| BACK TO BANGLADESH |
We have been back in Bangladesh now for about seven weeks. Eli just turned three months old and we couldn’t be happier with our beautiful, healthy and happy son. Many of our days are filled with new sounds and giggles from him when he is awake. He enjoys playing with new toys that were lent to us and reading books with Nishant in the evenings. His bath time is a real treat after a hot day here and he splashes for as long as we let him.
At the beginning of September we said goodbye to my mother after her two and a half week visit. She was really helpful as we transitioned back, and we got to spend precious moments with her and Eli. We now try to regularly video chat with our family and send them photos so that they can see Eli grow with each new day.
We miss our family a lot, and this summer was a very special time for us all to reconnect and enjoy important moments together. We are very thankful and blessed for the ongoing support that we receive from both of our families as we continue in our work in Bangladesh.
This past month has been a busy time for our family, especially as I get used to new routines of caring for Eli as well as beginning to work again. I am now working part time and am able to do most of my work from home so I can continue to breastfeed.
| MOVING PALLIATIVE CARE FORWARD |
In September I was able to participate as a faculty member at a palliative care conference in Dhaka. This conference is run through the Asian Hospice Palliative Care Network (APHN) with funding from the Lien Collaborative for Palliative Care. Approximately 35 physicians and nurses from the Dhaka area attended a five day course in which many topics were raised related to palliative and end-of-life care in Bangladesh.
I had the opportunity to teach a session and facilitate daily rounds in the local hospital, and afterwards we had small and large group discussions on the recommended plan of care for our particular patient. It was a good learning time for all the participants and as we completed each day, the level of interaction with the faculty increased.
Teaching in a cross-cultural context as a foreigner can be challenging, especially with different English accents and learning styles. However, from my experience last year teaching in a Bachelor of Nursing program at a local university, I was able to connect with and engage the participants. English is the most common language used for medical textbooks and research papers, but primary care in Bangladesh is given in Bengali. Sometimes this can lead to confusion and reduced comprehension, but we all worked hard together to overcome these challenges and ensure positive learning for everyone.
Palliative care has made great improvements in Bangladesh in the last year with now the possibility for physicians and nurses to study and become specialized in this field. However, more work is needed to ensure that this type of care that is now available to those living in Dhaka is also made available in regional centers across the country as well as rural village areas. Also, the use of effective and affordable pain medications like Morphine remains misunderstood and under prescribed for patients dying and suffering with pain.
The Lien Collaborative continues to work in these areas and network to advocate for this medication to become more attainable and recognized as the treatment of choice for those dying of cancer pain. The main government run teaching hospital in Dhaka now has a unit in which palliative and pain management can occur with qualified staff. The hope is that as this hospital makes this a priority, the other regional centers will slowly begin to do the same.
Palliative care is something I am passionate about as early on in my nursing career I was deeply impacted through my home care work. It is a vulnerable time for patients and families, and I saw that through good nursing care I was able to support them. This type of health intervention isn’t where MCC focusses, but I am grateful that I have been given the flexibility to continue to network and be involved in some small aspects of palliative care in Bangladesh.
The conference I participated in is part of a three year program with a conference being held every six months. However, due to political unrest in Bangladesh, the schedule has been delayed in the past but we are planning to meet again in March 2016. Being one of the few faculty members based in Bangladesh, I hope to maintain good relationships with the local nurses through ongoing online assignments and mentor them as questions and dilemmas come up in their work.
| NEW PROJECT |
In my work within MCC, together with Nishant and a local colleague we have been preparing a concept note for a new health project that we will submit for approval next month. In March we had spent time in India researching various HIV/AIDS interventions and now we have been working hard to design a project that appropriately addresses the needs in the communities where we work. While we were back in Canada this summer, our local colleague facilitated various focus group discussions in order to evaluate MCC’s current HIV Peer Educator program, and also the identify and understand the related health needs for our new project.
| PRAISING GOD |
In September we hosted a bible study in our home, and it was a good gathering of friends for a time of food and fellowship. I led the study with a reflection on the Doxology, which is a common hymn that is sung at the end of worship gatherings. It is familiar tune and verse to many of us.
Praise God, from Whom all blessings flow;
Praise Him, all creatures here below;
Praise Him above, ye heavenly host;
Praise Father, Son and Holy Ghost.
(Thomas Ken, Doxology).
As we sang the Doxology and reflected on scripture that reminded us of God’s provision in our lives and the need to praise Him, I was drawn to praise Him specifically for the last three months. Eli has been a huge source of praise in this transition into parenthood. There was a week in the last month in which Nishant was suffering from a viral infection that made life in our home very difficult. He could not hold or care for Eli for several days. I was very exhausted and busy with things around the house as I cared for both of them, and I didn’t go outside of the house for almost five days!
But in those moments of frustration, feeling alone and sad, Eli would smile or giggle in a new way. I was reminded of simple joys, simple reasons to praise God. I am so thankful to be a mother, and I know that I will be forever changed. God is changing my attitude, my faith and my life through this process. It hasn’t and it won’t always be easy, but I am committed to praising Him, “from Whom all blessings” really do flow!
Rejoice in the Lord always, again I will say, rejoice.
PLEASE BE PRAYING THAT:
1. Eli adjusts to the heat and humidity. He currently has a rash/eczema over most of his body that we are treating.
2. We experience safety as recently a development worker was murdered. This was a message we received from Canadian government:
“There is a threat of terrorism in Bangladesh. At the end of September 2015, the Australian and United Kingdom Governments informed their citizens that there is reliable information to suggest that militants may be planning to target Western interests in Bangladesh. Attacks cannot be ruled out and could be indiscriminate. Terrorist attacks could occur at any time and could target areas frequented by expatriates and foreign travelers. Limit your attendance at events where Westerners may gather, for example in hotels or conference centres. Exercise caution and maintain a high level of personal security awareness at all times and in all places, and monitor local media for the latest information on threats to security.
On September 21, 2014, the Islamic State of Iraq and the Levant (ISIL) released a statement threatening retaliation for the American-led coalition campaign against ISIL in Iraq and Syria. The statement encouraged opportunistic and indiscriminate attacks against citizens and interests of countries supporting the coalition, including Canadians. Individuals and terrorist groups in the region may be inspired to carry out attacks in a show of solidarity with ISIL. On September 28, 2015, an Italian national was shot and killed … [in] Dhaka. ISIL has claimed responsibility.”
The country is now on high alert as British and Australian intelligence agencies have warned of an attack on Australian targets in Bangladesh. Consequently, the Australian cricket team cancelled a planned visit to Bangladesh.
3. Our families experience peace in the midst of uncertainty.
4. We continue to have a heart of worship and praise God in the midst of challenging times.
Erin, (Nishant and Eli)