Bangladesh 16MAR-19MAY MCH-3

Please also read Bangladesh -1 & -2 first…
08MAY09- Medical Trip into the Chittagong Hills Tract. I was invited to go along for a medical trip into one of the trips deep into the Chittagong Hills. My ID doc warned me to absolutely do not go into the Chittagong Hills, as there are dangerous diseases. So, off we go. The plan was to go to a tribe that was completely removed from civilization, and truly, they ended up at the literal end of the road. We drove for four hours. First, we went through a checkpoint that most westerners are not allowed to pass. Since our group was favorable to the government and going for medical reasons, they let us through.

We then had to stop in the town of Lama to obtain the presence of armed escorts–the Bengalis are always afraid of insurgency. We proceeded on, first on paved road, then very bad, very narrow paved road, then dirt road beyond comprehension, and then we arrived at a river, across which the village of our destination stood. Almost nobody spoke Bangla, so we had to use two translators, the first to go from English to Bangla, and the second to go from Bangla to their tribal tongue.

We set up several stations to examine patients and saw over 110 patients. We did stop for lunch. Most to patients had vague symptoms, such as abdominal pain for years, or knee pain, but we did see some real pathology. Almost all the kids have helminthic diseases, and so lots of anti-worm medicine was given. The main economic revenue was from growing tobacco, which we could see in various stages of processing. The photos also show us having lunch (quite tasty), and an important crop, tobacco, that the Brits are pushing on the Bengalis. Nancie also gave mid-wife lessons, and a little kid demonstrated that the birth-control pundits had already come through (those were not balloons). Also, note what the ladies have in their ears … large bells, plus flowers, plus, rolled up taka notes. This was a sign of affluence. All in all, this was a once-in-a-lifetime experience that few Westerners could ever imagine experiencing.
09MAY09- Safari Park  There is a “zoo” about 2 km south of Chabigang, which is a large open Safari that animals are kept in mostly natural surroundings. A relative of the head of the OR at MCH (Satindra, or Shoti) is an assistant to the veterinarian at the Park, so, we are able to get in for free and ride on the roof of our vehicle around the park. The Bengal tigers could be seen, but we moderately concealed, and thus could not be photographed. Also, there were numerous monkeys all over the park, some in cages, and some outside.

The top attraction was the ability to ride an elephant. They aren’t very comfortable, bareback. In the end, the zookeeper had a refreshment prepared for us, which is a coconut with a small square cut in it, and a straw inserted for drinking the coconut water. Coconut water grows on you and is totally perfect when you are extremely thirsty for quenching your thirst.

By the way, this sign was NOT in the zoo. Elephant crossings can be quite damaging to automobiles, especially on the main interstate, as this road is.
11MAY09 – A ferocious windstorm occurred this morning, requiring maintenance to turn off all the generators. This meant doing rounds at the hospital with backpacking headlamps, and in total darkness. The electricity goes off quite frequently, about 10-12 times a day, usually only for 15-90 seconds, though it could occasionally last longer. It is quite often to be operating and the electricity goes off, because not only do the lights go off, but the electrocautery and everything else goes off.
13MAY09- I did my first c-section under local and ketamine, with Dr. John. Kind of a freaky experience. We couldn’t give the mom a spinal as she was being a bit too theatrical. She had cervical-pelvic disproportion (the nurse mid-wives figure that out), and we needed to get the baby out. The baby boy had a bit of meconium but did well. It’s a nice technique to know how to do, as you must get the baby out before the ketamine gets to it.
15-17MAY09- The evening of 15MAY, Uttam invited me to speak with a group of young men and women who get together regularly at church. The topic was unity. I spoke to them mostly about the need for love, moral purity, and delight in getting together with fellow believers. The next day, Les and Deb Collins headed out with me and Betsy to Chittagong. We flew into Chittagong, but we were so dopy, we didn’t remember much of it. On the 16th, I went shopping to get a few more lungis for all the people who asked me for one, including Onkel Herbert and Hannes. I also picked up a load of spices. This area (BD) of greater India was the source for most of the spices of Europe, and we were able to take home many bags of the best spices, as well as one of our favorite treats, Chanachur, which is this hot, spicy finger treat you eat, sort of like the Pub Mix that you would get at Costco, but much tastier, and less fattening. We settled in at the Chittagong Guest House, then, Betsy and I had the honor of meeting Jim and MaryLou Long. Jim is the general director of ABWE in our area, and MaryLou was the director of the William Carey Academy. Both of them had the sweetest and most attractive personalities.

