15. From the Apollo Hospital

I never thought I would be writing a blog post from a hospital bed! I suppose it’s an experience not everyone might have. (Though, surprisingly, during my time in Bangladesh, 11 of my fellow 24 volunteers were hospitalised at some stage.) Before coming to Bangladesh I had only ever been in hospital once, and therefore I was more than a little apprehensive when Dr. Dawn Rees (originally from the UK) insisted that I be admitted.  The reason: a bad respiratory infection that I failed to shake off, despite copious amounts of medication.

Dhaka is not an ‘easy’ city to live in. (See posts 7, 8.) Air pollution in the capital is of serious concern. I subsequently (8^th February 2010) read a report in the Daily Star newspaper quoting Department of Environment sources which stated, alarmingly, that the density of airborne particulate matter had reached 247ug/m³ (micrograms per cubic metre), nearly five times the acceptable level of 50ug/m³ set by the National Ambient Air Quality Standard of Bangladesh. Incidentally, the World Health Organisation air quality guidelines recommend a maximum acceptable level of 20 ug/m³. Cities with 70 ug/m³ are considered ‘highly polluted’.

A further complication is that airborne particulates are considered more harmful when they are 10 micrometres or smaller in diameter: in Dhaka they are 2.5 micrometres or smaller. The report goes on to say that thousands of brick kilns burn used automobile and rickshaw tyres together with low-grade coal and fuel-wood.  In addition, old buses, fleets of trucks and thousands of other poorly serviced vehicles contribute greatly to pollution, as does dust from roads and construction sites, and toxic fumes from industrial sites.

Doctors say that such high levels of particulate matter are causing premature deaths, as well as pulmonary, respiratory and neurological diseases. While it is widely known that many people die each year from diarrhoea-related illnesses, less is known about respiratory illness or the number of respiratory-related deaths.

Unfortunately, I was unaware of the degree of pollution in Dhaka. In hindsight, as an asthmatic, perhaps I should have investigated the situation more fully, but I understood, based on VSO’s policy and rigorous medical screening, that they would not approve an assignment location for a volunteer if they considered it unfit. I think they realised this oversight when they heard I would have to be hospitalised and immediately offered to fly me home. However, I am already much invested in Bangladesh and am not prepared to give up just yet.

Any fears about my hospital stay were unfounded. The Apollo is an international hospital and the standard of care is high. It is also expensive and therefore only those of considerable means can afford to come here. Luckily, I am covered by health insurance. On arrival, I was issued with blue-striped pyjamas: all patients are required to wear this loose, baggy ‘uniform’. Any worries this might have generated (of being led away to a cell, for example!) were quickly dispelled when I saw my room – 6404 – on the sixth floor. It is spacious, spotless and air-conditioned, with an en-suite bathroom, a TV and a great view. If meds don’t work, surely the comfort and luxury of this room will make me feel better. The joy of taking my first hot shower in Bangladesh, in ‘my ensuite’, will sustain me for a long time.

While many volunteers have been struggling with intestinal problems, I can’t ever remember losing my appetite, even when ill, or rejecting any kind of food, anytime. (I’m not sure whether I should be embarrassed or pleased about this!) Therefore, I’m enjoying the food here in the hospital which is delicious. It’s a luxury not to have to think about what I might eat or cook.

At the beginning of my stay I felt very weak and a tad feverish, and therefore resting was easy. However, although I soon began to feel a little stronger, the infection persisted and continuing rest remained essential, in conjunction with medication and nebulisation. As the days started to move on, I felt disappointed, particularly in relation to delaying starting my assignment (although for now it is the latter part of the ‘induction programme’ I am missing). VSO staff are not happy either, given the (oft-quoted) ‘importance’ of the organisation I am assigned to. (In hindsight, ironically, there was no need to worry in this regard – see post 25.) However, since I have no alternative but to stay put in order to recover, I need to put this to the back of my mind. And the experience is turning out to be interesting in its own right. Though I don’t always feel great, and recovery is slow, I am making new friends and learning more about Bangladesh. The word ‘boredom’ rarely features in my vocabulary, and it’s no different here: there are constant sources of interest.

