Harvest time!

Written by Antje on May 25th 2016 21:29

I couldn’t believe it has been 3 months since my last weblog. My last picture shows people planting rice. In the last 2 weeks the rice has been harvested! Time flies!

 

The last few months have been busy. It has been difficult to combining my work as a surgeon with also being the medical director of the hospital. Managing has not always been easy for me. But I do see that I am able to manage both of my functions better and I understand more how the hospital works.

 

In April I spent 2 weeks in Greece to keep my surgery skills up to date. I learned a lot. 30 Surgeons from other developing countries were also present. We enjoyed exchanging ideas. Immediately following this I spent a week in Crete. My mother and sister came to meet me here. The oranges in Crete were ripe which helped us drink as much fresh orange juice as possible!

 

 

Here are a few pictures from my balcony. This is the road to the city of Parbatipur. This was the first time I saw a threshing machine.

 

 

 

This morning these men were cutting the grain. Within 2 hours 3 fields were harvested. The sheaves remain in the field until they are carried away.

 

 

A saying that has recently spoken to my heart is ‘ami kormo kore khai’ . This means 'I eat due to the fact that I have worked'. It is a way to say that you are a laborer. Many of my patients say this when they are telling you it is difficult for them to pay their hospital costs or to go elsewhere for further treatment. Fortunately the hospital has a “poor fund” which helps people pay when they qualify. There is a committee that determines how much aid a patient receives after determining just how poor he is. The purpose here is to give poor people the help they need. Others pay what they can afford.

 

The next 2 pictures show people looking for left over grain. The fields were harvested and they are looking for anything left over. This is a lot of work and reminds me of the story of Ruth in the Bible.

 

 

 

For the last week the lychees are ripe! This tree is in front of our house. Fresh lychees are so much more delicious that lychess from a can that you can get in The Netherlands. This is a reward for surviving the warmer weather :-) 

 

LAMB's 40th anniversary!

Written by Antje on February 9th 2016 21:22

This will be a blog with many pictures. More than a week ago, we celebrated the 40th anniversary of LAMB. It was a BIG feast that lasted 1,5 days. We invited the entire staff, and hundreds of other official relationships.

For me, the feast started with a ride to the airport. The Director Hospitals from the Ministry of Health came for a visit, and protocol demanded that I, the medical director, should greet him at the airport. With, of course, a bouquet of flowers to hand him in this greeting (of which I don't have any pictures :-)). 

Thursday afternoon, we had a meeting with speeches. In the picture, you see me giving a speech, and afterwards we had a chance to share memories. Also, a number of co-workers, who had already worked for the project for more than 35 years, were decorated. 

DThursday morning began with a short march around the hospital compound, with every wearing hats….

The party continued in the large party tent that had been erected for the occasion. All you can see is bamboo and cloths. 

There were a lot of speeches by various officials, and it was quite complicated to watch over the right sequence of speakers. The least important people had to speak first, gradually building towards the most important ones at the end. It is not acceptable if a less important person would get up to speak after an more important person….

Because our security situation remains fragile, we had police protection during the festivities. Fortunately, there were no incidents. Actually, it all seems rather quiet, so we worry less and less about our security in this land. 

Besides the official ceremonies with speeches, there were all kinds of stands at which various parts of the project could present their work. As you can see, people really outdid themselves in these presentations. 

The festivities ended with a cultural program of song and dance. Here is a group of small girls waiting their turn….

All throughout, there was a feeling gratitude. We believe that God had His hand in the beginning of the project and that He helped us throughout all these years. We are grateful for the many lives that have been touched all these years. 

The day after: the stands are taken down… 

And now, it is back to normal life. It is less cold than in January, more patients come to the hospital and rice is being planted in fields that are being pumped full with water. Soon, I'll write more.

A new year ahead!

Written by Antje on January 12th 2016 22:19

As it’s now more than a week into January, it’s high time I said something about how I spent Christmas here.

Christmas began back half way through December with all kinds of celebrations. The photo below shows a Christmas celebration in the outpatients’ department in which songs were sung and in honour of Jesus’ birthday a cake was cut. I had the honourable task, as surgeon, of cutting up the cake into as many pieces as possible :-)

After that there was a Christmas celebration for the staff. A celebration tent was especially put up in which this took place together with a celebration of the end of the school year and a commemoration of the end of the civil war in 1971. Because there is such a low risk of rain in the cold season, the tent is made of thin cloth and bamboo poles. The photo below shoes the final scene of the nativity story. For the observant reader, note the live sheep.

 With the uncertain security situation in Bangladesh after a number of attacks on foreigners, we now have police guarding the hospital grounds. In the photo below you can see the celebration tent with policemen on duty and therefore able to have the chance to hear the Christmas story. 

