By the numbers

It is the eve on my last full day here in Bangladesh. While initially I felt somewhat lost in this (for me) strange land, in retrospect time seems to have flown by: I cannot believe all the things we saw/did/experienced over the brief expanse of 30 days…

102 women surveyed: 32% of whom are or will be in need of family planning

2 trips to Dhaka, 1 to Sylhet and 2 random villages in between… for a total of 24 hours + in a car (obviously not at one time, though it often felt like it)

30+ CNG rides with ~7 rickshaw rides (it takes more skill than you think)

Consumption of 7.5 lbs of rice (minimum) and no less than 900 roti… as well as countless bags potato crackers (i.e. spicy potato chips) and innumerable packages of “energy” biscuits

77 stairs up to our Dhaka hotel room (my only exercise all month)

10 hospital/clinic tours (with dozens of interesting cases)

~20 – the number of Bangla words I know (PITIFUL)

1 very LARGE bat living near our Narsingdi home (which I could have done without seeing)

1 stomach that remains “confused”
AND

0 roadsides used as a toilet (my personal success story)

Now for the 19 hours+ separating me from JFK .

Tea?? Biiiiiscuit??

It’s a good thing I really like tea. And that I am a fat kid who can never turn down food, especially if it happens to be in carbohydrate form… because during our tour of the many medical institutions in Sylhet, we were offered tea and biscuits (sometimes more) at every single turn. Basically, if we went to 4 different institutions, there were a minimum of 4 tea breaks… which is fine, but given my usual overheated state and aforementioned paranoia of urinating anywhere outside the comforts of my lodgings it was, occasionally, just TOO MUCH. (Two “quick” digressions. 1. It still boggles my mind that there were so many medical facilities in the city of Sylhet, when there is clearly an dire need for such institutions across the rest of the country, and reportedly even across the district of Sylhet, itself. If only they could disperse. AND 2. While many aspects of this culture have been difficult to adapt to (like the fairly constant spitting… men, women, kids… doesn’t matter, big lugey coming your way), the overall hospitality offered to me, to anyone really, is amazing. People are often overly concerned that the big white bideshi will hurt herself, but they are always well-intentioned. OK. Digression complete).

Of course, on one such tea-laden day we ALSO stopped at the tea garden (on the ~border of India). Tea everywhere! But it was actually quite pretty and serene. The company doctor gave us a tour of the gardens, themselves, as well as the processing plant (which given the lack of safety anything could only conjure images of missing limbs for me). We had… TEA… but outside, at the exclusive guest cottage (formerly used for vacationing/relaxation by the wealthy during the British colonial era; one's stay apparently required royal approval... it has weathered some). Despite my overload, I must say that the tea here is fairly good, and when enjoyed in normal people quantities, I quite like it.

We left Sylhet on Friday, safely carried by “local” transport, though the air conditioned version which most Bangladeshis cannot afford. Our ~4.5 hour journey was interrupted by 2 stops: one for afternoon prayer and the second for lunch. At the second stop I ventured to the bathroom: it had been scouted out by Rupa prior to my leaving the bus. She gave due warning of my bideshi arrival. No less than 4 people enthusiastically directed me to the washroom, which was really only about 3 feet away. And the attendant inside knew to guide my bideshi behind to a western toilet. I have managed to avoid the side of the road thus far. Fingers crossed.

Arrested Development

I forgot to mention the other interesting thing I learned during the course of my travels. At the start of surveying, we ventured to the char in a fairly massive group: myself, Rupa and up to four interviewers/logistics people. However, as part of our work here, we hoped to train the interviewers to go alone to administer the survey (sounds silly, but actually the concept of surveys is foreign, thus troubleshooting is often required). That way this survey (and then others) would not require our presence. We planned to send our female interviewer with one of the other NGO workers (who happened to be male) early last week, but quickly discovered that this was not possible: a female CANNOT travel with any male who is not family. Basically, you can get arrested for such “activities.” Oh, ok. Under the umbrella of the NGO, this may become possible later but because vigilance is heightened during Eid we decided to hold off at present.

