Friday, August 15, 2008
Since returning, we've moved into our new home in the city. BRAC has a residential building in Niketon, not far from one of Dhaka's hubs (Gulshan 1). It's been nice to be so close to restaurants serving things other than rice. The noise and air pollution have been a bit of a change from Savar, though, and when we first moved in our room (I'm sharing with Vanesse) had a serious mold problem--luckily that now seems to be under control. The weather here is already starting to cool down, and I think the bulk of the rain seemed to have happened while I was at home. I'm looking forward to the cooler seasons--though I've adjusted somewhat to the climate here, my body seems to prefer a more temperate lifestyle.
I had a nasty run-in with the flu a few weeks ago, and was stuck in bed for a couple days. Sadly that meant missing fieldwork for a group assignment. The following weeks, though, gave me the opportunity to travel to Nilphamari, in the north of Bangladesh, fairly close to the Indian border. It was about an 8 hour drive from Dhaka, and with 11 other people in a van, the trip was certainly an adventure. It was a truly beautiful area--quiet and clean, and the people were even less accustomed to seeing foreigners than they are around here. Our assignment had us looking at the operation of a recently piloted integrated nutrition program in the area--really interesting, and it afforded me a lot of time to attract a large crowd of children to be entertained with the camera.
I also realized that I have photos still to share from a trip to an arsenic affected area. Again, mostly of children, because they are typically the only ones willing to be photographed. But, Sonargaon photos, too.
I'm also very happy to report that my Fulbright extension has been granted, so I will officially be able to stay through the end of the year. While I'm sure part of me (the part that eats) would like to go home sooner, I'm thrilled that I'll have the opportunity to stay a bit longer. Another experience like this might be hard to come by, so I'm going to try to take full advantage of it during the next 4-and-a-half months.
That being said, I'm now trying to figure out exactly what I will do after these 4-and-a-half months are over--the real challenge. Suggestions are welcome!
I hope to post a little more regularly for the remainder of my time, but I certainly can't promise anything, considering my track-record. I guess we'll see what happens...
[My new and ridiculously slow internet connection doesn't want to load photos now... will add them in soon!]
Tuesday, July 1, 2008
Today I'm nursing a bit of a head cold--the same thing happened after I first arrived in Bangladesh, so perhaps it's just the 24 hours of travel not agreeing with me. The travel, on the whole, was not bad. I was even upgraded to first class on my flight from Dhaka to Bahrain. I had certainly never been in first class before, but for one with legs as long as mine, the extra space was highly appreciated! And the food was pretty spectacular, too, surprisingly enough. The other two flights had me back in economy class, as usual, and my trusty iPod met its sudden and tragic end between Bahrain and London. It has been running steadily for four years, so I suppose it was about time. Still, I shall miss it!
The house seems very quiet and empty without Gib, but being here is helping me to adjust to the change. We have a nice big picture of him in the living room, too, so that's here to keep me company.
Cold medicine and residual jet lag are making me drowsy now--it may be time for a brief nap. Hopefully more updates as my time here unfolds!
Friday, June 6, 2008
School has been going well, despite recent ups and downs. The course in Health Economics and Financing was really very interesting. We had two excellent professors come to teach that unit; a few years ago both were at LSHTM, but now one is at Hopkins and the other is working for the WHO. Earlier this week we started our final course before the vacation--Environment, Health, & Climate Change. Off to a bit of a slow start so far, but on Thursday we have a field visit planned to see some arsenic mitigation programs in action, so I'm quite excited about that. Hopefully it will prove fruitful--more about that on the weekend.
Lastly, I'll end with a video clip that our economics instructor showed us. It's from a website called Gapminder, and it's a short (and fairly dynamic) discussion about the population growth in Bangladesh. I wanted to embed the video here, but my internet connection is being rather painfully slow, so for now I'll just refer you to the link for "GapCast 5". If you have a couple minutes, I encourage you to take a look...
Sunday, May 25, 2008
In other news, we began a new course in Health Economics today. Sounds a bit dry, but the instructor is a very enthusiastic British gentleman and I must admit, he's making the subject fabulously interesting. I'm afraid that's about all the commentary I can offer on the class thus far, but I'm sure you'll also be able to find my concluding remarks here.
