Sunday, April 28, 2013

More Photos!

Photos includes:  My new fitted pants, lecturing in the classroom, instructing on the medical ward, meeting with the directors of DMCH Oncology and the nursing bridge trust, the sunset from my deck, the sunrise from my roof, a riveting ride on a rickshaw, my bedtime bug protection, and the escalating riots.

Bangladesh Building Collapse

When I was 17 my least favorite morning of the week was Saturday.  With an ever-changing extracurricular activity schedule, Saturday morning was my one set shift at the local dry cleaners, which dragged me out of bed before 8am, and at that age indicated torture. The shift lasted four hours and always included a bagel brought by a sympathetic friend and a pile of gossip magazines supplied by my boss to entertain me while in-between helping customers at the counter. I should also mention that I received $40 for those “hard” worked Saturdays, totaling $120.00 a month pre-taxes.

On Wednesday, any avid news watcher would be able to tell you that a factory building collapsed in Dhaka, Bangladesh which housed 3,122 employees who produced garments  that are out sourced for the western world. And by this morning, any avid news watcher could tell you that the death toll count of these factory workers is up to 364, with 2,200 rescued (many at the cost of their limbs), and an estimated 550 people missing under the debris. With today marking Sunday, the 5th day since the catastrophe, it is well past the estimated 72 hours a human being can survive without food and water. I mentioned those who would know these facts would have to be an avid news watcher because it has been my observation that these stories, even in Dhaka, run second and third to what is happening in the first or Western World. On Thursday I could tell you more about how much the Boston Marathon bombers mother shoplifted from a Natick, MA mall then how many factory workers were still missing from watching the news. 

I was reminded of my job at the local dry cleaners and my $120.00 a month I then received, as I watched a 17 year old girl interviewed today after her hand was cut off from the slab of cement it was mangled under to rescue her from debris. The station called her lucky and I went numb thinking how at age 17 I would have defined lucky. It would have incorporated more than a minimum wage of $38.00 a month, it would have indicated that if a building was deemed unsafe on a Tuesday, I would not have been forced to return on a Wednesday, and without question it would have included 2 hands.

Being American I know that I am just as much part of the problem as the solution. As I walked the hospital corridors down to the ward filled with women rescued from the collapse today, I realized any of the items I was clothed in may have come from a similar unsafe factory in Asia, as Bangladesh reports they release 23% of their garment productions to America annually. I realized while I was being brought down to comfort them, I just as much owed them an apology for being part of a world that allows this kind of treatment and I caught my breathe when my guide was asked to bring us to the unit at another time  as the Prime Minister of Bangladesh was currently inside visiting.

As we turned to leave someone asked me, “If you want I can take you outside to see the piles of bodies that weren’t pronounced dead until they got to the hospital”, and while I politely declined, I turned in time to see a lifeless woman my age being wheeled by to join the others. I said a prayer, not knowing if it was to the god she believed in or the one I had been raised to believe in, but pictured both fundamentally  saying “We hate this too, were working on it, and so can you”.

Tuesday, April 23, 2013

Riding home from Dhaka Medical College Hospital

Each day I have spent at Dhaka Medical College Hospital has ended the same. After finishing our  meetings, Maryanne and I are accompanied outside by members of the trust and I pretend to not notice the vastly growing crowd that surrounds our small group. Our driver  pulls up and we are shuffled into a van while people either bang at the windows or take our picture and we are whisked  off into the sunset.  I know how it sounds.  It sounds romantic and glamorous, like, say, a celebrities blog which accounts her stressful day as she tries to shop alone.  But it is neither romantic nor glamorous.  The people who surround the car are not paparazzi, in fact they are living on less than a dollar a day according to and are suffering from a variety of ailments, some of which don’t even exist in the western world. And they bang on the windows because they think the two, western girls inside the comfortable, air-conditioned  van, have the answers on how to either feed or cure them or maybe even both. 

Dhaka Medical College Hospital (DMCH)  is meant to be a 1,700 bed hospital. I say meant because it is government run, meaning it is free to those who can’t afford payment and it turns no one away. According to the hospital’s director, a daily census may run anywhere from 2,500 to 4,000 patients and due to the overflowing population in the building, every turn of the head shows patients sharing beds, lying on the floor or sitting in stairwells mid- treatment. While patients lying in stairwells defies fall prevention protocol at every turn, contact precautions are non-existent  and the roles of physical, respiratory , speech and occupational therapist all falls onto the doctor or nurse, amazingly,  DMCH still manages to get patients better. 

The nurse’s role at the hospital is quite different from what I am used to, which is what we were brought into assist with via lecture and one-on-one clinical training. As one DMCH attending physician explained to me “Your skill set would make you a doctor here, the nurses here act more like maids.” And with one nurse to a ward that averages 25-30 patients, no skilled assistance and orders written in English instead of their native Bangla language, I am concerned with the lack of room for improvement. However, despite their heavy workload and lack of break (the nurses work up until lecture time and then get someone to cover their ward for 2-3 hours to hear us present, I am beyond amazed at their rising English skills, perseverance and optimism as they come to lecture not only motivated but excited to be selected and trained for the end result, Bangladesh’s first Bone Marrow Transplant unit.  

Each day I ride home with DMCH and its many faces of illness, despair, need and hope in my thoughts long after the vast white building is out of sight. And while I spend the ride wishing I had the key to fix the suffering of the Bengali people, I know I do not, I could not.  So, I repeat a favorite Florence Nightingale quote of mine “  never lose an opportunity of urging a practical beginning, however small, for it is wonderful how often in such matters the mustard-seed germinates and roots itself “, and I hope the small group of nurses suffice.

