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Power failure in the hospital!

Written by Antje on September 5th 2019 11:27

The last two weeks were filled with concern about the power supply. One of the main fuses, where power enters the compound, burned out. Apparently, this fuse was already in need of replacement, but the correct part had not been found by the people responsible for purchases. Now the situation had suddenly become urgent.

Thankfully the hospital could be supplied by a generator, but the rest of the compound had no power. This month it is around 34°C by day, with high humidity, so it feels like 40°C. Not pleasant without ventilation. The fuse was temporarily replaced for a few hours, but it soon became apparent that this was very temporary indeed because it started to overheat!

Yesterday this fuse was replaced by another, which caused a fault. A number of switches burned out. Suddenly there was a total power cut. Including the hospital. There are often power failures in the hospital caused by a failure of the local network, but normally the main generator is started up and within a couple of minutes there is power again. Not now. It was thought that the problem would continue all day.

Now we had to think very seriously of priorities. We do have a small emergency generator which was ready as a backup for the replacement of the fuse, but it became now essential. Most of our oxygen supply comes from oxygen concentrators: machines which extract oxygen from the air and deliver it to the patient. The advantage of this is that we don’t have to bring in many cylinders from the city. The disadvantage is that they use electricity. An emergency cable had to be run from the emergency generator to the neonatal ward, to the delivery suite and to the operating theatre. That was quite quickly sorted out.

No power also meant that our ultrasound didn’t work, and we had no Xray possibilities. The laboratory also didn’t have any electrical power so we couldn’t do many diagnostic tests. After an hour we managed also to run an emergency cable to the lab so that we could start tests again.

And then, after about three hours without power, complaints started coming in that there wasn’t any more water! The water pump that normally fills the water tanks had also stopped. As well as this, from the moment that there was a power cut in the first place, there were no ventilators running on the wards so it was hot everywhere!!!

Thankfully after about four hours, an emergency solution was found and we had power again. However, we were warned that no air conditioners could be turned on; as most of the wards don’t have any, that wasn’t really much of a problem. Finally, one of our staff arrived yesterday evening from Dhaka with the right part, which was installed in the middle of the night. Hopefully everything will be OK again.

I’m thankful that it really rained hard yesterday morning, just before all the fuses blew. Because of this, we had many fewer outpatients than normal. So we were able to see the patients who did actually manage to come, despite the dark, hot examination rooms.

And I was really impressed how well people here cope in a crisis. I didn’t hear a single complaint from the patients. People in dark, hot wards had their own fans which they could wave and didn’t complain. Nobody asked how anything like this could possibly have happened. Our own staff just responded by doing what needed to be done and got on with it.

Here is a photo of me with our new dermatome for removing skin for transplantation. About half a year after our old one broke, we bought this second-hand one. It works really well! I’m thankful for people who support us in all kinds of ways and keep the hospital going.

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The rice has almost everywhere been planted again... 

Family visit and food parcels

Written by Antje on August 7th 2019 21:10

Last week my sister and her husband and their children came to visit me. It was an opportunity for them to see a part of my work here. My sister and niece were willing to dress like Bangladesh ladies. I gave them a tour of the hospital. My sister even watched an operation. In a nearby village we visited a ‘safe delivery unit’ and a group for young people. One of the purposes of this group is to discourage young people from marrying too young. We also visited one of our nursing assistants at her home.

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We made a trip to Saidpur, a nearby town, to do some shopping. Because of the rain season, we had a heavy rain shower.

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After a train trip to Dhaka we spent the afternoon at the Dutch Club—and even went swimming!! The second day we visited the old city with its river port. Here all the ferries from the southern part of the land come in. I enjoyed having the family for a whole week. It was good to renew and strengthen our bonds together.

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Bangladesh is now in its rainy season. That does have some advantages—for instance the rice fields are under water and do not need to be irrigated to plant the rice and the days that it rains it is cooler. Unfortunately this also means that the rivers have more water. The large rivers come from Nepal via India and collect quite a bit of water along the way.

In our work area there are communities living in “char” areas. This is a sandbank along the river which doesn’t flood every year. People live and grow crops here. This year parts of those “char” areas were flooded. I took this picture last week when I returned from Dhaka. In the middle the Jamuna river and around it is the land.