I've also recently had a new creature move into my room--I seem to be sharing my space now with a small, gray mouse. Not too threatening in appearance, but when he found he could get into my food drawer he had a field day. He also tried to make a home in--and successfully destroyed--some of my clothes. Over the weekend I purchased several air/water/mouse-proof containers, and my things are all safe now. I've not seen any sign of him for a couple days, so I'm hoping he has vacated. We shall see.
I'm sitting here trying desperately to think of other things to report so that I can put off my reading a bit longer, but sadly I'm not coming up with much. Life is progressing steadily and smoothly (despite slight interruptions by rodents and the like), but not too eventfully these days. So I'm afraid I'll cut this short for the time being, and hopefully I'll have more to discuss soon.
Also, in response to a request for donut pictures: I bought another on the weekend with every intention of photographing it. However, I was too excited about it later that evening to remember my plans--not until I had eaten about 5/6, anyway, and that would have made for a fairly uninspiring image. Maybe next time...
Tuesday, May 20, 2008
I was in Banani to collect my mail at the American Center (after it had been sitting there for about three months... and thanks once more to everyone who sent things!!), and so I stopped by a nearby bakery, King's Confectionery, for a quick lunch before returning to Savar. They had all kinds of lunch-like pastries, and they were quite good, and I also used the opportunity to get a couple donuts for the road. Now back in my room, I thought I would give them a try, and they are fabulous. I think I will forsake all other food now, and eat exclusively donuts until the end of December.
In other news, Health Systems Management has proved to be a highly interesting course, and our professor is wonderful. I think he may actually know everything. We have our final exam on Thursday morning, so he very generously gave us the day off to study. Now that I've had my donuts (and eaten them too), I think I'd better use what's left of the day more wisely... But this was too exciting of a happening not to be properly documented.
Saturday, April 26, 2008
Wednesday, April 2, 2008
I'm now nearing the end of the fourth week (out of seven) of our Epidemiology/Biostatistics unit. We have had one exam in each subject now, leaving everyone quite drained. I have to admit, though, I'm really enjoying these courses. I had forgotten how much I liked math (excluding calculus, of course...), so that has made stats much more enjoyable. Most people are severely hating it right now, so I'm happy to report that I'm not in that camp. And epidemiology is incredibly interesting--we also have some excellent instructors from ICDDR,B teaching the course, making it even better.
There haven't been any more incidents of gastroenteritis lately, which is good news for the students. There have been many complaints about the food in general, however. Some say it's too spicy, some say it's not spicy enough; I think there's too much oil, and everyone is tiring of the lack of variety. Many have taken to escaping to Dhaka on weekends for breaks from the culinary monotony.
An announcement to everyone: I'm not neglecting to send post cards on purpose. I have not been able to find a SINGLE post card in this country. It seems they're just not available. Also, according to another American, the postal service in Bangladesh is not presently sending any mail to America (for reasons that are very unclear to me), so the only way to get a letter home would be to spend $20 to FedEx it. So, for both reasons, I haven't sent anything. I will try to think of a way to make it up to everyone--what's the fun in having a friend abroad if they can't send you mail?
The weather is getting progressively hotter, and I finally feel like I have adjusted. It is currently a very comfortable 84* F in my room. The rainy season is a few months away still, but we have had a few preview thunderstorms. At this point, I can say that I'm pretty excited for the monsoons to start, but the novelty will probably wear off quickly if the sun is absent for too long!
I don't have much else in the way of news, so I think I will end this post with a few pictures from Independence Day celebrations in Savar. Several of the students went to the independence monument in Savar last week on the holiday (March 26th)--just about everyone in the country has the day off, and thousands of people visit the monument. As we found out, a group of foreigners in the midst of all the nationals can attract quite a lot of attention. We were there for about 45 minutes, and every time we paused for more than a few seconds, we were surrounded (literally) by hundreds of staring people. Now imagine what happens when we all line up for a group photo (seen being taken by classmate Arif, who stayed with me the night I spent in the hospital)...
