Tag Archives: Bangladesh

NCDs

Came across this interesting article on non-communicable disease in the Daily Star a couple days ago. Check it out here in the Daily Star.

Quite an interesting take on things – and it’s true. A closer look at DALYs (disability adjusted life years, which are a public health indicator of total disease burden) in Bangladesh reveals that NCDs now impose the largest health burden in the country. As the article states, NCDs (inclusive of injuries) accounts for ~61% of disease burden while ~39% is from communicable disease, maternal and child health and nutrition combined.

Policy reflects this as well. Bangladesh’s five-year plan for health identifies cancer, CVD (cardiovascular disease), and diabetes as severe public health problems. But does the policy translate to action? Efforts towards NCD prevention and treatment have been a low national priority for funding and programming in light of the current focus on the MDGs.

We establish global criteria for improving health, which end up defining national public health agendas. It’s unfortunate when the global benchmarks do not reflect the true need of the nation in question; nations are tied down by outside influences that define funding and thus what initiatives can do and what they must focus on.

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In Honor of Harry Potter: Top Ten List Why Bangladesh is Like a Page out of HP

*July 16, 2011

I know I usually try to write a bit more seriously, but everyone and anyone who knows me can attest to the fact that I am an avid Harry Potter fan. And seeing as how I missed the premiere yesterday, aka the end of a very notable era in my life, I thought I’d write a blog post in honor of this special occasion.

  1. Just like you need an entry letter of admission to Hogwarts, you need an entry letter in order to be admitted into Bangladesh.
  2. I felt just like Harry did when he got his first set of robes, when I picked up my first set of salwar kameez.
  3. The weather is as temperamental as the stairs of Hogwarts castle.
  4. “Of course it’s happening in your head, Harry. But why on earth would that mean it’s not real?” I hear car-honking all the time (I mean all the time), to the point where I think now it’s just happening in my head. But it’s still real!
  5. Remember the Knight Bus, the triple-decker, purple bus that quite literally squeezes itself through traffic? This actually happens in real life, right here in Dhaka. You think your bus can’t fit through those three cars in front of you? Think again.
  6. I swear someone is carrying a Deluminator around here. Why else does the electricity go out five times a day? And no, lumos does not help.
  7. You don’t choose the rickshaw, the rickshaw chooses you.
  8. Can’t find Platform 9¾? Welcome to my life of trying to find most places in Bangladesh. You’ll see Road Two, Road Three, Road Four, and then suddenly Road Eight. Where are Roads Five through Seven? Except walking through a wall to reach my destination doesn’t work so well for me here.
  9. I sometimes wish I could take a sip of some Polyjuice Potion, so I wouldn’t stick out so much.
  10. Everyone I’ve met here emits the incredible hospitality and warmth of Molly Weasley.

Just a list of things to show my appreciation for all of the small idiosyncrasies and magic happening right here in Bangladesh.

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Filed under Dhaka, Travel

Journey Woes and Lessons

It’s unbelievable to think that it’s only my first day in Bangladesh. I feel like years have passed since I left Cary.

Despite the fact that this is the longest journey I have made in my life, the flights here were all relatively easy-going until Istanbul.

As I was boarding the final plane east at Ataturk International Airport with the mid-journey stop in Karachi, I handed my passport to the Turkish airline official checking the gate passengers. She flipped over the green pages, and finally asked me if I had a visa. I told her I didn’t have one, that Turkish citizens can receive a 90-day visa on arrival. “I’ve never seen a Turkish citizen go without a visa,” she replied. She called over her colleagues to discuss and analyze, and informed me that the only thing the government would give me, maybe, would be a non-extendable “landing permit” for 15 days. At this point, the most incredible feeling of panic had surged into my body. I know I had read, “visa on arrival” on the Bangladeshi consulate website, which I had searched in-depth even before I knew I could come to Bangladesh. I showed the airline officials my invitation letter from Friendship, on the verge of tears, and one of the men said in Turkish, “I mean, I don’t know if they’ll take you, but I’ll sign off. She has a letter and everything.”

I joined the group that had already been checked, probably visibly shaken. A Pakistani woman I had met minutes before came over and asked me if I was okay. I sat, telling her and a surrounding group of people the saga of my Bengali visa, or the lack thereof. A man sitting across from me stated in a Bangla accent I have come to love, “Everything can be done with money. No problem.” One sitting behind me said, “Don’t worry. I know the Director of Foreign Affairs,” and scribbled his name and contact information on a sheet of torn paper. We lined up to board, and a Turkish man waiting behind me said he thought he remembered that they give visas on arrival. He asked me why I was going, I told him about my public health work, and he said, “Are you sure you want to go to Bangladesh? For that long? You know what you’re getting yourself into, right? I went for a week and I regretted it.”

With annoyance, I boarded the plane, to experience the slowest, most torturous eight-hour flight of my life. “What if I can’t get in?” became the only thought in my mind, echoing and strengthening with each passing minute. What would I do? I couldn’t contact anyone – no phone or Internet. I felt like a toad of some sort had lodged itself in the middle of my throat and any real capacity of my brain to think logically was impeded by “what-ifs” and scenario possibilities. I had been nervous before just about the airport pick-up; now, I knew that I would be the luckiest girl in the world if I could just get in.

The sweet Pakistani woman I’d met before sat next to me for six hours to keep me company, talking over possibilities and listening to me. She tried so hard to distract me from my own thoughts, directing my attention instead to the stars at dawn outside our window, or to my family, or to the US.  It is the most incredible act of kindness, to sit with a stranger during their tough time to help them through. We finally landed, and she told me I was welcome to visit her in Pakistan if Bangladesh didn’t let me in, leaving me her phone number and contact information.

