Dr Edric Baker is home in NZ April - July 2012. During this time, in between relaxing with family and friends, he will be speaking to groups and at Church services in a number of centres around the country. Details of public meetings are below. Arrangements are still being made in some places and these will be added as they become finalised.
December 2011
Christmas Greetings from Bangladesh
I’m sitting, working, at my table on my verandah at the back of the outpatients’ side of the health care project. The noise here is constant. The murmur of voices (adults and children) in the background, the sound of people talking and then a mobile phone goes off and someone’s voice gets even louder. It is standard practice here to shout into a mobile phone. There is also the sound of traffic, though a lot quieter than in Dhaka. I can sometimes hear a bicycle bell as they signal to people (and animals) that they are behind them and coming past. Motorbikes have made their place here recently as a means of public transport and can be heard frequently tooting their horns. Before I came, large trucks transporting pineapple would come through the Project blasting their air horns but that stopped as these trucks made the dirt road in the rainy season unpassable for all including themselves. The road is now in the process of being tarsealed with promises from authorities that the trucks would be provided a loading bay some 1.5km before Kailakuri. This remains to be seen. I’ve been sitting here when golshap (lizards) have wandered past, the largest almost 3 feet long. If I’m quiet he moves slowly. The golshap keep the rat and snake population down, so are useful to have around. I’ve yet to photograph a large one. At night the ground is alive with small toads, also useful. They keep the insect population down and I often find them in my house hopping over the floor along with geckos running across the walls. My biggest frustration living here is the internet connection, occasionally I am lucky and can get reasonably good access from my verandah but often I need to move elsewhere on the project grounds where the signal might be better. I spent an hour in the inpatients’ office one night on my computer (so far the best place for internet connection) while staff (just around the corner) were stitching a wound on a patient’s leg. He seemed to be in so much pain I thought they were stitching without anesthetic but later learned that he had, had a local and it was the uncomfortable position he was being held in which made him moan. This man was on his bicycle and had been in an accident. I was told he got caught between two trucks trying to pass each other. The villagers have taken the truck driver and truck owner into custody to be tried for the accident. Village justice here is recognised by the authorities so when involved in an accident in Bangladesh it is a case of hit and run as justice meted out by locals can be severe. During the operation the power went off and stayed off for most of the time. The operation continued by torchlight. (I sometimes wonder if these power cuts are a means of torture by the authorities. The power gets shut off at the most inconvenient times especially in the evenings when it can go on and off, two or three times or more.)  Unfortunately the middle of October saw some staff spend time in hospital with severe fever from a flu virus, while many were cared for at home for up to a week. This was along with a financial crisis caused by the hold-up of funds in the bank, where some staff could not be paid for four days. Finances for many here can be extremely tight and it was found that a few of the staff needed to borrow money in order to buy food. We hope never to have this situation occur again. The financial crises continued on for another month while donations sent from overseas were tracked down and finally transferred into our bank account. Now as we enjoy the cooler weather of autumn and move into winter, the flu virus has abated and we live in anticipation of a more secure financial future. Christmas comes as a time of hope and joy for many as they celebrate the birth of Christ. For those of you who celebrate Christmas we trust you will all experience the many blessings of the season. Please remember in your prayers and gifts those who struggle with the daily necessities of life, often through no fault of their own.
Christmas Greetings to you all, from the staff of the Kailakuri Health Care Project.
Christine Steiner Funding and Management Consultant October 2011 Mid September 2011, volunteer Christine Steiner travelled to Bangladesh to live and work at Kailakuri. Christine writes: I have moved into my new home on the Project grounds. I spent the first 4 nights in Dhaka then the next 6 with the Holy Cross Sisters (Mina and Rupa) at Pirgacha (some 30min cycle from Kailakuri). The cycling has been good exercise and I’m so pleased I have a mountain bike, the fat tyres make negotiating the mud and ruts in the road a lot easier (thank-you Glenn). Interestingly no-one here on the project wanted it and I think they wonder why I like it. I’ve also been getting some sideways looks as it’s quite different from the standard Bangladeshi cycle, or maybe it’s also because I’m a foreigner. Many workers in the Project are trying to help me with my Bengali. I quite often get asked if I am well or have I eaten (this is all I understand so far) amongst other things. I have learnt to answer them and can now say ‘see you again’. The days from now will probably start to become fairly routine. I haven’t done a lot of work yet except access and send emails, but now that I am here living on site I will start to get onto a few things that need to be done and I know there is more, especially looking for funders. Last Tuesday, Pijon (the Project Manager) and I went to Mymemsingh to sort out my internet connection and buy a printer. Wireless internet connection at 1gig per month is about NZ$5. It cost about NZ$50 to sign up. I also picked up a mobile phone to use here (about NZ$15 – the cheapest they had) as calls, even overseas, are very cheap. A trip to Mymensingh (46km) takes about 2 ½ hours. We started out by motorbike (the driver, Pijon, then myself on the back). This was from Pirgacha to Modhupur (about 30min). From Modhupur it’s by bus to Mymemsingh. The motorcycle ride is actually quite pleasant especially when compared to the bus, whose driver spends most of his time tooting the horn, braking and accelerating. We had quite a successful day, only forgetting to buy a power stabiliser which we should be able to buy in Modhupur so meanwhile I’ll use the one I brought from home which I thought wasn’t working because although the ‘protected’ light was on, the ‘faulty’ light was also on. This is apparently because the electricity current is weak. After being told it was not easy to find a place on the Project site to get internet connection, I am totally rapt that I have it on my verandah. It’s a bit dodgy and a bit slow at times but I can use it and that right now is the most important thing. I’m expecting to go mad soon with the mosquitoes unless I find a way of coping with them, roll on winter, I’ve been told it’s not too bad then. I’m not sure my feet will ever be clean again! I’m often walking on muddy footpaths and roads and well, cycling through muddy potholes in sandals doesn’t help either. My feet have also been swollen since I got here – again roll on winter! The food is rice and rice and more rice, heaps of it with each meal! However, the cooks have been kind and are making me rooti (flat bread) for breakfast though I think that is also made out of rice flour. The food is very basic, turmeric goes into everything and I’m pleased to taste garlic often. Most food is cooked until ‘dead’ and has varying degrees of heat (spicy and depending on when I get to the dining room for a meal). The only fresh food I’ve had are pineapple and tomato. They also cook a green vegetable for each meal and even though I’m not usually fussy - it’s not nice! I still try to eat it as I guess it has to be good for me. Meat is usually fish (eel – full of bones) and chicken. And we also get boiled eggs. Each day the power goes off at least twice and always in the evening for at least two or more hours. Right about dinner/bed time! It makes a laptop and wireless internet and rechargeable table lamps very useful. The spiders are the size of the palm of my hand but harmless, toads come into the house to eat the bugs, one slid down the toilet the other day (poor thing). There are lizards and each time I see one it seems larger than the last I saw - the last one being 2-3ftlong. These lizards keep the snake and rat population down so they are quite useful to have around. The lizards are also apparently quite safe as they are scared of humans but have been known to bite and can do damage with their tails. I’ve been told they live in the roofs of houses. I’m not sure I want one in mine, I’ll have to photograph my ceiling for you. The cicadas here are deafening!!! I thought there was a fault with the electricity when I first heard them. What makes it worthwhile being here are the people. I have felt welcomed and accepted from the start and hope that as time goes on and my Bangla improves I will be able to build some good relationships.August 2011 VOLUNTEER WANTED TO DEVELOP AND MANAGE A GIFT SCHEME IN NZ.
At the recent AGM (see below) a motion was passed agreeing that the NZ Link Group will establish a donor gift scheme. The scheme will allow benefactors to fund specific activities at the Kailakuri Health Care Project. The gift packages will vary in nature and size. Some will suitable to give to friends and relatives as birthday or Christmas gifts, others will be more suitable for larger or corporate donors. A range of gift packages will be planned and costed by the Kailakuri staff. They will design gift packages for things that are needed the most. Small attractive vouchers will be designed describing the gift and the benefits which the gifts will bring to the poor. A volunteer is sought to develop this vision and manage the gift scheme. Here is a rewarding challenge for somebody! Is that somebody you? Interested? Looking for a way to serve? Got some questions? Please contact Link Group Coordinator, Peter Wilson: kailakurihealthcentre@gmail.com
ANNUAL GENERAL MEETING The AGM, held recently in Hamilton on 16th July, was attended by Peter Wilson (Chair), Glenn Baker (Treasurer), Ann Baker, Hilary Lynch, Nelson Lynch, Hilda England, Alton England, Betty Baker and Christine Steiner. Main points discussed during the meeting follow for your information Financial It was noted that donations from NZ are down in the last 12 months. This has been countered by an increased donation from the Morgan Family Foundation and from donors in the USA. Finance of ongoing operational costs remains a concern. A motion was passed thanking Peter Reid for auditing the NZ Link Groups accounts. A motion was passed agreeing that the Link Group establish a donor gift scheme and seek a volunteer to develop and mage this scheme. A motion was passed agreeing that the Link Group “as a registered Charitable Trust, set up a separate bank account and establish a scheme for attracting bequests and other donations to create an investment fund, the proceeds of which would be used to support ongoing operational expenses at Kailakuri Health Care Centre.” Carol and Peter Laing, have graciously agreed that this fund be named after their mother, Libby Laing who gave so much of herself to the poor of Kailakuri and who loved Bangladesh so much. We will keep you informed as this new long term support initiative is developed.