In other news: am currently in Sylhet (northeast Bangladesh, ~4.5 hours outside of Dhaka) visiting a variety of medical institutions here. On Monday, I visited a private medical college. While this was certainly interesting (it is always intriguing to see a different medical institution, particularly one that is international), the highlight for me was yesterday’s visit to the leprosy hospital. Leprosy is certainly not as prevalent as it was previously, but still enough of an issue here to warrant ~3 government hospitals. Given that we NEVER see it in the US, this was the first time I was able to see patient’s afflicted with the disease. Most of the patient’s were doing well, though many had suffered debilitating injuries secondary to its natural course. [http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002323/]. Later in the afternoon, I witnessed another personal first – a patient afflicted with tetanus (remember how much your tetanus vaccine hurt? It is worth it). He also was doing fairly well (actually ready for discharge), had initially presented with difficulty swallowing due to lockjaw. He had inadvertantly injected himself with the bacterium when he tried to drain a foot abscess with a piece of metal. [http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001640/].

Infectious Disease Hospital

In general, the government hospitals are much worse off than private institutions (similar to home, really). The infectious disease and leprosy hospitals we visited were government-run, so more dilapidated but not entirely horrible. However, these are relatively low-flow facilities (the leprosy hospital had ~48 beds). Today, we visited the Sylhet Osmani Medical College, a 500 bed facility typically at 3 times (!!!!) capacity. Where do the extra 1000 patients go? On the floor and every other available space in between. It was fascinating to see (we participated in morning rounds) but (not surprisingly) depressing as hell. The doctors are knowledgeable and doing a phenomenal job in a very difficult, resource constrained setting. But I could easily identify a handful of patient s that I knew would never leave. (There was a young girl who suffering from acute kidney failure who would have been an ICU admission at home, quietly suffering in a corner bed… dialysis was planned, but I am not sure there was a permanent solution. I did, however see a curable and SUPER INTERESTING case of cholecystitis (gallbladder inflammation)… the usual cause is an obstructing stone, but here it was… wait for it… a roundworm, ascaris (http://en.wikipedia.org/wiki/Ascaris). You could SEE it on the ultrasound!

Sylhet Osmani Medical College

Old Maid

Among the many questions hurled at me during the course of our interviews on the char (and there are MANY), the one I most frequently recognize is that regarding amar shaami and bacha (my husband and kids…. or lack thereof). Of course, there is still not much in terms of Bangla that I recognize, but this comes up often enough that I can quickly respond bacha na to the laughs of many (the mute speaks)! I guess for the village women this answer is amusing for 2 reasons: 1) I am very much an old maid (to be discussed below) and 2) they probably want to know why this random outsider is coming in asking about family planning, having no family of her own.

In reading about family planning here in Bangladesh, I’ve learned that the country has in fact made great strides in terms of implementing contraception use. Since the 1970s, the average number of children per woman has gone from ~6 to ~2 (concurrent with an increase in contraception use from 8% to 61%). Yay!

Buuuuuuut… there is still plenty of room for improvement (hence our potential family planning project). Though the legal marriage age here is 18, national data indicates that most women get married at the age of 16. In the char (and other rural areas) this number is closer to 15 (though we have had numerous survey participants who married at 12-13, with one as young as 9). Marriage marks the point at which childbearing then becomes acceptable; thus the younger you marry, the more time you have to bear children, the more children you are likely to have. And, all of these things directly impact both maternal and child health (and ultimately, maternal and child mortality).

So, at my current age of 28+, I should have been married for ~15 years, already with a child as old as ten. Considering how plants fare under my care, this thought is terrifying.

A tale of two kidneys

So our aforementioned field trip involved some ~7 hours in the car with a brief stay in a remote village as well as a quick trip to the char. Even though the weather has become much cooler as compared to the temperature on my arrival, it is still HOT. Our short walk to the house of our patient left me mildly sweaty. Then we were ushered into a relatively small room accompanied by no less than 5 family members. There was no “current” (electricity), thus no fan for circulation, and all surrounding windows were quickly blocked by curious villagers. Initially, we wore masks (to protect ourselves from the possibility of measles or chickenpox), which we removed after determining that the patient’s rash was most likely viral in nature. These masks are also HOT, suffocating even, given the right circumstances (such as NO circulation and a crowd of 900). What I really wanted was some pani (water) BUT I had to balance this desire with my EXTREME fear of having to pee. My terror is based on the fact that there is NO WHERE to go, other than the surrounding landscape. Even in the villages, latrines are not an absolute guarantee. Given that this white bideshi draws a crowd just standing there, I did not want to see what would happen in the event I needed to squat on the side of the road with my behind exposed. Not to mention that there is not much of a road “side,” and quite a bit of “fresh” water, just a slippery slope away. I, thus, decided that I would ignore my thirst and not drink ANYTHING all day. And hold any urine I happened to make for 14+ hours. Moral of this story: my kidneys HATED me! HATED.

