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DE RUEHHI #0398/01 0990742
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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
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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