INTERIM MISSION MANAGER Christine Steiner of Hamilton who visited Kailakuri last year has volunteered to help out over an interim pending somebody volunteering to work as Mission Manager on amore permanent basis. It took a long time (very frustrating for all) but finally all the approvals and paper work came through in July and a visa is currently being issued by the Bangladesh High Commission in Canberra. Christine hopes to travel to Bangladesh towards the end of August. This is a very exciting development and we are thrilled that Christine has felt challenged to take on this testing position. At Kailakuri, Christine will liaise with donors, process funding applications and help out with training of staff and some administration. Our sincere thanks go to those who are providing financial support for Christine in this new step on her journey through life. Our gratitude, love and prayers will be with you Christine. Funding ($3,500) is currently being sort to build an extra cottage so that Christine can be accommodated. LONG TERM PLANNING FOR MEDICAL OFFICER IN CHARGE Dr Mariko who is working at Kailakuri for 8 or 9 months of the year has been able to relieve Edric’s load somewhat. With the arrival of an Interim Mission Manager, it is anticipated that Edric’s load will be lightened even more, thus allowing him to spend time canvassing for both financial and personnel support inside Bangladesh. Discussions have been held with both Church Mission Society (CMS) and Service In Mission (SIM). Both of these organizations are publicising the need somebody to replace Edric. A young American couple, both qualified medical Drs, who visited Edric in the field some years ago, returned recently and spent two days at Kailakuri. They apparently are looking for a place where they can carry out their life’s work and service, but there is no indication that this will be Bangladesh or Kailakuri. It is however encouraging to know that there are young committed professionals who are willing to commit to this demanding type of work, and this gives us hope that a replacement for Edric will be found.
Thank you for your continued interest and support.
Peter Wilson, Coordinator, Kailakuri Health Care Project NZ Link Group
May/ June 2011 NEWSLETTER Dear Friends, thank you all for your kind friendship and help. Please may I tell you about one of our most important activities.
A Diabetes Programme for the Poor.
All human life is interconnected. Every person is sacred and of immense value and every individual is responsible for others (corporate social solidarity) as well as self. This applies to environment, social structures, behaviour and caring. People must have dignity and basic health care must be available for all.
The Kailakuri Diabetes Rehabilitation Programme shares the Kailakuri aim of health for the poor by the poor. People with diabetes must be enabled to control their diabetes and return to normal health and life.
Bangladesh is one of the world’s poorest countries with a population approaching 160 million. Due to poverty at least 40% lack access to one or more of the following: basic nutrition, adequate clothing, shelter, safe water and sanitation, medical care, education and common justice. When five to ten percent of adults (four to eight million) suffer diabetes, then at least 40% (one and a half to three million) will need help in accessing appropriate care. Social services and structures are generally unable to meet the needs of common people because of numbers, other priorities, lack of awareness, failure to adapt to the problems of the poor, failure to meet the requirements of solidarity, lethargy or corruption.
Sujit Rangsa : Sujit, a 31 year old Garo tribal Christian is now head of the Kailakuri diabetes programme. He comes from an extremely poor family seven kilometres from the Indian border and developed diabetes at the age of 16. In 2000 at the age of 20 he came to Kailakuri, 80 km south of his home. He had been unable to sit school certificate and was 45 Kg (BMI 19). The Kailakuri centre opened four years before had 213 patients under supervision. The paramedics were responsible and caring and there was a lot of teaching. Rashid whose father had had diabetes was in-charge.
Sujit’s health improved (now 58 Kg, BMI 25). He became a paramedic in 2003 and has always been very conscientious. He subsequently passed school certificate at open college, married and has two sons. (As a diabetes patient he thought he had no chance of marriage until sweet petite Sheema appeared on the scene). The older son Rodro suffered birth trauma and is severely handicapped, still unable to sit or feed himself at the age of seven. Sujit took charge of the programme in 2009.
The Kailakuri Diabetes Programme.
Diabetes is a life long disease caused by failure to utilise blood sugar. The programme is caring for 1120 patients of whom 60% are on insulin injections and 40% on tablets, 97% Muslim and 53% female. Half of the insulin patients are under 30 but only 9% of tablet patients. Almost all our patients are very (or extremely) poor. Most have already been diagnosed before coming to us. Screening is by symptoms, patient examination and blood (or urine) testing. They pay small fees for entry into the programme, travel to Dhaka and for Kailakuri hospital admission and then small monthly fees. All patients are means tested by home visit. The cost of the programme last year was USD 59,000 (BDT 4,300,000, NZD 79,000) coming to about USD 40 per patient making it an extremely low cost programme, amounting to one third of Kailakuri expenditure. The Diabetes Association of Bangladesh BIRDEM Hospital provides concession priced insulin without which the programme tribal Christian is now head of the Kailakuri diabetes programme. All new patients needing insulin are taken to Dhaka to register. Thereafter they are managed at Kailakuri. A monthly report and requisition go to Dhaka to get the insulin, at present 1300 vials per month.
Survival and freedom from crippling complications depend on good blood sugar control, the basics of which are diet, drugs, exercise and blood or urine sugar monitoring. It is essential to prevent the acute complications of very low or very high blood sugar, either leading to coma and death. And for this it is necessary to find a balance between technical precision, cost, disruption of daily life, easy understandability, motivation, emotions and social factors. The KHCP is sometimes criticised because of extreme simplicity and low cost, but it is hard to find an effective competitor in the field. Abdus Sattar: At the age of 63 Sattar is now an elderly Muslim and according to custom tints his hair and beard with an orange dye. He is always happy, says his prayers from time to time, goes to the mosque occasionally and has no malice against anybody, a typical village Muslim.
He developed diabetes at the age of 25, was diagnosed two years later and came to us two years after that in 1986, the newest of our seven patients. All his life he has been extremely poor. He had about six years of education. In those days it was the Thanarbaid Health Care Project under the Church of Bangladesh and he recalls the care and teaching he got from the staff. Diabetes care was very low cost for the patients. For the first time he was able to keep his diabetes controlled.
In 1987, the year before the terrible flooding (a third of Bangladesh went under water) he was taken on the staff. (The next year we took on quite a few new staff to cope with the work load of visiting flood refugees and the epidemics of diarrhoea and dysentery).
Sattar has four children. Two sons are married living at home independent from their parents. One daughter is married off, another still at home with her parents. Before joining the staff Sattar was a village labourer, always afraid of acute hypoglycemia. When work is not available there is the danger of insufficient food to match insulin dose and acute drop in blood sugar. All patients have the occasional acute reaction and carry sugar in order to counteract it rapidly. (They are also supposed to carry a diabetes I.D. card). The symptoms are fear, tremor, palpitations, dizziness and weakness. Sometimes they behave as if drunk. (One young man from a remote area went into acute hypoglycemia. The village people thought he was drunk and beat him to death.)
An important part of the programme has always been home visit to patients with problems. For many years Sattar had responsibility for the south side of the programme. He thinks that over the years he has probably visited 1500 homes, all by bicycle. His first cycle was an old lady’s cycle which was not very good. Then we bought him a new cycle which got stolen one day at the market. He is now on his third cycle, still running well after 18 years. The “driver” (Sattar) however has developed asthma and had to be taken off home visits. His wife made him give up smoking ten years ago. Otherwise he is in good health with no apparent chronic complications from his 27 years of diabetes (although he has five times had severe hypoglycemic reactions). He used to cycle about 20 km a day, four days a week.
He has seen the relentless increase in patient numbers as the diabetes “epidemic” has increased and our programme become increasingly well known. Always there has been a friendly relationship between patients and staff. Because of the good teaching and motivation, patients now follow the rules and control their diabetes better than before. He recalls the opening of the Kailakuri sub-centre in 1996 which was important for the development of the programme. Two years later one after another sub-centre was opened as numbers increased. Now there are five, meaning much less travel for the patients and reduced pressure on Kailakuri. Patients come from up to 120 km away. When the centre became independent from Thanarbaid in 2002 staff and patients took more responsibility, better medical supervision was possible and the programme improved.
The advantages of the Kailakuri programme are: 1) Easy access for the poor, because external funding is sought, 2) Very good motivation and teaching, 3) Efficiency and enthusiasm because the director (Sujit) is so conscientious and careful.
More about the Kailakuri Programme
Apart from Sujit the staff comprise four sub-centre paramedics, three inpatient paramedics, four trainers, five health assistants, two office staff and a home visitor, 19 in all, of whom eight are diabetics and four over school certificate. Including Kailakuri there are five follow-up centres to which patients come for monthly review. All but one get a weekly clinic to which 50 to 80 patients turn up. With three paramedics in attendance it is possible to assess diabetes control and solve problems. About 600 patients are on insulin and 400 on tablets. Type 1 patients need insulin for survival. Type 2 patients may need insulin for good control. In Type 1 the main problem is insulin production, in Type 2 it is insulin action. Unfortunately about half of our tablet patients are still being lost to follow-up because of default.
