testing capacity has yielded chilling results - 28 out of the first
115 samples in 2008 tested positive for H5N1 (Note: the Department
of Animal Health in Hanoi confirmed positive results for H5N1 in its
tests of samples from Lang Son in 2007 and 2008, though its numbers
varied somewhat from those provided by the officials in Lang Son).
And these birds are not simply destined for local tables, many find
their way to markets and restaurants throughout northern Vietnam,
including Hanoi. Though Lang Son cooperates with other provinces,
it does not have the resources to interdict shipments into or out of
its borders.

Little Cooperation with China on Smuggling or AI
--------------------------------------------- ---

8. (SBU) Despite the magnitude of the issue, Vietnam and China have
few cooperative efforts to monitor or stop chicken smuggling. In
fact, according to Lang Son market control officials, China does not
consider the practice to be illegal and so provides no assistance to
Vietnamese attempts to patrol the border. Lang Son animal health
officials do not communicate with their Chinese counterparts and so
do not know when or if animal outbreaks occur across the frontier.
Human health officials would notify Chinese health officials if they
detected a human infection at the border, but would not provide
direct notification of other cases, instead reporting to the
Ministry of Health, which would then notify international
authorities. These officials assumed the Chinese followed the same
practice.

Addressing HIV/AIDS
-------------------

9. (SBU) Lang Son reported its first HIV/AIDS infection in 1993 with
rapidly increasing numbers throughout the decade -- approximately
200 new patients discovered annually. As of 2007, Lang Son had
2,674 cumulative cases, with 1,440 fatalities. Most victims are men
between the ages of 20 to 39, primarly intraveneous drug users
(IDUs). Lang Son city and two districts bordering China provided
the most cases, most likely due to easy access to drugs in those
areas. (Note: HIV/AIDS officials stated that Lang Son and Guangxi
authorities met annually to discuss prevention efforts, the next
meeting to take place in June 2008). Though Lang Son remains one of
the most heavily impacted provinces in Vietnam, its relative ranking
has steadily dropped from the fourth most cases in 2004 to the tenth
most in 2007. Officials credited assistance from the Ford
Foundation for successful intraventions (including a clean needle
and free condom program) that significantly reduced the percentage
of IDUs infected with HIV/AIDS, from 46 percent prior to the
program's initiation to only 27 percent within 36 months. While
pleased with this success, HIV/AIDS responders noted that infections
have increased in other groups, particularly among women married to
male IDUs and, to a more limited extent, among commercial sex
workers. To that end, the province intended to increase its
destigmatization programs to better integrate family members of

HANOI 00000398 004.2 OF 004


HIV/AIDS victims into society.

Lang Son's Silent Forests
-------------------------

10. (SBU) Lang Son forest protection officials stated that the
illegal wildlife and timber trade flowed one way - into China. They
reported little wildlife smuggling directly from Lang Son, but only
because Lang Son's forests had already been emptied of endangered
wildlife in the 1990s. Now, Lang Son serves primarily as a way
station for birds, monkeys, and snakes from other provinces and
abroad as they head to Chinese markets (with some animals detoured
to local dining establishments). Though the province has instituted
propaganda campaigns, high demand (and high prices) in China ensure
a steady supply. Lang Son has 300,000 hectares of forest, an
attractive target for illegal logging - both for domestic and
international consumption. In 2007, the Forest Protection
Department confiscated over 10,000 pieces of rare wood, a drop in
the bucket in the total trade.

Counterfeit Goods Easy to Find in Local Markets
--------------------------------------------- --

11. (SBU) In meetings in the provincial capital and at two border
gates, customs officials consistently stated that no smuggling of
any kind took place at any of the border gates, reiterating a
message delivered to Embassy Econoff earlier this year (ref B).
However, 200 meters from the Tan Thanh domestic border gate, a large
and well-organized shopping-mall style market contained dozens of
stalls selling a full range of counterfeit electronic goods and
apparel. "IPod nanos" sold for 300,000 dong (approximately USD 20),
while consumers could browse amongst several semi-familiar brands,
including "Pannusonic" and "Addidas." Notably, even Chinese brands
suffered, with several obviously fake Chinese DVD players for sale.


Michalak

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