Bangladesh

Festivities at the Annual IUBAT Nursing Picnic

spring 2018 picnic - pot pinata

Students play “pot pinata” – where the participant is blindfolded and attempts to strike an upturned clay pot on the ground ahead

On March 15th, 2018, current BSN students planned a student/faculty/alumni picnic.  Every year, students have the opportunity to organize such an event in order to have some extracurricular social time, but also to develop their leadership and organizational skills whilst learning to work as a team.  The students organize the picnics themselves, including all the transportation, food, games, sound system, venue and budget.  The location often varies, with some examples in the past being resort parks or rural areas.  This year, approximately 80 people, including faculty, alumni, students and family members, attended the picnic, hosted at a park in Gazipur, about 2 hours by bus from the university.  There was a swimming pool that was enjoyed by many and games were played.  The students cooked food for the attendees and fun was had by all.

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Students swimming in the park, an increasingly popular pastime.

Stories from the Heart of the Rohingya Refugee Crisis

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Firoza, pictured here, with a patient from the camp.

We always love getting updates from previous graduates, especially from those working with unique populations and can give us insight into current world events and international aid efforts. One such graduate is Firoza (featured in this blog post), who had the opportunity to support and provide aid to Rohingya refugees amidst the refugee crisis in Bangladesh. Firoza works with Sajida Foundation, a non-profit social organization focused on providing quality healthcare and social development programs to disenfranchised and marginalized populations and communities. From October 4th, 2017 to December 31st, 2017, the Sajida Foundation sent a team of 22 staff (comprising of 4 doctors, 4 nurses – including Firoza, 10 volunteers in varying capacities, 1 pharmacy assistant and 3 administrative staff) to the Ukhia Rohingya Refugee Camp in order to reach the ultimate goal of, “…ensuring accesses to basic health and nutrition services among Rohingya refugees, including lactating mothers, newborns and children, to help them survive, recover and gain control on their healthy futures.” Firoza has very kindly recounted this experience for our readers (warning, please note that this passage includes details that some may find disturbing). She writes:

Our team operated at a health camp with a fixed location, where we offered primary healthcare with antenatal care, perinatal care, and emergency management. We also have ‘kid’s corners’ with extracurricular activities and drawing materials so that children can play, and consequently reduce their own stress levels. We provide them with healthcare and engaging activities to reduce the chance that they become involved with criminal activity.

We also have the volunteers provide field visits to offer assistance to those who are unable to visit our health camp. These volunteers visit each and every household, looking to help those who need it most, especially pregnant women, sick children and the elderly.

My responsibility in this team is to supervise the volunteers and nursing staff in our provision of healthcare to the residents of the refugee camp. We have encountered many barriers to care and hardships, for example, an unexpected crisis was when a Diphtheria outbreak occurred in the camp at the beginning of December.

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Firoza, consulting with a group of patients.

The conditions in the camps are very difficult. When we first arrived, more than 5000 Rohingya refugees were arriving per day. They did not have food, clothes or shelter, many Rohingyans made use of a nearby tree for a makeshift shelter. There are often cries for food from children and the elderly, but because they are so dehydrated, there are no tears. These memories are painful to recall. The lack of shelter rendered the refugees defenseless from the forces of nature, contagious disease and other animals. For example, an eight-month old child was bitten several times by a fox overnight due to a shortage of indoor accommodations. There were also a variety of other complaints, ranging from skin disease, such as scabies and ringworm, to post traumatic stress disorder. Most of the Rohingya people had lost one or two family members, with some losing more than five. Equally distressing, there were many pregnant women who had lost their husbands at the hands of the Myanmar military and consequently had been sexually assaulted.

One patient’s ordeal that stands out in my memory is one of a woman presenting with complaints of vaginal bleeding. She tearfully expressed that two months prior, she was in Myanmar and was three months pregnant at the time. One day, three Myanmese military members arrived unannounced at their house and killed her 13-year old son. As she tried to stop them, one of them raped her and caused her to spontaneously abort her unborn child. I could feel that woman’s pain, and it stays with me until this day.