Diabetes management at Kailakuri is very much simplified. However the loss of fine precision is more than made up for by patient and family understanding and cooperation, ease of management, staff patient bonding, and motivation.
Most of the time there are eight to 20 patients admitted at the Kailakuri centre: for diabetes training and recovery of health, diabetic ulcers, pregnancy-delivery and other problems.
Abdul Hakim: Hakim is now aged 40, married with two sons. He developed diabetes at the age of 17, started treatment with us at 18 and became a worker at 19.
He had schooling to class 6, both government and Islamic and was able to recite a third of the Koran when he got diabetes. He says that when he first came to Thanarbaid in 1989, diabetes care was part of general patient care and it was I myself who gave him his first teaching. He was the newest of nine diabetic patients under treatment by the programme. They all knew each other and he recalls with emotion the first eight who died, four from diabetes complications. They grieved when another died. Several were due to lack of family support, three severe hypoglycemia. Family support is much better now, both because of Kailakuri teaching and because diabetes is so much more common and understood in the community. Hakim has always been a person who empathised and identified with others and not only has he developed a wealth of experience in diabetes management but also knows many many patients personally.
The simplicity of the Kailakuri programme is essential. The programme is important because of the quality of patient care (due to high motivation) and the intensity of teaching. It is unique in this respect. The simplicity of the diabetes diet (30 gm carbohydrate exchange marker system) is necessary because of the variability of village life (physical work and food availability). Almost all the patients follow their diets. They test their urine five times a day by the old Benedict system (boiling urine with copper and iron salts). The cost of test strips for blood sugar is prohibitive at 30 to 50 cents a strip. The compromise of blood testing only three times a week renders the test almost valueless because blood sugar levels change so much. Probably 70% of Kailakuri patients faithfully test their urine as taught and adjust their drug doses accordingly. Despite patient to patient variation in levels at which blood sugar spills over into the urine, staff know the patients, understand the significance of their tests and are able to advise them accordingly. Hypoglycemic reactions when they occur are almost always due to abnormal physical exertion. Severe uncontrolled diabetes (keto-acidosis or hyperosmolar syndrome) is caused by sudden stopping of insulin or tablets, because of lack of money to travel to the sub-centre for drugs, because of illness appetite loss or because of emotional of family problems. The low cost of the Kailakuri programme is essential for the poor. Hakim has had a huge experience with diabetes patient care. For a period of six months he was in charge of the entire programme. Independence from Thanarbaid was necessary for the development of the programme, setting up of sub-centres was necessary, and the preparation of the diabetes programme constitution in 2004 essential for the security of the programme. He doesn’t see much value in the committees (I differ with him on this). Extremely important are the weekly meeting discussions attended by all staff. They all know about the problem patients. Staff also attend the weekly teaching-training sessions of the Kailakuri project. Sub-centre paramedics need to understand both diabetes and other diseases. They must be empathetically intelligent, know the patients and behave empathetically towards them.
All new patients are home visited for means testing. They are also visited if they default or if there is some other problem. This is of the utmost importance but difficult with only one home visitor.
Conclusion: The greatest dangers are acute hypoglycemia (due to mismatching of diet, drugs and exercise) and stopping of insulin or tablets. Chronic complications (foot ulcers, kidney or eye damage, strokes, heart attacks) occur very late in Type 1’s but much earlier in Type 2’s because they have usually had diabetes for a number of years before diagnosis. Blood pressure control is important in these patients. The best diabetes management option for the poor is: simplicity, intensive teaching, simple diet regulation (stroke marker system), urine test monitoring (stroke recording system), blood tests when in doubt and patient dose adjustment.
Many patients do not fit easily into the standard categories of Type 1 and Type 2. We wonder whether more research is needed into other contributing factors: eg: effect of rice milling on glycaemic index, malnutrition in early life, widely prevalent toxins such as nitrates in well water, organo-phosphorus-insecticide food contamination, urea contamination of rice and brown sugar (to improve colour), arsenic contamination of well water or the omnipresent coil burning fumigant smoke used to repell mosquitoes. Research is also needed for the development of very low cost sugar testing methods and service delivery. Kailakuri could be a model for this. The Kailakuri Diabetes Rehabilitation Programme is a very good diabetes primary health care programme which should be copied. Its sustainability depends on 1) ideology, motivation and teaching, 2) funding and 3) a certain level of medical supervision. It is no. 3 that is the most precarious at the present time. We need a younger long term doctor who believes these things and is ready to act accordingly. Please help us.
Best wishes and thanks.
(Edric Baker) Medical Officer in-charge
Contacts: Bangladesh: Edric Baker, <edricbaker@gmail.com> Hasna Hena Khan, <hasna@iird-bd.org> New Zealand: Peter Wilson, <peter_wilson@paradise.net.nz> Hilary Lynch, <tui_eden@xtra.com.nz> Glem Baker, <gabakerbcs@clear.net.nz> USA: Virginia Klein, <v.klein@psdintl.org> Nicholas Tseffos, <nwatseffos@gmail.com> Web sites: http://sites.google.com/site/kailakurihealth USA: www.kailakuri.com
Edric’s Health. Edric recently needed prostate surgery (non-malignant). There have been some post-operative complications which are not completely resolved at this time. Please pray for a good recovery.
Intern From New Zealand. Wellingtonian medical student Louis Kirton has just spent one month working at Kailakuri where he was able to do some basic laboratory procedure training and carry out a very useful diabetes survey which he has now written up. Thank you Louis.
Donations: Payment by direct bank credit: Bank Account Name: Kailakuri Health Care Project - Link Group. Account Number: 010 486 0185024 46 Name of Bank and Branch: ANZ, Whakatane. If paying by direct credit, please note payee name so that you can be identified.
Alternatively a cheque made out to the Kailakuri Health Care Project - Link Group and posted to: KHCP-NZ Link Group, C/- D G Baker, 33 Waiewe St., Whakatane. May 2011 Dr Edric recently undertook prostate surgery at a local hospital in Bangladesh. The good news is that his condition was found to be non-malignant. The bad news is that the surgery was not done particularly well and Edric is being re-admitted on 25th May for further surgery. Please pray for him at this time. This week Louis Kirton, an enthusiastic young medical student from Wellington New Zealand, will be arriving in Bangladesh. Louis will be spending five weeks at Kailakuri. During this time, amongst other tasks, he will be upgrading the laboratory procedure skills of key para-medics. March 2011 Dr. Mariko Inui who is working at Kailakuri is writing a Blog and you can see this on: http://marylin25.blog115.fc2.com/ Please Note: The Blog is in Japanese, but if you click the 'Translate' button at the top, you will get a rough translation. Even if the text is difficult, the Blog is worth looking at for the photographs. Greetings to all our friends, Winter is burns reason in Bangladesh. Temperatures go down to 100C or less. Poor people do not have proper clothing and housing to keep warm and so gather around the fire at night. Beautifully coloured cheap garments catch alight and blaze up in flames. However not all burns are due to standing too close to the fire: I. Jahanara (aged 40). Jahanara was the mother of Komol now aged 27. Suruz our senior paramedic is his cousin. Komol fell in love with Moina when he was at high school. He passed school certificate and went on to college. Her parents agreed to the marriage but his did not. So they had it in a registry office. They were very much in love but his parents never accepted her. They were Muslims. So at Id he took her to her parents’ home for the festival. Night fell while they were on the road. The rickshaw was crossing a bridge when five men attacked. They blindfolded Komol and took him away. When they released him two hours later he could not find Moina and retuned home in despair. Next day her body was found under the bridge. Komol became distressed and agitated. Fearing the police, his family sent him away to distant relatives but they could not hold him. Komol was crying out and demanding to see the body. He escaped and went to the bridge to see the body and fell into the hands of the police who beat him and tortured him until he said he had killed her (which he hadn’t). He was sent to prison in Tangail and the girl’s family put a court case on him which lasted seven years. Finally he was found guilty and sentenced to be hung. His family appealed to the high court which ordered the same. They then sold off still more land (for bribes, etc) and the case is still pending. When Jahanara heard the high court verdict she because senseless, depressed and distracted and finally poured kerosene on herself and set it alight. She was brought to us with 100% burns (see last Newsletter). There was nothing we could do. We prayed with them and sent her home, but they took her to Mymensingh where she died a few hours later. II. Monoara (aged 22). Monoara gave birth to her second child. Following custom she secluded herself for 40 days. When going outside at night for toilet, coming back in post-natal mothers have to be very careful lest evil spirits cling to them, gain entry and kill the baby. So according to tradition, Monoara on coming back inside stood right up close beside the fire flapping her arms and sari to shoo off the spirits. But attack came from another quarter, the fire itself. Up she went in flames and come to us with 40% burns (40% of the skin burnt). Our paramedics are very good and very highly motivated. It’s not very nice looking after these patients and you know better than they do what is in front of them. First step is pain relief and intravenous fluids. Then the question, do we keep them or send them elsewhere. The problem is that we haven’t yet found a suitable place to send them. No where else gives the same meticulous attention to dressings and patient wellbeing and within affordable cost. The first three days are crisis days for fluids, fluid balance and feeding. Dressings are done daily from the start. Skin may be blistered and painful or dead and leathery. Gradually it starts to lift and you are left with a great raw area. After washing with savlon or sterile saline and cutting away dead tissue silver cream is smeared on. This is very good but has to be removed each day. We give the patients oral ketamine before starting but it is still not nice. They look horrible and despite pain relief and sedation usually scream in fear. The patient is layed naked on a table on a clean polythene