Thursday, March 27, 2008
Tuesday, March 25, 2008
Yesterday the student from Ethiopia had similar symptoms, and ultimately ended up spending the night at the same hospital (in the same unit, even) with the same treatment. He actually had a culture done, though, and should have the results by tomorrow. Whatever he had is probably the same thing I had, so I'm as curious about the results as he is. He's back now, thankfully, and on the same regimen of antibiotics and oral rehydration therapy that they prescribed for me.
A couple of the other international students, too, have been complaining of mild symptoms lately, so it's starting to look like we have a small outbreak on our hands. It's certainly causing some fear among those who haven't had any problems yet... The administration is beginning to be more concerned now, though, so it will be interesting to see how all of this pans out.
Friday, March 21, 2008
Thanks to everyone for the well-wishes. Hopefully I'll have happier things to write about here soon. On a very happy note, however, my hospital stay (admission + consultation + treatment + ICU bed "rental" + prescriptions) cost a grand total of... 3389 Tk, which (according to today's conversion rate) is equal to $50.27. I'm still in shock!
Tuesday, March 18, 2008
When I woke up feeling quite normal yesterday, I had no idea what my evening would have in store. I spent about 7 hours in epidemiology lecture during the day, reviewing concepts of exposure and outcome, common-source epidemics, and attack rates (to name a few). As soon as class was over I was feeling dizzy and nauseous, so I opted for a quick nap. Sleeping was restless, though, as I felt like I was having trouble breathing. So when I saw friends later on, I told them I was feeling "weird"--the only way I could describe that combination of symptoms--and I informed them that I would probably just be resting in my room for the rest of the night.
Around 6:30, I developed some pretty severe diarrhea that persisted for a long time, intermittently; at 7:30 I began vomiting (and did so another 6 times over the course of two hours. None of my symptoms were abating, which struck me as odd (based on past experience), so I informed a friend who insisted I should be taken to the hospital--in this context, the combination of diarrhea and vomiting can be very much an emergency. But there are 15 doctors in our class, so all of them offered differing opinions about what should be done with me, and it took another half hour before the collectively-decided course of action was a trip to the hospital (just in case any complications developed).
After a very uncomfortable ride in the school's van, we arrived at the Enam Medical College and Hospital in Savar (about 20 minutes away from campus). The consulting doctor who met me at the door asked for my history and decided that I should be admitted for treatment of severe dehydration and gastroenteritis. By this time I was feeling extremely weak--I was very thirsty but I was also terrified to drink anything because I knew any input would prompt another vomiting response. So I was admitted, and my paperwork was completed with the help of the--literally--van-load of people who came with me: the TA for our current course, who is in charge of such little emergencies when they arise; the campus manager, who speaks no English at all; one of the school's drivers, who I had never seen before that night; and three other students: Basir and Arif, both medical doctors (the latter from Bangladesh helped immensely in communication with the medical staff), and Vanesse, fellow anthropologist and resident best-friend (who served as my voice during most of the proceedings).
After the paperwork was completed, I was transferred upstairs to the ICU--it was cleaner and quieter and more private. By this point it was 10:10 pm. I'm not sure that such a case was typical of the ICU, but I am also fairly certain they don't get a lot of Americans coming into this hospital, so I was getting at least a little special treatment (and I was grateful for it at the time). So they put a butterfly catheter in my left wrist and started me on a saline drip, followed by a Cipro drip (antibiotic), followed by a glucose/saline drip. I haven't had an IV since I was 10, so it was kind of a strange experience. They also administered an anti-emetic so that I could drink things safely, and a sedative so I would sleep through the night. I had my ups and downs the whole night, but my friends (the three students) stayed the entire time with me, and were never out of sight. Vanesse was able to sleep in the bed next to me (or she was able to try to sleep--I was the only one with the sleeping pill and it made a big difference), and the guys were taking turns in another bed nearby. I don't think any of them slept more than an hour in total, but I was so thankful for their presence--what otherwise would have been a very scary experience for me was much less terrifying because of their being there.
