On 29th July 2015 a group of 15 medical students met for first or second time in their lives – in Bangladesh. Some of them had spent hours travelling together from London to Dubai to Dhaka; others had flown to Dhaka from other cities in Asia. On their first evening together the team engaged in small talk about their travels. Then, unsurprisingly, absolutely shattered they went to bed ready for their 7am start the next day.

In Dhaka, the group spent a day with BRAC Bangladesh, visiting its sites and learning about its maternal health, tuberculosis and female empowerment programmes. They spoke with patients and facilitators and learned about the methods that BRAC Bangladesh uses to meet the population health needs. In Dhaka the team also spent a morning at the National Institute of Burns and Plastic Surgery. They observed plastic reconstructive surgery patients, burn victims suffering from severe electrocution, open fire injuries etc. and patients being treated for rare deformities. Dr. Papon, a senior Plastic Surgeon at the Institute, accompanied the group, explaining the patient conditions

From the 4th August to 17th August the group began their clinical placement at the Hope Hospital in Cox’s Bazar. During this period they were exposed to global health issues and practices in Cox’s Bazar through their clinical rotations and visits to three nearby villages with Hope Foundation staff, viewing the Women and Children’s Public Health Projects there. Through conversations with the villagers the volunteers were exposed to the lifestyles and health practices in rural Bangladesh.

At the Hope Hospital the group was predominantly exposed to obstetric fistula and maternal and children’s health. They were able to observe rare pathologies as well as gynecological operations including caesarian sections, vaginal births, a cervical amputation, and hysterectomies in this under-resourced tertiary facility.

Hope and Selfless provided a Fistula Camp. The observed doctors conducting examinations on fistula-patients took histories, observed fistula-repair surgeries, provided emotional support to patients after surgery and observed post-operative care and consultation. The camp lasted four days with two fistula-repair surgeries on each day. Each volunteer observed a minimum of two fistula-repair surgeries and received the opportunity to discuss the surgeries with the specialist surgeons Dr. Biswas and Dr. Prantika.

The group was exposed to the social impacts of obstetric fistula through formal and informal contact with specialist surgeons highlighting the effects of obstetric fistula in Bangladesh elucidated its social impacts and the obstacles to effective treatment and time spent in the wards allowed the group to communicate with fistula patients, discovering their stories and how living with obstetric fistula had affected their lives. Speaking to patients enabled the volunteers to understand how the condition affects women’s lives in Bangladesh:

…Today we had the chance to spend the morning watching a fistula repair surgery on a 19 year old girl who had been abducted age 12 and developed a fistula It’s amazing how skilled the doctors have to be to perform such an intricate procedure with such limited resources, but the fistula of this girl was closed up and she should be recovering soon. Saying that, her abduction, young pregnancies and thus fistula formation will affect the rest of her life. Even though the fistula has been surgically closed for now, there’s a chance it will reopen and leak again – but even if it does stay closed, she will probably have stress incontinence for the rest of her life. What’s more, her fistula has caused such scarring that she will never be able to get pregnant again – imagine being told that at only 19, when you’ve already been through so much? I can hardly bear thinking about it…

On 14th August the volunteers delivered a health camp with Hope Foundation doctors and coordinators in the remote village of Moheshkali. In approximately 4 hours they provided medical attention to an estimated 136 patients. On 16th August the team delivered an additional health camp in Eidgar. Poor weather conditions resulted in lower-than-expected patient attendance. Nonetheless working in small teams to examine Bangladeshi villagers with no English speaking abilities provided useful preparation and training for the two health camps they delivered in the region of Sylhet.

On 19th August the group flew to Sylhet after a rest day in Dhaka. On 20th August the group worked with the Sancred Welfare Foundation and Sylheti field doctors to deliver a health camp in the Sunamganj District. The team provided medical attention to 1023 patients. On 22nd August the Elective Aid volunteers worked with the same field doctors to provide a health camp in the Turuk Khola district providing medical attention to approximately 900 patients.

4 weeks, 15 medical students and over 2000 patients! #ElectiveAid2015

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