Another story that stuck with me was of a child who was playing in our ‘kid’s corner’, where more than 20 children could safely play and interact with one another. We had instructed the children to draw and write what was currently in their minds and hearts and one child, a five-year old, wrote, “ I want to go back home.” That statement touched me because it represented despair, but also hope for a future, in a place that was home for the Rohingya people, where they would be accepted and belong.

Much gratitude to Firoza for sharing her story, despite the sensitive nature of her work. Thank you for bringing light to the atrocities and difficulties being faced by the Rohingyan people and thank you so much for your contributions – extending a helping hand to a population who so urgently need our help. For more information on the Sajida Foundation or to donate, please click here. For more information on how you can help the Rohingya refugee crisis, please click here.

Dhaka Faced with Problems of Growth

The Guardian article features the overpopulation problem in Dhaka.

The Guardian article features the overpopulation problem in Dhaka.

In a special series on overstretched cities running in ‘The Guardian’, an article looks at the rapid urbanization and growth of Dhaka, Bangladesh.  Due to this growth, problems such as insufficient monsoon rain drainage in the sewer infrastructure have emerged, partially due to the administrative problems of Dhaka.  Beyond the difficulties faced by the sanitation workers lies the problem of a country of 160 million with no effective political decentralization of authority to regions and urban government.

According to UN Habitat, Dhaka is the world’s most crowded city and the fastest growing in terms of population.  This overpopulation means that Dhaka has grown faster than infrastructure development and that the management of the city is lagging.  In Dhaka, governance of the city systems are the responsibility of, “a chaotic mix of competing bodies”, which leads to a lack of coordination and many hands passing the blame.

The city sewer cleaners, dubbed as having the ‘worst job in the world’ by international media, face stigma and dangerous work conditions.  Many in the profession are Hindu dalits, significant because the majority of Bangladeshis are Muslim, and Hindus were singled out for persecution during Bangladesh’s war for independence from Pakistan.  Furthermore, dalits belong to the lowest caste level, known as ‘untouchables’, and often are given low-paying, lowly jobs in society.

Despite these serious issues of urbanization, there is hope: Bangladesh has won praise for it’s progressive responses in other arenas, such as climate-change, and experts deem that social movements borne from the confines of urban spaces can have the power to change and discipline governments.  According to Population Sciences Professor Nurun Nabi, “Many stories will be written by the people of this nation – forget about the political parties.  Someday they will wake up and be forced to comply with their speech.”

For more information and a fascination depiction of the strain experienced by this megacity, please click here.

 

Long-time Volunteer Examines the Progress in Bangladesh

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In our last post, Sara Jackson, a long-time volunteer with the BHP, described her first visit to Bangladesh.  It serves as juxtaposition to her most recent visit, in 2017.  She recounts her most recent trip:

“I recently returned to Vancouver after three months in Bangladesh.  The IUBAT nursing program has their own Bangladeshi faculty these days; therefore, instead of teaching, I spent my time supporting the instructors by writing exam questions, filling in some knowledge gaps and accompanying them to hospital clinical practice sites with the students.  The faculty are all young, bright, passionate, and well-versed professionals.  I found the students to be open and willing to learn and succeed in this not so easy country.  I was able to offer some language instruction and was pleased to edit research papers and assist with academic writing.  I basically jumped in to help as needed.

Apart from work at IUBAT, I prepared a two-day workshop on hygiene and infection control for the Sajida Organization’s (an NGO-health organization) new homecare aid hires.  This was a very positive experience.  The Organization invited me to attend a three-day workshop on High Risk Labour and Delivery, facilitated by Team Broken Earth from Newfoundland.  The target audience was a large group of OBGYNs that the Sajida Organization employs at their progressive hospitals.

Another one of the highlights was a social event on a Saturday. We spent the day on a hired boat with large speakers and a DJ. One of the students prepared chicken biryani and snacks for the cruise. Bangladesh has a six-day work and study week, so this was a great opportunity to have some much needed leisure time. I was enjoying myself so much, I decided to extend my time in Bangladesh by an extra month. The work was so interesting and varied. Bangladeshis are warm, welcoming, kind, and not to mention, have a great sense of humour!