I didn’t take any photos of the other Christmas celebrations on the day itself. We celebrated Christmas Eve with all the singles together at our place. On Christmas Day there was a morning service, a great rice meal for lunch and then the opportunity to visit friends and colleagues to wish them Happy Christmas and sample their special Christmas bakes. Particularly lovely was the evening of the 25^th, when we had a carol evening. There were loads of people as different families brought their guests with them and it was lovely to sing many of the carols in harmony.

Then, the day after Christmas was again a normal working day….

New Year’s Eve was also pretty special. This month the LAMB project has already been in existence for 40 years and this is going to be celebrated splendidly. We went by bus to Rangpur (at least an hour’s journey) to invite all kinds of VIPs to come to the celebration. The heads of paediatric medicine, gynaecology, paediatric rehabilitation, our hospital administrator and I in my new capacity as new medical director all travelled together. It was a day in which we were warmly received everywhere (3 foreign women in saris and 2 Bangladeshi men), but often had to wait until there was time for us to say something. In the photo we are sitting in the office of the dean of the faculty of medicine in Rangpur. In the background you can spot the display of 16 security cameras on the screen…

Since then I have been working for over a week as medical director and I must admit it’s not at all easy. Particularly hard is keeping track of everything that needs to happen, and what is important and what can wait. I can, I suppose comfort myself with the thought that last week was exceptionally busy with emergency operations. The result was that the time I had set aside for administration was in practice quickly used up for other things.

I hope and pray that in the coming weeks things will become more peaceful. Below one more photo: the view from my balcony. The rice was all harvested by the end of November and beginning of December and now the fields seemingly lie bare. But there is a strip of green to be seen where the new rice plants are already growing. Soon they will be large enough to be transplanted. In a few weeks they shall probably start irrigating and my view will be green again!

Parents visiting and life without facebook

Written by Antje on November 26th 2015 18:18

My parents arrived two weeks ago for a visit! Time for a good visit and hart-to-hart sharing, and to show them something of my life here. My mother is enthusiastically taking pictures and making videos. After their last visit two years ago, my mother made a video and now she is thinking hard once again what she can tell about my life in a short video.

Last week, we spent a day in Saidput, a town about a half hour drive from us. The curtains on our porch really needed to be replaced, so we went looking for fabric. In the picture, you see my housemate Kris and myself keep a close eye on the weighing of the fabric we had selected. It was to be sold by the pound.

In the meantime the curtains have been sewn and our porch looks a lot better.

After our succesful choice of fabric, we ate at a local restaurant. Here’s my parents and I in the VIP part of the restaurant. The usual thing is to eat with your right hand, and in the background you can still see the sink in which you are supposed to wash your hands before you eat. It was a busy restaurant with fast service, so you know that the food is freshly cooked and safe!

A few days after our visit to Saidput, there was another attack against a foreigner. This time, it was against an Italian priest who lives and works in Bangladesh already 30 years. In Dinajpur, a city 45km from us, he was shot on his bicycle on the way to work. Fortunately, he survived the attack. Around the time of this attack, there was also a court case of a war tribunal dealing with the war of liberation of 1971, a case in which two people were sentenced to death. Since the day of this attack, social media sites like Facebook and Whatsapp are not accessible in Bangledesh, and internet has become much slower.

We have also become more careful with going outside the gate of our compound. It is better for now to forego a nice day of shopping in Saidpur.

This week, I am off. I decided to stay here on the hospital compound instead of going away. I’m quite successful in staying out of the hospital for now (the second day), and I hope I can rest up.

At the end of the week, we travel to Dhaka to wave my parents goodbye.

Safety

Written by Antje on October 27th 2015 19:44

The last few weeks in Bangladesh have been rather tense. As you may know  in the capital city Dhaka late in September an Italian man was killed. A few days later in Rangpur  a city 1 1/2 hours from us  a Japanese man was also killed. This happened in a country where violence is not uncommon  but where we as foreigners always felt safe. It is still not clear if terrorists were behind this or the deaths were for another reason. The consequence of this is that the foreign embassies have advised people not to ride alone is cars or to use a riksja or other open transportation.

Currently at LAMB Hospital there are 6 police agents in addition to the security we already have. Since these 2 killings there have been no further incidents with foreigners. The question now is how long do we comply with the limited travel advice and when do we ignore the advice. The embassy's advice is always stricter that what we found to be reasonable  but we do not want to act irresponsibly.

These restrictions have not affected my daily work. I live on the hospital compound and can always get to my work. The travel restrictions apply only to foreigners. Patients can come without any travel restrictions. Still this was a quiet week in the hospital. There was a hindu festival the whole week. Last year during this festival I visited staf  but this year I did not do that. It is wise to avoid large crowds.

