There will be days when you think…

As Team 3 prepares for the next mission in Bangladesh later this week, some of our Team 2 members who returned home a couple of weeks ago, have put some thoughts down on paper to describe what it meant to them to be a part of the BPM Team. We’ll publish a few of these over the coming days as we wait for Team 3 to arrive in CXB.

Shane. 

DRG2 Shane

There will be days when you think “I can’t do it today”.

The breakfast you eat will be nearly inedible after a few days. It’s exactly the same every day. You’ll crave fruit and salad but it’s Bengali Roulette to eat anything raw or washed. You need to be nearly paranoid with anything you touch and put near your mouth.

The smells from the latrines is overpowering. The flies thick. The noise constant. Water contamination likely. Dust when dry and thick heavy mud when wet. The drive to and from the camps is long and full of near misses. You will learn not to look out the windscreen and look out the window instead.

It will be hot, steaming humidity and relentless sun…you will carry more water than supplies every day, and drink more water and sweat more than you thought possible. Yet still feel a headache and thirst associated with dehydration. The tents are stifling and like ovens. Any physical exertion will be hampered by your sweat. It will sting your eyes, drip from your face and compromise your grip.

You will see and hear stories of despicable violence and heroic endurance that you cannot process. Witness injuries that should not have happened to anyone, especially children. Wonder how harsh their former existence was, that this new life is somehow better.

By days end, your muscles will ache and your clothes stink. Your sweat will leave white salt deposits on your clothes. Washing them in a bucket will clean them, however due to the humidity, they will still be wet in the morning. Beggars are present the moment you leave your hotel. They are constant and hard to ignore.

Restocking your bags for the next day is a task. Trying to foresee what you will need to take more of and remove what you may not use.  Yet leave enough room for water. Buying water to keep stocks up for the day, for you, your mates and some dehydrated people you treat.

The cleanliness of your room will be dubious.  The air stagnant. THE SHOWERS COLD. The bed hard. But it will be like a cloud at the end of the day. Mornings will be adorned with the Call to Prayer at 0448. With all the stray dogs howling in tune.

So, back to the days when you think “I can’t do it today”. When your alarm goes off…. you will lie there and feel every ache… every tired muscle and the growing unease of seeing everything again.

And then you will think of the kids with their smiles, walking with you and holding your hand. The adults bringing you a chair to sit on when you stop and offering you the little food they have to eat. The thanks in the eyes of those you treat and their families. The eagerness to help you as you go through the camps. A hand on your back as you cross a creek. Carrying your gear to help you when you tire. The children playing and laughing. The respect given to you by the big players. The honour of knowing you are one of a few Australian groups on the ground giving health care to these beautiful people. You think of the support from your family and friends back home. You think of the team with you and how you have a bond with them – they have your back and you have theirs.

All these thoughts will make you drag your sorry arse out of bed, get your backpack on, run down the stairs and get out there!

Sometimes you might wonder, what can one person like me actually do? If not a enough, it was something. I hear there are more and more aid agencies over there which means a lot more people doing a lot more somethings. I’m very grateful to have been a part of that. I’m very grateful that on the mornings I woke up and thought ‘I can’t’, I did. AS PART OF A TEAM, WE GOT SHIT DONE.

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The DRG2 Team L-R back row: Shane, Alex, Simon and front row: Lily, Kate, Amy, Mel. 

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BPM in Bangladesh…what’s next??

After the successful return of DRG Team 2, many of our supporters have contacted us to ask “…what’s next?”.

IMG_2530This morning we are very pleased to announce that BPM will be deploying a third (and final) DRG team to Bangladesh, deploying on November 27th, 2017. 

This will be a dual-purpose team with the following objectives:

  1. Provide care to the sick and injured Rohingya population in the ever-growing refugee camps, continuing the excellent work of teams 1 & 2
  2. Train a team of Rohingya volunteers to act as a ‘camp ambulance’ (similar to our KRT project in Nepal), the aim of which is to connect patients with health services as they grow in the refugee camps.

