im off

im going bak on the 31st dec.. gotta help my people with my own hands

last day in dhaka and last blog entry

so, i woke up today after a really nice night out

i took the friends i had made over here all out for dinner at this authentic chinese restaurant called 'Cathay' which is on rd 133, gul-1.


mike, the canadian/chinese VSO worker ordered for us all. none of us minded this cause hey, he knows what the food is all we know are the descriptions. it was a nice collection of friends i had made. two of the were english VSO workers, of whom was is a guy called tom who actually lives in the same town i am going to be working in. and then i also had the bangali friends who i had made. in all there were nine of us. and like typical bangalis, we were all late for the 8.30 booking. but that doesnt matter, what matters is that it happened and now when look back on this amazing 12 weeks i feel nothing but a fist of despondency against my cheek.

3months ago, i hardly knew how to speak bangla, i didnt know anything about dhaka, and to be honest, i had no friends either. but i didnt allow this to get me upset, i am here because i am a bangali and i want to be involved in the creation of a better bangladesh.

for the past 4 weeks, since india, i had been working at square hospitals in west panthapath. i chose to work in a private hospital because i wanted to get back into swing of things in terms of hospital medicine. i agree i would have seen much more in dhaka medical, but the reality is, i wanted my last 4 weeks to be relaxed and jungle fever that is dhaka medical, doesnt really appeal to me.

my tutor is a doctor who used to work in london. in fact it was his old boss that put me in contact with him and then via a few exchanges of emails, i was at Square. square, is the most modern hospital in bangladesh. its posh, clean and most of the staff have worked abroad so they deploy a foreign work ethic, something to which i am much more familiar about and comfortable in.

square was a good experience, i saw patients with signs and met lots of nice doctors and on wednesday, i did a short presentation for them about what i have learnt which everyone said was really good, but i think it might be because i put loadsa photos into it. lol

today i am off to the aparajeyo safehouse to see the kids again for the last time in goodness how long. i dont know how i am going to react, i have a sneaky suspicion that i am going to be in tears, there is about 300 kids with so much potential and talent, but sadly, bangladesh can not accomadate them in its society and so its left for Aparajeyo to do the best they can. i am going to be going with a friend of mine who is a barrister. she specialises in human rights and she has an interest in these children as well. this is the 1st time she is going to see this part of society, i am just curious as to how she is going to react. but i guess i will know in a few hours time.

the weather in dhaka is getting warmer, the frequency of storms is more common and the fruit ripening season is looming. all these ingredients mean monsoon is on the horizon. im sad im not here for that but in a way i am glad i am. i dont like getting caught up in the storm, and since i public transport everywhere, getting wet is a consequence of it.

however, i must admit i have grown an affinity for dhaka. i know my region of bangladesh is sylhet, but like london, i really like dhaka. i am a stokie who loves london and i am also a syhletty who loves dhaka. i really hope that my plan to come back here someday as a this great doctor will be a reality. i want to invest so much into this city and country and to help right many of the wrongs that exist. this is a lengthy process, and i shall be on the ladder a junior doctor from august.

i will try to visit bangladesh every year, and i will make sure i stay in dhaka a few days at a time aswell. the only sad thing i have not done is go to the village and see my relatives. selfish i know, but i honestly didnt want to see them. i feel as though my independance would have been compromised as i know many of them would have reacted to me as somebody who has no idea about bangladesh, but to be honest i have surprised myself as to how easy i have fitted into this city. crazy shit eh?

my flights tomorrow morning, need to check in for 8am. i will be back in london and back in halls for around 11pm uk time. i get a suspicion that UK is going to be so mundane, and that all the problems people have are just so petty. bangladesh has really put things into such a good perspective for myself and i shall not see things in the same context as i used to before.

as a parting wish for bangladesh, i wish for more british bengalis, like myself, not necessarily doctors will come to bangladesh to get more than a snapshot about the reality here. the country needs the university graduates like myself to help in making the place better. for those who dont know, the country has no official government, and sadly, corruption is so popular, you can not live without it. thats why this country needs us foreign bangladeshis who have grown in systems where corruption literally doesnt exist. i dont want to sound naive and pretend that living in the UK that all is flowers and green grass, but at least, social class, and corruption are issues that are not holding back the people.

so my point is, if you are a british bangali, come to bangladesh for a few months or even a gap year and see what the country your parents left is really like and use the gift what god gave to you to share with those who need it.

shuwaib

crazy india

just come back from a crazy fortnight in india..

the place is vast with many treasures. i met with matt, raj and prit and celebrated life and becoming doctors.

