A Constant Stream of "Bubbles!!"

Today we drove three hours outside of Dhaka to a rural community endemic for kala-azar, a fatal parasitic disease spread by sandflies. I was excited to get out of the city but I have one word to say about the drive out there and back… HORROR. TERROR. LIFE FLASHING BEFORE EYES.



Ok, maybe I have a few words. Traffic is bad in Dhaka. It’s like trying to drive among a billion people all hopped up on PCP. It’s an aggressive, loud, complicated dance right up against the line of insanity. But once you leave the city, the roads open up. Which means that you get to do this aggressive, loud, complicated dance at sixty miles per hour! At least in Dhaka city, there are so many cars, bikes, rickshaws, people running across the street that you really can’t go much faster than a few miles an hour for longer than a few seconds. But on the open road... I could not look out the front of the van. It was too terrifying. I had to will myself to just look out the side window and not look out the front where I might catch a glimpse of the bus barreling right for us as we swerve around another bus at 7 million miles per hour. And the drive back was even more fun because we included the added excitement of it being dark! If Marcus was driving, I would have been emitting a constant stream of ‘Bubbles!!’ alarms.

Well, in between the terrifying drives, being out in the rural communities was fantastic. Every person that we’ve interacted with here, be in the doctors, nurses, scientists, patients, villagers, or whoever, have been incredibly warm, welcoming and wonderful. We visited with a few patients being treated for kala-azar at the local sub-district health complex. Two small children who were recovering well and one young woman who, unfortunately, was diagnosed probably too late. She was so anemic that her tongue and conjunctiva were white. She needs a blood transfusion which they cannot do at this facility. There is a medical college hospital about 30 minutes away that has the capacity to do transfusions and while treatment for kala-azar as well as all services at the medical college hospital is free for the poor, her family cannot afford the transportation costs or the costs associated with having a family member stay with her during what would likely be a month long stay. So she remains at the health complex, receives her daily treatment to kill the parasites, but too much damage has already been done.



After leaving the health complex, we went out to a community health outpost where people with kala-azar may go to first to seek a diagnosis. We walked around the community and visited a household that has had the disease. They had about three small mud huts for 5 family members. We went in one which had just enough room for one bed and a pile of grain. On the walls, we found several little sandflies. We of course, gathered quite a crowd with us we visited with them with people just appearing from nowhere and following us around. We amused the kids by taking a few pictures and showing them. They don’t like to smile for the pictures but they crack up hilariously when you show them how serious they look.



From there, our hosts kindly fed us mountains of food. They tried to make it not spicy for us, but, at one point some kind of green pepper made it into my mouth and I swear I almost passed out in my mutton. Seriously, I had to take a moment and actually, couldn’t really eat after that. Just one small slice of a small green pepper took me down. The other thing I kept thinking as we ate was how much Marcus would HATE eating here! I mean, you have access to silverware in most restaurants. But a home-cooked meal in someone’s house is different. They piled our plates with rice, mutton, chicken, fish, dhal, and vegetable curry. I don’t think Marcus could get through that meal using just his right index finger and thumb as he does for chicken wings. And after dinner, we were served a dessert of sour curd and milk bread. I took one look at that and channeled Andy. In order to not be totally rude, I told them that I couldn’t eat dairy! I did taste a tiny little bit, just out of curiosity and, wow, I did not like it one bit. Not to mention that dairy products are not pasteurized here so I’ve been trying to avoid them at all costs.

We arrived back at the hotel at 9pm, totally exhausted but also really thankful for the opportunity to get a glimpse of a community dealing with kala-azar.