A brief commentary on the bathroom in my lodgings . Unlike our “wet and dry” system back home, the bathrooms here (and in India, per Rupa) are a one-stop shop. It is as if the toilet bowl were literally in the shower. Basically if I shower and later decide to the use the facilities, the floor/shower floor is all wet/sudsy. It’s also quite difficult to dress post-shower as everything is wet.

(note my suds in the corner post "shower"... basically I dart in and out under the cold water... in the mornings it is so cold, it usually takes my breath away)

And lastly, the highlight of my day: Diet Coke!!
(tastes a little different , but still a nice change from water)

Field Trip

Yesterday was a fairly interesting day in that we took a pseudo-field trip to a remote village some 3 hours away (by car) from Narsingdi. Our purpose was to offer medical advice to a family friend, who was initially described to us as lethargic and weak with both fever and a rash. He had been this way for at least five days, and since getting to a hospital or clinic was nearly impossible due to a combination of distance and expense, we were deemed the next best thing. At the very least, we could determine if a trip to the hospital was absolutely necessary.

Driving here is… special. To the bideshi (“foreigner,” like myself) there seems to be no organization. However, one quickly realizes there must be some order to the chaos, or no one would ever get anywhere (and certainly not in one piece). This particular car ride was slightly better than our trip to Dhaka. Rather than a 2 lane road for the entire journey, there was actually a 4 lane highway, and subsequently much less traffic. That being said, it was still a free-for-all between rickshaws, CNGs, scattered cars, massive trucks and of course 9 gazillion pedestrians. (And cows apparently. Per Jasim, the “Eid holiday” (I believe Eid al-Adha) is in ~2 weeks; beshi (many) cows are being imported from India (ironic, given that they are deemed sacred there) to be sacrificed here as part of the holiday; http://en.wikipedia.org/wiki/Eid_al-Adha. The markets have been bustling in preparation).

Once near the village, we were forced to make a slight detour due to the current rain (and heavy rains the day before) which had washed out the road. We proceeded into the village on a mud path; the surrounding area was lovely - scenic, quiet (the perfect spa retreat). I wound up having plenty of time to take it all in: a little less than half a mile from our destination our car got stuck in the mud/cement. It takes a village… to get a car out, apparently. With lots of help we were able to free our transportation, thereby resolving to walk the rest of the way. It would have been a very picturesque trek, but I remained strictly focused on maintaining my footing. The mud really was like cement. There were times when I advanced, but my flipflops did not.

Our patient looked ill, but not critically so (yay)! We suspected he had a virus (affecting the respiratory tract and epiglottis). What he needed most was fluids, which we subsequently obtained at the not-so-nearby pharmacy. Pharmacists here do not receive any formal training, yet are front-line providers for many patients. Based on symptoms, they “prescribe” any number of medications (antibiotics, steroids, breathing treatments, you name it). The pharmacist helping us would actually also be the one returning to our patient’s home to place an IV and start the fluids. The entire concept seems crazy to me (given the recurrent possibility of medication misuse), though the lack of human resources/healthcare often makes it the best (and only) option for individuals who are sick.

"Google?"

Can you remember the last time you googled something? (Not to frighten anyone, but us, doctors, google stuff... a lot). What about the first time? Ever? I certainly can't remember. For what seems like forever, the internet and search engines have enabled me to find information, and since my move to NYC, not get lost (at least as much as I would otherwise). Most of us could not fathom a world without computers; it is an integral part of out everyday lives. And yet, despite this, it is not something I can readily teach... at least not based on my experiences here.

Farzana is one of our interviewers/basic translators. She is an absolutely lovely, somewhat reserved 18 year old currently taking a year off of school. Given that she is related to the family I am staying with, she was enlisted to help with the development of the NGO and for now, the family planning project. She has completed (I think) ~11 years of schooling and has NEVER used a computer. One of my first tasks was to teach her Excel, so that she could help us enter our data (and better understand exactly what it is we are doing). She picked it up quickly given that she had never seen Excel/basic computer programming before... nor had she ever used a mouse (a laptop mouse, no less). While we were in Dhaka (with Wifi), I took the liberty of introducing her to Google-- an instrumental component of my life. Have you ever tried to explain Google to someone who hasn't seen it before? Now add in a fairly significant language barrier. We muddled through, though I don't think she was as excited about its existence as I was. However, she did make her way to YouTube which got slightly better reviews.