The next day, Betsy and I toured the William Carey Academy. It is a grade K-12 school, and probably among the top several best schools in BD. Thus, many of the wealthier families send their children to this academy. It has a mix of Muslim and Christian students and provides an avenue for the missionaries to approach the Muslims in Chittagong. Next to the school is the free academy, also run by the ABWE, but for the hopelessly poor children in Chittagong. It is with the deepest regret that Peni H. was gone and that we could not tour the free school. Lunch is served every day, and children are given an education they would otherwise never get in BD. After this, we did some more shopping, stopped at Moonshine for groceries, where a local beggar girl always gets a nutritious piece of candy from one of us.

Driving to and from Chittagong is another matter. The map shows no towns. That is because it is practically a continuous town. It was ceaseless mayhem. If one didn’t have a strong constitution, they would get a heart attack in 5 minutes on the road. It is 10 times worse than Jamaica, and 100 times worse than NYC. Chittagong has about 5 million people, yet we saw only one traffic light, which everybody ignored. Combine that with innumerable rickshaws and baby taxis, and you end up with pure mayhem. It is surprising we were able to get anywhere. For food, on the 16th, we had lunch at Bonanza, which serves BD national food. It is distinct from Thai, Chinese or Indian food, and unbelievably good. Why BD food hasn’t made it in the USA is a mystery to me. The next day, we had lunch at Pizza Hut. The pizza was not greasy and tasted quite good. We were pleasantly surprised by the quality of food in Chittagong. Then, there is Chanachur. It is the most awesome snack in the world; sweet, devilishly hot, low fat, wonderful to eat. Pick some up, if you find it anywhere.
18MAY09- The Operating room threw a good-bye party for us. We smiled a lot, but our hearts were in tears. Betsy and I will truly miss the many people, ex-pat and national, that we have met here. Many people have asked us if they could pray for us, as we return to America. We ask now, that you would specifically ask God to bring us back to Bangladesh.