lots of fun and frolics

i think im getting blog exhaustion. i cant be arsed anymore now to update.. ill try to again. i feel refreshed now and will start again to do write stuff

peace out

i went to a wedding, but i dont know who's!

hey guys

my boss asked me to go to a wedding reception tonight. i asked what should i wear and she said, a panjabi. turns out i was the ONLY person wearing one and it was bright royal blue! ahh well, at least i made my entrance...

the food was shit but i met some nice people.

enjoy

the two women i am with are my boss and the lady with the red bindi is laila auntie. laila auntie is really cool, her dress sense at times is weird, but she has been like an auntie to me, and making sure i am ok all the time. lovely woman, i should get her a sari or something as a present..






shuw

i am still alive

the blog has been a bit dead this past week which i am sorry for, ive been tied up this week with stuff and planning my india trip. but i shall try to update this thing and let you readers know whats happening...

if you do read this, please leave a lil message, i want to know how many people read this blog.

thanks

shuwaib

from Womb to Tomb

on my second visit to a healthcare organisation in dhaka, my boss at FPAB sent me to another NGO organisation called Bangladesh Women's Health Coalition.

in the morning, i took the ritual of a CNG taxi to mohammedpur, the west part of central dhaka, the journey itself in the morning is pleasant. the road takes one past the parliament building which i have yet to snap and also the impressive structure of bangladesh's astronomy centre. regarding the stars, bangladesh spent a whopping 120M USD on building this? its strange why education like this takes prioty when that money could have been utilised in an appropiate channel eg the poor people!! or rurual education!!! lions led by donkeys...

so i reached the head office of BWHC a little early and i met the good friend of my boss, Dr Julia Ahmed. the striking thing about her is that she is relatively young to be head of an NGO. i would say she is early forties and is in good health. i was in her office for about half an hour discussing my reason for being in bangladesh and my reason why i have chosen in essence reproductive health when i could have chosen any speciality and any destination in the world.

i told her honestly that the idea of seeing the world is a desire of mine, and i would love to be where chewee/tony are or even where raj is but this opportunity to return to the homeland and to not be a tourist but someone who has a more grounded understanding and dare i say it, maturity is a chance that i couldnt pass. i admit frankly now, that dhaka is not the best place in the world especially for a social life or having fun, but i have london for that and i have my friends and also a certain special someone in manor park that i can have fun with.

anyways, Dr ahmed, explained what BWHC was about and the moto they have is, healthcare from the womb to the tomb. today, i was in for a treat, i would be sent by the company car (luxury or what) to see all the clinics they have in their urban programmes, they do rural programmes, but me being the city boy i am is finding it difficult being in the countryside. i think i get nightmares about the rural clinics of health care because i hate bangladesh countryside, for some, its natural beauty, for me it is a symbol of boredom. (no offence to the lovers of bdesh countryside)

the first clinic i was sent to was about 3miles away from the supreme court. the supreme court is this strikingly whilte building in the heart of the city and it is where all the legal things are fought about, i dont know whether or not the place is an honest place to be involved in as a lawyer but one thing which i know about bangladesh, is that, never trust the government, even if they are involved in a massive crackdown at the moment. this is a country with people with hidden agendas and a lust for money and social status.

so i arrived at the first clinc. there was a loss in the translation, i thought i was going to spend the whole day there but this was purely a visit. this centre was a maternity centre, it was a building situated right in the heart of one of dhaka's most poorest populations, and it served the people not just as a maternity centre but also as a health care clinic. the building was four floors. the ground floor was the reception and pharmacy, the second was the GP clinic, the third was the obs/gynae section and the top was the office. the lady who recieved me here was dr rebekah. she was a wonderful women, explaing what the centre does and who it serves and all the history and any answered any of my curiousities. people have been treating me with very warmly here, i wish people could be a bit more like this in england, especially at the hospitals.

so, i was then handed over to the anaesthist who deals with c-section pts, his name is dr rashid, very nice guy, young tall and a bit overweight. he then gave me the grand tour of the centre, introducing me to all the staff as 'Dr Mirza' (still feels weird knowing that im not gonna be Mr anymore) explaining to them all that i am from the UK and here to have a look at health care here. the staff were very friendly and really nice, asking me if i want a cup of tea every 5s, but it was touching. after the ground tour, i was then shifted over to the driver who brought me here to go to another urban clinic. i was sad to leave this centre, cause i really liked it and wouldnt have minded spending the day and doing some medicine in their GP section of the building.

i now went to another clinic in an area which was more poor than the centre i was at. the clinic was small and here, they have a doctor, a counsellor and no pharmacy. the doctor that works here was a young doctor, probably 25 and her name was dr khan. the striking thing about her was that she was really pretty, (hubba hubba!!!) but she was cool, she gave me the brief guided tour of the place and explained who her patients are and etc. after 20mins, and another 5 offers of a cup of tea, i then sadly departed, not being able to use my charm on her to go to the second to last clinic i was going to visit.

