So a lot has happened in the last few days but we haven't blogged due to technology issues. We have a few pictures which we can hopefully attach.
I'll start from friday when we presented our audit to the doctors at the meeting. We were very happy with the work of our audit as it showed some promising change but lots of room for improvement. Evidence based medicine is not understood well by the doctors here. We discussed the social barriers the doctors have when trying to do the best treatment. The problem is that when a child has diarrhoea the parents stop feding them and demand iv fluids and antibiotics. These treatments are not needed and may cause harm in the majority of cases. Interestingly there was a period in our audit which had a marked increase in iv antibiotics and fluids without more patients. We raised this in the meeting but shubrho quickly dismissed it as coinidence and got us to move on. He explained afterward that the 3 weeks of poor management we described were when one particular doctor who was at the meeting was on duty. We found this quite funny but also interesting that one person can skew the results of the whole audit.
On saturday I was invited to the funeral of the mother of the builder who is employed by the hospital. Shubrho and I took the ambulance out to a wee village where the celbration was taking place. After a designated time of mourning there is a celebration feast when someone dies. Our host, the builder, greeted us dressed only in a dothi which is a peice of cloth that men wind around their waist. He had a shaved head as part of his mourning practise. The format was much the same as a wedding. There was a huge cooking operation underway when we arrived with massive pans set on bricks with a fire underneath. This was all going on in a paddy field which the builder had drained for the occasion. Despite being in a field there was a big tent which even had fans and electric lighting. The food was excellent as always and there was plenty of it.
After the meal we bumped into one of shubrhos patients, a small boy who had ashma. His toothless father invited us to his home to see the house. The house was made of mud with a thatched roof and I think their goat shed was about the same size. The family all came out to greet us and show us around. Despite being surrounded by mud, the sisters were wearing bright yellow salwar kameez with fancy shawls. I myself had white pyjamas which had bright yellow curry stains so I think I looked he part.
Also on the way back we stopped to look at the river. And all the dundee folk will love this... there was a field of jute next to us. While we were standing there a wee boy came up to us and demonstrated how he could dislocate both shoulders. We were suitably impressed with this party trick so he did it again.
On saturday the local hindus were out appeasing thesnake godess. This involves setting up a big sound system in front of the deity and having a big gathering with loud indian music. The idea is to get her to protect you from snake bites in the coming year.
Today we went to church early in the morning to see he baptism service. The service was fairly long and as it was in bengali I only pick out the odd word. After the service we formed a procession led by the church band and walked through the streets following the sounds of the tabla and harmonium. When we arrived at the pond the pastors waded in and got to work babptising 30 people. Meanwhile children were swimming round and mothers were washing clothes on the bank. This was a really special time as lots of the local community came out to watch and it was good to see the church being visible.
Neil
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