The staff monitored my vitals on and off all night. At one point my BP was down to 90/60, which is quite low for me, and just before discharge this morning I had a temperature of 101. But in the end I was deemed fit to leave, and they gave me a big box of drugs to take with me. Pretty much they're going to continue to kill any bacteria that might be living with me, and they're going to ensure that I can't lose fluids by any means.
I arrived back on campus this morning feeling thoroughly disgusting, and I still haven't had enough strength to stand up long enough for a shower (which is driving me NUTS), but I'm in higher spirits, and I have been sleeping on and off for the last 6 hours. Everyone says I need to try to eat something now, so I guess I will attempt to comply with the orders of ALL my resident doctors. And I have 1.5 liters of Oral Rehydration Solution (developed locally 30 years ago by two of the school's instructors!) that I'm supposed to be drinking. So maybe I will do some of that before part 4 of my day-long nap. My goal is to be strong enough to shower within the next two hours, so I have a little way to go...
Ok. That is my tale. If I look at it as a learning experience though, I can understand why treatment of diarrheal disease is such a priority in this country. Such problems are ubiquitous among all age groups, and there's an entire hospital in Dhaka dedicated to the treatment (and research) of diarrheal disease. But seeing how quickly I went from feeling alright to feeling dreadful, it's easy to understand how such problems cause so many fatalities in Bangladesh every year. Diarrheal diseases are the leading cause of death among infants and children--that's why the development and now widespread use of ORS was considered such an incredible public health feat--it saved millions and millions of lives, and it continues to do so. So even though I'm feeling a bit like I've been hit like a truck, I also, in a way, feel closer to this country that I'm now calling home. Which is a good thing, I think.
Saturday, March 15, 2008
The day following the wedding I departed Dhaka for Cox's Bazar with five other classmates: Vanesse (from the Netherlands), Basir (from Afghanistan), Su (from Myanmar), Shah (from Pakistan), and Antora (from Bangladesh, who marvelously arranged all the trip details for us). It's a 10 hour bus ride from Dhaka to Cox's Bazar, so I left well stocked with snacks and Dramamine...
On the whole, I think that not much narrative is needed--just some pictures with a bit of explanation. First of all, a map of the area might help:
On our first full day, we left Cox's Bazar for Teknaf--the point from which we departed for St. Martin's Island (the southernmost point of the country). We took a two-hour boat ride to the island--here's a photo of the dock before departure.
Vanesse, Me, Su & Shah on the boat:
When we got to the island, we had some fresh seafood for lunch, and then had a few hours to explore the beach before the return trip. As you can see, some of us enjoyed the beach in true tourist fashion:
On our walk back to the boat, we stopped for fresh coconuts. If I had this man's job, I would be hand-less by now...
And we made friends with some children.
And then we found a lot of palm trees.
That afternoon we ventured to another beach. I made everyone pose for a group shot:
There are lots of children around who happily watch shoes and such for a few taka.
Sunday, March 9, 2008
We just finished Quantitative Research Methods--two weeks' worth of action-packed, survey-writing fun. I did get to tailor my independent project to be more in line with my overall arsenic-related research goals, however, so that was very useful.
Today we began a seven week Biostats/Epidemiology module. I can't really offer any judgement yet, but first impressions are promising. Yet again we have a group project, but luckily we were able to choose groups this time. I think they just wanted to make sure no one ended up dead at the end of the seven weeks. Rumor has it that this is the trickiest course of the bunch, so you may not hear much from me for a while, but I still have beach trip pictures to post so hopefully I'll find the time to do so.
Otherwise, not much is new here in Savar. The weather is getting warmer, but I'm becoming used to it. And having AC helps tremendously. Vanesse and I went into Dhaka over the weekend for a day of escape: pizza and aimless shopping can work wonders. And I'm becoming much more confident in my ability to navigate in the city--on the whole, everything here is starting to feel more normal, more like home.
One of these days I'm going to take a picture of the sunset. It is absolutely stunning, and unlike anything I have ever seen in the northern hemisphere. I wondered at first how the red dot on the Bangladeshi flag represented the sun, but now I understand entirely.
And my lunch break is now drawing to a close. Off to learn how to use some kind of statistical software... More soon, I hope!