Here you see a picture of the doctors that work in the hospital. The picture was taken when we said goodbye to 2 of the doctors. You can see that there is about 1 foreigner for every 2 Bangladesh doctors.

About a month ago my help, Rani, became a grandmother. The mother of the child lives and works in Dinajpur, about 20 miles from us, but she still has maternity leave by her mother, Rani. This happens quite frequently. The child’s father stays to work and there is no help with the caring for the child. This way the mother gets help and also advice from her parents. The foto below was taken when I went to see the new grandchild!

Lastly a picture of a patient I currently have. Sumay is 3 years old. When she was 1 year old she burned her foot when she stepped into the ashes of the cooking fire. Now her big toe is not growing properly. This week I operated on her toe. She is a very friendly child that greets me (and everyone else in the ward) very enthusiastically. This is extra special because most children are not pleased to see me. I am associated with painful things and they begin to cry when I come. This is understandable because children with large burn wounds definitely have pain and have gone through a traumatic experience. That makes it extra nice when there is a child that likes me! Lastly a picture of a patient I currently have. Sumay is 3 years old. When she was 1 year old she burned her foot when she stepped into the ashes of the cooking fire. Now her big toe is not growing properly. This week I operated on her toe. She is a very friendly child that greets me (and everyone else in the ward) very enthusiastically. This is extra special because most children are not pleased to see me. I am associated with painful things and they begin to cry when I come. This is understandable because children with large burn wounds definitely have pain and have gone through a traumatic experience. That makes it extra nice when there is a child that likes me!

Vacation in ´own´ country

Written by Antje on September 16th 2015 22:09

Since I’m going to be in Greece next spring for a conference, and because it felt like I’d only just returned from my months in the Netherlands, I decided to have my holiday in Bangladesh. I went to Malumghat for two weeks with Joanne, who heads up administration where we work. Malumghat, where there has been a mission hospital since the 1960’s, lies between Chittagong and Cox’s Bazaar right down in the south eastern part of Bangladesh.

The reason we went there was because they have a guest house where, being far from traffic and crowds, did basically nothing. There’s a swimming pool on site where we swam for about an hour most days, and we read and chatted a lot.

We were also treated to an extensive tour of the hospital by the surgeon who has been worked there for the last 20 years. In contrast to our work at the LAMB hospital, which specialises in caring for mothers and children, Malumghat focuses on orthopaedic surgery. It was interesting to observe the differences and to talk with a fellow surgeon about particular aspects of working in Bangladesh.

One of the remarkable trips we went on during our holiday was to a steelworks, which is delivering steel joists for the concrete construction of a new building going up at LAMB. Joanne had received an invitation to visit there and because we were staying only a short 115km from Chittagong, we thought that it would make a nice day trip. What we hadn’t reckoned on was that it would take us 4 hours to get to Chittagong! The road was full of holes and it rained quite a bit, making the traffic conditions even worse. In the end we were more than 11 hours on the road for a lunch appointment and visit to the steelworks planned for less than an hour. Even so, I must say how fascinating it was to see how huge, long steel beams are heated and then transformed into thinner joists. Unfortunately we weren’t allowed to take any photos inside. Here is a photo of me, Joanne and the representative of the steelworks who showed us around. Notice the passing workers and their (lack of) safety equipment.

Another trip we made was by bus to Cox’s Bazaar. Bangladeshi people are proud of this place because it has the longest uninterrupted beach in the world. Not exactly like the Dutch idea of a trip to the beach: no undressing more than down to your shalwar kamees (photo), and swimming also only fully clothed. So we stayed pretty much out of the water.. The photos show the sun beds and inner tubes you can cheaply rent. It was amazing that there was by chance a Dutch friend of mine at a conference in Cox’s Bazaar and that we were able to have lunch together. My store of cheese, stroopwafels and chocolate is now topped up!

The area around the hospital is a beautiful, flat landscape which even though it lies more than 10 km from the coast, has tidal streams in and out. On one of the days we had a walk there – pretty tricky going as it was the rainy season with plenty of mud around.

These young girls came up to us and walked along with us for a while. They were keen to be photographed. What’s nice about digital is that you can show the photo immediately it’s been taken. They thought it was amazing...

We’ve already been back now two weeks at LAMB. Back into normal busy life. Holidays seem ages ago. As soon as I got back, my theatre lists were planned completely full with people who felt they had had to wait far too long. But now I’ve caught up with the backlog on the waiting list and it’s OK now. The rainy season is mostly behind us and it’s now mainly hot and very humid. This photo I took at about 7 in the morning. Not a cool morning either – it was 29ËšC at the time! Only a month to go and the cool season starts...