The Rohingya Volunteer Ambulance Network (or “R-VAN”, for short) is our solution to a growing problem identified by Team 2. As the team went about their work (especially in the massive Kutapalong 2 camp- which now holds almost 450,000 people), it became increasingly apparent that there was a huge need for the creation of an ambulance network throughout the camps to treat and transport those that are simply too sick to make it to the health clinics.

IMG_2501Essentially, what Team 2 identified was a large – and growing – population which were not only presenting with acute problems resulting from violence and persecution, but also chronic ailments typical of all large populations.

Given the vastness of these camps and the incredibly taxing conditions, our team encountered patients who were becoming critically ill simply because they could not make it to suitable healthcare facilities.

The role of DRG Team 3 will be to work with our partners in Bangladesh (namely Care Intl. and Non-Violent Peace Force) to recruit a team of Rohingya volunteers and train them in basic first aid, patient assessment, extrication and transport. The initial team (around 20 volunteers) will be kitted-out with uniforms, First Aid kits, medical supplies and patient transport equipment (eg: stretchers).

IMG_0335The goal is to grow this team into a network capable of servicing the furthest reaches of the refugee camps. BPM will have an ongoing involvement with these teams in the coming months.

Of course, all this is made possible by the unbelievable support from YOU- our supporters! Please continue to spread the word of our work and keep in touch- your words of support and encouragement really do mean the world to us!!

If you would like to help our mission, you can donate to the Backpacker Medics cause here:   https://chuffed.org/project/bpmdrg-bangladesh#/supporters

For media enquiries please contact Denny Dixon on 0407 160 771 or denny@backpackermedics.org
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DRG Bangladesh Team 2: Field Report: 7th November, 2017 – Final Report

Last day in the field. And just like so many of our days, a mix of despair and joy. Our first job of the day was to pick up Abdul Karim, the elderly patient we had found with a chest drain in place. After driving him to the camp, Simon, Amy and I carried him the 1.5 km to his shelter. His chest drain is still in place, but cleaner and more secure. It will be there for the rest of his days, which sadly probably won’t be long.

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Next it was a visit to Ibrahim, the paralysed gentleman who we have been visiting for the last couple of days. Simon secured a new catheter from the Red Cross Clinic and replaced the one Ibrahim had had for a while now. He was very grateful, but struggling with the knowledge that he may never walk again. We stayed with him as long as we could, talking through options and letting him know that his story had already touched so many people and that there were incredible people in the background determined to make his life a little easier. We assured him we wouldn’t desert him.  

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We then joined Alex, Shane and Mel who had been busy attending patients in Jamtoli to the south. Our main man, Moslem, had heard of a number of patients who required attention, and they had been working their way through the list. There was nothing too serious and they moved even further south to Leda camp. We stayed with a young mum and her 7 day old baby boy. She had last 2 previous children, both at 7 days old. She was terrified that the same might happen to this one.  We spent some time educating her on how to swaddle her child while at the same time keeping the head free of blankets and wraps. We have noticed that many young bubs are wrapped and covered in such a way that their faces are covered in blankets as well as having blankets around their heads which they can easily turn their little faces into. I really hope mum takes our advice on board.

Our final patient of this mission was a young man Shane, Simon and Mel had come across a few days ago in Unchiprang. 18 yo Mohammed Yunus has had a tumour growing steadily on the side of his face over the last 5 years. It is beginning to impede his breathing and prevents him from eating solids. It is also becoming increasingly painful all the time. Mohammed had lost his entire family. He was befriended by another refugee on the arduous journey over to Bangladesh. He’s been with him ever since. The team would like to help everyone they meet, and solve every problem they encounter. But that’s impossible. But this is one situation that we can help with. We’ve already seen what it is possible to achieve  through our surgeon friend, Dr Badsha. We had shown him photos of Mohammed’s tumor, and he thinks he can help. Mel has generously donated the hefty deposit for the operation.  Simon, with funds he has raised through his GoFundMe page, along with Backpacker Medics, will cover the rest. It is an absolute pleasure to be able to finish this project on such a positive note, knowing that, even after we have gone, our contribution will still be changing and improving lives.