sheet for the daily ordeal. Monoara was taking about two hours each day. It would be hard to give sufficient praise to our staff who care for her so lovingly. Monoara is Muslim. Sobuja is a young Muslim woman with us now for about four years whose home is in the village of Hagurakuri just east of us. Nibita (Mandi) and Hameda (Muslim) also in their twenties come from the village of Bagaduba immediately south. Each is married with two or three children. Two do the dressings together. Each burns patient has two attending relatives, one for day- time duty and one for night. For them it is one long night-mare. Each patient has a low wooden frame over them on the bed and the bed clothes are layed over it so they don’t stick to or abrade the skin. The patient lies almost naked inside as in a little hut or tent. Monoara has been with us for six weeks now and a lot of her skin which was superficially burned is now almost healed. She still has 15% deeply burned, mainly on the back of her buttocks and thighs. It would be desirable to do skin grafts immediately on arrival or else later on as soon as the areas are clean enough, but we can’t really get them clean enough and besides we haven’t yet found a hospital to do the grafting at low enough cost. When patients die, if not in the first few days it is usually due to starvation, infection or electrolyte imbalance. III. Momin (aged 7). Momin came from Ramnagar, five miles away. It was a cold winter night. There were hot coals and ashes from the cooking fire put out on the ground behind the house. You have probably all noticed how much more active (or hyper-active) small children are than adults. We all slow down as we get older. If a person aged 20 or 30 did the things a five or seven year old does everybody would say they were mad! (One of the most appealing things about working in a poor high density area is that the children are so natural). Well that’s what Momin was like. He was out the back putting straw on the ashes to make a fire and get warm. He stood close and it caught his lungi. The first mistake he made was not to cry out for help. If you roll the patient in a blanket or throw water on them you can put the fire out. The second mistake he made was not to have pulled and thrown off his lungi to escape from the flames. But if he got his hands burned how would he eat his rice? And his parents didn’t know that if you pour cold water over the burned area for half an hour it will decrease the damage. He was 60% burnt. His parents were in their twenties. Usually relatives do not realize just how bad the situation is. We cannot get 60% (or 50%) burns patients to survive and there is probably nowhere in Bangladesh that can, except perhaps for the very good burns unit in the Dhaka Medical College Hospital. I told the father that we probably would not be able to save him, but the father was adamant. They were too poor to go elsewhere and they had trust in Kailakuri! Dressings were done by Minhaz aged 20. Minhaz is very good with patients and especially children. He plays with them, kids them up, jokes, tells stories and generally clowns around. The patients love him. Momin’s skin was horrible, almost all full thickness, and he looked awful. He cried and screamed at dressing time. Minhaz was fantastic but Momin got worse and worse and thinner and thinner. Imagine what it is like for the parents. They both stayed with him. You see your lovely child turned into something that doesn’t look like a human being any more. You look at his lovely suffering, anguished face and try not to see the rest. The burns involved the whole of his back, a third of his front, most of both legs and the back of his head. (Please forgive me for writing all this. Libby once said, “Edric you shouldn’t put so much tragedy into your letters. People can’t take it!” But you’ve got to get it out of your system. And besides I feel that people need to know. Imagine the daily situation in war areas). You can understand the bonding that develops between patient, staff and relatives. On Tuesday I went to see his dressing being done by Minhaz and Roton. These two young Muslim men are part of our project’s hope for the future. Both are poor. Both are thin, BMI 16. Minhaz is unmarried, aged twenty, lives with his parents, extremely poor. Roton is 33 and is understudying Minhaz. He is married with one child and is a great organizer. (If Islam decided to have a pope my vote would go for Roton. He is energetic, empathetic and kind, intelligent, knows all about everything and is always ordering people around, but he does it in such a way that you want to do what he says!). I have put him for twelve months on patient care to broaden his understanding of the project. Next morning when I went back to the inpatient side Hanif told me that Momin had died at six in the morning. I felt awful and yet relieved. I had a busy day and got back to my room about eight at night. Minhaz came. He was strangely silent. He had been feeling miserable all day and agitated and couldn’t concentrate on anything. At mid-day he went to Ramnagar for the village burial. At a Muslim funeral the men (women are inside) stand in long times one line behind the other while the imam prays. At one stage you all turn and look first to the right then to the left. This is an expression of solidarity. Then the body placed on a mat and wrapped in a sheet is lowered into the grave (before that the face is exposed for last viewing). On top is a sort of a bamboo lattice to stop jackals from getting at the body. Then everyone present throws on three clods of earth. Momin’s father was very strong Minhaz said. Minhaz broke down in weeping but Momin’s father put his arm around him and comforted him. Minhaz was still feeling upset and couldn’t sleep. We sat down together on a mattress. Minhaz recited from the Koran and I said a very short prayer. Then we both felt better and Minhaz went off to bed.
Post Script. I was feeling pretty upset about the burns patients and a couple of days later I rang Sr. Julie (NZ SMSM sister in Dhaka) and asked if she knew of any place we might send severe burns patients. The Dhaka Medical College Hospital burns unit is excellent she said. It has lots of foreign input, it is government so should be cheaper and there is a hospital social welfare service to help the poor. A few days later Sujit and Muazem were in Dhaka and I asked them to visit the unit. They said it was good and they saw a patient there with 40%, same as Monoara. They asked about costs and the relatives said that even after getting a lot of help from social welfare it was coming to about 40,000 taka (320 days’ wages)!. This is the problem. Health care is too costly for the poor. And we cannot justify putting that amount behind one patient.
Health care for the poor needs to be appropriate, effective, accessible, low cost, friendly, highly motivated and well supervised. This is what we are trying to do at Kailakuri. Our weakness is medical supervision. We need another long term doctor. People let us know if you find one for us.
Thank you all for your friendship and encouragement.
Edric Baker <edricbaker@gmail.com> Bangladesh Please share this newsletter with your friends.
December 2010
Three Festivals, One Endeavour, Two Humanities Each year October-November-December brings to us three great religious festivals celebrated by probably three quarters of the world’s population: Durga Puja (Durga worship) is the main Hindu festival in East and West Bengal; Id-ul-Ajahar (kurbari or sacrificial Id) is one of Islam’s two major festivals, and Christmas, one of Christianity’s two great festivals. At Kailakuri each staff group takes leave for its festival. The other two keep things going and the work continues. To understand Durga Puja it is necessary to appreciate that for Hindus Durga represents the caring maternal aspect of God. The mother figure is extremely important in Bengal. Durga is seen as the great Mother but also as the Destroyer of evil. To understand Id-ul-Ajahar it is necessary to understand that it celebrates submission to God, commemorating Abraham’s readiness to sacrifice his son when tested by God. Cows are sacrificed symbolizing the giving of wealth to God for his purposes and for the poor. The meat is shared and the hides sold to help educate the poor. The harmony and peace on this day are strikingTo understand Christmas it is necessary to appreciate the Christian analysis of the world’s problems and evil as being so overwhelming as to be only correctable by external intervention. Christmas celebrates the birth of that intervention and the incarnation of hope and love. Last Sunday, four days after Id, I was awoken at six in the morning by Sujit. A burns patient had come. Winter is burns season but this one was different. Her entire body was burned. She was Suruz’s aunt. “There is nothing we can do”, I said. “How did it happen?” “Her son has been in prison for 12 years on a false murder charge. She poured kerosene over her body and set herself alight. Suruz (our TB paramedic) is terribly upset. You must come.” I walked up and down on the road outside with Suruz and then went to see the patient. There was nothing to be done. It was a cold morning. I said to put something over her, “She will be cold.” She was fully conscious. “But she cannot feel cold or pain or anything,” said the daughter – of course, because the nerve endings were all destroyed. I took the relatives outside and talked with them. Then we all stood around the patient while Minaz and Haydar (Muslims) prayed. Then they took the patient to try at Mymensingh but she died several hours later. I wanted to go to church but another patient arrived, Mina aged 18 delivering her first baby. She was very short. Aynal the village doctor (untrained) gave her oxytocin infusion to speed up labour (forbidden outside of a hospital situation). The uterus went into spastic contraction and the baby died. She probably had a contracted pelvis. I felt I could probably leave her and go to church. The uterus relaxed and in due course we sent her to Mymensingh for caesarian section. Then came a woman with retained placenta. She had bled profusely and we have no facility for blood transfusion. Nevertheless we are experienced in this kind of situation. Bijoy gave the ketamine anesthetic. Putting my hand inside it was a real struggle to get the placenta out. I think she must have been given ergometrine (to contract the uterus) in the village but the relatives denied it. Mother and baby are both fine now. We have had a burst of obstetric cases recently and are very grateful to the ten Belgian university students who came and put up our beautiful new obstetric block. Silpi (our diabetes miracle patient who came to us blind, wasted and too weak to stand, but eventually put on 25 kg, had cataract extractions and became a diabetes health educator) became beautiful and got married and pregnant. She had a stormy pregnancy with vomiting and weight loss and delivered a 2.1 kg baby. Mother is now fine and baby is slowly gaining weight (2.8 kg at two months). Another staff crisis was Sultan, another diabetes instructor and our very first diabetes patient (26 years ago). He went into hypoglycemic reaction and his hypertensive blood pressure went up to 230/130. He remained unconscious after correcting his blood sugar. I thought he had had a stroke but it was probably hypertensive encephalopathy. His diabetes and hypertension are now both controlled and he has no residual neurological deficit. When his pressure was coming down we checked his wife. She was 230/150! Both are now moderately well controlled.