Wedding

Written by Antje on July 30th 2015 21:12

Last Saturday, Joanne (another Dutch lady who works here in the office) and I went to a wedding. Strictly speaking, it was not the wedding itself – that had already taken place on Thursday – but the ‘Bouw-bhat,’ the rice meal for the bride. The marriage had taken place in the bride’s village. While this was the rice meal to welcome the bride in the groom’s village. The groom works in our project as purchase agent, and he comes from the capital of our district, Dinajpur. The feast meal was held in a rented hall, which in my opinion, was rather empty looking. We traveled by bus, dressed in our finest, and after the arrival of the bridegroom the meal was served.

As you can see from the picture the table cloth was newspaper. We could put the bones from the meat we had eaten on the newspaper. When we were finished the table cloth was thrown away and new paper was put on for the next group. As you can see, there is no silver ware, and everybody ate with his right hand, which is the usual custom here in Bangladesh, even in the higher classes. Personally, I also think it is easier to get the meat off the bones with my hand.

When we were ready with the meal, the bride arrived. It was her job to sit on a special podium and to be beautiful and to provide an opportunity for the guests to have their picture taken with her. We managed with difficulty to get the groom also in this picture!

This is the view from my balcony. The past Friday night it rained very hard here, and the rice fields are now beautifully filled up with water. Some of the fields have already been ploughed, so soon they will start planting. The green in the picture … those are weeds!

My work is going well. I continue to do surgery on adhesions after burns, and I have a better sense of which surgeries will be the most difficult. In addition, I did some abdominal surgeries – those remain a bit my ‘first love.’ Over the past few months, I have also done some shifts in gynecology. This is a team with a larger group of doctors, in contrast to my position as only surgeon, and it feels good to be a bit part of that team again.

In two weeks, I will take a 2 week vacation in ‘my own land.’ I go to the Southeast, to a mission hospital between Chittagong and Cox’s Bazaar. The main attraction of this hospital is a swimming pool, and I’m completely away from the routine in my own hospital. I’ve never been there, so it will also be interesting to see how they do things in that hospital, although I don’t plan to spend much time there except in a general tour. And we’ll probably make a few day trips from the hospital. I’ll keep in touch!

Pouring concrete

Written by Antje on June 29th 2015 21:34

This movies shows the pouring of the roof of the first floor of the project's new school. The pouring of the concrete had to be done within a day. It was all done by hand and took more than 12 hours ...

Fair!

Written by Antje on June 15th 2015 22:25

Over the last few weeks there has been a fair in our city, Parbatipur. One afternoon I went along together with Bea, our gynecologist, and her family. An area was cordoned off and for a small fee one was permitted entry. The first stall we saw was the sweet stall:

There were also many other stalls selling things like many kinds of hair clips, bangles and other kinds of jewellery. Everything cost 20 Taka a piece (85 Taka = 1 euro). Janine, the 9 year old girl who came with us, enjoyed everything very much. 

After looking round all the stalls, an ice cream….

Windmill ride powered by two strong young men, who literally wound the chairs round and round by hand. Left in the background is the haunted house….

Much storm damage

Written by Antje on April 27th 2015 21:37

Last week, our area has been hit by thunderstorms with short periods of very strong winds. The storm only lasted about 10-20 minutes, but the damage around the hospital and the surrounding area was enormous.

Below is a picture of the path that I usually walk from my home to the hospital.

The courtyard of the hospital, where people have room to sit around or hang their wash, was also hit badly. I noticed – how remarkable that was – that when there wasn’t enough clothesline available since branches had broken off and fallen across it – these very branches were used a clothesrack! The people here are very resilient!

The day after the storm, we receive word of the damage outside of the hospital area. Many of our coworkers had been up at night, because the roof of their house blew off, or because they were afraid their house might collapse. Many homes here have roofs of corrugated roofing sheets, attached between bamboo supports. When the wind gets underneath, the whole thing can just blow away. We heard stories of people who found their roof again after a long search, but also of people who even dredged the pond without success. And then people fought over who was the owner of the corrugated sheets they found. How do you recognize your own roof???

In the afternoon, I took a walk with a lady friend in the area. We had expected to see quite a lot of damage yet, but in the meantime people had already done very much. Roads and paths had been cleared again, most of the blown off roofs had been put back in place, although it was still a bit provisional. So I don’t have real pictures of the damage around the hospital.

The poorest people were again hit hardest in this disaster. Their homes are the least sturdy and they have the least reserve. Today, our hospital organized a workday for these folks, that provided more than the usual salary for them to help them recoup part of the damages.

Since my return here from the Netherlands, I have done many surgeries, some 20 patients altogether, especially children with deformities after serious burns. For some the results were excellent, but for others it was disappointing. I also operated on a few children with genetic intestinal defects, again with differing results. When seeing some of the disappointing results or serious complications, I have to remind myself that I do the best that I can in this setting and that most of my patients don’t have other options.