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There is plenty more to be done before this phase is over, with end of mission reports, ensuring continuity until the next team arrives, handing over the said team and preparing ourselves for the next phase that kicks off before the end of the month.  What I do know is that the team is exhausted.  Exhausted, but reluctant to leave.  There are mixed feelings of the joy of going home to their family and loved ones, tempered with not wanting to leave so many people still in such desperate need.  This is a testament to what these individuals are like.  Alex, Amy, Mel, Shane and Simon have put everything into this trip, starting with their time away from home and work, to the tireless days which started at the crack of dawn and went through till the sun had long gone below the horizon.  The worked all day long, foregoing lunch, walking untold kilometers, drenched in sweat and carrying heavy packs, without a single word of complaint.  They maintained a professional and positive attitude, despite the horrendous things they all witnessed and heard. They gave and gave, and kept giving.  It has been an absolute honour to work alongside such dedicated and motivating people.  It’s been my pleasure to be team leader of a team that requires no leading.  I can’t thank them enough.

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We had to include some of Nat’s beautiful shots of the kids that he met along the way. Who knew all this time that this awesome, inspiring Team Leader was also such a wonderful photographer … he says it’s just his iphone not him but …. we’ll let you decide.

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DRG Bangladesh Team 2: Field Report: 5 November, 2017

by Nat Crewe; DRG Team Leader

Cox’s Bazaar, Bangladesh

It’s seems that I spoke too soon. Today was a ‘2 stretcher carries and five gunshot wounds’ kind of day.

IMG_2607The team headed into Kutapalong 2 (KTP2). I can’t describe how big and sprawling this camp is. With our mapping system, we can see what ground we have covered, and pick our route accordingly. Today, we simply picked another unexplored area and set forth.

It wasn’t long before Amy, Simon and I came across a 45 y.o woman who had fallen while running for her life. She had landed on her hip and has been unable to weight bear since. Her family literally carried her to Bangladesh. She had still not been seen at a medical facility and her shelter is deep within the camp. Without any way of getting to help, it was up to us to carry her out.

So that we didn’t tie up the whole team with a stretcher carry, we employed some local hands to carry the stretcher. Mel and I accompanied the patient and on the way we picked up another that Simon had found who had a swelling in his throat and, as a result, couldn’t swallow. He hadn’t eaten or drunk anything in 3 days.

Once we dropped off our patients, we returned to KTP2. Almost immediately we were taken by a helpful local to a lady who had a bullet wound in her buttock. It had been treated initially, but was now infected. This poor lady put up with some excruciating cleaning, packing and dressing. She was left with some antibiotics and strict instructions to visit the clinic in 3 days. As we left the shelter, we were guided to another gentleman who had been shot in the heel. The flesh was necrotic, but in such a way that actually covered and protected the wound. No treatment required.

IMG_2623The next patient was heartbreaking. A 10yo boy who had been shot in the head. The bullet had cut through his scalp and clipped his ear. He had had skin grafts taken from his thigh to address his head wound, which were taking well. His concern was an infection in his ear below where the bullet had removed the top of the ear. It was swollen and pus-filled and very, very painful.

This little guy was so brave when I lanced the wound a drew off the excess fluid. We bandaged him up and gave him some lollies. He swallowed one whole thinking it was medication! We spent some time with the family making sure they were aware of the camp counselling services. As they were fleeing their 10 day old baby had been killed also.

Now that people are ‘settling’, I wonder how they might be coming to terms with so much loss and trauma.  