For a start, I read a newspaper – The Daily Star – every day in order to get a feel for life in Bangladesh (see post 19). I am also reading fiction (currently ‘Selected Short Stories from Bangladesh’ (1998) edited by Niaz Zaman) and listening to music. (Thanks to my fellow-volunteer Estelle for downloading some great tracks to my iPod.) I am trying to persevere with my Bangla (see post 11) and use it every day. Best of all, I’m meeting lots of new people and finding out about their lives. In the beginning, quite a few would come as far as my door and stand there, looking and smiling while I smiled back. Now they are all venturing in, and there’s never a dull moment!

Some of the nursing assistants, and the housekeeping staff, spend a lot of time looking through the stuff I have lying around. There are two young girls in particular that I have grown very fond of – Sabina and Lila, cousins from Barisal. Lila got married during my time in hospital: she is just 16. They are particularly in awe of my toiletries, although I only have a few things here with me. My daily shower routine is also a source of some amusement/amazement. Conversation is limited, given the language barrier, although we are making some progress with the aid of my dictionary. I have to admit though that there are times when I am just too tired to persevere.

I manage to have easier conversations with the nurses and some of the catering staff – many of whom have a little English and between that and my Bangla, exchanges are taking place. Because this is an international hospital, they are all required to speak some English. I now know eight nurses: Akhi from Rangpur, Fatima from Barisal, Rebecca from Chadpur, Fulmoti, Anjana, Charmin, Happy and Lovely (yes, these are their names and they live up to them). Some are married and have children and all stay in the nurses’ quarters on the seventh floor. They tell me things about their lives and ask me lots of questions about mine.

One lovely young man, Ronald, from catering, tentatively entered my room and asked me if I was Christian. He is from Pabna and one of the 1% of Christians in Bangladesh, and he told me that he was honoured to meet me. When I find out where somebody comes from I look it up in my Lonely Planet guidebook. Then on the second occasion we meet, I surprise them by asking an informed question about their home area. For example, when I met Ronald for the second time, I asked him about the famous Hindu temple in Pabna and the two rajbari  (raj=king; bari=house, so literally ‘king’s house or palace’). His face lit up: the Bangladeshi smile is so engaging and contagious. From our discussions, I am learning a lot about the geography of Bangladesh, and feel as though I know many of these places already. Delore and Anthony are also on this rota and equally lovely. Then there is Sikander, a very professional and handsome food and beverages supervisor. I spend a lot of time chatting with him: he previously worked in the Dhaka Westin Hotel and wants to travel to Australia (or now possibly Ireland!) to do hotel management. He is from Chadpur and the youngest and only son in his family. His father had a food shop, which Sikander took over after he died, but he later opted to lease it out and pursue a career in the hospitality industry. The food and beverages manager Shafique (Helal) is a lovely older man, very respectful and interesting to talk to. He is from Barisal originally and spent many years in Saudi Arabia working in a hotel there. He decided to come back to live in Bangladesh when his children were born. He regularly sends me complimentary trays of tea/coffee and biscuits. Alia (Costa) usually arrives with his tray: she looks very young and is very pretty and sweet, though extremely shy.

All of these people come and go throughout the day and sometimes overlap. They are extraordinarily kind and constantly complimenting me. I have been told on a number of occasions that I’m ‘nice’ or ‘beautiful’, that I have a ‘good heart’ and, most interestingly, that I’m a ‘lovely man’. Sometimes I don’t have the energy to explain. It’s easy to mix up ‘she’ and ‘he’, ‘man’ and ‘woman’. One day, Sikander told me that it was as if he could see the blood in my face, because my skin was so white and see-through. This was, in fact, meant as a compliment!

