After a couple of days, we have found a sort of routine together with the local team here in Bangladesh: In the early mornings we run a few kilometers with each other, while the sun rises.
After a swim in the river and some breakfast, we gather in the operation theatre for a short morning meeting. Problems of the previous day and night are discussed, before going through the patient list and the planned surgeries of that day. Two theatres run parallel to each other: one with major cases under general or spinal anesthesia, and one with minor cases under local anesthesia.
The important messages of today: the broken air conditioning in the OR has been fixed, and a new powerdrill that we need for the pins to fixate fingers has been retrieved from the market across the river: surgery can officially start!
One of our major cases is Anshar, a 14-year old boy with severe contractures of both hands and the left foot. He fell into hot ashes at age 2, and was only treated with some dressings after the acute burn. No surgery was performed, until January this year. A team of German reconstructive surgeons operated on his right hand, which was adhered to his underarm and could not move.
“I was never operated before, because we don’t have the money to have surgery in a normal hospital and because we live far away in a remote area. We have to travel far to reach the nearest hospital.” Anshar has two brothers and four sisters, and his father is a farmer. Traveling also means less income for the family. The Friendship Hospital ship is 70 kilometers from his home, and Anshar and his mother came with one of the transportation boats of Friendship. He loves playing with our camera. “There are many things I cannot do because of my hands. I am actually righthanded, but my left hand is a little bit better, so I taught myself to write with left. But I am in school and later I want to become a teacher. I also like to play soccer very much, and I am a fan of Neymar." The position of his right wrist had improved after the first surgery but he hopes to gain more function so we performed a second operation. We straightened his wrist and fingers and fixated them with the pins. In six weeks, the pins will be removed and Anshar will get follow-up during a physiotherapy camp.
The post-operative care and follow-up consults are managed by Malik, the 35-year-old head and main technician of the operation theatre. He has been working on the ship since 2007. His long-term experience makes him the boss of the OR in a natural way; his voice is recognizable from a distance and he manages the preparations and aftercare of surgery with a lot of expertise. It’s very valuable to discuss strategies for the patients and we exchange important tips and tricks.
Malik’s wife and children live in Dhaka and he can only see them when there are no surgical camps. He used to work in a management position before, but at some point discovered his passion for the medical field. He started working for Friendship because he wanted to help improve the healthcare for the vulnerable people in Bangladesh: “A lot improved already over the last years, but Bangladesh is very overcrowded and poor. Friendship’s strategy works because they bring healthcare to the people to provide better accessibility.” One of the parts he strongly believes that should be improved even more is counseling to prevent accidents to happen. For example about how to be careful with fire and to use better cooking equipment.
He is also part of the program “Train the Trainer” that Friendship is building. For a while now, a new technician has joined the OR of the ship: Gia. Malik is training him: his dream for the future is that Gia can take over his work at some point and train the next operation assistant.
Today we reconstructed four post burn contractures and a cleft palate, and we removed one small tumor of the palate. At the end of the day we changed the dressings of the patients that we had operated on during the first day. So far, there are no complications, but the future will tell us more about the longer term outcome. Malik is dedicated to assure good postoperative care and we trust that Anshar is in good hands and hopefully he will be able to become a teacher one day.