Winter is beginning here. Everyone thinks it is VERY cold! During the day it is between 22 and 25 degrees Celcius. But at night it cools down to 15 degrees. I am now wearing my fleece jacket and socks! But I can imagine that for the local people, who have few clothes and not enough blankets for everyone in the family, that 15 degrees is very cold. Almost daily there is mist in the morning and evening. The sun appears later in the day. Then you see people basking in the warmth of the sun! I sleep with a blanket, but otherwise it is lovely weather.

The harvest is in full swing. I took these pictures from the balcony of my house. It is easy to understand why Bangladesh is called the gold country when you see these rice fields.

As you can see harvesting is rather intense work. After harvesting the rice the kernels dry a few days in the fields before they are gathered up. Most everything is done by hand. And then the rice still has to be peeled. I don't fully understand this process. The rice is cooked briefly. The quality of the rice is determined by how many times it is cooked.

In the hospital we are also aware that it is harvest time. People are too busy to be sick and that makes things less busy than usual. However, we do see that people come later with their physical problems. People have been hospitalized with severe lung infections. Here you need to take into account that having someone in the hospital means that there are more people involved than the person hospitalized. Nurses work differently here than in the Netherlands. They do not care for the patients, but rather stick to medical tasks like distributing medicine, keeping records, putting in an IV, and more of this type of thing. The person responsible for the patient bathes him, turns him, helps him use the toilet or puts on a new urine bag.

The work here has started even though it is not extremely busy. That is not so bad! Operating has been going well. The personnel in the operation room are pretty well used to me and also the care afterwards is good. I most enjoy the patients that stay longer. There is time to get used to each other as well as building a relationship.

This is proving to be a time of growth for me. Here I do operations that a plastic surgeon or urologist would do. I need to consider—if I don't operate will the patient go to another hospital and could they do it better than I could? Some patients will be sent elsewhere and other patients I will operate on because I know that otherwise they will go home and be worse off.