Still moved by our young champion, we were taken directly to another young man in his twenties. He had been shot in the elbow and had lost most of the movement and feeling below the wound. It was also healing nicely, if not a little dirty. Mel and I cleaned and IMG_2631dressed it. When asked what we could do about the feeling in his arm it was with a heavy heart that we had to tell him that the bullet would have severed the nerve and that he probably would never get the feeling or movement back.

This apparent lack of communication between doctors and their patients, or possibly just lack of real understanding, was particularly poignant in our next, and last patient of the day. We were directed to a young man who was paralysed from the navel down.  He had no movement or feeling below that point, or any bladder/bowel control. He asked us what we could do for him. It turns out that he had been struck at the base of the spine by the Myanmar army as he was escaping in late August. He lost all feeling and movement immediately and has been like that ever since. He had been seen by doctors since and had a catheter inserted through which to urinate. I asked him what he had been told. He said that nothing had been discussed with him.

I sat with him and our wonderful fixer, Moslem, who translated, explaining everything that was occurring and why, and that there was almost no chance that he would ever walk again. Moslem held his hands and cried when he told him this. It was one of the lowest moments of this trip. To make matters worse he was lying on the bare, hard-packed earth. I told him that I would be back the next day with a mattress and to tend to his bed sores.

Whilst every day of this trip has been hard, some days are – emotionally – much harder than others.

If you would like to help our mission, you can donate to the Backpacker Medics cause here:   https://chuffed.org/project/bpmdrg-bangladesh#/supporters

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DRG Bangladesh Team 2: Field Report: 4 November, 2017

by Nat Crewe; DRG Team Leader

Cox’s Bazaar, Bangladesh

DSC_0950When Shane and Amy picked up a severely malnourished child yesterday from Baggoha camp, they noted that it was a camp that we hadn’t even been in to yet, and from what they could see, it deserved a closer inspection.  It also just so happens to be a camp that CARE, with whom we have an operational MOU, had asked us to scope out and assess the services of.

So the entire team made for Baggoha, then broke into two teams, spread out and went from shelter to shelter looking for patients. Meanwhile, I completed a systematic walk of the entire camp, assessing the services and plotting them on our system as I went.

DSC_0956It took half a day in the searing heat to cover the whole area. I even ended up treating my interpreter for heat stress…and he’s a local! What became apparent from our assessment was that, although quite well serviced, the latest official maps of the area (released just a couple of days ago), didn’t have the information that I gathered. I hope that by plotting the  services that I came across – food distribution, small health clinics, counselling services and so forth – the vital information can now be distributed to the plethora of NGOs on the ground. 

The teams making house calls came across quite a few patients. As we’ve been finding of late, the most usual presentations are the very young –  newborns, babies and young children – with an assortment of skin conditions, fevers, colds and gastric upset.

DSC_0905There is also the other end of the spectrum – the elderly with respiratory conditions. Decades of cooking over wood fires in the common living areas takes its toll. Something you’ll find without fail in all developing countries, and backed up by our own research in the Backpacker Medics supported village in Nepal.

All the patients were treated in place before we headed back to Kutapalong 1, the seemingly never-ending camp just a little to the North. Immediately we were presented with a young lady in the early stages of labour. It just so happened that a British midwife was in attendance. We made ourselves available should there be any complications and there was a need to carry her out. Thankfully everything turned out smoothly and we were able to call it a day. 

Readers may notice that we’re not seeing as many acute and emergency cases. As I’ve mentioned in a prior report, the refugee registration area also has a triage facility. As a result, the more seriously sick and injured people are being identified and transported to a medical facility before they reach the camps.

This, coupled with the easing of physically brutal tactics by the Myanmar military, means that serious wounds are less frequent. It is the common consensus across all the medical facilities that we talk to that we are now entering the next phase of this crisis. Close to a million people crammed into overcrowded camps with very little access to basic services – clean water, fresh food, adequate health care. They are coming. Slowly. But every day we are seeing the same things- measles, skin conditions, diarrhoea, fever, respiratory conditions. Whilst gunshot and machete wounds look brutal, make no mistake: here, all of these things will kill you. 

