The actual village of Tam Dao (known as Island in the Sky) is built into the side of one of the tallest of the limestone mountain range overlooking the Red River Delta. The mountain range is 80km long and only 10-15 km wide. It has 20 peaks, including the highest one called Tam Dao Nord (1592m above sea level). In 1906, French colonists began to develop a summer resort called Tam Dao Town, 900 m above sea level. It was originally built by the French as a hill station to escape the oppressive humidity of Hanoi but all that remains of the French era today is the rubble of once grand villas.

The total area of the national park is 36,889 sq km and about 150,000 people live in the buffer zone which involves three provinces, six districts, and 23 communes. Tam Dao contains a valuable tropical rainforest ecosystem, which is home to many rare and endemic species and the most diverse snake population on the planet. At last count, 108 different kinds of snakes or four per cent of the world's 2,700 species have been found in Tam Dao National Park.

The township has capitalised on its natural eyrie-like location, sweeping views, and impressive waterfall to offer noise-burdened tourists respite at its luxury resorts and restaurants. The base population of about 500 people swells to double that during the summer season.

Many visitors to the township are unaware of the bear rescue sanctuary at the base of the steep winding hill, or its purpose. As an additional grim irony, many of the stall holders and shops in the township sell bottled potions containing bear paws and traditional remedies containing bear bile.

And yet, a visit to the Tam Dao centre does help to put the whole issue in perspective, according to ‘Them” - a young Vietnamese university student who said she did not really appreciate the nature of Animal Asia Foundation’s mission until she had visited the sanctuary.

“We have had it [bear-bile based liniment and tonic] in the house for years; and my grandparents and family have used it. We never thought about where it came from, or what it was made of,’’ she said.

The Animals Asia Foundation has spent more than $US2m in infrastructure on the Vietnam Bear Rescue Centre (VBRC). Vietnam AAF director Dr Tuan Bendixsen says it has taken years to build up a relationship of trust between the VBRC workers and Tam Dao residents. Undoubtedly the centre has boosted the local economy. It employs about 100, mostly local, workers - as bear attendants [who clean, feed, monitor, carry and assist with medical procedures], other staff who make the occupational therapy or “enrichment toys" such as hammocks, balls and other materials used for the bears during their rehabilitation.

The centre also employs cooks and kitchen staff, administration and security staff and medical and animal husbandry professionals.

The centre has a huge kitchen and fresh fruit and vegetables are delivered in bulk and the bear’s diets are carefully measured and monitored. Though the Asiatic Black Bears are deemed carnivores; they are largely herbivorous and eat a lot of fruit, plants, seeds, bee hives and small invertebrates.  There is a state-of-the-art operating theatre and a medical staff led by veterinarian Dr Kirsty Officer, originally from Perth.

Veterinarian nurse Rae Joy is also Australian, as is director Tuan Bendixsen. The foreign staff live full time at the sanctuary in shared accommodation.

For the medical staff, the real work starts when the bears get to the centre as most need immediate medical attention. Officer says many bears have their gall bladders and other organs removed because they are so damaged from years of unhygienic and repeated bile extraction. The non-sterile conditions can quickly lead to infection, a situation which not only endangers the bear but also bile users. Bile samples have shown contamination with everything from cancer cells to pus.

New arrivals are kept in temporary quarantine cages and gradually rehabilitated over a three-month period before gradually joining the other bears in the outside enclosures. The animals show obvious signs of trauma. Several have missing limbs – evidence from being trapped in the wild. Some pace the cages, another is bald from rubbing its head repetitively against the bars, and all have teeth problems from malnutrition and biting the cage bars.

 "This stereotypical behaviour is a sign they are bored out of their brains," says Officer. "While caged there's been nothing for them to express their natural bear behaviours, so they replace them with these very unnatural behaviours."

“The best hope for the future of the bears is to educate a new generation about the dangers of bear bile remedies,’’ Bear manager Falk Wicker says.

"In Vietnam these remedies are not thousands of years old at all, they've been imported from China far more recently," he says. "Here it has much more to do with new wealth and with status."

“The active ingredient in bear bile -- ursodeoxycholic acid, or UDCA, which does have anti-inflammatory properties -- can be produced in a laboratory or from herbal compounds. It is just as effective and would save so many of these endangered bears.’’

The sanctuary has survived many battles in its short history. The most recent was a political land battle that became ugly. The centre faced eviction and relocation following an aggressive campaign to force the staff and the bears off the land. Mr Bendixsen was told in November 2011 that land occupied by Animals Asia at Tam Dao had been promised, possibly even sold or re-leased to a private company.

“The National Parks Department wanted the land to build an eco-tourism resort,’’ Mr Bendixsen said.

It's quite obvious AAF had done a good job with all the facilities, the people visiting the sanctuary. They recognised the potential,’’ he said.

It was a long and fraught battle that finally ended in January 2013 with a decision from the Prime Minister of Vietnam allowing Animals Asia to stay and continue its work.

"We are so relieved. We are trying to show that it’s not right that bears spend their lives in cages having their bile extracted for profit. If they cannot be in the wild, then at least let them be somewhere they can relax, show their natural behaviours and enjoy what is left of their lives,’’ Mr Bendixsen said.