IUBAT is now fully staffed with Bangladeshi nursing faculty.  I was fortunate to connect with IUBAT Nursing graduates employed in research, with international NGOs, as nurse managers, coordinators and in other high functioning and demanding positions in healthcare.  These students have a bright future to pursue.  In and around Dhaka, growth and change is highly visible.  Many of the construction and mega projects are mind- boggling to see and strangely futuristic.

One week before returning to Vancouver, two volunteers from Alberta, Nancy and Eve, arrived.  This was Nancy’s second visit.  The time we spend as volunteers in Bangladesh is so appreciated.  Volunteers leave this country with more knowledge, indelible memories, but mostly an open heart.”

Sara, we appreciate your insight, expertise and your immense contributions to the success of the Bangladesh Health Project, both in North America and in Bangladesh.  This longitudinal description is helpful for our readers who are interested in the progress of the Program and the country, or are curious as to how things are currently, as compared to when they themselves last visited IUBAT!  We look forward to more of these types of stories from people who have been with the Program over the years as it grew.

Long-Time Volunteer Describes her First Visit to Dhaka

Sara Jackson, a long-time volunteer with the BHP (also featured here and here), wrote to us and reflected about her recent visit to IUBAT. Sara is a volunteer at home, as our return volunteer recognition liaison since 2013, and abroad, serving as visiting nursing faculty and student support when at IUBAT. She has also lent her expertise to the Sajida Organization (an NGO health-organization in Bangladesh) for the purposes of homecare program development. When she is not overseas, Sara is a Licensed Practical Nurse in Vancouver, and has culled her vast clinical experience from a variety of settings, spending the last 15 years working with HIV/AIDS and co-occurring disorders, including palliative care. She is presently employed as a clinical research associate with the BC Centre on Drug Use, and is also an ESL teacher to internationally educated nurses.

We have asked Sara to detail her first trip to Dhaka so that it truly illustrates the transformation and the extent of the change that the Program has undergone. She writes:

“My first trip to Bangladesh was in 2014.  I volunteered with the Project as visiting faculty and worked alongside a critical care nurse from the US, two Canadian nurse educators, and a retired orthopedic surgeon.  At that time, fourth-year BSN students from Vancouver Community College spent a six-week practicum in Dhaka studying community and global health.  We were all hosted at the IUBAT guesthouse.  In addition, a most wonderful American poet from Louisiana, Dorie LaRue, shared the space while she was volunteering with the English faculty.  Dorie later published a book of poetry about her experience in Bangladesh entitled, ‘Mad Rains’.  It’s a wonderful read.  I was fortunate to have shared many Dhaka adventures with Dorie.

The IUBAT campus is in Uttara, a model town in the suburbs of Dhaka.  The campus was more modern than I imagined.  All classes are taught in English and the senior students had a good command of the language.  I instructed first and second-year students in bedside nursing skills and vital signs in the Nursing Lab and theory in one of the bright classrooms.  The VCC and IUBAT students studied and mentored each other.

The 'Soul Train' during Eid

The ‘Soul Train’ during Eid

Dr. Nazmul Huda from Dhaka provided us with plenty of opportunities to visit various healthcare facilities, including a weekend trip to his family home near Barisal in the south.  The road trip alone was like watching a non-stop National Geographic documentary.  It is difficult to put into words the scenes of humanity witnessed.  Dr. Huda also arranged a paddle wheeler excursion on a restored vessel down the Mehgna River.  We were able to spend some time away from Dhaka, the chaos capital of the world, at the tea plantation area of Sylhet, as well as Rajshahi, the mango capital of Bangladesh.  Rajashi is a lush, green, and agricultural area uring the monsoon season.  It is located on the Padma River and is surprisingly quiet.  There are many ancient Hindu temples and mosques close by.  What a dream to experience such a place.”