Several days ago my “daughter” Johura died aged 30 leaving behind her mentally retarded son Abdullah. Johura had chronic diabetes. She almost died from TB which was finally cured, but she never regained health again. She came back weak and wasted, probably from starvation plus pancreatic malabsorption. The day before she died she asked me to forgive her for all the wrong she had done (she was not an angel). Her uncle came and took home the body together with Abdullah. The Kailakuri Health Care Project is run by the paramedics. They have some amazing successes, but not always. One problem they are particularly good with is organophosphorus insecticide poisoning. Patients come in extremely serious condition and are discharged about one or two weeks later in good health and in most cases with the family problem that led to the suicide attempt solved. We get about two or three a week. Occasionally we lose one.
About two weeks ago a Mandi mother came from Sainamari with three sons. Two had high fever. Fifteen year old Subarkhon was semiconscious with virus encephalitis. He recovered and they went home. Then mother came back with Kitombo aged twelve in coma. He died. I will never forget the mother sitting beside the body. The youngest son, a lovely cheeky boy aged four sitting beside her looked up and grinned and said “Shi jok” (he’s dead)! Mother just wept
The Kailakuri project depends on motivation, training, supervision and good management. Dr Mariko is providing most of the medical supervision. Funding is almost entirely from private donations, mostly from New Zealand and America, channeled through the KHCP – NZ Link Group (New Zealand) and Partners in Sustainable Development International (PSDI, USA). According to Bangladesh law, funds have to come through the head office bank account (IIRD in our case). Each three years we present a proposal to the government NGO Bureau for approval. Then we may bring in funds within the authorized limits. IIRD does not take cuts. Each month IIRD sends us a TT of agreed amount from Standard Chartered Dhaka to our Shanali Bank account in Nardina and we send two workers to pick up money once or twice a week. All expenditures are internally authorized and are monitored. Accounting is by double entry system and subject to government audit. Our cash staff are Harun (25 year old Muslim, diabetic presently sitting BA Honours), Montu (Hindu aged 30) and Mozid (20, Muslim). They are poor, well motivated, honest and efficient – and supervised by Pijon (Christian), our project manager. Thank you all our friends for your interest, prayers and support. The human race comprises many different groups but there are two particular humanities which impinge on and embrace us, one with great problems and one with great empathy. A function of festivals is to bring groups together. We wish you all a sacred celebration of Christmas (the annual reincarnation of hope and love in Jesus Christ).
Edric Baker ----------------------------------------------------------------------------------------------------------- Volunteer Midwife Wanted. In August a team of enthusiastic Belgian students came to Kailakuri and built a new Obstetric Block. Now a volunteer midwife is sought for one to two months to provide further training to the paramedic staff so that full advantage can be taken of this great new facility. For some further details please contact Peter Wilson: kailakurihealthcentre@gmail.com Help With Administration and Fundraising In September a prospective volunteer from NZ visited Kailakuri for a familiarization visit. Subject to the Bangladesh NGO Bureau approving a visa, she is likely to go to Kailakuri in April for a period of six to 12 months to relieve Edric of administration and fund raising duties. A further volunteer to carry out these tasks is sought for 2012. NZ Link Group Treasurer’s Visit Glenn Baker was also able to visit Kailakuri in September.. He was encouraged and buoyed up by what he saw. In particular the staff who impressed him as more professional and businesslike and a lot more confident than his previous visit four years earlier. The new Outpatient Centre (funded by Newmarket Rotary with assistance from Half Moon Bay Rotary) is impressive and makes for much better all weather provision of services.
Finances are always tight and your support is valued. Payment can be made directly to: Kailakuri Health Care Project - Link Group. Account Number: 010 486 0185024 46 Name of bank and branch: ANZ, Whakatane. If paying by direct credit, please note payee name so that you can be identified. Alternatively a cheque made out to the Kailakuri Health Care Project - Link Group and posted to: KHCP-NZ Link Group, C/- D G Baker, 33 Waiewe St., Whakatane. 1st October 2010 A new wesbite with lots of photos and information about Kailakuri Health Centre has been established primarily for supporters in the USA. 30th September 2010 We have been advised that Dr. Edric has now returned to Kailakuri. 22nd September 2010 Malarial tests have proved to be negative. It is now thought Dr. Edric has a virus infection. 20th September 2010 Dr. Edric Baker has been admitted to hospital with a serious attack of malaria. Please pray for his full and speedy recovery. Edric's Unplanned Trip to India Yesterday on my way back from an unplanned visit to India we called in at our Nandina weekly diabetes clinic about eight miles from Kailakuri. I could not believe there were so many people there. The clinic is held in the union council building. Antaz (whom we taught to read and write many years ago) was giving a diabetes class to an enormous room of about 60 people. A little further on was Saleha (spitting image of India’s Sonya Ghandi) taking weights and blood pressures. Then I found Jihiskel flat out writing up patients’ data in the registration khata. At another table were our two paramedics Soronjon and Muazem, checking and advising patients and giving treatment (about half the patients are on insulin). Ujjol was in charge of the insulin. It was a hive of industry. All the staff have under school certificate qualificaton. Thank-you so much all of you who by your gifts make this work possible. It is a lot of work. Over the past nine months my role has been mainly correspondence, report writing, following finances and finding funds. This also is a lot of work. Quite likely you have had the experience of having to feed, clothe and educate a large family; funds are short and you just don’t know what to do. That is what Kailakuri had become like. Doug died. Libby died. The international economic situation is bad. You worry and you can’t sleep. You start to become irritable and depressed… People say `Just trust God` which is very correct, but the psyche is still at work. Finally I knew I just had to get away and get away fast. Our senior staff, Pijon, Roton, Sujit, Onen and Bijoy were fantastic. It was all arranged, I go for a month to the Digolokona, subcentre of Moriomnogor Mission, right beside the Indian border, beautifully quiet with beautiful scenery. It took some getting there – Thursday: six hours to Moriomnogor, Friday: 1.5 hours motorcycle trip to Digolokona, a tiny village of about 15 homes, mostly Garo (Mandi), a few Bengali Muslim, rice fields, streams and forested hills. The hills are about 150 feet high and very steep. Every day I went for walks up the hills, along the streams or to the nearby picnic centre where there is an extremely tall viewing tower from which you can see miles and miles over hills and forest. The border is only a couple of miles away, but not demarcated. Snakes, elephants and porcupines are the only dangerous wild animals left now. It is the elephants that are the worry, coming in numbers, they destroy crops and anything that gets in their way. They are protected and have the run of the forest going back and forth across the Indian border. And they are not fond of human-beings because they disturb them when they are feeding, coming out with bright lights, fire and anything that will make a loud noise. Elephants can get nasty if you get in their way, picking you up with their trunks or trampling you underfoot! I was told if you come across them in the forest, the thing to do is run away at top speed. Usually they don’t follow you. A couple of days after I arrived seven came into Digolokona. Unfortunately I was visiting the picnic centre and could not help chase them away. A few nights previously 20 to 30 came and the village people chased them into India. Next day I decided to visit the village of Hatichara Para about a mile away over a very steep hill, Two Garo men took me to the home of the village leader, Bornixon. All I had with me was a shoulder bag containing a mosquito coil, a gas-lighter and some hand-written reflection notes. (I had planned to sit on the top of the hill on my way back and do some silent reflection.) I stopped at Bornixon’s home longer than planned. There was so much to talk about as he has lots of relatives in our area. They gave me tea. Then I said, “I’ve just got to go because night will fall.” It was six o`clock. He said, “I will send my son with you.” I said “Don’t put him to the trouble. The track is absolutely clear.” And so he gave me a stout pointed staff. We both laughed. I said, “That will be excellent for fighting off snakes, jackals and elephants!” I set out. The problem was that on reaching the rice field below his home I turned left instead of right. I crossed the field and found the path which shortly went steeply upwards as it should. It seemed a bit thinner than before. I reached the top of the hill. This was obviously not the right path but, I thought night will soon be falling. It:s best just to keep going. The path is going in the right direction, south-west and will certainly take me to Digolokona. But it didn’t. Down through the forest I came to another rice field. The track was very obvious going along the side of the field, I walked quite a long way, It would surely join into our Digoolokona Valley. Then it fizzled out! Crossing the rice field I found another path. I’m in luck. It was a good one but after a while it went up the hill again. This was worrying. If I turn back now I will get lost and night will fall, It’s better to keep going. The path will surely lead somewhere . (Tracks go for great distances in the forest along the hill tops, used by woodcutters and people grazing cattle or smuggling them across the border.) I walked very fast because it was getting dark. I was really grateful for the staff Bornixon had given me. The track was getting thinner and it was now getting dark. Far in the distance I could hear a generator. That was encouraging. Then I couldn’t see the track at all, However, beating the staff on the ground I could easily feel where it went. Even though I had a mosquito coil, I wasn’t keen to lie down and sleep on