Bangladesh 16MAR-19MAY MCH-1

The flight to Bangladesh was incredibly long, with a stop first in New York City, then in Doha, Qatar, and finally to Dhaka, Bangladesh.

We then took a flight down from Dhaka to Chittagong, where we were picked up by our friends Stephen and Stephanie Kelley.
After a brief stop for lunch in Chittagong, we were on our way to Malumghat Hospital, with a first stop at Moonshine, the equivalent of Costco in Chittagong.

Because we were doped out on sleeping pills to reset our clocks, we remember only a few aspects of this part of our venture. The weather was warm but only mildly muggy. Here are some views of our guest house and the scenes immediately around it.

Betsy and I were soon jumping into helping at the hospital. It is totally amazing to see the variety and intensity of cases occurring. The general surgeons are performing all of the Urology and Orthopedic cases, including rodding femur fractures, doing TURPs, etc., etc. They are also doing some chemotherapy, and I will be working with the nursing staff at establishing a serious chemotherapy program while helping them to decide what the best and safest cases for chemotherapy would be. I am quite happy for the training that I received in Chicago and never thought that my moments writing chemotherapy orders with Linda Wild would ever come useful in the future. Well, it is.
Betsy and I are both having a daily language lesson. I love Bengali! Nomoskar! Kaemon achen? Ami bhalo achi. Eckon jay. Pore dekha hObe. The natives are friendly, and while very poor as compared to Amerikans, are rich in spirit. Betsy and I have so far not had too much time to get out into the neighboring villages. Last Saturday 21.MAR2009, I took a motorcycle ride up into the Chittagong Hills Tract. This is just east of the hospital, and sitting between us and Myanmar. It is a very rugged country, with lots of rubber tree plantations, and banana plantations.

You are not allowed to go far into the Hills without passing checkpoints. Fortunately, the lead person we were with (Dr. Kelley) was able to explain that we were only going in for tea. This we did, stopping in a cafeteria, that by Western standards would be described as filthy beyond belief. Yet, when you order tea, it is boiled and thus safe. They drink a hot milk tea, which I have not gotten used to, and so usually will drink lal cha (red tea) with a teen-kon-shomasa, which is a small triangular pastry, with a very spicy curry filling in the middle. Again, since these are baked, they are safe, even though they are from restaurants beyond belief in filth.
The weeks are a bit unusual. Friday is the Muslim holy day, so, Friday and Saturday are the weekend. Friday is the usual day for Muslim and Christian church services, and Saturday is a day like our Saturday. We would attend the Friday AM church in Chittagong, which was all in Bangla.

Notice how sandals are taken off outside a building. Sunday is a work day. The clinic is on Sunday and Thursday, and Monday, Tuesday, and Wednesday are operative days. The ORs are nicer than what we had in Jamaica, but still a touch below average standards in the USA. It is common to lose electricity at least 3-5 times a day, usually while operating, which is one of the only reasons we typically wear battery-powered head-lamps. The lights go off. The work goes on.
26MAR2009 Today is Bangladesh Independence Day. I worked in the hospital, and then went on a motorcycle ride with Stephen Kelley up into the Chittagong Hills. Afterward, the hospital threw a large feast for the hospital employees, about 300 people showing up. This was a mixture of expatriate nurses, doctors, and other missionaries, along with a large component of natives. Goat curry, fish, and rice were served. It was excellent. Traditional meals are not eaten with a fork or spoon, but with your hands. It is just a little too odd, eating curried rice with your fingers–it’s exactly what we were taught not to do.

31MAR2009 Today, we went to a Bangladeshi funeral. One of the beloved orthopedic techs, Lawrence Halder passed away unexpectedly early in life, possibly due to mismanagement in Dhaka of a simple eye problem. He had a son and daughter. Funerals occur within 1-2 days of the death, as they have no embalming or means of corpse preservation. Lawrence was buried in his backyard, next to his brother and father. The funeral was late at night since they were waiting for various people to first arrive in town. He was laid in a simple pine box and placed six feet under. It was quite emotional, with family showing a great amount of wailing.

Unfortunately, in this culture, there is no welfare or social security, and the death of a father can be a serious tragedy in life, his children in college, and a wife with limited earning potential. There was recently one young pregnant lady brought in by her Muslim husband in eclampsia, seizing, and required a c-section for infant delivery. A girl was delivered. The husband promptly abandoned her and was nowhere to be found. The reasons? 1) A c-section means that all other children will require c-sections, which is expensive in Bangladesh. 2) There will be a large hospital bill. 3) An infant girl has absolutely no economic value since a dowry must be paid to marry her off, and she will have no means of supporting the family. When people speak of how wonderful the Muslim religion is, I just consider the terrible absence of value held for the females in that society, where cows or goats are of more value than females.
03APRIL2009 Friday is the equivalent to Sunday in America, which is the day where people either go to church or to Mosque. Saturday is the free day, and Sunday is the usual workday. This coming Sunday is Palm Sunday, and next Sunday is Easter, which are also taken off by Christians as holidays in Bangladesh. Today, we went to the Bengali church, and then afterward went over to the house Dhirjidon, our language teacher.

He had invited us in for tea and rice pudding, both of which are very good, though I don’t really care for the milk-tea that they drink. They live in a mud-house but is fairly nice by Bengali standards. They have gardens outside their house and are attempting to grow some banana trees and mango trees. Dhirjidon has two young daughters and a fairly young wife (long story, but not typical for Bangladesh). They are all very proper, for instance, when you enter their house, they bow and then touch both your feet. The house kitchen and toilet are out behind the house. It makes sense to do that. Their life is very hard, and family life is completely dependent on the male being able to work. This is why they wish for sons, who could support the family when the parents get too old to work.
04APRIL2009 – Boat trip – I wish it was a boat trip down the Rhein, but such was not to be. No Lorelei, no castles, no good German beer. Oh well! We had a great time all the same. Uttam was our connection to some native fishermen. We went out in their wooden boat, powered by a diesel motor, built in Shanghai.

We had to wait for the tide to come in, then walked the plank onto the boat. We saw some people doing a boat repair onshore- the Bangladeshi version of the Krupp-Thiessen Boatworks in Hamburg. We then puttered down the river to the farm of a friend of Uttams’. He had multiple shrimp ponds, as well as a salt refinery. We watched them catching shrimp, and one of the men went off for some bird hunting with his shotgun. We had some drinks in the raised hut, which was actually very cool and comfortable. Baba (father) lived out on the farm, keeping an eye out for poachers, which are many. Finally, we climbed back on the boat and headed back home as the sun was setting.
02MAY09 Several days ago I performed a c-section with Dr. John, and everything went well. Post-operatively, the patient would not stop vaginal bleeding. We took her back to the OR and found an atonic uterus filled with clots. After multiple attempts to stop the bleeding, I finally ended up doing a supracervical hysterectomy. She did well, though she lost quite a bit of blood. Tonight, at 1 am, I was again called to do a c-section on a breech delivery. It went well, but with the anxiety of the complication of my last c-section.
Please proceed to Bangladesh -2 & -3. This blog was broken down into three sections to facilitate easier downloading.