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People in this flooded area lost all their food supplies and food parcels were made and distributed. A food parcel consists of 10 kg rice, 1 kg lentils, a liter oil and a kilo of salt. Last Friday a group of volunteers filled sacks with food parcels. They attempted to make 1960 food parcels. That is a lot of rice!! 

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It is very satisfying to be able to do this, but my hands are not used to his type of work. I had several blisters on my fingers!

 

Happy New Year!

Written by Antje on April 30th 2019 15:26

Happy 1426! Last Sunday (14th April) we celebrated the inauguration of the Bengali new year. This year it coincided with Palm Sunday. In the morning (at 7.30 am!) we had a procession with palm branches and sang ‘Hosanna, Hosanna, the Prince of Peace has come!’ Unfortunately, I don’t have any photos of this. Then there was a church service to celebrate Palm Sunday. Usually Sunday is a working day and the palm procession happens in the evening, but this time it was joined with the new year festivities.

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The new year was originally celebrated with a procession. The colours people wear for the new year are red and white. Many people continue this tradition of clothing.

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Little girls don’t normally wear saris, but they do for this occasion!

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Lots of people on foot for the procession!

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When we got back to the hospital grounds there was a dance, accompanied by a professional percussion band which was hired especially for the occasion. 

If you look carefully you can spot me also dancing – the tallest person in the group ;-)

 

Then there was a ‘Pantha bhat’: a traditional meal. This originates from the time when people cooked rice once every day, before refrigerators. Rice was stored in a layer of water. By morning was it slightly fermented. Ours was not fermented and tasted better ;-). It was served with a piece of fish, spinach and seasoned mashed potato. As you can see, it was popular (and free!).

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Serving the meal.

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This is how it was eaten.

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At the end of the day there was a three-hour cultural program in which children and adults could perform with singing and dancing. I made a short video of a group of our staff and student nurses who are descended from the Santal ethnic group and who performed a traditional dance. This dance is a little like the one I had taken part in earlier in the day.

I hope you had a very Happy Easter!!

Antje

Elections on December 30!

Written by Antje on January 1st 2019 19:36

Bangladesh is tense. National elections were held on December 30. That day, travel is curtailed, and everyone is anxious about whether there will be unrest. Thus far, there have been no riots or strikes, but there are daily newspaper reports that members of the opposition party have been arrested or attacked by members of other parties. (For an update on the elections you can read this article from the BBC.)
 
This past month, lots has happened. I have enjoyed a beach holidays, and we celebrated Deliverance Day…
 
During my vacation, I spent a few days in the capital city of Dhaka, and afterwards a week in the guest house of a mission hospital in the Southeast of the country with a lady friend. From there, a one hour bus ride took us to the beach. We went twice. It was a beautiful, long beach, and not too many people (for us, it is cold here!), so we could take long walks without being harassed. I walk barefoot in the water, but swimming was too much… These days took us completely away from our concerns at LAMB. 
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Everywhere, fishermen were at work. Below, you see how they launch a boat with united effort, but they also fish with nets. 
 
On December 16, Bangladesh celebrates the end of the War of Independence in 1971. We celebrated with mixed feelings this year. Early in the morning, one of our staff members passed away. Three years ago, I had operated her for breast cancer, but unfortunately the cancer had metastasized. The funeral was the same day. She had her husband and 14-year old son.
 
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Here we stand around the open coffin just outside her house, at about a 10 minute walk from my house. 
 
Immediately after the funeral, the cultural program for ‘Victory Day’. It was quite a switch.  
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 The children in the foreground had just finished their dance. It was a mix of dance and song, mostly by kids from our staff. 

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As medical director, I am often asked to sit up front. Fortunately, I didn’t have to do a speech this time…

The day after ‘Victory Day’ we celebrated Christmas with our staff. We used the same party tent a second time. Here are a few photo’s of the Christmas play with a real fire for the shepherds, as well as live sheep. We keep sheep because our laboratory uses sheep blood to make bacterial cultures of puss and other medical tests. Once a year, they get to be our actors...
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And finally, there’s Christmas.
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Here’s a picture of me in my Christmas sari in front of our Christmas tree.

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All foreigners sing an English Carol in the Christmas Church Service. 

Finally, I leave you with best wishes and God’s blessing for the coming year. 
 
For us, it will be a challenging year. Our nursing director has resigned very recently and we have no one to replace her. Fortunately, she left a well-trained manager to care for the daily nursing duties, but her ‘management responsibilities’ will be added to my job for the time being.
 