the forest floor in this undergrowth. Goodness knows what creepy, crawly things would crawl over me all night. Then I saw two extremely bright lights. Hooray! This will be the Bonoful Picnic Centre. I pressed on ahead but finally reached a place where I was caught in thick undergrowth with no track ahead of me and the track behind me lost. Now I was very worried. But the lights and the generator weren’t all that far away. Standing on a bit of a mound, I could see buildings on the crest of the hill where the lights and generator were. That’s odd. The Bonoful Picnic Centre doesn’t have buildings on the top of the hill. Well it must be a camp of the Bangladesh Rifles (border security force). So I shouted extremely loudly at the top of my voice for about half an hour, waving my staff, hoping they would come to my rescue but there was no response. I’ve got to reach that camp! There were steep densely bushed banks going down, it seemed, on three sides of where I was standing. But still I had to go forwards. So holding my staff, sometimes crawling through and separating the branches and vines with it, sometimes holding branches with my left hand and thrusting the staff into the ground below me with my right hand so as not to fall down the bank, I struggled along. It was too dark to see anything. God was with me. I came to a road!! This will take me straight to the generator, the lights and the BDR camp. They were very powerful lights. Then another surprise. Entering the camp at the place you would expect to find a little mosque was a Hindu temple!! Then I found a couple of soldiers but they couldn’t understand me and I couldn’t understand them. Finally I asked, “Is this India or Bangladesh?” “It’s India!” So I had arrived at a patrol camp of the Indian Border Security Force. When I thought I was going south-east, in fact, I was going north-west! They were very kind. I was dripping with sweat so they sat me under a fan and when I got cold they gave me a beautiful red blanket. They were watching a spectacular, exciting DVD about the Hindu god Krishna. There was a Ghurka soldier who could speak Bangali and another with English but for all the rest it was Hindi. I managed to explain my problem. I had been walking for two hours. They gave me a bed and fed me. They telephoned their base camp and in due course two vehicles arrived and took me there. It was a good road through the forest but narrow and winding. We drove very fast and twice almost knocked down wild cats. The base camp was a more elaborate affair with cement buildings and there seemed to be more soldiers around. At both camps they were armed with rifles. Here, there were several who could speak Bengali or English and intelligence staff who asked many, many questions, not all straightforward., “What was a foreigner dong wandering through the forest at night wearing only a shirt and a lungi.” Probably I had other people with me. Maybe I belong to a militant group with it’s training camp in Bangladesh. I had no means of identification. They gave me a bed and a mosquito net. “You will have to get up when our senior intelligence officer arrives.” He drove about 80km down from Tura, the main town in the Garo Hills and was extremely kind. (Garo Hills is the western half of Meghaloya State.) All the intelligence people were multi-lingual. For proof of my identity they could phone Yakub Chairman at Modhupur, I said, or else get the Bishop of Tura to phone the Bishop of Mymensingh. I gave them our Kailakuri number which fortunately I had memorized. He wanted to see what I had in my bag. There were a bit intrigued by my reflection notes. “You have written that you must follow the path of treasure. What is that treasure?” I said, “Jesus said the Kingdom of God is like a hidden treasure!” He understood. I had to write many things for them. “Do you feel afraid?” one of them asked. “No.” I said truthfully, “I don’t believe that you are wanting to do me any harm.” We finished at 1:30am but I didn’t get much sleep. What will they be thinking at Digolokona and Kailakuri? Next day there was a lot of waiting around. Both camp commanders were there. We watched Indian television and saw Monmohan Singh, President Lea and Sonya Ghandi. And there was a lot of screenage on the Mumbai celebrations of Krishna’s birthday. I bathed and was fed. I said I wanted a bible and to see a priest and if there was going to be a delay to speak with the New Zealand High Commission in Delhi. They quickly produced a Garo Bible which was wonderful. They were just so friendly and kind. They wanted to get me back to Bangladesh as fast as they could but couldn’t move until agreement came that the BDR would accept me, and they had to get my passport up from Dhaka. “We will have to take you to the police station because we are not allowed to hold anyone for more than 24 hours. We drove to the thana town of Mohendrogonj in West Garo Hills. Going along the border I got a clear view of an area I had visited a week before on the other side. We went first to the government hospital, pretty similar to the Bangladesh equivalents. I was seen by a young Garo doctor who gave me anti-malarials and antihistamine syrup for a skin itch. Mohendrogonj, the BSF commander told me, is the most backward area in the Garo Hills, Most of the population is Bengali (Hindu and Muslim) and have been there since before the India-Pakistan partition in 1947. The roads were awful and some of the people seemed very poor. The police station was like being back at home. The top officers were Bengali (Muslim and Hindu) and most of the rest Garo Christian, mainly Baptist. They too lent me a Garo Bible and were ready to bring a Korean priest. Everyone wanted my photograph and one of them played me Garo songs on his mobile phone. I was given tea and Bengali sweets. They bought me a change of clothes and pumped water so I could bathe at the tube well. They all spoke Bengali, Garo and Hindi and they took me down town to a restaurant for meals. You would have thought I was a close relative. I spent the night on the floor of the police commander’s office – the only problem was they beat off the hours on a very loud gong just a few yards from my head. I needed sleep, so I turned the fan on full blast, took a triple dose of antihistamine syrup and slept soundly until morning when I was rudely woken by a young man trying to sweep the floor. Someone brought a mobile phone with a Bangladesh sheem card and I was able to phone Kailakuri and speak with Antaz and Bijoy. “If we don’t get word from BSF and BDR I am ready to drive you to the border where there is a road on the other side.” said the police commander, “You get out and walk as fast as you can. Once across the border if the BSF calls you back just keep walking as fast as you can. Both sides are forbidden to shoot before dark. Are you agreeable?” “Definitely.” We were to be advised at three o’clock as to whether the BDR would accept me. The message came at four. We drove to the check post where we were met by the BSF. It was a sad farewell. Then we walked 200 yards to the BDR commander. I embraced him. I felt like singing the national anthem. “Do you know him?” asked the BSF. “Never seen him before, but he is Bangladeshi!” Then it was Pijon! They checked me against my passport brought by Tara Mia from Dhaka. Then we joined Sujit and Tara and went by motorcycle to Kamalpara Police Station. Again lots of questions and a written report. Jamalpur Intelligence and later on Tangail phoned. At the end of my report I wrote, I have nothing but praise for the way I was treated by the BSF and the Indian police. I feel honoured to think that my misadventure has allowed me to be an ambassador of goodwill between Bangladesh and India. We went back to Digolokona, What a welcome! When they discovered I was missing the school masters (2) and mistress and 30 little boys and others had set out in the night with lights to scour the hills. They found my sandal and staff prints and followed them all the way to the BSF camp, arriving at 11pm, only to be shooed away. They made contact with Kailakuri and notification went to Fr Homerich, the Bishop, Yakuh Chairman, Norte Dame College, the American and Australian Embassies and two cabinet ministers, then to their counterparts in Calcutta and the New Zealand High Commission in Delhi. Thanks to God all is now well and a very sincere thanks to all who labored behind the scenes to enable my speedy return. Belgian Students. A team of motivated Belgian students are spending August 2010 at Kailakuri building a maternity ward. They have a website: http://www.aec-sk.net/pb/project/en/info.htm They are also blogging their experiences: http://haspatal-in-bangladesh.blogspot.com/ If you hit the Translate button at the top you can get a (rough) translation into English. Newsletter June 2010 Health for the Poor by the Poor inter-faith international
“A health care system like Kailakuri is the only answer for the poor, because if you do not create a system that is really focused on including them then you will end up excluding them.” In this newsletter impressions of the system are presented by three people who are new to it. 1. Nicholas Tseffos aged 22 came to us in February, the very model of a modern American digital age medical student and an ardent follower of Fr. Doug Venne. He flew in with his computer and enough glucometers and strips to last us at least two years. He was tireless in typing for us (200 words a minute). He mixed with the people, loved the people and one month later flew out again---and continues to help us! 2. Dr. Mariko Inui is a 59 year old Japanese lady doctor and housewife sent to us by Japanese Overseas Christian Service. She will probably stay nine months and maybe longer. Her husband and son are both doctors. Her husband is surprised that she wants to work in Bangladesh when Japan is short of doctors, but Doctor Didi has fallen in love with Kailakuri and is going all out to learn the language. 3. 24 year old Sultan Mahmud, I.A.pass (university entrance) Islamic education system, is my special assistant and has been working with us for five months. He writes things for me, checks finances, cleans my house and washes my clothes. Recently when I was down with heavy flu, he and Momiron hand fed me! Sultan is a strict Muslim praying five times everyday and following all the rules and laws of his faith to the best of his ability. His marriage was somewhat of a crisis. His father told him a marriage was arranged to take place in seven days time. Sultan refused because his family would take dowry which is against the rules of Islam. His father took some convincing. Now he is happily married to an extremely poor girl of his own selection (no dowry). Lovely Nasreen used to be his maths’ student (home tuition). Their first baby is due next month. Nasreen is now aged 15.
