DBLM

Relapse Workshop

More travelling yesterday brought me to the north of Bangladesh, I flew into Saidpur, then we drove through Nilphamari city to Notkhana, the home of DBLM Hospital.  It was a quiet day, a wee walk, some photography and some warm hospitality, but today has been much busier.  I started off at devotions at the hospital, then went to a workshop currently being held for doctors from across TLM Bangladesh on dealing with relapse cases.

After a meeting, I was taken into Niphamari city to a clinic held weekly at the government hospital there.  Technically they have a room assigned, but it's pretty small, so most of the clinic was held outside in the yard.  On average they diagnose one or two new cases of leprosy here each week.  One of them today was a small boy, whose father had leprosy, and suffered severe complications and other health problems and sadly died.  I think the boy was only 6 or 7, which is unusually young to be develop leprosy, usually they see cases starting from around 12 years old.  This clinic is one of 24 clinics run by TLM staff in upazila government health complexes.

Physio technician testing sensation

 Upon my return to DBLM, I talked to one member of staff about the research projects going on here, as this area is particularly important for medical research due to high population and case detection, combined with fairly low population mobility, and is home to a number of important international research studies.  I then joined the doctors for lunch, before meeting a number of patients, and then getting a whistlestop tour of the hospital departments.  Once that finished, I spent more time in four areas - physiotherapy, the lab, assistive devices, where one very happy patient was having his first go with his new prosthesis, and the agriculture centre.  The physio technicians showed me some of their work.  I met a variety of staff during the day, many of them have been with TLM for upwards of 20 years, some always in DBLM, others have moved between projects, and I met two former staff who have now officially retired after over 30 years at DBLM, but are still around helping out, one an extremely experienced lab technician who is helping to train up his successors, and another former leprosy control officer who still helps with some of the research studies.  The hospital opened in 1977, and the first staff had a very difficult time, facing the same stigma that their patients faced, which makes their commitment to the patients all the more touching. 

First fitting of a new below the knee prosthesis

I also got a chance to see mycobacterium leprae through a microscope, a new patient had come in with a very severe case, the lab technician preparing the slide for me hadn't looked at it before, and his comment was 'oh wow!'.  Usually there are many fewer bacteria, and they are looking forward to getting a new microscope which shows the slides through a monitor, which will make it easier to see the cases with only one bacteria, which can sometimes be missed at present.  I also visited the assistive devices section, where they produce things like sandals, shoes and braces for people with leprosy or general disability, as well as prostheses.  I also saw the large TV where the women patients like to watch the soaps of an evening.  It as great to see the hospital farm, they have 12 cows which provide milk for the patients, which is nutritionally important, and they grow a variety of crops, and have two ponds with fish.  Some of this is for consumption and some for sale.  For example they grow a different kind of rice to the one usually eaten in the area, which sells for a higher price than the more common kind.

Weeding the rice - it takes skill to recognise grass from rice and remove the right one!

All in all a full day, and it's not over yet - I am having dinner with doctors, then going to the 'Fair of Happiness', a social evening with music and dancing for the patients held every Tuesday with singing and dancing, which is very popular.  It is organised by the hospital counsellor as part of the mental health provision in the hospital, as patients can have a hard time dealing with not just physical problems, disability and so on, but also stigma, which can lead to problems with depression, and this area of care is very important.  Should be a fun evening!  Tomorrow is a 12 hour (at least) drive back to Dhaka, stopping in at two projects en route.