There have been lots of funny incidents, mostly related to culture and language. Today, for example, two orderlies from radiography brought in a wheelchair to take me to X-Ray. I explained that I had already had two chest x-rays but was told: ‘No, no – it’s x-ray of penis’. In light of the ‘lovely man’ compliments, referred to above, I was now, understandably I think, more than a little alarmed, not to mention embarrassed. Could they be under the illusion that I was a man?  I am taller than most Bangladeshis and my hair is very short at the moment, and then there is this contour-obliterating pyjamas….. But neither having the energy nor the language facility I just sat into the chair and off we went to X-Ray. The radiographer came out smiling, and asked loudly and in clear, crisp English if I understood that this was an x-ray of the ‘penis’. I couldn’t believe it, but tentatively asked: ‘Where is that?’ I was profoundly relieved when he pointed to my head: the sinuses (PNS=para nasal sinuses) were the offending items to be x-rayed! I found it hard to stop smiling throughout the x-ray: the poor radiographer must have thought me slightly touched.

Sometimes the laugh is on me. One evening, a ‘huge’ mosquito flew into my room with the evening juice delivery man. Of course it made directly for me, as I knew it would. I rang my bell to see if I could get someone to get rid of it (I was hooked up to a drip and a nebuliser). Within no time my room was full of people (I must have had all the staff from the 6^th floor in my room), and they were falling around laughing at this crazy bideshi (foreigner) swatting feverishly at the air, all because of one mosha (mosquito).

There are also moments of misunderstanding. I am given a semi western-style diet. This causes problems at times, especially in relation to cutlery (the Bangladeshis eat with their hands – see post 6). My tray invariably arrives with something missing. For example, in the mornings I get cornflakes and toast. Often, the milk is missing for the cornflakes, or the butter for the toast. And there is always an odd selection of cutlery e.g. two forks. (I am now adept at eating cornflakes with a fork!) There’s little point in trying to get things changed at that point. Mornings are very busy: there will be lots of smiling and ‘ji’, ‘ji’, (yes, yes), but nothing happens.

My doctors, Dr. Azizul Hasan and Dr. Dokwal, are surprised at my slow recovery, and have done every test possible to make sure that nothing is being missed. Different theories have been mooted. It may be that I have an allergic reaction to the polluted environment in Dhaka. I don’t buy this though: it doesn’t ‘feel’ like an allergy. One theory that seems plausible to me is that I have a viral infection. This could explain my slow rate of recovery and the fact that I am not responding to antibiotics. However, there are no facilities in the hospital to ascertain if this is the case or not.

I haven’t yet mentioned the amazing views from my window. Sometimes I find myself standing there, unable to drag myself away, until I am forced to sit, before I fall down. There’s a small, emerald-green lake below the window, by a grove of palm trees. To the left there is a new development of well-appointed apartments, some finished and others still under construction, and in the far distance there’s a ribbon lake (I thought it was a river but Sikander says it’s a lake), and a larger-than-life sized statue of a freedom fighter, with one arm outstretched towards the sky. To the right I can see squares of water too with fields and houses in-between. Every time I look out I see something different. One day I was mesmerised by a group of colourfully-dressed women and children, who were picking through a mound of rubble, dumped there by a digger from the construction site farther back. They spent hours under the heat of the sun, tirelessly picking through the material and sorting it into bundles of stones and glass and sticks, but the prize find seemed to be paper cement bags, which they carefully smoothed out and stacked. I am guessing that they will get some taka from recycling all this material.

Another morning, I opened the curtain to see a woman bathing in her sari in the lake below, and later doing some washing from the lakeside. It was such a tranquil scene. In the fields behind the trees, there are always groups of children playing cricket, and sometimes a game that looks a bit like rounders. There are also quite a few cows around, and they are occasionally herded from here to there. Over to the right there is a long, flat-roofed, stone house with ochre-coloured shutters, sitting in what seems to be a field of water. The lake is covered with a strikingly green crop (water hyacinth?). One day, I saw a young mother, in a bright-orange coloured sari, up on the roof of this house with her little son, as people walked to-and-fro on dusty, red-brown paths in the background. Yet another scene that looked like a still from an art film.