1. Nicholas writes: Past where the tar-seal ends, across the rice fields and encircled by pineapple and banana plantations lives an ideology: “For the poor by the poor.” These are the words that the Kailakuri Health Care Project lives by. Thanks to the devotion of Dr. Edric Baker. This New Zealand native has devoted his life to ensuring that the poor are not denied their right to life. Despite 68years of age he sleeps on the floor and only has one mode of transportation, a 25-year old bicycle(quite a contrast to the Doctors in the States!!) Sleeping in a dirt hut, eating on the floor with his hand and bathing in a lungi at the tube-well is as customary to him as Tempurpedic mattresses, fine dining and jacoozie tubs are to Americans. In fact he told me that going back to visit family in New Zealand has become a rather embarrassing situation because he no longer knows how to perform such simple tasks as opening the car door or sleeping in a bed. At all costs this humble servant of the poor does not do anything to compromise the ideology of the Clinic. He has accepted a life of poverty and allows himself no material pleasures but rather gets his joy from the patients he serves. Dr. Baker lives by a type of motto himself, “If you learn the language and live with the poor you will learn to love the people and soon find that your life has been changed forever.” How true I found this to be. I am sure many of you are wondering, “Who the heck is this Nick guy? ” I grew up reading the mission stories of Fr. Doug Venne, and was lucky enough to have him preside at a grade school Mass in Milwaukee, Wisconsin. In fact my introduction into Doug’s life was from my older sister who came home from school screaming, “The priest took his eye out in church! ” (Editor: Doug had a glass eye following a truck injury in the Philippines). We went to an evening Mass a few days later and my father explained how Doug was a grade-school classmate of my grandfather (Editor: All three bear the name Nicholas Tseffos). Many days have passed since then, but the words of the annual “Coconut Chronicles” have stuck. Two years ago I wrote Fr. Doug and asked him if I could be of any help to the Kailakuri Health Care Project, which led me to Dr. Baker. After graduating in Biochemical Sciences from Marquette University, I began fund raising for supplies and saving up enough money for a plane trip to Bangladesh. In February 2010 my life was changed forever. Each morning at Kailakuri starts as all of the able patients, families, staff and strangers are welcomed to gather on a burlap sheet, which is placed over the ground. Books from the Muslim, Hindu and Christian mediums are passed out to the group which is gathered cross-legged on the burlap. Encircled around a grouping of fresh-picked flowers, the men and women are separated on their corresponding sides in preparation for prayer. What is to follow is one of the most respectful and beautiful gatherings a person can witness. Differences are not focused on, but rather similarities are embraced. Each faith adds their own prayer and song to create a community of human beings who are collectively trying to fill their void for purpose and salvation in the best way known. The Kailakuri Clinic’s campus is one of mutual respect. It is one of the only places in Bangladesh where religious affiliation works in harmony and does not stem hatred or violence. (Editor: most places desire harmony not hatred) I was welcomed into the Clinic during a prayer service, which is just how I was thanked when leaving. I was given a bouquet of flowers to bring back, but unfortunately the U.S.Customs Department does not feel this is a worthy gift to enter the States. However if I had been able to get the flowers off the plane, I would have passed them out to each of the people who have so generously donated to the Project and explained just how unique and worthwhile KHCP is. Each and every supporter of this cause is essential to the care and continuation of the Kailakuri Health Care Project. Although the operation is extremely grassroots, the care far exceeds the simple resources. I attribute this to the compassion that the staff has learned from Edric. As a result of my experiences, I promise not to let Kailakuri be forgotten. I hope I will be granted the opportunity to return to Bangladesh. If anyone would like to contact me in regard to stories, experiences or pictures please feel free to email<nwatseffos@gmail.com>. (Editor’s note: (i) It is interesting that Nicholas was so moved by our joint prayer. Two days ago a Bangladesh television crew visited and insisted on filming our joint prayer meeting for transmission throughout the country (ii) You can see some of the photos Nicholas took on: http://sites.google.com/site/kailakurihealth/photos).
2. Dr. Mariko says: This is my fourth trip to Kailakuri, the first for three hours, the second for one week and the third for one month. This time I will stay at least three months then return to Japan to see my grandchild, children and husband. I really don’t know how long I will stay but I like Kailakuri and I like the village. Fifty years ago Japan was like this although of course we had no mobile phones, TV or computers then. I do not like cities. My husband knows it is no use ordering me back to Japan before I am ready to go. The people here are very hospitable and the staff very kind to the poor. New patients feel completely at home here after only one or two days. The joint prayer every morning is very important. I enjoy studying Bengali, and of course after only one month I am still learning the Project (Editor: all the work here is in Bengali medium). I have spent many years doing medical work in Japan both paediatrics and rehabilitation medicine. The common diseases here however are completely different, most especially the parasitic and infectious diseases and the high prevalence of TB. Besides, the whole medical system at Kailakuri is different. Whatever investigations seem necessary in Japan we order without hesitation. I have so much to learn from the staff here. But it is very interesting. Let me give you an example of the kind of tension I face. Eight year old Sagor was admitted with fever and wasting illness. Two days ago we got a mobile phone report from Jalchatra Hospital laboratory to say he has acute lymphatic leukemia. This is a curable disease in Japan but at Kailakuri the cost is beyond the means of the Project.
3. Sultan says: I grew up in the village of Kailakuri. Our family is extremely poor and I am the only one of six brothers and sisters to have passed primary school. I wanted to work at Kailakuri Hospital but they had no place. After marriage I had no way of feeding my parents and my wife. So I got a job in Dhaka in a washing company for nine months. It was hard physical work, twelve hours a day everyday with no days off. I was able to earn Tk 4000 a month. (Editor: this is about the same as village wages but village people often cannot get labor). After paying for food and accommodation there was almost nothing left for my family. The work that poor people get at Kailakuri Hospital completely transforms their lives. Many poor patients are able to get treatment at Kailakuri and get better, even from extremely severe illness, without great expense and without having to sell off family resources. It is important that Hindus, Muslims and Christians pray together every day, to get help from God for the running of the Project and to establish good relationships so that they can work together effectively.
Edric’s comments : When the television crew came to Kailakuri two days ago we were able to put across the philosophy of the Project which is so different from so many others and also to make an appeal for in-country donations and a Bangladeshi doctor.
I recently visited Bro. Ronald who runs a very large addict centre (126 patients) outside Dhaka City. His work has been widely acclaimed in Bangladesh. At the present time we have a young man in his care who is addicted to gambling. I told him with some emotion that we do not see funding security more than three months ahead. He said he can never see security beyond the present month and his project has been running like this for the past 15 years!
Please may we remind our friends once again of our contact addresses and how to send donations: Bangladesh: <edricbaker@gmail.com>, <hasna@iird-bd.org>; America: <v.klein@psdintl.org> New Zealand: <kailakurihealthcentre@gmail.com>. Checks should be made payable to: America: PSDI (with a letter advising for Kailakuri), New Zealand: KHCP-NZ Link. (posted to 33 Waiewe St Whakatane)
If you want a speaker to tell your group in NZ about the Kailakuri work, please email: kailakurihealthcentre@gmail.com Newsletter April 2010 From Dr. Edric Baker.
