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Chapter Three: The Child

By Paul J. Giannone

All too often, even now, I find myself standing in the doorway of a cramped, damp and unclean space. I know it lingers only as a nightmare, yet I can still see it, still smell it. I can still feel the fear of those who lived the last moments of their lives there.

The center room of the Hoi An prison hospital was about the size of a large living room. The mold-covered walls of stark concrete surrounded a combination waiting area, nurses' station, and examination room. As it all comes back to me, I see again an old wooden desk and chair, a glass medicine instrument cabinet and wooden benches.

The cabinet held no instruments, no medicines. At the far end of this room, a hospital sheet was draped over a single metal wire, forming a flimsy barrier for the patient examination area. The sheet was splattered with blood, dirt, and what appeared to be bits of skin. An equally filthy and dilapidated ob/gyn examination table sat behind the divider.

This room was for women and children under the age of 12, with the ward at the opposite end of the building for males 12 and older. The entire building was permeated with the sour smell of unclean human beings living in close proximity to each other, a smell much worse than that of any refugee camp I have ever visited. This mixed odor of vomit, perspiration, and feces oozed out of the doorway openings, mingling with something more bestial and primordial—the aura of fear.

As I stare, the dirty floor of the female ward seems to be alive and moving, and I see that it is covered with bodies. There are no beds. The patients lay on dirty mats on the bare floor. You could hardly put a foot down without stepping on a limb or torso.

Barbed wire covered the barred windows and stretched over the ceiling, creating a nesting ground for the birds whose droppings covered the walls.

When I return there in my mind or in my dreams, I am rarely alone for long. Almost always, the smiling face of Mr. Quang—the prison commandant—appears at my side. Like most Vietnamese, he was short in stature, with jet-black hair and eyes, a round face and dark skin. He had a cruel smile and the rough hands of a peasant. This was the man in charge of interrogations.

As a US Army public health adviser, I was assigned to conduct inspections of this facility and bring what medical aid I could to help the prisoners. On my first trip there, I asked Mr. Quang about the capacity of the prison. He replied, "About 400 prisoners."

"How many are in here?" I asked, incredulously.

Smiling again, he informed me that the prison now held approximately 1,400 men, women, and children. I would later learn that the figure was closer to 1,600. Mr. Quang shrugged his shoulders and suggested I inspect the holding centers.

It was common knowledge that every major Vietnamese city and town had at least one political prison, supported by the US government, that served to detain political prisoners and gather intelligence about the communist/political infrastructure.

Why not? We were at war, weren't we?

At each cell block, hands were thrust out between the iron bars, faces pressed against them. As I passed close to one of the cells, a little girl reached out and tightly grasped my hand.

After just a few minutes, Mr. Quang quickly moved me along to the male section. He did not want me to see any more women and children.

The silent guards unlocked the door, and we walked into a concrete room that could not have measured any more than 10 feet by 10 feet, full of prisoners squatting from shoulder to shoulder. Their ages ranged from about 12 to over 70. So many bodies were crammed into that space that there was no room to lie down or even to sit.

As we crossed the threshold, the prisoners immediately jumped to attention. Several obviously did this with a great deal of pain but they also moved quickly. Fear and torture are great motivators. I asked how many times a day these men were allowed to leave the cell to exercise, bathe, eat and relieve themselves. The response was an abrupt "twice a day for fifteen minutes and a bath once a week."

The next stop was the kitchen, the primary reason for my health inspection. A complaint had gotten to province headquarters, and rumor had it that there were actually queries about the prison coming from Washington.

Among other things, there had been outbreaks of scurvy and beriberi. Both are ancient afflictions with simple cures that have been known for centuries. Scurvy could be corrected by introducing fresh fruit to the diet; beriberi with more grain, yeast or meat. Neither should ever have occurred in a country as lush with vegetation and fowl as Vietnam. When the task was assigned to me, the implication was that this story might make the press if something was not done.

My first glance at the kitchen turned my stomach. The food was thin rice gruel, re-cooked so many times it was difficult to distinguish as rice. Looking through the large cooking pots I could see only a few bits and pieces of a substance that might have been fish or meat. An occasional strand of green leafy vegetable floated in the brew. It looked more like vomit than food.