Looking at the Pakistani landscape outside of my window during flight (and we weren’t allowed to leave the plane for security reasons when we landed), I noticed that the Karachi seemed extremely dusty and gray. Kind of like the movies, but I wish the same Americans watching those movies could have met some of the Pakistanis on this plane.  A well-educated, well-traveled and multi-lingual bunch, they would make any person think twice about stereotypes.

Life throws the most incredible people at you, right when you need them. I just don’t acknowledge it on a day-to-day basis.  During the wait, I also met a young woman sitting behind me, from the States, researching in rural Bangladesh on a Fulbright. Christy had learned Bangla, and was coming back from a short visit to the States.  She was the embodiment of what I wanted to be – she had an incredibly happy and easy-going spirit, and was extremely comforting to be around, both with the wealth of her wisdom and her down-to-earth mentality. We talked for a long time, and I felt more and more confident I would somehow find a way in. I told her my frustrations about people’s reactions to Bangladesh, how most people felt entitled to have a negative opinion on the country without ever having visited.  We talked about travel, about Dhaka, and she kindly offered to accompany me through immigration control when we landed, which we did, three hours of horrible baby-screaming, bumpy-flying later.

We walked out, and my body became more and more weak under the symptoms of anxiety. We approached the immigration desk, where two Bangla police were checking passports. My turn. My legs disappeared, my hands shook. He flipped the pages of my passport while Christy conversed with him in Bangla, I handed him my invitation letter and he directed me with a smile to the small room of a “visa office” behind us. My eyes had never seen anything so beautiful. Visa-on-arrival? Check. I was given a 30-day visa, not 90, that I can extend once in Dhaka. Even that, I owe to the fast-changing and ambiguous laws of Bengali immigration.

Happy as a clam, I walked with Christy to pick up my luggage, which arrived flawlessly. We walked out with our trolleys past the security cage where hundreds of families were separating or reuniting, taxi drivers were yelling, cars were honking. The monsoon rain had started since our landing, and a dynamic, colorful sight I’d never seen before met my eyes. Certainly, the rain brings life to Bangladesh, and it was the most beautiful sign of good fortune and of livelihood for me.

I got out of the airport just fine and made it to Gulshan-2, where I am staying. I’ve learned some very valuable lessons from this adventure:

  1. Airline officials are likely to know absolutely nothing, even though they boast walkie-talkies and Internet access. DON’T LISTEN TO THEM. If you read something on visa/travel regulations from a reliable and relevant source, print it out to show them. However, specific airlines do reserve the right to not let you board the plane if you do not have a visa, despite what the rules are in the country you’re traveling to. Call ahead and find out. I don’t think I would have been allowed to board in Istanbul if I hadn’t been Turkish and explained myself to them in that way.
  2. Worries are relative. Whereas before the idea of having to find my own way from the airport to my residence was daunting, that worry quickly seemed to disappear in the face of bigger worries.
  3. What goes around comes around. I have definitely accelerated the aging process for my parents by coming here, so it is only right that I also aged 40 years in the actual act of coming to Bangladesh.
  4. The same goes for good, positive acts. I will never forget the beautiful people – Munira, Christy, the Turkish businessmen, and THY hostesses – who provided a much-needed hand of help and encouraging words during a really trying time for me. I am still floored that I was the lucky recipient of such kind-heartedness, and I promise to pay it forward.

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“The world…is not an inn, but a hospital”

Hospitals have always intrigued me.

I remember, as a child, being captivated by the massiveness and grandeur of the hospitals that I saw through taxi windows in Istanbul. I experienced hospitals through the eyes of a patient as a teen, so I have also felt their unique power to evoke fear. As a family member of a hospital patient later on, I became frustrated with the various doors and curtains that separated the world of the knowing from my world of the waiting. Serving as a volunteer and working as a barista in a local hospital all throughout high school, hospitals transformed into a sacred space for me, guiding patients from sickness to health. Sometimes. If they could pay.

Sir Thomas Browne wrote in 1643, “the world…is not an inn, but a hospital” – a pretty surprising and discouraging statement from the acclaimed author of Religio Medici. Or as Amartya Sen has so wisely put it, an optimistic thought considering that many people who are most ill in the world today get no treatment, nor any access to effective means of prevention.

For a long time, I’ve known my future would somehow or another involve…hospitals. I am so interested in this idea of humans harnessing the sciences and putting them to use to fix each other biologically, and helping each other sustainably.  At UNC, I have dedicated the past three years to learning and discovering the different ways this can really be done. No surprise – I’ve found that multi-layered and diverse problems can only be addressed with multi-layered and diverse solutions.

From what I know, Friendship operates under this very premise in Bangladesh, approaching health equity not with the view of “health” in isolation, but with all of the social and economic embeddedness that comes with it. For details, take a look at the “Friendship Info” tab above, and/or watch the video below (focuses on reconstructive surgeries at Friendship but gives a solid overview of the organization and where it operates).

I am incredibly excited to start my internship with Friendship! Though my role will undoubtedly change and evolve, I’ll be evaluating Friendship’s current community-based healthcare services in the areas of family planning and reproductive health, in addition to looking at health-care seeking behavior in the chars. I will get to see Friendship in action – observing the satellite clinics and experiencing the work of the hospital boats first-hand.

I know I have an exciting journey ahead of me – one filled with copious amounts of learning, growth, adventures, new faces and stories, and even more learning. Six days to go!

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Filed under Pre-Departure