Sunday, June 3, 2018

More from Bangladesh


I always have to be in the right mood to write about my travels and it’s difficult to get there sometimes, I guess because it’s hard to face and because I wish I were still there. Plus there is always a certain amount of perspective that comes with any travel especially to a country very different from one’s own. That perspective can fade quickly and you can be a little ashamed of yourself for how quickly it fades. I also almost feel a little bit that real life is happening in places like the camps and in developing countries and that my own is life is very much a facade or a shadow of what real life is. And that is certainly true considering more people live without adequate basic resources let alone feel oddly “poor” because we can’t have everything we instantly want despite having an excess amount of food and access to any amount of clean water we could hope for. I don’t quite feel like I’m accomplishing anything in my little life here in the states sometimes despite being incredibly busy and worried about who knows what. 

And so I begin, trying to convey complex feelings even I don’t understand and to tell the stories of another world so very different from our own that I don’t know where to begin. And the world in the Rohingya refugee camps is definitely that. These people deserve, more than most, to have their stories told-for the sake of all humankind their stories need to be told. Now, I know that whatever I write someone will find a way to criticize or be offended by. I ask those people to keep their mouths shut or go help in the camps and then tell their own stories, not to judge me by mine-seen and experienced through my admittedly imperfect eyes. I can only write from my own experience, using my own thoughts through the eyes I have, at the present time of experiencing it. 

I put this disclaimer here because I am not what most people think of when they think of a “humanitarian”. Those who know me, know that I can come off a little cold, abrupt, rigid…sometimes ice-queen-y even. I’ve been told this about myself. I don’t know why I come across that way but I know that I do. I also know I am not overly sweet nor do I see the world through rose-colored glasses. I’m incredibly sarcastic with the dry, morbid sense of humor shared by many a nurse and most accurately once described as an optimistic cynic. I do love kittens though. My only reason for telling you this is to point out this…you do not have to be a perfect person to do something good. Even with our dark or imperfect sides, or even if we do not “look” like what others want us to look like while doing a certain activity, we can still do and be some good. Even if we are not “good” in a way that other people want to us be. Now to the camps. 

It’s difficult for me to convey individual stories this time because we really only had one translator.  I signed up go with SAM’s (Syrian American Medical Society)-the same group I went to the Syrian refugee camps in Jordan a couple of years ago. It turned out that only 3 of us ended up going. It was two pediatricians, Promise, a long-time private-practice pediatrician from Washington D.C., Samantha, a newly trained Brit from London who has done extensive volunteer work for long stints in developing countries with various NGO’s, and me. This was our team going Into the camps. Just the three of us. They each saw anywhere from 70-80 patients a day each and used the local Bengali doctors in training as translators. (There were two newly graduated Bengali doctors but who haven’t taken their exams yet. SAMs was paying them salaries to help out in the camps but mostly they were doing it because they were amazing, exhausted but tireless people.) I tried to help triage but since I had no translator our little triage information was basically limited to vital signs and and physical appearance. And mostly, the three of us, were there trying to give some respite to the doctors and “medics” taking vitals who’d been doing so for who-knows-how-many months, generally 6-7 long days a week. God bless each one of them. 

There were a few friends that generously sent me money to help me balance the cost of this trip and buy medical supplies for the clinics. Most of what I bought was basic stuffs like blood pressure cuffs, thermometers, stethoscope, etc. Although my job was incredibly easy it was complicated by not being able to communicate with the medics who were there before me who I think appreciated the respite but didn’t want to dump on me and I didn’t want to come in and step on toes but we did all in all get along and felt each other’s good intentions even if we couldn’t communicate in words. One of the medics even used my sharpies to make me a beautiful drawing and presented it to me with a shy smile. 

There was one little girl, about 9 years old, who came to the clinic several days in a row for something that the doctors were following. She would have to wait for hours to be seen and would shyly watch me (well stare at my eyes really and try not to get caught) So I brought her over to my little triage table. I taught her how to use the equipment and take vital signs. Her whole demeanor and smile changed throughout the week. She became my little nurse’s assistant. It also made a lot of the people who came to the clinic to be seen crack a slight smile to see working there along side of me. :)

I need to talk a minute about the children there. The Rohingya in general seem to be a very mild, somewhat shy people. But even in other places, like the rest of southeast Asia where, culturally, the people are very calm and mild, the children are still curious and still smile and play. The children within the camps were abnormally stand off-ish and mistrusting. (Understandably so.)  They did not try to interact at all. In fact, it took quite a bit of coaxing to get them to interact. It makes sense given what they’ve been through and are still going through but it was so drastically different that it stood out immediately. Eventually…I did get them to open up :).  If I had any kind of impression or thoughts while preparing for this particular trip it was, “focus on the kids”. I think playing with the children helped the adults to relax and trust us a little bit more too. It softened all us a bit to have the kids start to smile, including the staff members working with us and the neighborhoods surrounding our little clinics. 