DSC_0934So what does this mean for the Disaster Response Group, who specialise in being a highly mobile and effective emergency medical team? Well, as we have proved in Nepal, we are also very good at identifying a need, and coming up with a solution.

The Rohingya people in these camps desperately need access to services of all kinds. The camps are huge and sprawling, covering dozens of square kilometres, with little concrete information about the location and capabilities of essential services. We are already working with local community members to build a network of volunteer helpers that will access every corner of the camps to connect the people who need it, with the service they require.

Before we leave on Wednesday, we will have already trained a number of camp members with this task in mind. This means that, although not here physically, the DRG work can continue. We then hope to build on this model when we return in December. 

If you would like to help our mission, you can donate to the Backpacker Medics cause here:   https://chuffed.org/project/bpmdrg-bangladesh#/supporters

 

 

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DRG Bangladesh Team 2: Field Report: 3 November, 2017

by Nat Crewe; DRG Team Leader

Cox’s Bazaar, Bangladesh

 

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The wonderful Dr Kate Baecher

It was a sad morning – we had to say goodbye to the Dr Kate, our wonderful psychologist, who has to get back to her real job.  The care and love she has shown to the refugees, and the team has been nothing short of angelic. Her energy, enthusiasm and professionalism is inspirational.  We’ve lost a valuable team member and will miss her for these last few days.  But she’s promised to come back in December and the project will be richer for it!

 

So, one member lighter, the rest of the team headed into Modushara camp, which is an extension of the Kutapalong camp we have been spending time in lately. We split into two teams, but stayed within 200m of each other in order to assist with treatments or stretcher carries.  

Amy, Lily and I got busy almost immediately with a number of small children.  Firstly a 2 year old with a fever and measles, something that seems to be becoming more and more apparent in the last few days.  With all the families living in such close proximity, it’s inevitable that something like measles will spread like wildfire.  Measles in a healthy, well nourished child can be a challenge, but for an undernourished, underweight and otherwise unwell child, it can be a death sentence.  

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In this area of the camp alone, there were quite a few cases of measles presented to us. Of real concern was a 4 year old boy who was limp and gaunt.  He hadn’t eaten for 3 days.  His observations weren’t too bad, but we arranged transport to the clinic to get him hydrated and fed.  Although the Red Cross clinic is under less strain, we are sending all undernourished children to the busier MSF clinic.  This is because they have an MOU with the Action Against Hunger right next door, and all children needing food get referred there after being treated by MSF.  

IMG_0331We were then called by Alex and Shane to assist with a stretcher carry.  A young lady with fever, with altered sensation in her extremities as well as diminished muscle tone. Given that we had been presented with a possible polio case just the day before, we were taking no chances and carried her out of the camp – a gruelling 3km walk in the heat.

Amy and Shane transported her to the Red Cross clinic, then travelled further south to Bagghona, where we had been told there was a very sick 3 year old.  We had even been sent pictures – she actually looked like a 6 month old baby, she was so malnourished. She got a ride the the MSF clinic immediately.  

Meanwhile Alex and I walked way out to what we thought was the edge of Kutapalong camp.  But it just kept going and going.  We walked for a couple of kilometres beyond the ‘official’ edge of the camp and we were still among shelters. We did eventually get to the fringe, where we found new arrivals, literally that day, cutting out places for themselves in the scrub and making their new ‘homes’.  

We didn’t actually find any sick or injured people among them, which was a pleasant surprise.  It would seem that the violence being perpetrated on their people as they flee has abated somewhat – no doubt due to international condemnation and scrutiny.  But we heard continued stories of threats and intimidation.  I doubt, given the recent past, that it would take much to frighten these people.

