The neighbors know what is going on when they hear peals of laughter coming from the house of Pham Thi Hue. The dying women have gotten together again.
Crammed onto a couch and little chairs, the women shout and clap as they talk about the city's shortage of shrouds or about the dying man with the bloated stomach who slept under a bridge.
They are members of a support group for people infected with HIV in a society where they are widely shunned, where drugs are scarce and treatment is expensive and where a diagnosis of infection is still, for most people, a sentence of death.
They gathered on a recent Saturday in this big port city near Hanoi, 15 women -- many of whom had not told their families they were infected -- sharing companionship and the relief of laughter from lives of poverty, illness and dread.
In the face of discrimination and in the absence of adequate health care, they are for the most part one another's only support.
This is a country teetering on the brink of a nationwide epidemic, with more than 250,000 people infected with the AIDS virus and with only 10 percent of those who fall ill receiving the treatment they need, according to UNAIDS, the UN agency.
Vietnam's health care system is well organized, but HIV has until now been concentrated among intravenous drug users and has not been treated as a priority. Experts say it is beginning to spread quickly into the broader population, and one of the chief barriers to prevention and treatment is the stigma that makes outcasts of those who carry the virus.
Hue, 26, who was infected by her husband, a drug addict, was one of the first to speak out publicly on television "to show that we are people, too." The support group she founded three years ago -- called Haiphong Red Flamboyant, for the name of a flower -- is expanding in this city and is a model for similar groups around the country.
What the women rarely talk about, except when they are joking, is the near certainty that in time they, too, will fall ill and that they will be feeding, bathing and consoling one another, and caring for one another's children, as one by one they die.
"The meaning of the group," said Nguyen Thi Sau, 29, whose husband has already died of AIDS, "is so that when you die, you are less lonely."
In what they say is a form of therapy, the women have chosen to look directly into the face of the suffering that lies ahead, nursing, cleaning and feeding the sick, collecting the bodies of people who die alone in hospitals or on the streets and attending the funerals of those whose families have turned their backs.
"Some days I have to take care of four people who have died in the hospital," said Sau, who worked at a shoe factory until she was fired.
A number of the patients, she said, are prisoners who have been sent to the hospital to die, covered in their own filth and still chained to their cots.
"I'm the one who has to close their eyes when they die," she said. "After that, I can't sleep at night."
Over the past three years, scores of women have been members of Red Flamboyant. Many have died, but the group has only grown -- and spawned new groups -- as more infected women step from the shadows and join.
Most of the women gathered that Saturday said they had been infected by their husbands here in a city where drug addiction is widespread, and most said their husbands had already died. All had lost their jobs when their employers discovered that they were infected.