(Aside: once Jasim's (my Bangladeshi host's) NGO, Ongkur, is really up and running,there is a plan to introduce computer training in the schools, potentially allowing students to get more competitive jobs in Dhaka).

Lastly, my pic of the day, courtesy of the government run TB hospital in Dhaka.

If spewing blood doesn't scare you enough into taking your TB meds, not sure what will. This was the featured mural in one of the waiting rooms.

Diarrhea!

(No, I don't have it... yet).

Took a (very) brief tour of the cholera hospital in Dhaka (psudo-related article here: http://www.time.com/time/world/article/0,8599,2048937,00.html). It may be hard to believe that one can get excited about cholera, but excited I was. It is not something we see in the states (thanks to water sanitation, etc.), though it remains common (and deadly, particularly for the young) in much of the developing world. This hospital has served as a model for many programs in other countries and is a center for research on this disease and other diarrheal diseases.

What surprised me, I guess, was the relative organization of the facility, despite the high volume of patients. My source for comparison - the Mount Sinai emergency room, which induces PTSD-like symptoms for me. It is crowded, loud and absolutely unbearable for more than five minutes. Complete and total chaos is the only adequate description. This Dhaka hospital, in stark contrast, had an aura of calm. Granted, the short-stay unit/emergency room area was much more spacious than our own ER, but the volume of patients was apparently higher. AND the majority had profuse, watery diarrhea... despite this, things remained clean, organized.... pleasant even.

(So "beds" occupy every available space, though what is interesting is that these beds are actually modified cots, that are covered in plastic sheeting, which (bear with me) have a hole in the center underneath which resides a bucket. Primitive yes, but brilliant really: things are kept clean, there is a way to measure the amount of volume lost and no one is running to the bathroom, its right there. LOVE... in the time of cholera!!!)

Dhaka solution/rehydration solution:

Also... me (appearing as a brown sack... I guess of rice, considering the amount of I have been consuming) on an abbreviated tour of the city. I think this was Parliament.

My life (at the moment) in pictures

Since my computer died less than 24 hours after arriving in Bangladesh (another victim of the heat, it seems), I did not think I would be able to post any pictures from my camera. However, Rupa was nice enough to let me use one of her spare computers, which also happens to have the software for my camera.

So here are some pictures for perusal.

It's a char life.......

We arrive at the char by boat. Everyday I give myself a little pat on the back for not falling into the river (lets hope this trend continues). Depending on the time of day, our initial arrival will be quickly noticed or only acknowledged once we move from the shoreline into the center of the village. And then the chairs appear... plastic chairs from every possible direction... they multiply rapidly, accompanied by the strict instruction "Boshien" -- sit. This is particularly aimed at me, the strange, short-haired, light skinned person who speaks funny. Throughout the course of our time on the island, I am ushered into different chairs depending on the angle of the sun, as if everyone is afraid I might melt if left out too long (though to be honest, some days, I am afraid of this myself).

We (me, our trusty interpreters/interviewers and my colleague/mentor) sit and then attempt to recruit "eligible" participants - men and women who are married and are of childbearing age. Despite the somewhat sensitive nature of the topic at hand (family planning, the use of contraception, birth history) it is absolutely impossible to obtain privacy. The aforementioned chairs are merely placed in any shady space available, only on rare occasions do we interview in the home. Regardless of location, administering the interview is akin to talking in a crowded bar. There seems to be a steady din in the background. Distractions abound: children running or crying or fighting, chickens running or squawking or fighting, other villagers interjecting their own comments or asking questions. At times the interview will almost seem like a group effort, until one of the interviewers reminds them that only one person should be answering. The chairs form an irregular circle, around which some twenty people crowd. Through it all, I find it hard not to break a sweat.

Administering the survey, itself (which takes approximately 10 minutes), is also not a simple affair (even in the absence of the above distractions). The questions we ask are often misunderstood. Many of these people have little to no education. They can't read or write and do not even really conceive of a world beyond their island, having never had the opportunity to know anything else. They, too, have questions and are not always satisfied with our answers: what can we give them, how can we help them? We don't know either (but are trying to find out... not always reassuring for those looking for assistance).

