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Vietnamese usually rely on traditional treatments, which may be used along with Western-style medicines. One common treatment called cao gió involves using a metal object, such as a spoon or coin, to vigorously rub the skin along the spine, neck or temples until red scrapes appear. Moxibustion, another remedy, involves holding small rolls of herbs near the skin and lighting them. Pregnancy is considered a positive experience in Vietnamese culture. Most women go to local clinics to give birth. A midwife assists the birth, and women usually rely on their mothers or other women for support during labour. In an effort to control population increase, the government has imposed sanctions on couples who have more than two children, a practice that has led to a dramatically lowered birth rate, though a high rate of abortions. Outside of large cities, people have very limited access to modern health care, and facilities often lack basic medical supplies and adequate staff. Hospital facilities are improving, but there are still few beds and most patients have to pay for services, making care inaccessible.
Years of war caused many health-related problems in Vietnam. In jungles, bomb craters became breeding spots for mosquitoes, which spread malaria. Other infectious diseases such as tuberculosis have been widespread, while the rate of HIV infection is rising. Food shortages have led to malnutrition, increased vulnerability to disease and lowered life expectancy. Millions of people do not have access to clean drinking water. Government programs to educate the public about sanitation and pest extermination have been only partially effective. Despite these problems, health in Vietnam is improving, with life expectancy being 70 years for women and 65 for men.
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