Matlab Upazila

Traveling from a semiarid climate to one as tropical as Bangladesh was obviously a total shock to my system. Not to mention the shock to my hair. Utah killed all the natural curl I once had, but Bangladesh must be some sort of sorcerer because those curls were resurrected! Back from the dead and traveling to the people on the American continent to deliver his message… oh wait. That’s the Book of Mormon. Sorry. I haven’t had my coffee yet.

So my hair was out of control, and I know I joke here quite a bit about how much I look like an eight-year-old boy who just rolled out of bed on Saturday morning. And I even mentioned this to our group, that I may be a very confusing sight to the residents of Bangladesh. But on the fourth day of our trip I entered the lobby of our hotel with My Hair and a brightly striped long-sleeve shirt clinging to my curve-less body, and the photographer was like YOU SO WEREN’T KIDDING.

Thanks a lot, JOSH. Listen. You are not allowed to make fun of women who look like eight-year-old boys unless you are a woman who looks like an eight-year-old boy.

That day we were headed out to a subdistrict called Matlab to see the unbelievable work of the ICDDR, B who have implemented a package of interventions in maternal health with amazing results. First we had to drive an hour and a half in traffic to the Meghna River, one of three that forms the Ganges Delta, the largest on earth fanning out to the Bay of Bengal. And then we divided into two groups and headed out on small boats. And it was incredible.

Because not only were we out of the traffic and densely packed city, but we also got to see the country expand out before us, glorious and humble in equal parts. We waved and caught smiles from fishermen who passed by. We saw groups of boys playing soccer on the banks. We saw children swimming in the mid-day heat, women washing clothes in the water just steps from their homes.

The simplicity was a refreshing contrast to everything I had seen or felt up to that point.

The ICDDR, B originally focused on cholera (it’s widely held that cholera has its origins in the Ganges Delta), but their work has expanded over the years to include issues such as maternal health and HIV/AIDS. What they’ve been doing in Matlab has helped decrease the maternal mortality rate significantly, and we got to see firsthand what techniques they’re using.

First we met with a field worker whose job it is to track the wellbeing of every household in her region, and she happened to be making a house call to a woman in need of a pregnancy test. This field worker keeps track of all the information she collects on a mobile device which keeps physical paperwork to a minimum.

The woman awaiting the pregnancy test had a boy who observed quietly, oblivious to the fact that in the next eight or so months he’d have a sibling, one whose chances of surviving childbirth have been greatly increased.

Women who do become pregnant receive prenatal care in what’s called a sub-center facility (there are more than three dozen in Matlab), and the one we toured was, relative to some of the facilities we’d seen earlier in the week, in superb condition.

Women give birth in these sub-center facilities, but we also witnessed a group in the process of learning Home Based Life Saving Birth Skills from a midwife just in case of emergency.

Once a baby is born a community worker will visit the mother and child for the next 28 days before assigning her to a fixed site center near her home for further care. Also, it’s at these fixed site centers that babies receive life-saving vaccinations.

This baby is actually awaiting a vaccination…

…from this woman who has been running a fixed care facility for over 35 years.

Our final stop was back at the main hospital run by the ICDDR, B, and it really was one of the most encouraging things we saw on the whole trip: babies receiving care days after birth…

… a woman in active labor with access to a doctor and clean facilities…

… and finally what’s called a Kangaroo Care ward. I hadn’t even realized up to this point that the concept of a NICU doesn’t really exist in Bangladesh. So to mimic the warmth of an incubator, these women give their premature babies skin-to-skin contact until they are out of the woods.

I am writing specifically about this part of our trip because it shows change and progress. Yes, there are still questions as to how to further develop these programs and how to replicate it elsewhere. But when someone ever says that the problem is too big to fix I can point to this and say, not for these women.

And I salute those organizations who are at least trying to fix parts of the problem.

  • MollyCT

    Just wanted to say thanks for focusing on the beauty of the people, the work, and the environment in Bangladesh. I think the cynicism that throws up its hands when problems can’t be “fixed” in one fell swoop comes from having our only images of poor places be negative ones.

    Also: I second the call for a photo of the hair!

  • HannahMango

    I would argue (as it looks like Cecile and
    megalimugwump also would) that the incubator mimicks the warmth of skin to skin contact, rather than the other way around. In many cases increased technology is helpful and saves lives but it isn’t the end all be all of health and wellness.