There were two clinics that we went to in different areas of the camps. Mostly we saw primary care type stuff. But really next level primary care. People came with colds and body aches but much more severe colds and body aches than what we might go to the doctor and complaining about. People had really, really bad colds that had gone on for weeks/months. They had respiratory infections that were extreme. And the body aches, I can only imagine were exponentially worse than any body ache I’ve ever experienced. The amount of work and walking they do in a day on almost no calories (if any), not to mention the referred pain from the traumas and emotional stress that they experience probably puts my worst stress headache to shame. We saw 60lb women carrying 30lb bags of rice and double buckets full of water (I think a gallon weighs like 17 lbs or something). The heaviest patient I recall seeing, including men, weighed 119lbs. It is not a stretch to compare their physical appearance to that of what you may have seen in holocaust videos. Everyone was malnourished and some of the babies were terribly, terribly thin. 

I do have to mention that there are supplemental feeding clinics for babies and breastfeeding mothers. There are a few “hospitals,” one particularly that has and “ER” with inpatient capacity set up by Doctors Without Borders. There are women support groups and even some education going on. In the space we were using as our clinic, another group was training some of the women as mid-wives. There are people helping and doing some very good things. However, the amount of help available in comparison to the amount of need is heart-breaking. If our help was a drop in the ocean, it wouldn’t even be big enough to make a perceptible ripple. It goes back to something I’ve come to realize and shared with people in the past. I cannot change the world, I’m not going to solve world hunger, what I do is not enough. But it is what I can do. I have very, very small circle of influence but I will do what I can within the tiny speck of my world.

We saw several cases of the mumps, a few cases of the measles, lots of chicken pox (completely preventable diseases with vaccination) and there was an entire clinic set up to the treatment and containment of diphtheria (also preventable with a vaccine) by Samaritan’s Purse. I have to admit the clinic was impressive. From my standpoint and impression based on that clinic and what I’ve seen elsewhere, they do phenomenal work. Unfortunately, we saw very young children already developing cataracts and losing their vision. I don’t know if this is from the sun, dust, or disease but we saw it more than we should have. I don’t know if anyone is there doing or screening for this but I sure hope so. To see people have permanent damage, go blind or even die from easily preventable circumstances in our day and age is so frustrating. 


The need for basic life necessities was incredibly scarce, despite the amount of aide attempting to be provided by the host country of Bangladesh and from various groups and NGO’s throughout the world. I saw unimaginable-and even as I witnessed them- unfathomable problems of pure survival. 

Again, we mostly saw primary care issues: colds, asthma, muscle aches, a few wounds…only of course they were all a much higher degree of “sick” than what we in western cultures might consider going to the doctor for. The colds had gone on longer and were more severe. The muscle likely much more extreme due to sleeping on the ground in addition to having all the extreme physical stress they put on their bodies from the amount of physical labor it requires to survive on nothing. I’m sure we can all agree they likely have much stronger emotional stressors that contribute to the pains, hurts, and exhaustion that can lead to physical, emotional and mental illness. 

Throughout my time in the camps as I went about trying to do what little I could while there I kept finding myself grateful for the little things. Seeing all the dirty, swollen, busted up feet I suddenly found myself very grateful for shoes. I was more appreciative of each bite I took while there. And, oh, how thankful I was for a hot shower at the end of the day to rest, relax, and be very clean after being so hot, dusty and sweaty. And I’d think, as I indulged in what felt like a much “needed” shower and washing away of a long day, that most of these people had likely never had a long hot, shower like that. Even before they escaped across from their home country of Myanmar/Burma, they likely did not live in such a way that afforded for much rest, let alone hot running water with the turn of a knob. And I grew more and more thankful for little things. And as I grew more thankful I grew more charitable and wanted to give more. As I watched this happen within in myself there was a thought that kept surfacing: Giving out of guilt doesn’t do anyone any good. Giving out of gratitude will change both the amount that is given and the feeling with which is received. 

There is always a temptation to feel guilty for what we have. Especially when we see such extreme, dire circumstances. I do’t believe that guilt does anyone any good. Wouldn’t we all rather receive a gift from a friend who is happy to give than a hand out from stranger who feels guilty? Even with the language barrier, maybe because of it, these were my friends and I was made happier for what I do have and simultaneously happier to give what I could to my new friends. 


Thank you again to all those who helped. It makes a huge difference in what I am able to do when in the camps and for my faith in humanity. God bless you all.