But despite the somber nature of the situation at hand, the mood is often lighthearted. I, myself, often provide comic relief - albeit unintentionally. On my first visit, one of the women wanted to know what was wrong with me... she assumed I was dumb and mute. This myth persists, despite frequent use of my ~4 word vocabulary. As for my hair, my penchant for sweating and my weird shoes (very fashionable thick rubber-soled sandals rather than flip-flops) - all continue to be a source of amusement. All I can do is stand there, mute, and laugh too.

Daily Living

So I have been here a total of five days (am not going to lie, though the days go fast, it seems much longer). It has cooled down some, such that after a cold shower (under two fans at high speed) I actually needed my sheet for some warmth (if only briefly).

Typical day for me consists of waking at ~7 AM (initially earlier, now later). As most people know, this is ridiculously early for me, but I find it easier to work in the mornings - its cooler and I am less likely to be distracted. The fact is, there are seven of us living in 3 rooms. Rupa (the doctor I am with here) and I share a room (while there are FIVE!! people who share the other bedroom. Though bedroom is a loose term, as it really does function as office, living room, entertaining room and sleeping room. Last night, I literally just packed it in and laid down despite the fact that two additional people were working in my room.

From 9 until about noon Rupa (and now I) work(s) with the staff, for "capacity building," basically training them to give surveys and process the information. (I also just realized I never fully explained my project here. Basically we are going to the more remote villages outside of Narsingdi (which is, itself, an hour outside of Dhaka)... they are small communities on the chars (islands) of the Meghna River. A friend of Rupa's is setting up an NGO - Ongkur (which means sapling in Bangla). We are currently working on determining the family planning practices of the women and men on these islands - we want to know if they use contraception or if they want to and how we can improve access. Why do we care? Bangladesh is amongst the most densely populated countries on the planet, with a current population that exceeds 150 million. Couple this with ridiculously limited resources and you get a very large problem. The poverty is astounding. The healthcare nonexistent).

Sorry for the digression... back to a typical day. Around noon we leave by CNG - a motorcycle-like object (run on compressed natural gas, hence CNG) with a covered seat in the back: usually 5 of us pile in and take the ~40 minute ride to the "dock," where we pick up a wooden motorboat (steering is provided by a wooden rudder, operated by the boatman). The CNG drivers are reminiscent of cabbies in New York - lots of honking and swerving (though it is usually on account of the cows or goats leisurely crossing the road, or the massive number of people on the streets of the mass of rickshaws and CNGs coming in the opposite direction). As for the boat ride, it is usually quite pleasant. In ~20 minutes we reach the chars and administer our survey to ~4 or so people (which actually takes ~1.5-2 hours). More on char life later.

We take the same route home, where I usually take my second of 3 showers. There ensues eating, more work and then collapse into bed, only to awake and repeat!

Day 2

Arrived yesterday and took a one hour (air conditioned yay!) bus ride to Narsingdi where I will be staying for the next 5+ weeks. The trip and ensuing day was definitely a crash course in Bangladeshi culture. Again, I can only describe it as an assault on the senses.

But before I elaborate further, I need to comment on the heat. I am pretty sure that with the humidity it is (minimum) 5000 degrees. Every small movement leaves me sweating profusely; even breathing seems to take a lot of effort. We carry around towels to wipe our faces. I went to sleep after a cold shower and woke up SOAKED in sweat. I was just lying there and yet appeared as if I had run a marathon. Twice. OK, digression complete.

So I arrived in Dhaka (amidst applause) around ~8 AM. The flight from Dubai was not as comfortable as my first flight, given that it was quite crowded, everyone was very pushy (the announcement was made that zone A was boarding and all 400 passengers rushed the gate) and deodorant was clearly optional (myself included, as I had not packed it in my carry-on). I realize many aspects of this are cultural, so I tried not to become irritated, though it was occasionally difficult. I had a lovely little Bangledeshi lady next to me who kept trying to speak to me in Bangla; I estimated she was about 50 years old, but in helping her fill out the passport paperwork discovered she was a mere three years older than myself. During the flight, she would intermittently grab my wrist (didn’t matter if I was sleeping, wrapped up in my blanket, engrossed in the inflight movie) to check the time on my watch: initially this was endearing, but mid-nap it became rather annoying (especially when it occurred what seemed like 20 times; I would be sleeping or watching TV and I’d feel this random clawing at my wrist... it was also apparently impossible for her to get anything out of her bag without elbowing me(hard!) in my left boob at least fifty times.... impressive given that she was shorter than I and very petite).