    Otherwise, thank you for your posts about your trip.

  • Indigo

    Heather, thank you so much for sharing your story with us.

    Many of my friends are pregnant, raising babies, juggling work, etc. The availability of pre- and post-natal care isn’t even questioned, it’s assumed. I enjoy spending time with them, but I truly wish for them and their families that they could understand for a moment some of the things you experienced in Bangladesh.

    As women, compassion is our strength. We all need reminders to share it more freely with family and strangers alike. THAT is what builds community.

    Proud to be a member of the Dooce community :)

    XO – Dana

  • Cooky

    Thank you so much, Heather, for these amazing posts. Your pics and descriptions move me to tears. There is so much we can do. Thank you for stepping up and doing this important work.

  • edenland

    It must have been such a culture shock.

    I love reading these posts. There’s a whole world out there, and a world of difference to be made.

  • hildag

    WOW thank you Heather for bring so much attention to this. It is amazing to see and read about all of this. It has definitely made an impact.

  • slappyintheface

    I so hope that your posts inspire others to find their passion and cause. I can’t even imagine what kind of world we would be living in if every single person found their “cause” and spent a part of each of their days helping other people.

    Thanks for the posts and keep working to fight “the good fight”.

  • postmodernmama

    This is such a valuable cause and I am learning so much by reading your posts. I had never heard about the idea of a kangaroo ward – but it makes so much sense, especially in a place where incubators aren’t available.

  • monkeysmom1

    This post reminded me again how lucky we are to have so many options with regards to childbirth. I was just talking with my grandma yesterday about how awful childbirth and having babies can be, and complaining about it! Then I opened up this post, and saw the picture of the birthing chair in the Bangladesh village, and was reminded how lucky I am to have given birth as a Canadian woman. Both of my daughter’s births involved potential life threatening situations, but thanks to excellent health care and doctors, they came out perfect. Thank you Heather, for making me smile every day and reminding us how lucky we have it. I fully support your cause and your trip sounds amazing!

  • LillyO

    I am with those who have found this series absolutely riveting. I love the substance and diversity of your spirit!

  • Gwenola

    Heather, I effing love you. Just when I decide to become a doula, you do all of this. Your trip and passion for maternal care is so amazing to read about and to keep myself informed. I loved your blog before and now I am enamored by it. Thank you! I was also particularly interested by the Kangaroo Unit. Birth expert Michel Odent cites studies saying it is more favorable for premature babies to stay close to their mother rather than in an incubator. It helps with attachment and many other things. I highly suggest reading his work. I look forward to more of your maternal care posts! All the best, Gwenola from New York

  • doobrah

    So stop teasing us about the curly-headed eight year old. We need photos!

  • ChickWhitt

    The buckets at the end of that table have me in tears, so thankful that in 30 some weeks I will give birth in a hospital

    If that doesn’t make your trip worthwhile, I don’t know what will.

  • wakeandbake

    Wow. Why do I need to donate, they have some sweet digs! Ok, I can contribute to something such as this. Maybe they can get a delivery table that is not precariously balanced on bricks. That last picture kills me.

  • saturdayjane

    I am not a frequent commenter, but I wanted to tell you that for the last few weeks, your writing has been absolutely riveting. Actually, riveting might be the wrong word. It has been excruciating and heartbreaking, and the passion you feel for these women and these children has been bursting out of every word.

    Thanks for your attention to this issue, and for treating the people involved with the great respect and compassion that they deserve. I have a jar in my kitchen to save up my pennies and dimes so that maybe, in some tiny way, I can help too.

    Keep writing. In many ways, it is difficult for us to read, but it’s medicine we sorely need to take.

  • playrawkstar

    heather -
    these posts of your trip are inspiring and invigorating. while i have heard that there has been much angst over your trip from others, i think it is of tremendous value to show people that every person and every action counts. as someone who is regularly criticized for doing community work while traveling (absurd, right?), i genuinely applaud you for what you’ve done, especially to leave your family and devote your time and efforts to helping strangers on the other side of the world.

    congratulations on such an incredible experience!

    natalie – trek4change.com

  • Casey P

    Heather, What is the boy, whose mother was getting the pregnancy test, sitting on?

  • dooce

    @Casey P it’s a stack of dried corn cobs. I’m not sure exactly what they use them for, but I’m guessing that they burn these more than they do wood. Someone correct me if I’m wrong.