The flies and rats got their portion of the meal long before the prisoners did, so it was no surprise that gastrointestinal problems were rampant in the prison.

Returning to the dispensary, I passed a two-room concrete structure that was entirely surrounded by barbed wire. This was where prisoners were tortured.

Some were tortured for information. Many were tortured for the sake of being tortured. There was no significant information or enemy secrets to be had from most of the prisoners, but they still became the victims in an escalating spiral of violence.

This building did not discriminate. Men, women, and children all spent time in the interrogation center.

Back in the dispensary, I set about preparing to see patients. My first was a girl, about sixteen or seventeen. She lay on her back in a corner of the women's ward, her head pressed tightly against one wall and her face towards the other. Her arms and legs flailed about frantically as if she were in the throes of an epileptic fit. As I approached, she made the most ungodly sound.

Then I saw that the girl was very pregnant, perhaps seven or eight months along. Her eyes were glassy. Drool came out of the side of her mouth. She was unaware of my presence.

Luckily on this trip, a US Navy doctor had accompanied me to the prison and was now in the same ward. I yelled for him, and as he began his examination, I backed away to give him room.

Meanwhile, a male inmate had somehow had made his way to the doorway of the women's ward. He beckoned to me and I walked over. The man was in his late thirties or early forties and kept repeating the Vietnamese term "dau," meaning "pain." I examined him and found a long lateral bruise running six inches on either side of his navel. There were several swollen welts on his head. He had obviously been a recent guest at the prison interrogation center.

I was not allowed to supply any medicine, and with none in the dispensary, there was little we could do. I gently took his arm, gave him as many aspirin as I could, and told him in Vietnamese how to take them.

The doctor called me back to the girl. He slowly pulled off his stethoscope, handed it to me, and told me to listen to the girl's abdomen.

My untrained ears heard nothing. He took his thumb and middle finger and thumped it against the girl's stomach. She screamed and I heard an echo sound. He put his hand on my shoulder and told me that the girl was not pregnant. Instead, she had been through some sort of trauma that caused her to gasp in large amounts of air. Consequently, her stomach had blown up like an enormous balloon.

The dispensary matron said in Vietnamese/American slang that the girl was "dinky dau," meaning crazy. She had been brought to the interrogation center and tortured repeatedly for several days. Her captors had inserted live electrical wires into her vagina. Sometimes they would attach these wires to her ear lobes and electrify her brain. Other times they would drop water on her to intensify the electric current.

Sadly, this was not my first exposure to torture.

Once, at a short-term holding center for POW's near my compound, I saw an elderly woman who broke into uncontrollable spasms whenever she was touched. She had been tortured with electric current, and her "interrogators" were not just Vietnamese. Some were Americans.

The interrogators had discovered that women did not stand up to electric shock torture as well as men, and so that became the method of choice for them. The men got a combination of electric shock, beatings, sexual mutilation, and torture known as "waterboarding." The latter was performed by holding the subject down with a towel over his mouth. Hot soapy water would be forced into his mouth through the towel. The soap would clog up the towel causing the victim to drown or suffocate.

Another method of water torture was to force water up the victim's rectum with a high-powered water hose.

It was a Vietnamese version of the Salem witch trials. If an individual was labeled a Viet Cong suspect, he or she was arrested without warrant and then tortured. The torture continued until a confession was wrung out or until the prisoner died. Those who wanted the slightest chance of survival confessed to being a Communist. But they were unable to provide information on troop and weapons locations, so this prompted more torture.

I had heard the counter-arguments before: "But the Communists use torture." Of course, they did. But unlike the Americans, the Communists never professed the ideals of human rights and democracy.

Consider the girl whom I mistook for being pregnant in the Hoi An Prison. I found out that her father had been a member of the political party that opposed the corrupt ruling Thieu regime in the 1968 elections.

To no one's surprise, President Thieu and Vice President Ky won the election in a landslide. One of their first acts to consolidate power was to declare that all the political opposition were Communist, and opposition leaders were immediately arrested—or, in some cases, shot on the spot.