19-20MAY09- The Trip Home. We actually left the night of 18MAY on the night bus, Green Line. It was a top-class bus, but a bottom-class road. The inability to sleep on busses and the insane way people drive in Bangladesh led to a very restless night. It was only by God’s grace that we arrived in Dhaka, now so tired, that when we got to the Baptist guest house, we had breakfast and collapsed, sleeping all day. For devotional reading that day, our Psalm was 65. Please read it. It was a perfect description of Bangladesh. First, it suggested that our only hope was in the Lord, which is true though rejected by most Bengalis. Then, it spoke about how the Lord makes the earth bring forth massive abundance for us. This was true in every small village, and in the large cities. Everywhere you looked, you would see rickshaws to large trucks laden with fruits, vegetables, and other edible produce, or animal for the market. The fruit variety was tremendous, including things I’ve never heard of, but the mangos, papaya, bananas, watermelon, Jackfruit, cucumbers, coconuts, and many other products were quite abundant. We will always remember Psalm 65 as our Bengali Psalm. That evening, we had an even more insane drive to the airport, with the driver acting as though he was possessed of the devil. The airport was rather quiet. I found another Bengali cookbook that also had English and purchased it. It was a reflection of the superb food we had gotten in Bangladesh. I would have thought that the food would have been rather unremarkable, but it was everything but that. Even when we ate in the distant tribal village, the food was quite excellent. It is very spicy, again, reflective that Bangladesh was the area of India where most of the spices in the past centuries originated. It is no wonder that Bangladeshi cooking demands multiple complex spices. I purchased a number of packages of spice but realized from the cookbook that there were many others that I could have picked up, in order to make an original meal. The cookbook also calls for many types of rice. In Bangladesh, as Dr. Kelley tells me, there are at least thirty types of rice, each a bit different from the others. I have never seen the type of rice that we typically ate in Bangladesh here in the US. Even the way they cook it is slightly different as there are flecks of spice seen in the rice (I hope that they weren’t actually insects that got into the rice!) There was even black rice, which is often used for dessert. There is a type of rice that smells (and tastes?) like excrement. Most of the rice types we had were quite good but were of a non-sticky variety. They would never eat the rice plain but mix in the halud (yellow) seasoning sauce with their hand, making a sticky ball that they then could eat with their fingers. I’d really like a copy of the recipes but could not find them. Meanwhile, back at the airport… There were a huge number of young men in the airport, together with large groups all wearing a similar piece of clothing. These were men going to Arabic countries for work. We forget that the largest export of Bangladesh is human workers. The flight to Doha went well, and we arrived in Doha at 11:30 pm, and due back at the airport at 6:00 am, so we canceled our hotel and slept a few hours in the airport. It felt good getting on the airplane, at last, to set foot on US soil. Except for a minor hassle where a female angry official at the baggage screen confiscated some of my AA batteries (Gottlosen Schwein!), we got on ok.
Trip People that we have met… I especially am overwhelmed by my friend Steve, a man who has earned the favor of God and man and blessed beyond measure. He is the most multi-talented person I have ever met, skilled in broad aspects of surgery and medicine, deft in the Bengali language, brilliant as an administrator, and single-minded in his Christian faith. I have never met a more brilliant, multi-tasking, an innovative person in my life. As an example, one of our patients had the port catheter break off and lodge in the right atrium. There was not a single procedural radiologist in the country that had ever retrieved such a catheter. So Steve did it in the OR. The snare would not grasp it properly, so he sterilized a colonoscopic grasper, ran it up the vein, and successfully retrieved the catheter. I was amazed. He and his family will remain forever in our fondest memories of an example of true giants.

Nancie is one of the most faithful nurses I have ever met, blessed with multi-talented skills as a nurse, but also a sense of honesty of encounter and practical saintliness that would offer any of the greatest saints a hard run for first in the kingdom. She would never fit the Hollywood image of a saint. She is the opposite of Mother Theresa. Dynamic, spunky, speaks her mind, no display of fake religiosity. Yet, as you get to know her, you realize that every drop of blood in her is of the sincerest Christian love. She oozes Christ. I’d vote for Nancy over Mother Theresa any day for “sainthood”. Yet, she can do anything and everything, including run anesthesia, pass chemotherapy, resuscitate babies and run a neonatal ICU, organize field medical clinics, and I’m sure I’m missing many other things. I have never met a nurse ever as competent as her in so many things, and yet so sweet and loving as a person. Equal with Nancy are the other nurses with whom I have developed the deepest appreciation, including Mary, Ruth, and Gail. Mary was the quiet but competent counterpart to Nancy. They lived (sort of) together, and richly complemented each other in personality, talent, and sweetness. Also, hyper-competent beyond any nurse I’ve ever met in the US, Mary never seemed to complain, but always maintained a delightful joyful countenance that exuded genuine concern for everybody she interacted with. All the nurses deserve a similar commendation for their selfless devotion to the mission, yet I realize that whatever I say will be matched infinitely greater by the God whom we give ourselves.

Nathan the holy man – I first met Nathan, when I was trying to resolve Mac connection problems. I have encountered one other MAC user besides Nathan, leaving only three Mac users in the entire country of Bangladesh. Real men use Macs. (Actually, real women also use Macs). Nathan finished a year of language study in Chittagong and is now honing his language skills, especially the Chittagonian dialect, by living with the natives in the village, in one their mud houses. He is a very bright but soft-spoken character. Last Good Friday he preached his first sermon to a small church south of here, said entirely in Bengali, and yet stirring a number of Muslims to ask him for a Bible to learn more about the Christian faith. His dedication and concern for the Bengali people are monumental.

