Our experiences from Lalmonirhat, the last district.

I can’t believe we have already completed our final destination of the trip, to the district of Lalmonirhat. This trip has been going by so quickly, and yet when I look back on the number of projects we have visited it is astounding. I found this week especially interesting given the majority of the programs we visited were healthcare oriented, my particular focus. The district is located about 1.5 hours northeast of Rangpur on a narrow strip of land bordering the India. The area is almost entirely rural with no large urban centres. This means the province lacks many vital services and was the poorest of the districts we have visited. People are often forced to travel hours if necessary to receive proper care in Rangpur. To see this level of disparity, even after visiting all the other districts was truely eye opening.

After making the 1.5 hour drive we arrived at our guesthouse, another sweet 4 storey building which is usually used by RDRS for training. The staff here are as friendly and welcoming as anywhere, but there was one slight let down, no A/C! I had managed this in my room in Kurigram and for a day visiting the chars, but never this long and with no common area for relief. I feel quite selfish complaining about this minor inconvenience when many people are living with no electricity at all. I’m sure we’ll have as enjoyable of a time here as all the other districts.

Once settled we go to visit the law courts and speak with 5 lawyers representing RDRS protecting many of the abused and victimized women. These cases can range from rape or assault to dowry disputes. The lawyers say they are currently working on 44 cases, but the legal system in Bangladesh is a slow process and there is little legislation protecting women. This makes it clear that changes have to be made at a constitutional level if progress for women rights is to be further improved. Another I found interesting, although 3 of the 5 lawyers we met were women, only approximately 5% of lawyers in Bangladesh are women. Many women are married and supporting a family at a young age and are not given the opportunity to persue such extensive education.

The next morning we were given the opportunity to join in on a meeting with a union federation discussing future developments for 2014/15. We all agreed we gained little knowledge from this, as it was difficult to comprehend the projected developments with such little knowledge of the area. In the afternoon we visited an eye-care clinic run by RDRS. This facility offered free care to the poor and ultra-poor with services such as optometry and treatment for different diseases such as cataracts or infections. Attached to the hospital is a rehabilitation centre for visually impaired youth. With children ranging in age from 5 to 18 years old. The centre provides educations along with training in ADLs (activities for daily living) and vocational training such as woodworking or tailoring. This facility was most impressive of what I have seen so far. All the children seemed very happy and were gaining skills vital to allow for independence upon returning to their community.

The other sites we visited while in Lalmonirhat included the main district’s hospital, The Sadar Hospital, and the TB and leprosy clinic run by RDRS. The Sadar hospital was extremely understaffed. For example the surgery ward of 50 beds was serviced by only one nurse and one nursing aid. The hospital has 33 positions for physicians with only 6 filled! They didn’t even have staff to operate the X-Ray machine or the sonogram. For a major hospital serving approximately 1,000,000 people this is shocking. I was informed that most of the doctors are trained in Rangpur and would rather practice there in private clinics then this public hospital. I feel the government needs to provide more incentives for working in these rural areas or reserve more spots in their medical schools for rural applicants, but both of these solutions take money and have their only disadvantages.

After seeing all of these health programs I can really see how difficult it is to provide accessible primary healthcare to the poor and rural areas of the country. One strategy that does seem to be improving this disparity is an increase in field workers. This strategy is especially effective in providing family planning education in more remote areas and is one of the main reasons for the recent decrease in family size.

We are now back in Rangpur to relax and prepare a presentation and report for RDRS. We’ve also scheduled in another visit to the women’s rehabilitation clinic, Rangpur Medical College and a Prostitution Support Clinic. I am looking forward to these last three programs before coming home after such a life changing experience.