the place was called gandaria, and it was situated a mile north of the big river buriganga. this place was right in the heart of 'old' dhaka. the area was made of a meshwork of slums where most of the patients live. as you can imagine, the patients here are commonly ill with TB being the most common disease. dr shilpi, a young doctor was the lady in charge here. her job here was similar to that of a gp, patients come in, their notes are provided and then bang, same as a GP surgery in england. the difference here compared to the other places where i had visited, was that, i was now playing an active part in patient diagnosis and management. dr shilpi, gave me the privaledge of taking the history and and prescribing the medication. i saw a crazy number of patients in the space of 3 hours, all these patients are sadly very poor and dont have very good education. its just hard to comprehend this exists especially in the comfort of england. but i tried to do as much as possible to help, for example, with one patient, i taught him how he should be using his asthma inhaler. dr shilpi, had her faults, she didnt give a damn how he was using it, but, i told her simple things like education is imperative!! i was afraid i may have been patronising her, especially since i am still a student... but at the end of the day, she was really nice to me and said i am welcome to have dinner with her and her husband at their house. after we finished the clinic at 4pm, it was time to move on to the last place to visit for the day.

this place, if my parents knew i went to would be upset but i am the today and they are the yday. this clinic was not a clinic as such but a place with counsellours providing healthcare and advice. no doctor chooses to work here because they fear they may not be employed elsewhere. it sad that a mentality like that exists here but i will explain to you why.

the final clinic i visited was the drop in centre where commercial sex workers visit to receive healthcare and advice. it also serves as a nursery for their children so they can receive education whilst the mums are at work. poverty is so desparate in bangladesh that there is an estimated number of prostitutes that exceeds the population of some small countries. islam and a conservative social culture mean nothing when it comes to helping the poor in the land of bangladesh. so if you are curious why i went to visit this place, its beacause i care about these people whilst others do not.

i was received here very warm. the lady who works here is called anodha, and she was a former sex worker and now a trained health care advocate. teachin about condom use and recognition of STIs. she was really nice and i was touched when she called me brother. i told her, please dont call me brother, call me shuwaib. she went to show me her humble clinic, and the achievements they have made displayed by photos taken by BWHC. she was a very proud woman. i got to meet some patients that were here and spoke to them about what they were concerened about and i once again answered the questions about why i am in bangladesh. but i didnt mind, i am just satisfying their curiousity like i am doing with mine. at the end of the half hr i was there, i had a crowd of 6 patients, and i demonstrated to them how to put on a condom. if no other doctor will show them, i really should. the 6 of them knew exactly how to put one on, they didnt use my willy to demonstrate but i bought some bananas for the demonstration.

i then popped my head into the nursery to see what the kids were learning. so innocent and yet forgotten by their people. i said my goodbyes and i promised anodha i will return and teach the kids the english alphabet before i head back to england.

it is sad that an NGO takes resposibilty for them and not a GO. on the bright side of it though, and slightly contrary, BWHC is funded partly by the bangladesh government. however, it is a shame the government can not just come out and be frank about the internal problems of the country but does the easy option and just pay someone else to do the work for them.

i got home that evening for 9pm. i stopped off at Kozmo lounge, the best place for coffee in this city. its a nice coffee shop. i will take pictures of it, but i go there to just wind down.

anyways, im off, gonna chill for the rest of the day.

shuw

private medical care, u gotta love it

On Monday, I spent the most part of the working day in a private medical college in gulshan. I was looking forward to this very much because it would be an interesting stark contrast to what I am used to after learning in the clinical settings of the NHS. My previous exposure to private healthcare was at the south Wellington whilst I was doing my SSM late last year and also at a harley street clinic. I, however, have been trying very hard to be open minded in what I will expect in when I go to these places. I cant be biased and the british upbringing I have shouldn’t cloud my expectations of what exists.

Healthcare in Bangladesh is very important. It is expensive here and there is a massive shortage of facilities in the public sector. However, in the private sector, the patients here are the ones that can afford to pay for their consultations and medicines and the rent required for the hospital bed. Knowing all this, one should also bear in mind that this is a country where the average wage is under the golden British pound.

