In Sickness and In Health
on From Banglatown to Bangladesh (Bangladesh), 07/Nov/2009 08:39, 34 days ago
Typhoid, dengue fever, tuberculosis, giardia, urinary tract infections, appendicitis: just a few of the plethora of illnesses experienced by volunteers in Bangladesh over the last year. This is despite the fact that all of us underwent medical examinations before we left our home countries, in which we were declared to be healthy* individuals. These days a stay in Apollo, the Dhaka hospital of choice, is almost like a volunteering rite of passage, alongside our first journeys on cycle-rickshaws, first realisations that our work plans are entirely unrealistic, and first tastes of illegal Bangladeshi whiskey (for some volunteers at least).My own stay in Apollo was back in July. The hospital is a mammoth maze of shiny floors, many departments, vast numbers of patients and their families, and confusing bureaucracy. It is a private hospital, very expensive, but well-equipped and with some highly qualified doctors. My stay was a few days only, and while it was luxurious (a single-occupancy room including a fridge, a television and an en-suite bathroom with hot water), I was itching to leave by the end. I won't go into the frustration of trying to talk to select doctors and nurses, whose interests lay not in my symptoms, but in those important questions of where I am from, what I do in Bangladesh, and if I cook for myself. Similarly, there's no need to describe the rather invasive pre-surgery tests and preparations required, nor the sickening taste of the soup I was served twice a day.Because really, I was luck to be there. Given that more than 80% of Bangladesh's 150 million-strong population lives on less than two dollars a day, the numbers that can afford this sparkling, monotone haven of sterility must be tiny. A one night stay in my room cost 7,500 Taka, which translates to about£75 or three-quarters of my own middle-to-high-income month's salary. Indeed, Apollo's bright lights and high-tech equipment are worlds away from the colour and the poverty of the slums just outside its doors, and equally distant from the dark, crowded hospital in the hills I first visited for tests, whose single ultra-sound machine had been unusable for weeks.As I write, my own hospital experience has been reduced to a few blurry memories, some minor post-operation scarring, and a rather hefty medical insurance claim. I am however now grappling with a much more common, and significantly less serious, illness. It is the sneezing, sniffing, coughing, sore throat and headache of that well-known 'disease': 'The Attack of the Change of Seasons'. I have mentioned several times that Bangladesh has many seasons. The exact number I am unsure of, as no matter the time of year, I am told that the seasons are changing. Similarly, the vast majority of minor illnesses I have or hear about are attributed to this continuous shift in temperature and climate.Being eight hours away from Dhaka, and given that the flu I am experiencing is not exactly a major illness, I have been undergoing self-treatment in the hills, along with the help of my friends and colleagues. I am very lucky to be surrounded by incredibly kind individuals, who take good care of me, whether I am sick or well. But as with most of my experiences in Bangladesh, the cultural differences around illness are striking.Despite the general importance placed on modest appearances (for women at least), this emphasis on privacy disappears entirely when it comes to bodily functions. Not only are belching, burping, spitting, and noisily clearing phlegm from one's throat all entirely acceptable as public behaviour, but any illness, blemish, or appearance change are widely and openly discussed, as are possible causes and cures.While of course the change in seasons is the main explanation given for my flu, other possible explanations have included late nights (I was out until 11pm the night I got sick), loneliness (I now live on my own, which is very unusual here) and not eating enough chilli (even though I claim to like chilli, and to use them quite generously in my own cooking, being abideshimeans that I cannot of course be eating enough).And while the suggested cures have been not so different from those in the UK, the general experience is still very different. Doctors visits are not one-on-one affairs, but involve at least five additional visitors, partially for translation, but mainly for group dissection of the sickness. The first time I was asked by a doctor in front of a group of still-new colleagues if I was experiencing a 'burning sensation' while urinating I was rather shocked. But I have now realised that these group visits are just one way for people to show that they care. And to indulge that fascination with all things bodily function-related.You will be pleased to hear I am now slowly overcoming my coughs and sniffles. And since there must be at least a few weeks until the seasons shift again, and I have already gone through my hospital visit rite of passage, I can look forward to a healthy future. But, given both the resilient nature of Bangladeshi germs compared to weakbideshiimmune systems, and the multiple meanings of the word 'healthy' (see below), I should say instead that I hope for a period of being well, for myself and my fellow volunteers.(*A note on 'healthy': after a few months in-country I realised that being told you are looking 'healthy' is not quite the compliment it seems. Rather than indicating a bright-eyed and fresh-faced appearance, it is basically a more polite, and widely used, way of saying that someone is looking rather chubby.)