This past summer, I returned to Vietnam on a deeply personal mission. I grew up in a small village, where I watched my older sister endure cruel teasing at school because of her cleft lip. That memory never left me, and it contributed to my decision to move to the U.S. at 21 and pursue a career in medicine. Now, as a third-year medical student, having studied orofacial clefts in school, I decided to go back to Vietnam to better understand how the condition is experienced and addressed there today.

     Over several weeks, I traveled across the Vietnamese countryside by bicycle, motorbike, and ferry to interview 21 mothers and 5 physicians. I listened as families shared their stories with raw honesty. One visit stayed with me: a mother and her three children living in a home with cardboard floors and walls and a roof made of tin sheets.

     “My socioeconomic status was poor,” she told me quietly. “I struggled to provide for my family and had to work hard every day to support my children. I didn’t have the means to visit doctors or afford medical care.” Her words reflect a painful truth—poverty continues to limit access to even the most basic healthcare, especially in rural areas.

     As I listened to these women, I noticed a generational shift. Younger mothers often showed less stigma or shame around cleft conditions, a hopeful sign of cultural progress. But deeply rooted challenges persist. Many mothers had little to no access to prenatal education.

     One admitted, “No, I didn’t learn about folic acid or other vitamins. The doctors didn’t teach me about them either.” That absence of guidance is critical—folic acid, when taken early in pregnancy, can significantly reduce the risk of orofacial clefts and other neural tube defects. Without that knowledge, many families are left vulnerable.

     Cultural beliefs also continue to influence how women experience pregnancy. One mother shared a folk practice she had followed out of fear: “There were other beliefs too, like not stopping in the middle of crossing a doorway. You had to walk all the way through, or else you would have a difficult birth. There are many of these folk tales… but whenever you hear these things, you feel scared.” It became clear to me that while some traditions are benign, others can create unnecessary anxiety or distract from evidence-based prenatal care.

     Through this research, I came to see how health outcomes are shaped not just by medicine, but by culture, education, and access. My own mother told me about her struggle to find care for my sister—and how, in the end, it was a visiting American doctor and Operation Smile that made the difference. That story, and so many others like it, reminds me how uneven the path to healing can be for many families.

     Despite the challenges, I left Vietnam with a sense of hope. There’s progress—more openness, more compassion, more recognition that cleft conditions can and should be treated without shame. But to truly move forward, we must prioritize maternal education, improve access to folic acid and prenatal care, and create systems that serve all families, regardless of their zip code or income.