Part 1 – 2010
The latest session of operations took place in the Sylhet area where BanglaCymru hired an operating theatre for three days at the Women’s Medical College Hospital, Sylhet. Following the consultation and medical assessment it was decided that forty patients were healthy enough to undergo the operation. The majority of the patients were extremely poor making a living from fishing in ponds and riversides without any hope of ever being able to buy the smallest boat. Others scraped a living by gleaning in the fields and one or two driving rickshaws which means that they are regarded as belonging to the lowest level of society in Bangladesh.
On the left, the operating theatre. On the right, the sign outside the hospital
As usual, the session was organised by our medical co-ordinator, Dr Jishu a and Dr Salek, one of Bangladesh’s foremost specialist on the cleft condition once again was the chief surgeon. This kind of session is called a ‘cleft camp’ in Bangladesh; nothing like the Urdd or Boy’s Scouts’ camps here! However, the main purpose of these camps is to go out to remote areas to inform people about the treatment and to reach patients who could not travel to the capital city let alone afford the surgery. This time the medical team consisted of three new assistant surgeons apart from Dr Jishu; Dr Rupon, Dr Polash and Dr Mannan and the anaesthesiologist was Dr Ragib. The workload was exhausting and, due to the time constraints one day they worked from 8.00am till 2.00am the following day!
This time again many burn patients came to the hospital pleading to be treated. Once these ill-fated people become aware of free treatment of the exterior body they think they are eligible themselves. It’s a heartless task to turn them away. I sincerely hope that BanglaCymru in future will be able to assist these patients. Other problems that became apparent once again during the medical assessment were patients who had been previously treated for the condition by unqualified people begging for the work to be reversed and to be treated anew and others who had unfortunately been to the quack / witch doctors and exhibiting the tabij round their necks. These are small tubes of ‘special potions’ which are of no medical value at all.
On the left, Babu and his mother. On the right, the deformed face and hand
One sad story was that of Babu. He’s a six year old little boy who looks half his age living with his mother. Babu’s mother gleans in the fields and mends clothes in the evenings to earn enough to keep them alive from day to day. The mother lost a child before Babu was born from an illness that would have been easily treated here in Wales. Babu had medical problems other than his cleft lip including a congenital deformation of his hand and respiratory complications. The father had abandoned the two when Babu was a baby and blamed the mother for the children’s medical conditions, and badly assaulted her many times before leaving. But that was not the end of the mother’s misery. Her mother in law who lived nearby taunted and assaulted her repeatedly for bringing shame and curse on the family. This is one symptom of the belief that emanates from the superstition associated with the condition amongst the uneducated. Unfortunately, Babu was not one of the patients who had their lives changed at Sylhet, but we have invited him later in the year to Dhaka, the capital city to a hospital with better medical facilities and where all his medical problems will be addressed. BanglaCymru will not abandon him. However, forty children and young people were treated at Sylhet and will now start new lives in this beautiful, noble but extremely deprived country.
Part 2 – 2010
It wasn’t the usual sunny weather that welcomed me to Bangladesh this time but unrelenting rain and threatening floods. The natives are convinced that the global warming is confounding the natural six season order of Bangladesh and evidence of that was that the monsoon season had arrived far too early. The rain might be an opportunity to clean the dirty streets and the open channels of the city that men use openly as a toilet. However, I soon changed my mind when I heard about so many people who lived by the river sides losing their lives and a bus full of students swept to their death in a local river. Following those days of heavy rain we experienced stifling, unbearably hot weather even for the Bangladeshis for this time of the year. To crown it all panic broke out in the community when anthrax spread into the city. Nothing in moderation, whatever it might be, happens in Bangladesh
It was the Hindus’ turn this time to celebrate a special event in their worshipping cycle, namely the Durga Purja. The clay effigies of the Durga with her ten arms and her accompanying effigies in their attire of splendour in every corner of the Hindu neighbourhood were truly amazing. Even more amazing were the raucous processions taking the effigies of the Durga to the rivers for the elements to repossess them.