I have tried taking some photos through the window but the quality is not great (see below): the window is not that clean and the glass is highly reflective. I wish I could open it but it’s locked. I have been told that it’s not hospital policy to allow patients to open windows, in case some patients ‘go out’. Hmmm…. As good a reason as any I suppose, considering I’m on the sixth floor.

I had a wonderful surprise when I looked out this morning: I saw a kingfisher flying over the lake. They are much bigger here than our little ones at home. It was incredibly striking, difficult to estimate its size at a distance, but certainly clearly visible and identifiable from my window. The metallic-blue colour was unmistakable and as always, stunning. I also regularly see another lovely, large, orangey-brown bird-of-prey flying over the lake, often hypnotically hovering in the area for prolonged periods. I think it might be a kite.

I’m so glad I have this window because there are times when I feel as though I’m not in Bangladesh anymore. This room could be anywhere, but when I look out the window, I am always thrilled that I am still here, and I never fail to see something that draws me in. It’s a strange feeling though: it’s as if I am in a bubble, protected from the environment, but able to see it through glass.

On the 14^th April, Bangladeshis celebrate their new year – Pahela Boysakh. According to the Bengali calendar, this is the beginning of year 1416. Although they use the Gregorian calendar today, they still celebrate the old Bangla New Year. I awoke to a very sweet, early-morning text from Sikander wishing me a happy new year:  ‘Shubho Novo Borsho’. In turn, I wished the same to all who came into my room during the day, much to their delight. Sabina and Lila had told me, the day before, that they had the day off and intended to go to the festival celebration in Ramna Park, where I intend to be on this day next year. They wear their best red saris, lots of make-up and have henna designs painted on their faces, arms and hands. As I watched the celebrations on my TV (this is one of the few times I ever turned it on), I found myself hoping to spot either Sabina or Lila. There was little chance of this, of course, given the huge crowds. Over the following few days, I found numerous descriptions and photographs in the papers of the celebrations around the country. It looks like a really fun day. 

Finally, the day of my departure arrived. I travelled back to Lalmatia in a bright-yellow, rickety taxi through Dhaka in all its stereophonic, technicolour magnificence. I felt very excited to be back in the midst of the hustle and bustle. All the volunteers I had arrived with – Tony, Estelle, Ciony, Rosie and Carla – had by now left Dhaka to begin their assignments in their respective rural locations. I am the only one of our group whose placement is in the city. They had come to see me in the Apollo: now it felt odd being back in the induction flat without them, and amongst volunteers that I didn’t know. The bougainvillea was in glorious bloom on the balcony, and after settling in I sat there quietly with a cup of tea. Right on queue, the muezzin’s call rang out as if to welcome me back. Though I felt quite weak and tired then, I was back in working order, Deo gratias, and I was conscious of feeling perfectly happy: happy to be healthy, happy to be here in Bangladesh and eager to fully engage in my new life.

These, then, are some of my experiences from my time in the Apollo Hospital. More than anything, it has given me first-hand experience of the health hazards faced by Dhaka’s residents on a daily basis. The difference is that I was able to get proper care, an option that is not available to the majority of the population. Without the possibility of effective treatment, many continue to live in poor health, or indeed to die prematurely and needlessly. I am thankful to Dr. Dawn Rees who insisted, despite my protests, that I be admitted for treatment. I am deeply grateful to all the doctors, consultants, physiotherapists, nurses, aides, catering and cleaning staff in the Apollo, for making my stay such a happy, interesting and healing one. I will miss you all! A sincere Dhonnobad.

Below are some photographs of my hospital stay. Unfortunately, since Cooliris was acquired by Yahoo my lovely photo walls no longer work. 😦 I have replaced them with links to a web album until such time as I can find a better solution.

PHOTO SLIDESHOW

Click on image below and then on the top-left image (22 photographs). Enjoy!

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