I arrived at the college and I was greeted by the principle of the college; he is a good friend of my boss at FPAB and therefore, this is how I got the contact and the arrangements for my visit. The principle, himself was a character that really put the fear within me. He has very few facial expressions and he appears at times to be obnoxious to my curiosities of his college. I actually felt quite intimidated by this man, thinking that the next time I open my mouth will be something that offends him. We both had tea together and I told him my schooling history and family history and he then told me his history and how he had been to London to get a PhD from the london school of tropical medicine. For some benign reason, when I tell anyone the name of my medical school, they appear clueless which leads me to believe, is it a shit uni??

The prof then called one of his staff, a young doctor who lectures in pharmacology at the college to give me a guided tour of all the departments at the college itself. They take a lot of pride here, and the facilities they have; one thing that struck me was the amount of science these students do. I swear the stuff the 1st years were being taught was the stuff I learnt in high school, I swear by it.

Then I looked around the anatomy labs and histopathology and microbiology depts, I was feeling thick because at Bart’s we don’t do half the stuff these kids get taught. We have learning landscape but that is nothing to what they have. The big contrast is that the kids in Bangladesh learn, or should I quote, memorise text, pictures and things. They don’t use their minds to work things out or how to apply their knowledge, but they learn things in text books like the way I used to learn my lines whenever I used to be in a school play.

After I had been given a tour of the college, it was now time to be given a tour of the hospital. The hospital is very clean. If you are going to be in a private hospital, cleanliness is the thing that makes one feel that their money is well spent. At the hospital, it can hold a maximum of 300 patients. And unlike an NHS hospital, there were, believe it or not, only 20 patients. On questioning why there are only so few, the answer is, ‘it’s a new hospital and many people think it is too expensive.’ This excuse is exhausted and I felt extremely insulted seeing a hospital not being utilised for its maximum potential. There are people dying at the entrance of government hospitals and this place does nothing to help. It really is sad. The other thing that really pissed me off was the fact there are so many doctors, just lounging around, reading a paper, drinking tea and literally being paid to do nothing. These doctors go abroad to get fancy letters like FRCS, MRCS so they can go back to Bangladesh just so they can be paid 1 lakh per month to sit on their arses. It really is a disgusting sight.

My guide then donated me to another doctor who works in the ITU, there were three registrars for ONE patient!! The patient had a stroke and the registrar was going through the history of the patient and discussing the management plan. I looked at the notes and the drug history for him, and I was shocked. This patient was being treated for symptoms of the stroke. But nobody has even bothered to treat him in preventing a second stroke. Even his drug history was awfully managed. His doctor who was looking after him for his diabetes and high blood pressure was not even applying the modern guidelines in his drug regimen. I then told the registrar it was no surprise he had a stroke. The registrar then defended my accusation of negligence by saying the community doctor must be some crappy village doctor. The truth is, the community doctor is probably some city doctor, making big bucks but not properly looking after his patient. This was disgusting and if this were England, we would have a legitimate legal case here.

I understand when it comes to medicine I am not the sharpest knife in the drawer, but I know my basics and I am now a lot more confident and I feel competent in knowing when a patient is being fucked over by his doctor. Anyhow, needless to say, the registrar and I fell out. The irony was when the ITU consultant came down and I then told him what should be done. I am not even a doctor yet, I have another 4 months left. I was feeling extremely angry. Thank god in the UK we have NICE guidelines.

Afterwards, I was then taken to see the outpatient clinics; here I met an Indian couple. They were the typical Bangalore IT workers employed by a Bangladeshi company. Sad, that Bangladesh doesn’t have people to do their jobs but India does. Anyways, the couple were in because the wife was having her 1st antenatal check. They were very nice people, very chuffed to have a ‘Dr’ from the UK come sit in with them in their consultation. The reason of concern for the lady was that she was anaemic and as they were vegis, they needed to put more iron in their diet. The advice the obstetric consultant was giving was simply ‘take iron tablets’. I then intervened and asked, are you not going to advise anything else? So, I then gave them dietary advice, what to eat, what to avoid, what to do to stay fit and how to recognise the signs of anything bad that hopefully wont happen. I think the consultant was quite offended, because I was doing her job, the only difference I was that I wasn’t expecting a fee. After the consultation, I went along to see the ultrasound being done. I swear in England, ultrasound is not done by doctors. It is a nurse’s job, however, here they employ a doctor to do ultrasound all day!! What a waste of resource. She doesn’t even report the findings, all she does is applies the jelly and gets the image. That’s it!! 5 years of med school so she can take pictures! This was ridiculous, next thing I was expecting to find was a doctor mopping the floor. I mean no disrespect to people who do these jobs, but doctors treat people.

I learnt after this day that the place was really inefficient, and only god know how the hospital survives and is able to afford to pay doctors their wages whilst they have so few patients. I learnt today how an MBBS is wasted and when I think of it, it makes me sick.

i didnt take many pictures, i dont think the places deserved it