DSC_0871We met more people like us!  For the first time since we’ve been here, we came across another roving medical team.  Humanitas are a British NGO who have a team of doctors that hike into the camps with all their gear, set up shop in someone’s house and treat anyone who comes. They move on every couple of days in this fashion.  They were highly enthusiastic about our model, and we have agreed to meet over a meal and talk further and learn more about each other!!

If you would like to help our mission, you can donate to the Backpacker Medics cause here:   https://chuffed.org/project/bpmdrg-bangladesh#/supporters

 

 

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DRG Bangladesh Team 2: Field Report: 2 November, 2017

by Nat Crewe; DRG Team Leader

Cox’s Bazaar, Bangladesh

As planned, we headed deep into Kutapalong Camp to find an elderly patient that required a stretcher carry out to the Red Cross clinic.  Alambar is 70 years old and has been in the camp for 2 months.  She has hardly eaten in all that time, and is woefully thin.  In spite of her terribly low body weight, the rest of her health is somehow holding up.  

Dr Kate has spoken to her on a couple of occasions now, and has diagnosed her with severe depression. Not surprisingly, this crisis has taken a heavy mental health toll on the Rohingya people.  Their scars are not just physical, but are etched deep in their minds and hearts too.  Kate has been just as busy as us.  The stretcher wasn’t heavy –  Alambar weighs next to nothing –  but is was an arduous journey, up and down little hills, through dirty streams and muddy fields, around five kilometers in total. Thankfully, we got her safely to the clinic where she was received with warmth and care.

After drinking litre-upon-litre of water, the team went straight back out into Kutapalong . The fringes of this camp are grossly neglected and underserved. Within minutes Amy, Dr Kate and I had identified a critically ill 1 month old girl.  The bub – the eldest of a set of twins – was struggling so hard to breath it was possible to see her skin being pulled in between her ribs in the effort.  She was exhausted and was able to take milk without vomiting.

IMG_8832We made preparations to transport her to the clinic straight away.  As we were leaving the hut, we were presented with a 3.5 month old girl, Husna, who had been accidentally dropped 7 days prior. She had not been taken to a clinic, although there was a real chance she had fractured her leg.  We transported her and the twins immediately to the Red Cross clinic.

Meanwhile, Simon, Mel, Shane and Lily had been walking and treating throughout the western fringes of Kutapalong.  Among their patients was a severely ill child that was presenting with measles as well as diarrhoea so bad that her buttocks were red raw and infected.  Shane and Mel took her straight to the isolation ward at the MSF clinic.  

Our last task for the day was to help out the Red Cross with a transfer of a 11year old girl, Toslima, that had started to lose power to her legs 2-3 weeks ago, and was now totally flaccid below the waist, was stiff in her neck and could hardly move her arms.  They were unsure of the cause, but couldn’t rule out polio.  It was decided that she would need extensive tests that were outside the scope of the incredible Red Cross/Crescent field hospital.  

IMG_8842It is not easy to transport a Rohingya out of the camps, let alone get them into a Bangladeshi hospital – but we had to take the risk.  So we put Toslima in the very back of our van, which fortunately has blacked out windows. She was propped us between myself and her doting father, who held her all the way.  We have been coming and going so much now from Cox’s Bazar, that they no longer bother with us at the checkpoints. But we still had to be cautious.  We got through unhindered, then Simon and Kate worked their magic once we arrived at the public hospital, and she was admitted immediately. To their credit, there is a ward just for Rohingya refugees (which goes against the ‘official’ regulations of Bangladesh). 

IMG_8844I can’t begin to describe what this hospital is like, but it’s an assault on the senses and stretches credibility.  But they do what they can, for free, for as many people that they can.  

There is so much to do out there.  Every day has been a HUGE day thus far, but we are going to have to dig even deeper and make our last 5 field days count.  

If you would like to help our mission, you can donate to the Backpacker Medics cause here:   https://chuffed.org/project/bpmdrg-bangladesh#/supporters

For media enquiries please contact Denny Dixon on 0407 160 771 or denny@backpackermedics.org
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