But, our time came to start on our prime mission. I travelled with Dr Jishu, our medical co-ordinator, Professor A J Salek our chief surgeon and the rest of the team on a long and tiring bus journey to the town of Rajshahi on the banks of the Ganges situated near the border with India at the north western part of Bangladesh. We crossed through unique lowlands of marshes, swamplands and lakes where we could appreciate the precarious ecological balance which is the daily threat to life in Bangladesh. According to the Bangladeshis themselves Rajshahi is a particularly poor area because the swamplands had been a barrier to the development of the area and hardly any resident would venture to the other side of the marshes.
As we approached the hospital a large crowd came to greet us. Many bowed to show their respect and others smiled widely with excitement as we alighted from the bus and unloaded our medical equipment. Here we saw scores of babies, children and adults with various degrees and forms of the cleft condition and during the next eight hours we assessed in excess of a hundred patients all with similar sad stories. We all smiled when one elderly man came to be treated with a very severe cleft lip and he was probably the oldest patient I had met on my many visits to Bangladesh.
“How old are you?” Asked the chief surgeon. “Fifty” was the answer. The surgeon smiled and asked him further, “Tell me what it was like here during the British Rule and the time of Gandhi?” He replied, “I was a young man at the time but I remember it well!” British Rule in the old India came to an end in 1947!
The next patient was a woman of approximately the same age. She had an atrocious cleft lip and a badly deformed gum but her beaming smile endeared her to everyone.
“How old are you?” asked the surgeon. “Forty”, she replied with confidence and another cheerful smile. “I doubt it”, said the surgeon mischievously, and she responded and said; “Well, I lost my father and mother when I was young and they never told me how old I was before they died!”
One young boy of approximately eighteen years of age was asked to leave the room to ask his father outside how old he was, but the vast majority of the patients were young children and babies. It was so difficult to try and comfort them in their nervousness because of the language problem. They were facing a panel of strange men in a room full of unfamiliar medical equipment with the doctors prodding their fragile lips and forcing their mouths wide open to examine their cleft palates. It was the smallest quota of sentimentality that was ever given to Bangladesh and even smaller to these vulnerable children that evening.
It was so sad again to see patients that had been previously treated unsatisfactorily and where the procedure could not be reversed. One tearful mother brought in her twelve year old son who had lost all his premaxila, which is the part between his mouth and nose. He looked dreadful. A surgeon with no plastic qualification had removed all tissue and muscle from this part of his face and nothing could be done within our limitations at Rajshahi to help the boy. The mother pleaded with the surgeon to do something. With great emotion myself I saw the mother leave desolately with no positive outcome to her efforts. However I saw through the side of the door that she was reluctant to leave the waiting room. I could see her staring sorrowfully at me through the crack in the door. When the door was opened for the next patient the mother dashed back to the room like a hurricane, passed the surgeons and officials and threw herself on the floor and kissed my feet in her anguish and desperation. “I beg you to help my child,” she cried. The blood drained from my face! Shaken myself I pleaded with the chief surgeon to offer something. What about some kind of cosmetic treatment? What about some kind of prosthetics? Anything at all! I reasoned as if I knew exactly all the available medical options. The following day the mother returned with her son. I could see the boy wondering from one room to another, presumably seeking help, and without doubt, being directed covertly by his mother. This was one of the most poignant scenes I had ever seen! Later that day somebody told me that the chief surgeon had given him his phone number and the address of a specialist hospital in Dhaka. I was in such awe for the perseverance, the unconditional love and the sheer unwavering commitment of the mother to give the best to her child.
The mother and son , The smile of the ’40’ year old , The old man from Ghandi’s time
Back home in Wales we have one specialist cleft centre which is in Morriston Hospital, Swansea. Here the complete, comprehensive cleft treatment is offered, not only to the child but also for the parents. In all, there are nine centres in the UK, and no surgeon in any other NHS hospital is permitted to undertake this specialised cleft procedure. I hope one day that this rule will be adopted in Bangladesh.
During my stay, despite the cholera outbreak in our hospital, an amazing 98 cleft patients received the highest quality, successful surgery – an astounding achievement for BanglaCymru! In addition, we promised to fund the treatment of our first burn victim who was a twenty-five year old girl who had burns to her face and neck, and due to the contractures she could not move her head properly. You will remember that BanglaCymru recently decided to fund the treatment of twelve burns patients annually.
I send you all my very best wishes and my most sincere gratitude for your support. I am confidence that you will keep supporting the charity so that we can treat more than the astonishingly 251 lives we have by now changed because of your kindness.