Sunday, April 21, 2013

Photos of Maryanne and I shopping, touring Dhaka Medical College Hospital, with our 10 nursing students for the Bone Marrow Transplant unit, getting fitted for Sarees and with our helper Shilipi!


We have been away from home for almost a week now, and what a week to have been gone. According to a Google search, I am approximately 8,653 miles away from Boston. Given the horrific scenes of Monday, followed by the conclusive events on Friday, my head and heart are still somewhere lost over the Atlantic. I hope, however, to slowly drift back to the bay of Bengal shores and the work at hand. 

The directors of the trust have been very gentle with us these past few days while we recover from jetlag and have not taken us many places. We are staying on the “Beacon Hill” of Bangladesh known as Baridhara. Baridhara is the most prestigious neighborhood in the area, complete with a gate and guards at the main entrance. However despite this, every fifth building appears to have been demolished by things I have decided not to fully investigate. (Dad,  stop googling)  And, while our apartment wouldn’t necessarily be considered luxury by American standards, it is well above the definition of luxury to the Bengali people as it consists of 3 bedrooms, 3 bathrooms, a full living room, dining room , kitchen, remote controlled A.C., Wi-Fi and a servant whom for the remainder of my writing, will be referred to as our helper, Shilipi.

When I visited Punta Cana last year with my college friends we bought the elegance upgrade for a small additional cost, and the part I remember we were most excited about was that the package included a butler at our beckon call, should we want a bath drawn or a pillow fluffed. So while fluffed pillows and lavender drawn baths sounds perfect in an informative booklet, Vladmir met us at the door to our suite upon arrival and then was never to be summoned again, because it was a lot less work both mentally and physically to just fluff our own pillows then to sit and watch someone else do it.

That brings me back to the absolutely lovely Shilipi who is scheduled to be with us every day in the morning from 7a-10a and again in the evening from 5p-9p, but who we always let leave a couple hours early. Shilipi cooks us breakfast and dinner every day, does our grocery shopping and then cleans every inch of the apartment on a daily basis. I got out of the shower yesterday to find her folding all the clothes I had ferociously thrown on the floor while searching for a culturally approved outfit that wouldn’t make me sweat more than a bikram yoga session. I have since tried to be more mindful of the messes I leave behind. 

While Shilipi is employed by the trust to keep us “comfortable”, she has probably had as much effect on my mental comfort as she has had on my physical comfort. Being one of only 5 people that recognizes and smiles when she sees my face in this new world, she is becoming a fast ally. And while we are not at the level where I would ask her to play with my hair or discuss boys , she will sit on my bed while I skype and has already met the majority of my friends and family. It occurred to me how ironic it is that the only word I know in bangla is “dhanyabada”, which happens to translate to the only word she knows in English…thank you.  So Shilipi and I walk around continually thanking each other, which seems like a pretty good definition of friendship to me.

Wednesday, April 17, 2013

Safe in Dhaka but thinking of Boston...

Here and safe in Dhaka, Bangladesh! With the warmth of the people and the clean and “homey” apartment my initial transition has been great, or at least from the external views. Internally has been a bit more difficult than I would have hoped but that has nothing to do with the culture shock I was forewarned about. Let me explain.

When I first read the headline "Deadly explosion at Boston Marathon finish line" I was suspended 50,000 feet in the air and somewhere over Africa. I had just woken up from my very comfortable seat (no sarcasm, air emirates is like a tropical vacation compared to any other airbus I've ever been on), and re-read the brief BBC headline three times before reminding myself to breathe. This year, like past years, I had organized a volunteer nurse team for the finish line, better known as the "sweep team" as we triage patients between medical tents; When I found out  the conflicting date of my flight to Dhaka,  I cajoled one of my co-workers to taking over the "captain" role of our volunteer team. So, because there was no other information, my thoughts jumped to worst possible scenario, which was my coworkers and dear friends whom I had encourage to volunteer alongside me were injured or worse, and I was comfortably suspended 50,000 feet somewhere above Africa.

The panic set in and I woke Maryanne up and we both purchased internet access to check in on everyone and I am still counting my lucky stars that my Boston "loves" while mentally bruised, heartbroken and angry, were safe and sound. But, it has been and continues to be, rather difficult filtering the news from over 8,000 miles away.

Again today, I woke up heartbroken and angry that anyone could hurt my home on easily one of it's favorite holidays. By lunch time, the ache turned to guilt that I wasn't there to help at the marathon as initially planned, but mixed with extreme pride that my friends, fellow nurses and amazing hospital institution jumped into action and saved the day as best they could. And by dinner time I have read so many facebook statuses that I almost forget I am over 8,000 miles away and not sitting in Boston, drinking Dunkin Donuts and about to go for a jog on the Charles.

But I am not in Boston and I was lucky enough to be given an opportunity to represent MGH Nursing in Dhaka, Bangladesh. Perhaps, had my emotions not been clouded, I would have processed how truly strange it was to wake up on the last plane ride with people in the surrounding rows taking photos of the two white girls sleeping (I can only imagine how beautifully my 3 chins and drool captured on a flip phone camera). Or how awkward it was to stand and smile at the maid who unbeknown to us was waiting to be verbally released from her morning duties after she made Maryanne and I breakfast, and then cleaned our bedrooms while we ate. But instead I feel more like I am in a daze, with a dash of excitement as I look at myself in the mirror, draped in clothes a Boston girl wouldn’t usually chose.  

So I remember that while  it's hard to not be home coping with friends and family or working alongside coworkers, I get to show a very different part of the world what Boston and its idea of nursing is all about, and I would never let my city down.