Thank you Sara, for painting such a rich picture of your first glimpse of Bangladesh and of the BScN Program at IUBAT. Sara’s account will be continued in the next post, where she recounts her 2017 visit.

Volunteers Recall Memories of Bangladesh

Nancy and Emily at the "Mini" Taj
Emily Hagg, a ICU RN at the Foothills Medical Center in Calgary, and Nancy Campbell, a Registered Nurse with Alberta Health Services, recently returned from Dhaka, where they volunteered with the Bangladesh Health Project. We asked Nancy and Emily to regale us with their favourite stories and most memorable moments from their trip.

Emily: “I was in Bangladesh from Jan. 11th to April 3th, so I was there for almost an entire semester. My official role was as a Post-Graduate Research Fellow, which mostly entailed being available as a mentor to the nursing instructors already in place and helping out with whatever I could in the classes and clinicals.

Nancy: “I arrived in Dhaka March 7th and left April 8th. My arrival was easy for me as Emily was already there! Emtiaz from the IUBAT Nursing College met me at the airport and I felt supported for the entire time. My official position was the same as Emily’s: Visiting Research Fellow, and my role was the same as well, to support the Nursing Faculty in the clinical and classroom settings. I also had the opportunity to work with the Sajeda Foundation on the development of their Home Care Program and their Seniors’ Supportive Housing Facility project.”

Emily: “What I especially loved about my experience was how friendly people were in Bangladesh, from the instructors, the students, to people on the street: just big smiles wherever I went. Initially, I had to adjust to the attention and the people just wanting to know about you and get close to you, which is very different from North American culture! I also will always remember how respectful the nursing students were! They stood when we instructors came into the room, calling us “ma’am”, earnestly listening to every word we ever said, and being protective of us when we were out in public together, etc. They were so polite and pleasant to work with!”

Emily at the Pink Palace in Old Dhaka

Emily at the Pink Palace in Old Dhaka

Nancy: “Yes! The thing I will always remember is walking into a classroom that first afternoon and all of the students standing up when the faculty entered. That just doesn’t happen in Canada. As I got to know them, I was humbled by their commitment to their education: the daily challenges they had just to get to school, on top of having to learn in English – nursing education is tough enough without these challenges. There wasn’t single day that I didn’t have an interaction with one of them that made me smile. They included us in their annual picnic and it was an incredible day, full of surprises and adventures.

IUBAT was similarly great: a sanctuary created by the school with the tea in the cafe, the guards that helped you cross the road in crazy traffic and of course, the long lineups to use the elevators. The faculty of the nursing college were simply amazing. They mentored us on “life” in Dhaka as much as we mentored them on nursing education.

It was interesting to be stared at and be asked to take pictures with total strangers. Add to that the population density that I hadn’t yet ever experienced – I didn’t know what to think at first. While it was unusual to have my activities/freedoms curtailed, I did not ever feel threatened or unsafe. Also, everyone should ride in a rickshaw at least once in their life! One cannot think of Dhaka without thinking of the traffic and the noise; there are absolutely no words that adequately describe the travel by van in that city.”

Emily: “I was definitely surprised by the instant celebrity status we seemed to develop by just entering the country and how hard that was to get used to. I didn’t think it would be quite the extreme that it was. It would have been nice (and easier to move around) if we were more ‘invisible’.” 

Emily and Nancy at the guest house

Emily and Nancy at the guest house

Emily: “If I had any advice for those interested in volunteering, it would be to be prepared to ‘go with the flow’! Things change rapidly and your day seldom works out as you initially planned it. It’s important not to get stressed out about stuff like that. Also, the accommodations are better than the volunteer manual makes them out to be! There’s hot water showers, a washing machine available, etc. It’s also so nice not having to prepare lunch and supper everyday! Finally, Caucasians should be extra prepared to be an object of fascination every where you go. It often takes longer to move around because of this fact.”