 

My golden Bangladesh , I love you!

Written by Antje on December 4th 2018 21:22

If you think that I am more poetic than usual, you are right! I didn’t come up with this myself, it is the first sentence of the Bangladeshi national anthem. It came to mind as my housemate and I walked around the fields surrounding LAMB Hospital. It is harvest time and the fields shine with their golden color!

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Harvest time means that people are too busy to come to the hospital. And then there is money only after the rice is sold…

The last few weeks we have clearly seen that the winter season is coming. In the picture you can see that I am wearing my fleece jacket. Especially in the early morning and during the night It is rather cool, below 20°C. During the day it gets warmer and then is the fleece jacket not necessary, but apparently I am not that flexible Wink

During the last several weeks I have had help with surgery. a Dutch surgeon who has been here before while I was away. The first 2 weeks that he was here, there was also a British anaesthetist. Thus I planned high risk patients. We told the patients beforehand that we would call them when we knew the anaesthetist would be here.
One of the patients was a 2 year old boy with a congenital defect of the intestine (Hirschsprung’s disease). In the last few years I had done the necessary operation a few times but a few of the children had serious complications after the operation and some also died. Thus last year I decided not to perform the operation any longer unless I could operate with another surgeon. It was a joy to do this operation together. The child healed quickly and was able to go home in a few days. He does have a stoma that we will remove in a month or so. 

Most of the other patients on the list never came. It was very interesting that several patients promised over the telephone that they would come but didn’t. When we tried to call the telephone was not answered. It is interesting to note in this culture that it is not so bad not to come than it is to say on the telephone that you would not come…

Our midwive training program had an open day. The day was opened with speeches of local officials and several people from the project (the picture shows my speech). Afterwards there were stands showing what the students were learning. Of course these stands also had to be visited by the officials!

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Here you see several students doing a dance demonstrating the 6 steps to washing your hands

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The chairman from one of the local authorities is photographed ‘I love being a midwife’

And now I have 2 weeks of vacation! I will go with a friend to a guest house from a hospital in the south of Bangladesh. There it is very quiet and on a large piece of land. We can’t hear any traffic! Birds and sun are there! I need a vacation and hope to get rested up. Tomorrow we will go to the beach. It takes an hour with the bus to get there…

Woodcutters and rain

Written by Antje on September 17th 2018 20:16

It’s now 40 years since our project started and great many trees have been planted in this time. Trees in Bangladesh grow quickly and in the grounds of the hospital they had come to be too close together. And so it was decided to thin them out. It’s quite extraordinary to observe how the process of felling trees is carried out. I haven’t got any photos of the actual cutting down of the trees themselves, but first the tree were pruned in stages, in which branches were lopped off by somebody who had climbed up into the tree. I didn’t see any of the tree trunks being sawn through, but I was really intrigued with the process of loading the trees onto the trailers…
 
 
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We are now at the end of the rainy season. Here’s a film to give an impression of how it can really pour down here:
 
 
 
Here are two photos of the hospital grounds after such a cloudburst. You can imagine how difficult it is for patients to come to hospital on a rainy day… 
 

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Name giving

Written by Antje on July 16th 2018 21:55

Recently, I was invited to a celebration with one of our co-workers for giving her children a name. In Bangladesh, people usually wait a few months before naming a child.

This co-worker is a women who works with us in the rehab center for children. I know here already from my first term in Bangladesh in 1997. Being 16, she attempted suicide by jumping before the train and she lost her lower legs on both sides. She now walks on two prosthetic legs and manages quite well. Her life hasn’t been easy after this recovery. Her first marriage ended early on with her husband abandoning her, and with difficult she learned to stand on her own (financial) legs, which is quite a challenge here. A woman is always expected to have a man a guardian, her father if she is unmarried or her husband when married. If you are deserted by your husband, you return to the home of your father, but you are not always welcomed back. In her situation, with her father passed away, her older brother provided for her at least in part, but she built her own little house, and slowly added piece by piece.

Last year, she married for the second time. It seemed to be a good man, they got along well together and we had hope that her life would become more stable. Unfortunately, this man turned out to have a second family at about 3 hours travel distance from us. Just after she had become pregnant of twins, her husband essentially deserted her, taking along a large sum of money that she had borrowed to buy land. Her husband stops by once in a while, but overall this woman is left to her own.

