Sunday, February 24, 2008

The chance to see in Bangladesh

By Claudia Hammond
BBC News, Bangladesh

Four million people live on the banks and islands of the Brahmaputra river in Bangladesh. The only substantial medical facility is a floating hospital providing healthcare for local people.

A line of elderly people with pieces of masking tape stuck on one eyebrow queued up in the narrow corridor on board the old French barge.

A child waiting for cataract surgery
The operation takes just seven minutes

They were here for cataract surgery to restore their sight and the masking tape marked the eye needing attention.

"In the excitement people forget which eye it is," the surgeon told me.

There was not exactly time for tender loving care here. It was more of a production line.

After queuing in the corridor each patient was quickly taken into a side room and without a word given an injection in the eye.

Then, as soon as the anaesthetic had time to work, they were led into the operating cabin. Seven minutes later the surgery was done.

It was so fast that while I was interviewing the surgeon, I glanced down at the bed and already a different patient was lying there.

Not a moment was lost, allowing the surgeon to do more than 100 a day.

Floating healthcare

The red, white, and blue barge was sailed all the way from France by a charity called Friendship.

In this part of Bangladesh it is not possible to build a permanent hospital because every time the river floods the sandy islands crumble and disappear, often reappearing somewhere else. So most of the people are nomadic, moving to new land each time their island sinks.

The floating hospital at the side of the river
Inside it does feel more like a boat than a hospital

They live in small thatched huts without electricity and in some islands there is not a single boat, but however remote the island, word gets round when the floating hospital is in town.

After spending the night on a nearby houseboat, we wake to find that fishing trawlers are already dropping off hundreds of people from nearby islands.

They sit in lines on the brown, sandy shore in the shade of black umbrellas, each person holding a referral form from the mobile paramedic team.

Then comes the tricky bit. Getting onto the hospital ship.

This means negotiating 20ft (6m) of narrow gangplank, supported high above the water by rickety bamboo scaffolding.

The crowd are entertained by my attempts to balance with my recording equipment and trailing wires. It reminds me of the high beam at school.

A surgeon carrying out the cataract procedure

A surgeon can carry out more than 100 operations per day

But somehow relatives manage to carry elderly, disabled people along this precarious gangway.

Inside it does feel more like a boat than a hospital. It is very cramped and certainly not hi-tech.

But the European doctors told me the biggest shock for them was the lack of privacy.

They have to get used to consultations accompanied by a couple of faces looking through the window and three or four more people watching from the doorway.

I found myself squeezing past a young man in the corridor and he was keen to show me his hand.

He had been burnt so badly by boiling rice water as a baby that with no treatment available his hand had curled into a permanent fist.

More than 20 years later, he had finally just had surgery to open it up again, and this he told me would change his whole life.

It was not just that he could not use his hand before. Because of cultural strictures against eating with his left hand he had never before shared a meal in another person's home.

After this one operation he could socialise publicly and even get married.

In a tent on the bank the previous day's cataract patients waited to have their bandages removed, after spending the night in a temporary hospital ward in a tent on the shore.

Thirty wooden beds were lined up with no space between them.

In the past so many family members would accompany patients and share the bed at night that the wooden bed frames often snapped - so now it is strictly patients only after nightfall.

First sight

The doctor eased off the cotton wool pad and we waited to see her reaction to her first ever glimpse of the world

A little girl of seven, who had had cataracts in both eyes, was first to find out whether the surgery had been a success.

She sat cross-legged on the floor telling me, "When I can see I will be able to do everything."

The doctor eased off the cotton wool pad and we waited to see her reaction to her first-ever glimpse of the world.

I can only describe her expression as slightly confused and overwhelmed.

Maybe that is not so surprising if the first thing you have ever seen in your life is a doctor and two BBC staff with large microphones.

The local paramedics told me that they ensure that any new doctors see this moment of first sight because it inspires them to stay on to do what they can.

I can understand why.

But not everyone was so lucky.

Near the entrance to the tent a mother was sobbing loudly because her six-year-old blind son was too frightened to get on the boat for his eye surgery.

The clinic was now over and after spending all morning trying, and failing, to coax him on board she was now inconsolable.

He clung to her miserably. She knew this might have been his one chance in life to see.

From Our Own Correspondent was broadcast on Saturday 23 February, 2008 at 1130 GMT on BBC Radio 4. Please check the programme schedules for World Service transmission times.


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