The girl's father was arrested along with all his family. His daughter was separated from the others and taken to Hoi An Prison.

I approached Commandant Quang and demanded that this girl no longer be tortured. What information could they possibly get from her? For the first time in my career as an adviser, I raised my voice to a Vietnamese. I felt the cards were in my favor since they so urgently needed my presence to counter any negative press stories. To my amazement, the commandant consented without argument. As best as I could determine, the girl was no longer harmed.

Then a woman with a young baby showed up at the dispensary. I estimated her age to be about thirty, and she was terribly thin. Her skin was pale, and there were dark circles under her eyes. Her baby lay cradled in her arms, wrapped in filthy rags.

It was a baby boy, almost small enough to fit in the palm of my hand and in a severe state of malnutrition. His skin was stretched over his face and his eyes bulged out.

This was beyond my medical skills, so I left the prison and returned with another Navy doctor. He confirmed that something had to be done immediately. The best thing would be to transfer the infant to a hospital, somewhere clean and protected.

The commandant said he knew of the woman and child in question, but flatly denied my request to move them. He told me the woman was suspected of being the wife of a prominent Communist Party member.

The child and his mother were the by-products of Operation Phoenix, a US government-sponsored endeavor supported heavily by the CIA and intended to identify and eliminate Communist political party cadres in villages and hamlets.

The program did succeed in eliminating a large portion of the Communist infrastructure. Yet it also became a license to kill, arrest, or torture anyone labeled as a Communist suspect, and gave an already corrupt Thieu regime carte blanche to remove any of its opposition.

Foolishly, I thought I could rationalize with Quang. How could a baby this young be considered a Communist? How far could the mother and child get in their weakened states if they did try to escape? How did we know this woman was indeed the wife of the person claimed? I never got beyond his malevolent smile.

For the next few days, I went from one office to another at Province Headquarters. No one would see me, but I'm sure they were aware of my quest. Finally, my CO cautioned me to back off. American public health advisers had no business interfering with the internal affairs of the South Vietnamese government.

In desperation, I returned to the prison and begged Quang to release the child into my custody. I would take full responsibility. I would find a person to care for the child. The mother could stay secured at the prison. The answer was still no. When I returned to my quarters that evening I was told by my CO that I had been ordered to report to company headquarters in Da Nang to clear up some "administrative matters." The next morning, I was on the early morning Air America flight to Da Nang. The "administrative matters" were negligible, but they kept me in Da Nang for four days.

When I returned to the prison, the mother and child were gone, and the matron refused to look me in the eye. I ran to the commandant's office.

Quang was standing behind his desk pouring two cups of tea as if I was expected, and before I could say a word he mused, "You know, at times, even I don't like this job."

He continued, "If I didn't do as ordered, like you, I would find myself in a place worse than this."

A pause.

"The baby is dead. It started the night you left. The fever got worse and it went into a coma. I was under strict orders to do nothing. My superiors hoped that, if the father heard of the situation, he might give himself up. He did not. The baby died. The mother has been transferred to Da Nang for security purposes."

I turned on my heel and walked out of that prison, then told my platoon commander that he would have to court-martial me or put me in a combat outfit before I would go back. The illusion that brought me to Vietnam—to help in the fight against our enemies, the Communists—was dissolving. Instead, I had discovered that we were often the enemy.

My first tour there was drawing to a close. There was no reason to stay and many reasons to leave. And yet, I could not leave a place that had so thoroughly defeated me, body and soul, without some personal victory, no matter how small.

I once met a wise old Austrian doctor who told me that if I could save one life, make one person's living situation more bearable, then I had fulfilled my duty. It was so simple and so positive.

As a public health adviser in Vietnam, I had some power. Perhaps I could use it to help the people there, not necessarily the government.

I heard there was an active public health organization in Thua Thien Province, and I could work for them if I signed up for a second tour. I decided to stay in Vietnam.

Paul J. Giannone is a 40+ year career public health emergency responder, planner, director and author. His public health career began "under fire" as a two tour (1969–1971) Public Health Advisor with the 29th Civil Affairs Company in the Republic of Vietnam (Bronze Star, Army Commendation Medal, and the South Vietnamese Public Health Medal).