Fortunately, other co-workers in the rehab team have taken her in in their midst, and they look after her. After two months, she delivered a healthy set of twins, a boy and a girl, and now we were invited to celebrate their name giving, Nayim and Rupsie. The ceremony with the Imam had already taken place when we arrived. We had the honor to hold the children and to eat rise…

We are thankful that the children are growing well, and keep trying to support her. We pray that the babies will grow up to become strong children, and that they will taste God’s love.

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With the babies


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Babies, mother and visit


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Always great to hold a baby!


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The meal, with rice and goat curry, lentils and vegetables; we eat with our hands


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The courtyard before the house: the hay pillar, clothes on the line, and bricks waiting until there is enough money to continue building.


Happy New Year (1425)!

Written by Antje on April 17th 2018 22:14

Last Saturday, April 14, we celebrated the new year—1425—here. This was a big celebration! Here in a land where Muslims, Hindus and Christians live side by side, is this a celebration everyone can celebrate together. And this is done to the fullest! Traditionally this is a celebration in which the Bengali culture is celebrated. The colors red and white are prominent in the dress code. 
 
We started the day with a march. In previous years the banner that was held was made by hand, but this time it was printed. I found it  a little less beautiful!
 
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Ready for the march!  If you look carefully you’ll see that the next generation is much longer than the previous generation!
 
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With loud music and beating drums we walk in  procession.
 
Er was There was room for a dance!
 
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Then there was “Pantha Bhat “ -rice soaked in water overnight making it slightly fermented-. Historically, rice was cooked this way and then saved for breakfast.
 
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In the afternoon there was an “open podium “ where mostly children could dance and sing. 
 
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 And there was definitely a large audience!
 
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Also we as foreigners could sing a song. We tried as much as possible to let our mother tongue be heard.
 
All in all this was a full day, but also very nice. It was especially good to see how our staff and their families enjoyed the day. 

Birthday celebration!

Written by Antje on March 22nd 2018 13:28

It’s already a week since I celebrated my birthday. My parents came to celebrate the occasion together. It’s a real privilege to have them here and to show them how I live and work. And of course, they were the couriers of a huge pile of cards and presents! Because it’s a once in a lifetime opportunity that you get to celebrate your 50th, I decided to hold a big party. I invited all the staff here from overseas, and colleagues and friends – a total of 100 people! We had a BBQ and rice and lots of good conversation. I’m so thankful that I’m so healthy, that my parents are alive at this time, that I have reached this age, and that I can work here in Bangladesh!

A few photos of the party:

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With my parents.


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At home in new clothes for the occasion. 

 

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 BBQ chicken nearly ready!


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 Short speech to start the celebrations.


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Blowing out 5 candles.

 

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 Reading all the birthday cards...

Winter almost over!

Written by Antje on February 10th 2018 21:23

In my last blog, I wrote about Christmas and wedding celebrations. Looking back, January was a very quiet month, primarily because a had a very cold winter. Thermal underwear, a heavy vest and every other layer of clothing I could think of… it was no luxury! For several days, temperatures didn’t rise about 16°C (60F), and without heat the house is cold! 
Because of the cold, it was also quiet in the hospital. People don’t come when it is cold for planned surgical procedures or for other problems that can wait. Since it was rather quiet, I could devote more time to administration. It was rather nice that for a change it didn’t have to be done in the evenings. 
The last few days it is warming up again. I still wear a vest but thermal underwear is no longer necessary. I expect that it will be busier again in the hospital.
 
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Last week, I received a special visitor: Suruy, a boy now 11 years old, who came to use 4 years ago with serious burn wounds on his belly, his right arm and shoulder. I treated him with skin grafts with moderate success. He developed skin contractures in his shoulder, elbow and wrist in spite of the skin transplants. I operated on him twice later that year to correct those adhesions. This week, one of his family members was admitted in our hospital and his mother brought him along. He is going to school, and regained arm and shoulder function almost completely. It was very encouraging to see him. Especially since in the past week, two female patients with very serious burn wounds (around 40%) passed away. It was especially frustrating because they had been with us already for three weeks but died because of infections. In the next few weeks, I will try to find out how I can start with skin grafts earlier in the treatment to prevent such late infections.
 
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I am looking forward to visitors this month. My sister-in-law will visit for a few days with two girl friends, and a week later my parents will come to stay for three weeks. It is always very special to be able to share something about my way of life and work here.