Nancy: “Anyone who is open to a new experience should go. I would encourage my nurse colleagues to go and experience a world where you can truly mentor nursing leadership AND grow an appreciation for the respect that nursing receives in Canada. Perhaps a practical piece of advice would be to get your visa before you arrive – I spent 2.5 hours in the VISA on arrival booth and an additional hour when I left because I had overstayed by 2 days. Despite that, it was amazing to be able to have a small impact and change the world of nursing in Bangladesh. I hope to go back very soon.”

A big thanks to Nancy and Emily for sharing their favourite recollections of Bangladesh; we love hearing from our volunteers! If any potential volunteers are interested and would like more information, please go to the Volunteer section on our website.

Updates from BHP’s Advisor of Health Sciences

Alex IUBAT 2017
Alex Berland, Advisor of Health Sciences at IUBAT and founding member of the Bangladesh Health Project, reports on his recent visit to IUBAT.  He writes:

“The university is overall busier than ever with new construction underway to meet the demand for good quality higher education. College of Nursing enrolment remains disappointing, mostly due to proliferation of private colleges with cheaper fees; guardians may not consider quality in making decisions, especially for their daughters. IUBAT is now reducing BSN tuition fees with scholarships for strong students.

On a brighter note, I was happy to observe in both classroom and hospital the quality of current students. Obviously, our faculty are doing a terrific job promoting English use, encouraging critical thinking and pushing students to use problem-solving skills. Dr. Masud, Coordinator of the College of Nursing, is building a strong faculty team of graduates from IUBAT as well as other good colleges. After several meetings with faculty, I feel very positive about their ability.

Our library collection and nursing lab benefitted from re-organization by visiting faculty Anne-Marie Hummelman. Spring semester volunteers, Emily Hagg and Nancy Campbell, shared their positive impressions of faculty that they have been mentoring. Also, I visited an excellent practice site, Universal Medical Hospital, led by a visionary chairwoman who has hired IUBAT graduates as senior managers. Similarly, at Sajida Health Programs, IUBAT graduates hold senior roles managing innovative programs. Several IUBAT graduates recently sent news about their career accomplishments, so I am feeling very positive about the impact of the Bangladesh Health Project through its many supporters and visiting faculty over the past 13 years.”

Bangladesh’s Progress Highlighted in Medical Publication

The BMJ, an international medical journal, recently published an article entitled, “Why has Bangladesh done so well?”  In the article, Richard Smith, the chair of the Board of Trustees of icddr,b (formerly known as the International Centre for Diarrhoeal Disease Research in Bangladesh) discusses the elements that may have helped improve the standard of living in Bangladesh.

Bangladesh has had a tumultous past, rife with episodes of civil unrest, war and famine, with each event resulting high mortality rates.  However, it has now become one of the few low income countries to achieve the Millenium Development Goals: life expectancy has increased from 50 to 70+, child deaths under 5 years have dropped from 25% to 4%, and maternal mortality has fallen from 700 per 100 000 to 150.  Almost all children go to school, and the literacy rate of ~67% is equal among both males and females.

The author discusses several relevant cases of health improvements in Bangladesh, exploring why the country has made such major strides in its development. For instance, Richard Smith explains the role of factors such as education, research, cultural sensitivity, social science and female empowerment in the usage of oral rehydration treatment (ORT) to treat roughly 80% of cases of childhood diarrhoea, the highest rate in the world.  Lessons such as these has helped Bangladesh work towards becoming a middle-income country within a decade.  Despite all of the progress, there are still obstacles that Bangladesh has yet to overcome; amongst the issues are a moderately high maternal mortality rate, security, child marriage and loss of land due to climate change.

For more details and an in-depth analysis, please read the blog post on BMJ.com.

 

Bangladesh Health Project Plans for 2017

As the Bangladesh Health Project (BHP) progresses, we focus on new priorities and needs. With IUBAT alumni now taking more senior roles as nurse educators and managers, our volunteers offer more mentoring and coaching and less student teaching. Looking ahead, these are our objectives:

  1. Provide mentoring support for faculty of IUBAT College of Nursing

BHP has completed mentorship and training of several cohorts of BSN students.  Our next goal is to strengthen nursing faculty capacity.  Through phone contact, e-mail and visiting faculty volunteers, we will assist with program development, classroom teaching, clinical supervision and student evaluation. As feasible, we will continue to supply textbooks and teaching materials. We will provide demonstration lectures for IUBAT nursing students and for staff at our teaching hospital sites.

