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 water.org 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.