As time went on, there were many others that we had gotten to know. Need I mention Frank and Alvis, quiet, honest, truly caring people, faithfully giving of themselves for the mission here, leaving a successful practice in Nebraska to serve Christ in Bangladesh.

Or Harold and Shaun, who we see jogging by the guest house every morning, always reflecting a tremendous joy, and infectious enthusiasm for working with the people of Bangladesh.

Bob and Chrissy had lived and studied in Tacoma, and happened to know friends of ours at the Tacoma Baptist School system; they had two children, and Bob had returned to Malumghat where he grew up. Oddly, their home church was in central Illinois, and they were quite acquainted with the people from the denomination of our youth. We were reminded of what a small world it was.

Bob and Chrissy were wonderful, in that their demeanor immediately put you at ease – none of this “hey we are lifetime missionaries and holier than thou” attitude, but people that had a genuine love for the Bengali people and willing the sacrifice most of the conveniences of Amerika to serve here. There are a number of other people I could mention with similar acclaim. A close “soul-mate” was Jason, whose presence made our entire stay a great joy. He was like Onkel Herbert in providing a wonderful stimulus for thought, he and his wife have thought processes that leave me wondering if we were not brothers separated early in life. Clinically, I’ve not seen a better surgeon than him who is just a few years out of practice, competent, cautious, making excellent decisions, yet quite skilled in the OR.  A quote from his ex-professor and a dear friend of mine, JV, stated  “Jason-he was my favorite Chief resident last year (yes, he just graduated a year ago). A very mature guy and he and his wife are committed to third-world surgery. Wow.””

There was Steve and Monika, arriving after we did, and here for a two-year stent, yet always cheerful and enthusiastic in the work at the hospital. Steve and Monika and their kids were a total pleasure to get to know. I wish that we could have had more time getting to know this couple.

It is with trepidation that I stop here since virtually every ex-pat Missionary that I met at Malumghat deserves a lengthy comment, and the ones mentioned had all been served an injustice by the brevity of my comments. Among all these people,, it would trivialize matters to say that they are giving their time for the gospel and for the people of Bangladesh. They are not giving their time. They are giving up their lives.  It is a different spirit that I could see driving them, a Spirit far greater than our own personal spirit. May God richly bless them in this life and the life to come. We came to Bangladesh hoping to bring a small blessing to those working out here, and instead, Betsy and I received the greater blessing from them.
I should comment on a few of the Nationals that Betsy and I go to know.  Many times, one of the Nationals employed in the hospital would drop me a small note thanking us for coming out, with no mention of any desire for something in return. There was Dr. John, a tribal native of the Tripura tribe (!), now a surgery resident at MCH. John was a total joy to work with, offering a wonderful educational exchange, both of us learning off of each other as we cared and instructed each other on the wards, in the clinics, and in surgery.

Then there was the administrative assistant Uttam, a bit younger, always happy, grateful for his position, always wanting to chat about America or about the Christian faith. Here he is with Betsy, singing on the beach.

There was Lucky, an older single tribal person, who one day had all the ex-pats over for dinner. He works in the hospital store, being “lucky” since he gets an air conditioner in his office. He is a total joy to see every day. The people of Bangladesh tend to be very relaxed, and definitely not time watchers. That can be a touch frustrating, as an 8:00 o’clock meeting typically means 8:30 or so. They have been a joy to serve in spite of the nuances of their character.
I hope that in the upcoming month, I will be able to touch base with my American (and German) friends to show the photos of our trip. Photos are woefully inadequate to convey the actual character of our trip. It misses the smells, the tastes, the touch, the breadth and depth of the real experience of Bangladesh.