  • tallnoe

    You are doing amazing things and sharing amazing things. Thank you. Opening peoples’ eyes to what goes on around the world is important.

    And these stories are important. Small steps.

    Thank you.

  • racheler

    #1 – I know what you mean about The Hair. When I moved from west Texas to New Orleans, it was sooooo bad. It is still bad and it has been a year.

    #2 – This trip has been riveting to read about. It’s amazing how what we see as simple primary care in the States can help so many. Thank you for reminding us of that.

  • lisdom

    I am so glad you are writing about this. The more I read, the more angry I get about that Douche from the Guardian. Just reading stuff like this makes me realize more ways I can help people. Another blogger I read went on a trip to Kenya and blogged about it, and that’s why I sponsor a child now.

    Also. Christy. Turlington. When do we get a post about how she is the most beautiful woman on earth?

  • WayToGeaux

    I in no way would want to trade places with the mommies seen here, but I found the photo of the mom swaddled with her babe in the Kangaroo Care unit so beautiful. When my firstborn was born he was rushed into NICU and I didn’t hold him for four days. I physically ached to hold him. Now, no doubt I would not choose the care he received through his incubator over the mom in the photo, but there is something so innate, primal, natural at the thought of the mom serving as the external incubator for her newborn in need that makes me pretend that I could have done the same thing. Only because of how inspiring the photo is to mothers. Rambling…but as a mom, just wanted to say, thank you for sharing these moments.

  • Anu

    Great post Heather. Very informative. And for all those people who claim that change can’t happen, maybe that gives them a reason not to do anything. Keep the information flowing Heather, change will happen on its own…in the minds of the people.

  • Becky Cochrane

    And I salute you and your photos so full of heart that our hearts are moved, too.

  • kaethend

    Corncobs like those were seen scraping baby poop from the mother’s leg in the doc Babies (the African mama/baby). Not to say this is what’s going on here, but it does seem like a dry cob like that is useful… probably for more than one use.

  • kaethend

    And now that I’m on the topic of poop, I really want to know what sort of diaper-free/EC you observed. I’m all over that *shit.* Ok. Stopping.

  • Schnauzie_Mom

    Wow. Those pictures are both painful and beautiful. I can’t even imagine walking into a facility to give birth and seeing the table propped up on bricks with a bucket at the end. Thank you for reminding me how lucky we are in this country.

  • Cecile

    These women are really lucky, and in some ways luckier than us. Birth is meant to be simple like this, but with access to the right care if its needed. Also, kangaroo care is so effective for prem babies, just because we have the technology, doesnt mean its better to use it.

  • Mom101

    I find myself reading these posts without breathing. I love seeing you celebrate the do-ers.

  • Lauren3

    Dude, it’s possible I enjoy these posts even more than the ones about poop or Chuck or even Chuck’s poop. They are riveting, and I’ve passed them on to family and friends.

  • megalimugwump

    I wanted to comment on the Kangaroo care, like Cecile said, technology isn’t always the better way. In fact, mothers are FAR better at regulating their infants body temperature and breathing patterns than an incubator ever will be. The idea that we separate mothers and babies ever, especially pre term infants where the need to be skin to skin is even more important for survival, is simply insane!
    Google: Dr Nils Bergman. He has done some amazing research on the benefits of kangaroo care and skin to skin.

    http://www.meganthedoula.com

  • anya

    I just wanted to let you know that good people are out there, and sometimes they don’t let their voices be heard. As a result you may hear more negative comments. But really, who can criticize anybody for bringing attention where it’s needed? And appealing to our kindness, generosity, humanity, to help others in need? This is what being a mother is all about, caring about others. So please don’t pay attention to the jealousy and pettiness, you are doing important, good things by talking about your trip and by getting involved in this issue. Thank you and tell us more.

  • dianemaggipintovoiceover

    yesterday i saw a pregnant woman about 6 or 7 months along, wearing a tee shirt and skirt, and carrying a load of books, as i ambled across the plaza to the salt lake city main library. i glanced over to see “birthing from within” and smiled. i thought of you and me and many (not ALL) of us here in america who have the luxury of reading about various birth options, hoping to get what we want, and embracing what comes, especially in the form of a perfect, healthy baby. SUCH a far cry from women in bangladesh and so many other places in the world.