When we landed I was carried by a sea of Bengalis to customs and then to the baggage claim. As expected my 900 lb bag was amongst the last to appear. And similar to boarding the plane, all 400 people vied with several baggage carts to be RIGHT next to the conveyor belt. If they saw one of their bags coming around they would simply run up on the conveyor to the other side and grab it, rather than wait the 10 seconds for it to come around. The whole process took well over an hour and a half. During this time I met a young, English-speaking Bengali lady thought it was very amusing that I was there and who was clearly skeptical that I would survive the encounter. Which of course is exactly what I wanted to hear upon my arrival. In my head, I was like, “I’m from New York... I’ll show you.” And then on the walk to the bus I almost got pickpocketed: we were walking through the street and I was carrying my two carry-ons, trying to avoid being runover (by cars, buses, rickshaws, you name it) and avoiding the persistent stares, when a little girl of about 6 literally latched on to my pink backpack. I (again literally) could not shake her; I was in the process of bringing said backpack to the front (with her attached, I guess), when I noted that her hand was already rummaging around in the lower pocket. Nothing was lost as the entire crowd quickly starting yelling at her.

Managed to make it to the bus in one piece and quite fortuitously, it was just leaving (ie no waiting in the crowd for me). The air conditioning was savory, the child intermittently retching into a plastic bag (which was then flung out the window and shattered on the pavement) in front of me not so much. Despite the heat, my desperate thirst and overwhelming exhaustion there was no vomiting from my end.... yet.

Am about to embark on my first day of survey administration this morning. Am praying the sun goes in during our ~1 hour boat ride. Have I mentioned the heat is oppressive? OK, more on my lodgings (and rickshaw rides) later as well as my first day in the field.

(Also forgive my my misspellings and any format issues. The internet won't let me preview anything so I have no idea what it looks like. Will try to post pictures as well, though this may also be limited by internet capabilities).

18 hours in Dubai...

So being sleep deprived on a regular basis has its advantages: my 12+ hour flight to the UAE flew by quickly. I napped, ate, watched a movie and repeated until we landed. Granted I am nearly certain that every child on the flight was within a 2 row radius, but the provided headphones sufficed to block out (mostly) screams, cries, etc.

My last month at the hospital was rather busy, so I conveniently didn’t notice that I had an 18 hour lay-over in Dubai until the week prior to my departure. And since that week was typically painful, I obviously had plenty of time to plan. Thus, I literally walked off the plane, went to the information booth and was like WHAT DO I DO? Wound up booking a hotel (they kept talking free breakfast and I kept thinking thanks, but my next flight leaves at 2 AM) and then arranging for a bus tour of the city. Bus was a generous word, as it wound up being an SUV, containing me, our tour guide, an Irish couple and a gentleman from Pakistan (who was convinced I was the Irish couple’s daughter for like the WHOLE trip, even though my New Yawk accent was fully evident). Honestly not that much to report. Basically the whole of the city springs randomly from the desert.

Crazy to think that all of the building is a recent phenomenon, with entire conglomerates of buildings appearing within the past few decades.
Now keeping in mind I got a very (very) superficial view of the city, I was overall very unimpressed. It made me think of a classier Las Vegas – fun to see, maybe spend a few days and then move on. Granted you would need a day to do one of the desert Safaris and I would love to see the inside of the Burj Khalifa (tallest building in the world) and Burj Al Arab (the only 7 star hotel)... not to mention sample some of the reportedly delicious restaurants. As for the largest mall in the world, it overwhelmed me (despite my brief stay). I mean, it has taxis INSIDE to get you around. Which I guess is helpful when you get lost.

Disclaimer: These views may be slightly skewed through the eye(lids) of jet lag and being hot. And we know how I get when I get overheated. And tired. I actually fell asleep in the SUV/tour “bus” on our drive back. Took what will likely be my last hot shower (and succumbed to the pouf that will now be my hairstyle) and collapsed into bed. Now am biding the last few hours (and taking advantage of the internet) before I head back to the airport.

Burj Al Arab

Burj Khalifa

Dubai Mall

Dubai Mall

Take two

Itssssssssss baaaaack. Over the past four years, the clueless third year medical student who ventured to Haiti (http://littlebirdinhaiti.blogspot.com/) has morphed into a moderately less clueless third year resident (when!? how!?) embarking on a new journey... this time to Bangladesh. As before, I am looking to promote women's health (through a study of contraceptive use/practices), and, as before, I speak not a word of the national language, Bengali (Bangla). Here's to a new set of adventures!