BANGLADESH: Hear me out

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BANGLADESH: Hear me out

I struggle a lot sometimes with these blogs... trying to figure out the best way to talk about what is going on, give an accurate picture, represent somehow the reality of where we work. i want to be honest and say what i know of the people we are serving, but still avoid the pitfalls and traps of speaking 'for' people. so really, all i can do is say what i see.

I've been trying for days to put into words what I've seen and been told about individuals, humans just like you and I, who have been forced using unimaginable violence to be uprooted from their homes, their own country. Here are just some of the images from just entering camp about an hours drive  from Cox Bazaar, the everyday evening sun in Kutupalong refugee camp, and encountering an interesting and unexpected  community radio. I commend everyone here truly making the most of what they have, for instance the mighty creative vehicles constructed by a 9 y/o. 

The clinic was consistently busy, with around 350 patients a day in the outpatient department and around 200 admitted patients a month. The people had run out of money and their health deteriorated.

We saw more and more people with severe malnutrition, particularly children under five years old. At one point we had 20 patients a day with severe measles in our isolation tent. We received a lot of trauma, and lots of accidents involving children, tetanus, rabies, and other cases I wasn’t used to seeing at home. At the facility we rarely see a newborn that weighs more than 2,500 grams (around five and a half pounds). The mothers are usually malnourished, so the babies don’t have a very good start.

But even then, there are some things i will never talk about explicitly in this blog. the survivors that come to the clinic have stories that are not mine to tell, and would never be appropriate for this forum. but i could give you glimpses perhaps from what i read in the papers, stories that are printed every day of young women assaulted by people they know, or women attacked as they walk home in the night, in the day... really it doesn't appear to matter when they are walking...

and there will never be photos of our beneficiaries. i will show pictures of the clinic when empty, and from that, you will have to imagine a monday, when every bench is occupied by women and their family, women and their friends, women and those who support them/ depend on them.

i want to tell you all a story about people working so hard to fight back against the injustice of violence. i've met so many people who, whether survivors or allies, are committed to ending sexual and domestic violence in png. i could introduce you to high level politicians, to women i meet on the street, to volunteers i talk to in meetings... and i want you to hear that story while i explain the reality of violence here, the scope of it.

and i can tell you our little story, as msf. our story of medical support. of a small act in the midst of this struggle. while it rages on, we say very simply, we are here, you deserve medical treatment, you deserve your health, it is not negated by someone else's violence.

that is what i can tell you.

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BANGLADESH: First impression

A tremendous electrical storm woke me from sleep with a terrifying show of lightning, accompanied by driving rain. It lasted more than an hour. When I got out of bed the next morning, I stepped into a puddle. At first I thought that window frames were not water-tight, but then I realized the toilet had leaked into the bedroom. Backflush.

Petee The Goat. I was told not to start naming animals because I'll end up getting attached and want to take them home...

Petee The Goat. I was told not to start naming animals because I'll end up getting attached and want to take them home...

The minivan arrived at 7:15 to take us to work. I began to regret having eaten a greasy omelette for breakfast. We made good progress driving north, despite dozens of goats on the road. To our left, semilunar fishing boats were beached, ready to be launched at high tide. To the right were prawn hatcheries. 

We hit traffic driving south on the main road, National Highway 1. All traffic was at a standstill. But patience is not a virtue held by Bangladeshi autorickshaw drivers and after a couple of minutes, they came buzzing past, horns blaring, belting down the wrong side of the road. Someone asked our driver what was the cause of the holdup. He slowly and deliberately said, “It…is…a…traffic…jam.”

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We thought that there may have been an accident and I considered getting out of the van to see if my services were needed, as a medical Good Samaritan. My colleagues advised me against it. Discretion prevailed, but imagine the newspaper headlines, “Expat medical team remains cosseted in their air-conditioned vehicle while Bangladeshis perish in road crash.”

In front of us, a truckload of Bangladesh Signals soldiers in rather fetching camouflage uniforms climbed down onto the tarmac. Their officer looked efficient. He had a row of pens and pencils tucked into a pocket on the sleeve of his uniform. He strolled down the road past the stationary vehicles, looking into the ditch. I wondered out loud if he was considering whether it could be possible for a truck to bypass the obstruction by going off-road. “No, he’s just looking for a place to pee,” said one of the Water & Sanitation engineers in the minivan. 

When we started moving forward, the drivers behind us became irritable and parped their horns if we didn’t immediately drive closer to the vehicle in front. We overtook the source of the blockage, a massive earthmoving machine mounted on a low-loader. At last other agencies were responding by supporting infrastructure. I guessed that the machine would be leveling ground for the new Red Cross/Red Crescent hospital by the side of the road at the Rubber Garden. It was far too big to tackle the muddy tracks inside the camp itself.

The hospital is muddy and miserable when it is raining. Rain pelting on a corrugated iron roof makes such a racket that taking a history is almost impossible. The consulting rooms and wards have concrete floors, but the tents have flooring made from plastic sheeting. People find it difficult to get to the hospital because the paths in the camp have turned to muddy streams. Old people who venture out run the risk of sliding and slipping in the mud, fracturing their wrists and hips. More work for us.

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MYANMAR: Innovations- Local Resources

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MYANMAR: Innovations- Local Resources

Using what's available

Innovation can mean finding high-tech solutions. But not always.

The use of local materials is indeed an important lesson for all the local medical staff, aside from resolving the little problem of height. In a resource-strapped environment, the difficulty of sending advanced equipment and materials to address local needs is that when the humanitarian organization leaves, the supply will probably be cut. Enabling the local staff to rely on themselves is the most ideal and sustainable way to ensure the running of all kinds of work in a place with very limited resources.

The improvised ostomy bag.  

The improvised ostomy bag.

 

Sometimes you really need to twist your brain to find the right local materials for different situations. DIY-ing colostomy bags that collect patients’ excreta was one of the most unforgettable experiences. After brainstorming, Rodel, our ward nurse from the Philippines came up with a brilliant idea of a DIY ostomy bag - connect a surgical glove with the sterilized lid of a jar of coffee powder. Then, tie it on the patient and make sure the glove gets changed every day. This could avoid leakage that previously happened when we simply used adhesive tape to stick the “colostomy bag” glove onto the patients’ stoma (the opening in the abdomen where excreta is removed).

But then we received a baby who was only four days old and his stoma was as small as a quarter. The lid of the coffee jar was way too big for him. We eventually used a lid from a glue stick instead and connected it with a condom and a surgical glove. And that was the “colostomy bag for babies”. Do not look down on these little tricks. The local medical staff then know how to make their own colostomy bag to cope with urgent needs even there is no way to get the real ones. This takes us one step closer to achieving the objectives of our project

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