Saturday, February 23, 2008
Friday, February 15, 2008
Apart from working on the project, I haven't done very much lately. Almost all waking hours were spent somehow away from my room, and mostly away from the internet, too. However, when I was in my room, I met another of my roommates:
I went into Dhaka earlier this week to attend a security briefing at the US Embassy. To get there from another area in the city I enjoyed a sunrise rickshaw ride--quite the experience, I must say. Also, it was suddenly very strange to see so many Americans in the same place. I then managed to get to the American center to pick up my mail, so a big Thank You to everyone who sent things--it was so exciting to have some dispatches from home! (And some chocolate!) I have very good intentions of sending mail to everyone at some point, but I've yet to find a post office around here. I'll keep looking, though.
During the coming week, we have planned to go to Cox's Bazar (the longest uninterupted beach in the world, apparently), in the southern part of Bangladesh. One of our classmates is getting married this weekend, also, so a few of the other international girls and I are planning to go sari shopping tomorrow so that we can appropriately dress for the occasion. I'm pretty excited.
More to come when I return from the trip, and hopefully some good pictures then, too.
Sunday, January 27, 2008
Friday, January 25, 2008
As one of our exercises, we again ventured into the village (this time on bicycles!) to get an idea about the health concerns of a few families. Each pair (national and international students) visited a house and asked about illnesses, their perceived causes, and the related courses of action. Responses were then reviewed in the larger group setting, and I decided to share a few here.
- 11 month-old male with fever, coughing & wheezing, rash, and diarrhea
- Explanatory Model: mother works hard during the winter months with cold water, and this coldness is then transmitted through breast milk to the child; the child tends to be sleepless at night, and is therefore exposed to more cold weather.
- Treatment: allopathic treatment by medical doctor; homeopathic treatment specifically for rash
- Lethargy, protrusion of tongue, enlargement of eyes, difficulty speaking
- Explanatory Model: possession by evil spirits/ghosts during the month of Magh (winter)
- Treatment: recitation of Qur'anic verses (Sura Jinn) by a maulana; allopathic treatment if recitations are unsuccessful
- Curvature of the spine, chronic back pain
- Explanatory Model: as a result of witchcraft or sorcery, a ghost was sent down from a tree onto the patient's shoulders
- Treatment: visiting fakir bari (witch house); needed to counter the supernatural cause of ailment
These particular ailments were not common among the households visited, and it seemed that more widespread health problems were explained more in terms of popular biomedical understandings (and accordingly individuals sought treatments that were either more allopathic or traditional/herbal in nature). I chose these cases, rather, because they really demonstrate the links between culture and health, and because I found them so very interesting.
Saturday, January 19, 2008
I arranged to make lunch today, and was escorted to the kitchen by one of our extremely friendly cooks, and found myself in the middle of a VERY large space full of Bangladeshi men who spoke very limited English. So that in and of itself was an adventure. I managed to explain that I needed onions, garlic, salt, pepper, and herbs if they had them (they didn't). In the end, everyone was so excited to assist that I didn't really do anything but stir the pasta and taste-test. The end result was a sort of Bangladeshi-Italian fusion dish, with a sauce made of the above ingredients, some soybean oil, and the local variety of squash (very large green "pumpkins").
It's very hard to re-create a recipe you're used to in an environment that's so foreign--the only similarities between my kitchen at home and the kitchen here were the knife and cutting board, which made for a very different cooking experience. It was also extremely fun to watch all of the chefs come and examine the pasta (imported from Italy) and the tomato puree--clearly neither ingredient had ever been seen in that kitchen before. They were passed around, and pieces of dry pasta were sampled (as I feebly tried to explain that it's only good when cooked). Almost everyone was convinced that my sauce was going to turn into some kind of curry, and I was offered soy sauce, fish sauce, turmeric, eggs, and chicken as possible ingredients, all of which I had to turn down (the squash was my compromise).
Quite fun, all in all. And I got pasta for lunch, which was another nice break from the rice routine.
Friday, January 18, 2008
And some of the slum in the foreground, next to the water, with the Dhaka city scape in the background.
Thursday, January 17, 2008
Serious academic discussion outside the BRAC center. (Vanesse, Shah, Berezy)