The Exodus for Number 2

The next morning the shuttle ride to the hospital was very sobering. As we picked up the rest of the staff and students in the area we took some of the backstreets and we were able to see some of the living condiitons people are subject to in Bangladesh. The streets are filthy. After it rains they remain muddy and flooded for days. The paved roads have potholes left and right. Goats, cows, feral cats, and dogs pace the side of the road. Trash is piled up on the shoulder of the road. The streets themselves are crowded with people, rickshaws, cngs, and taxis.

We arrived at the center and attended the "morning meeting". Every morning for about 30 minutes someone presents the research or the work they've been doing at the center. So far we've seen meetings dealing with different treatment for HIV positive pregnant women and how to best prevent the child from being infected as well as a presentation given by an English Doctor about some of the differences in medicine.

After the morning meeting its typically around 9 am. That means we work for half an hour before tea time. Tea time is something Joel and I have become accustomed too. After having tea time for a month, we're going to have to get used to this 10 minute break thing back in the States. We're spending our first week working in the short stay ward and the emergency ward. The very first day we were shadowing Dr. Kahn. The head of the short stay ward. He was very determined that we find a sample of cholera stool. So we procured one of the nurses and walked through the hundreds of patients checking buckets until we found samples of the different stools resulting from the common diarrheal illnesses. We observed the process of a severely dehydrated cholera patient being admitted to the hospital and how it was dealt with. Later, we went on rounds with several of the doctors. The center is paper free. All the records are kept on pocket pcs or computers. The doctors update their handhelds as we proceeded on rounds. After talking to each patient the doctor's translated what was going on medically and the cultural problems with the illness. Many of the babies under 6 months were not being breast fed and were instead being fed by powdered milk and contaminated water, resulting in the various diarrheal illnesses.

Old Time and New Time

I know you've all been waiting for our posts with baited breath. So I apologize for the delay. Things like the internet and power are a bit special here. As Joel said, when we first arrived we were pretty wiped out and slept for most of the day. After waking up that night and setting an alarm to meet Jill the following day at 8:15 am we went back to sleep. Our bearer arrived the following day and began to take care of the chores and fixed us breakfast. I glanced at a clock and saw the time was 7:00 am more than enough to time get ready and have breakfast. I began to ponder how I was supposed to shower in water that is somewhat questionable without getting sick when the phone rings. Mark (the bearer) answers the phone and explains to us that the car is waiting downstairs to drive us to the center. At this point we scramble to get ready. In 10 minutes as I'm putting on my shoes Jill comes upstairs to see whats taking us. We grabbed the last of our things and hurried downstairs. After we were in the car we mentioned to Jill that all of the clocks in the house were an hour behind. She laughs and explains that for the first time ever, Bangladesh has decided to participate in daylight saving. That the locals, several weeks after the time has changed, are still utterly confounded with the unfamiliary concept. When scheduling a meeting people have to say 3:30 pm new time as opposed to old time.

After arriving at the hospital and doing some paperwork, we had our first tea time. More to come on tea time in later entries. Here we were introduced to other students at the ICDDRB who were doing similar shadowing experiences or research. Some were from the states (UVA med school, Emory) others were from Bangladesh, others from Australia, etc. Nothing helps you make fast friends like arriving in a developing country with no idea what the heck is going on.

After tea, we finished the paperwork and were given a tour of the hospital. The ICDDRB is mainly a diarrheal research hospital. As such, most everyone admitted has diarrhea as a symptom. There are 7 wards within the hospital. Patients arrive at the emergency ward. If the patient is severly dehydrated within a minute they are on a bed with an IV in. If they do not look in dire need, they sit and answer some basic history questions and are sent to a ward accordingly. If the patient only complains of diarrhea and shows little to no signs of dehydration they are sent to the outpatient ward where they are given ORS (a riced base Oral Rehydration Solution). After several hours they are evaluated and sent home. If they show some signs of dehydration or after the severe dehydration patients are stable enough to move, they are sent to the short stay ward. Those patients with other underlying conditions are sent to the longer stay ward. Patients in dire condition are sent to the special care ward. There is also a research ward where patients in clinical trials are housed as well as a nutrition ward for severly malnourished patients.

The ICDDRB provides all health care for no cost to the patient. Because of this and their excellent reputation with diarrheal problems, patients will come from hours away to reach the center.

The Arrival...(not the '96 movie with Charlie Sheen)

Well we arrived in Dhaka safe and sound after a 37-hour flight, of which six hours were in Mumbai. Needless to say we were somewhat tired. Mr. Hasan met us at the airport and drove us to Road 71 in Gulshan 2. It was a harrowing experience on the drive there. We thought we were going to die at any moment. At moments we weren't farther than a few inches from the other vehicles. Amazingly, we made it without so much as a slight bump. The apartment was very spacious; it was a two-story, four-bedroom, and three bathroom abode. We introduced ourselves to Mark, the bearer. He serves us food, cleans the apartment, does the laundry and shops for us. It's great! And then there's Bodhisattva (Bodie), the feral cat that the apartment owner bottle raised from a kitten. Up until the first weekend here, we never saw the cat except in the morning when Mark was here. And now it loves us...well usually, until it goes psycho and claws/bites Adam. A little while later, Jill arrived and welcomed us to Bangladesh and fortunately told us that we didn't need to go to the ICDDR,B until the following morning. She gave some money to the bearer (since we hadn't exchanged any of our currency yet), told us she would be around the following day at 8:15 am and left us to recover from the flight. I went upstairs and fell into a coma for about nine hours, woke up for about two hours and then fell asleep for another six hours.