  1. Support IUBAT graduates in their professional development

In recent years, we have supported IUBAT alumni working in hospitals, colleges and NGOs with mentorship for issues related to advanced education, nursing administration and access to technical information. We will continue supporting our graduates as they advance in their careers and undertake leadership roles.

  1. Develop resources to promote nurse education in Bangladesh

We will continue to offer textbooks to local nursing colleges, ideally establishing a central library for advanced materials, to be used by faculty and senior hospital staff. We will continue developing our Open Education Resource, an open-source collection of BSN curriculum materials for faculty to use in lesson preparation: www.OR4NED.com

  1. Build relationships with colleges and NGOs to improve health services in Bangladesh

We have good relationships with many health care organizations; some are practicum or internship sites for IUBAT, others offer good-quality education or health care services. Most are in Dhaka, while a few are in outlying areas. We will support these agencies as requested, with consultation and educational materials.

  1. Support research projects on quality of health education and health services

We will arrange student internships and projects to link local and global researchers. We have the potential to support some applied research projects on quality of health services, particularly for training and mentorship in research.

We continue to welcome volunteers, either working from home, or at our guest-house in Dhaka. Please contact us about current opportunities.

Current IUBAT Faculty and Former Student Awarded with Scholarship

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Mohammad (Kiron) Ali is currently a faculty member at IUBAT, teaching students at the very same school where he learned to become a nurse himself.  When asked how he came into nursing and about his future vocational goals, Ali shares some wonderful news with our readers.  He writes:

“Greetings from Bangladesh! I am very sorry for the late reply, as you can imagine how busy we are during the semester end at IUBAT.  I came into nursing in 2007, a couple of months after successfully finishing the Higher School Certificate examination.  The decision I made to study nursing was against my family’s wishes.  Historically, nursing is locally viewed as a poor profession and dirty job.  Consequently, I faced discrimination and criticism from my family, friends, and neighbours.  In my youth, I had never dreamed of becoming a nurse, nor did I know what nursing truly entailed.  While I was studying in higher secondary school, I had a growing interest to enter the medical profession.  Fortunately, I had the opportunity to talk with Prof. Dr. Karen Lund, former Chair, College of Nursing at IUBAT.  She gave me full insight and knowledge about the nursing profession, and I applied for admission that same day.

Presently, I am working very hard for the residency permit (RP), which takes a lot of paperwork.  I’m happy to share the news to all of my well-wishers, nationally and internationally, after getting RP, and a scholarship!  I have been accepted to the Master’s of International Health program at Uppsala University, in Uppsala, Sweden.  The program will last two years and begins on August 29th, 2016.  Furthermore, the scholarship I have been awarded is called the Swedish Institute Study Scholarship (SISS), bestowed upon me by the Swedish Institute, a public agency whose commitment is to gain knowledge and understanding of different cultures, their people, and to promote Sweden and Swedish issues globally.   Here is more information about the scholarship and the Swedish Institute: SISS – Application procedure and key dates: Swedish Institute.

For my accomplishments in my career thus far, I would like to thank three special people in my life.  Prof. Dr. M Alimullan Miyan, Vice Chancellor of IUBAT, for giving me the opportunity to study at this university under the umbrella of the Knowledge-Based Area Development program (KBAD).  Secondly, Prof. Dr. Karen Lund has been the biggest motivator in my life.  Finally, Prof. Alex Berland, Senior International Adviser of College of Nursing, who has been my mentor.  I will continue writing with follow-ups and updates.  I deeply acknowledge the efforts of all those I mentioned and hope for a continued strong Bangla-Canadian relationship.”

We’re grateful for the update and even happier to hear the great news, Kiron.  All the best to you at the end of a busy semester of instruction, and for your two-year Master’s program in Uppsala!  Perhaps we will hear more about your international adventures further into your career.