Mrs. Libby Laing amazed everybody by coming to a very difficult developing country for the first time at the age of 58. She was a New Zealand Plunket (district mother-child health) nurse ideally suited to our mother-child village programme and skilled in group work. She trained the staff and built up a self-reliant team that over the years has helped many hundreds of poor mothers and children-one of the highest risk groups in poor communities and the top group in cost-benefit priorities. She was a talented person who would not allow essential needs to be overlooked. Many village homes owe their safe drinking water and their latrines to the efforts of Libby. Bangladesh is not an easy assignment. After four years of consistent work she continued to visit each year and to support us as coordinator of our New Zealand Link Group. All her work here she did by bicycle. She personally went around the villages with every worker giving advice and guidance to each one. She trained them and supported them with whatever was necessary. And she found funding for the programme. She would be greatly distressed if a child were not properly cared for or if one of her staff was suffering family problems (not all of them have easy husbands). She was driven by love and female determination. She once wrote to a friend “Since coming to Bangladesh I have learned to be assertive” to which her friend replied “Libby, you always were assertive; you must now be positively aggressive!” She was a person who got things done and did not easily bow down to obstacles and she had a sense of humour. She once threw a banana at me in the course of a friendly debate (she was always buying bananas for me and we were always having friendly debates) upon learning which her friend wrote “Libby I have three questions: 1. Did you hit? 2. Did it have the required effect? and 3. Did you eat the banana together afterwards?” Because she thought with her heart she knew well how to bind people together in friendship. When she resigned from her roles with Kailakuri she said to me, “Edric, I’ve still got so much love inside me. I’ve got to go on doing things for people.” And she came back to work with handicapped children in Dhaka (at the age of 70). Libby was the mother of two children, Carol and Peter in New Zealand, and a widow, but also the adopted mother of the SMSM sisters in Dhaka who affectionately called her their mother superior. May God take her up in His loving arms to her eternal inheritance in the place where fractions and denominations are unknown. Her departure was completely unexpected. She came to our area for about a week before Easter. The day she returned to Dhaka I gave her a large delicate wild flower I had picked at the side of the road. I apologized because it got crushed in my pocket. Tears came into her eyes. A few days later she had her massive stroke (“in the arms” of the sisters) and did not regain consciousness. Muslims, Christians, Hindus, everybody wept at our Kailakuri prayer meeting. The day before the body was flown back to New Zealand six of us made a nine hour up-down trip to Dhaka to say goodbye in the hospital morgue but it was not the same. The mother child programme has 17 staff working in the same number of villages, Muslim, Christian and Hindu. Currently they are caring for 1128 under-four-year children and 112 antenatal mothers. Their team leader is Leo Rema who is small in size but massive in knowledge and experience. All the staff were devoted to Libby. In the future the programme should be enlarged when we are able to develop our administrative capacity and can find the funding. We thank God and the NZCMS for giving us this wonderful colleague and friend. We have farewelled Fr. Doug and we have farewelled Sr. Libby but the poor are still with us and the work must go on. We believe that the poor are precious in the eyes of God. They are deprived of essential health services (priced out). The two losses we have sustained have opened our eyes to the precariousness of our work but it must continue. We have lots of weaknesses and faults but never the less we have a good strong team, a very good programme, lots of friends and supporters, and lots and lots of people are helped. We have just taken on a new young man, Pijon Moming to be trained up as project manager and are about to get Dr. Mariko lnui a highly motivated Japanese lady doctor who will probably be with us for nine months and may be longer. Two New Zealand Rotary Clubs, Newmarket (Auckland) and Half Moon Bay have just given us a large new out-patient block and Newmarket has also given a house for the lady doctor. A Belgian student group is going to come and put up an obstetric unit. Our urgent need is for an English speaking person who will take our people and our work to their heart and take on donor correspondence, English office work and fund raising and then move on to management upgrade. Then I will be able to give my time to essential medical work and doctor hunting. Then I will be ready to leave in peace when the time comes. I cannot say how grateful we are to all of you our partners in making this work possible. Please continue to help us.
In affectionate memory of Libby, from Edric Baker and the team at the work-site. --------------------------------------------------------
Outpatient Clinic Building. Construction of the new Outpatient Clinic has been completed. Outpatients can now be received inside, instead of outside in all weathers as in the past. We are grateful to both the Newmarket Rotary Club (most of the cost) and Half Moon Bay (top up funding) for making this possible.
Cottage for Dr. Mariko. Many thanks to Newmarket Rotary for their generosity in also funding the building of a cottage for Dr. Mariko to live in.
You can see photos of these buildings on: http://sites.google.com/site/kailakurihealth/latest-news
Medical Intern. Nicholas Tseffos from the USA recently spent six weeks working at Kailakuri. Thankyou Nicholas for your support and input.
Mission Manager. A project manager is urgently needed at the Kailakuri. NZCMS is currently advertising for a suitable person to take up this key posting. Please look at http://www.nzcms.org.nz/vacancies.php
If you know of somebody who could be challenged to take on this important role, please refer them to CMS.
Financial. Historically Dr. Edric has tried to maintain enough money in the bank to meet two months of running expenses. Unfortunately donations have slowed down recently and currently the bank balance is less than one month of running costs. This is running very close to the wind and is causing some stress. Please pray about this and if you are able to make a further donation please post a cheque made out to Kailakuri Health Care Project - Link Group and post to:
KHCP-NZ Link Group, 33 Waiewe St., Whakatane 3120, New Zealand
Please share our newsletter with your friends. Contact addresses: New Zealand · Glenn Baker, <anneandglenn@gmail.com>, USA · Virginia Klein, <v.klein@psdintl.org>, Bangladesh · Edric Baker, <edricbaker@gmail.com), · Hasna Hena Khan, <hasna@iird-bd.org>, · Dr. Edric S. Baker, Kailakuri Health Care Programmes, P.O. Pirgacha, Madhupur, Tangail 1996, Bangladesh April 2010 Libby Laing It is with great sadness that we advise that Libby Laing passed away suddenly from a massive stroke in Dhaka at Easter time. Libby first went to work alongside Edric in 1998 and worked hard at training the paramedics and developing the Mother and Child Village Health Care service. Over the past decade Libby travelled every year at her own expense to Bangladesh and worked three months with the village paramedics. The love and skills that she imparted live on, but she is sadly missed. March 2010 New Outpatient's Reception Centre Kailakuri struggles to meet the insatiable demand for out patient services with 80 - 90 sick and desperately poor people presenting every day. Up until now, facilities have been limited to a small mud hut in which patient consultation can take place. Initial reception, recording of personal details, weighing and taking of blood pressure has been accomplished out side, (see photo on the Outpatient webpage). With financing from the Newmarket Rotary Club (NZ) plus some top up funding from the Halfmoon Bay Rotary Club (NZ), a new Outpatient Reception Centre has now been built. Our thanks go to both clubs for their generous support.  Mud Bricks being prepared and baked in the sun for building of the Rotary Outpatient Centre  Construction of the Rotary Outpatient Centre nearing completion.  December 2009 Father Doug Venne A few days after Christmas, we are sad to advise that Kailakuri lost a faithful supporter with the death of Maryknoll Father Doug Venne . Ordained in 1959, Father Doug spent fifty years living and working with the poor initially in the Philippines and since 1975 in Bangladesh. In the mid 1980’s he was impressed with Dr. Edric Baker’s pioneering work in establishing health services for the poor. From that time he provided moral, spiritual and physical help to Edric and the project. For many years, this servant of the poor wrote the Kailakuri Health Centre quarterly newsletters. Ever humble, ‘your correspondent’ he called himself. He also attracted funding support from for Kailakuri from friends and family in the USA.
For Father Doug’s life story see:
2009 End of Year Newsletter
A Message from Edric Baker
Good News of Sustainability
Greetings from Whakatane, New Zealand. I have been travelling around this beautiful country seeking help for Kailakuri. People have welcomed me, shown hospitality and given extremely generously, even in the midst of economic difficulties. The tour brought in NZ$20,000 (US$14,400). Thank you for your wonderful kindness.
Yesterday, a beautiful warm late spring day, I visited a graveyard high up on a hill crest between Whakatane and Ohope, a beautiful site surrounded by New Zealand native bush. Birds were singing behind the delicate tinkling of hanging metal memory sticks. The stone said ‘JVT Baker, born 1913, died 2009’ and there was a cross. We were proud of Dad, head of a Government department, honest, hardworking and not afraid to say things needing to be said. He was quiet and gentle and gave us a secure home, good education and strong family life, and he was a strong believer in the sanctity of marriage, and a very long time supporter of the Kailakuri Project (as is my mother).
I did not come home immediately when he died but wanted to make a planned trip after an interval to mourn at the graveside, be with my mother and re-bond with the family. All these have happened while I have been in NZ these past three months. Anne drove me to the cemetery and came back for me 2 hours later. I had not realised it would affect me so much.
Mother is also in her nineties and I was overcome by feelings of impermanence, loss and insecurity. I knelt down by the grave and then went away and sat down in a field of long grass, golden dandelions and buttercups, to pull myself together and think of the words of Jesus, who gave Himself that we might live. He also had a lot to say about impermanence and the transience of temples and cities – obviously the same goes for structures and institutions too!
We cannot hope that the Kailakuri Health Care Project will last forever. Nevertheless it meets essential needs and must be sustained as long as possible, for the poor by the poor. And it brings Muslim, Christian and Hindu communities together in harmony. The work is done by paramedics and village workers most of whom have under school certificate level of formal education. They had 30,000 outpatient visits last year, 1400 diabetic patients under supervision, 1200 under-four-year-old babies on regular home checks, 900 inpatients, 560 antenatal mothers, 90 TB patients, etc. etc. 88 staff on about NZ$60 (US$44) per month and an overall running cost of about NZ$18,000 (US$12,500) per month. This is very low when considering what is achieved, but the money still has to be found. A day’s village wage is about NZ$2 (US$1.5) but there are long periods when labour is not available. Other health services are very difficult to reach, too few, too costly or not appropriate.
Kailakuri has been extremely successful. The reasons are: simplicity, low cost, low level local staff, local committees, commitment, good basic training and supervision and overseas support.
It is because it is so different that the project’s sustainability is such a challenge, depending not on qualified staff and costly investigations and medications, but on community immersion, empathy, understanding, simple actions and careful patient care. Jointness and prayer are a higher priority than advanced technology. Qualified doctors are normally unable to cope with village isolation or give up their private practices and often they fail to appreciate the devastating effects of high medical bills on poor families. (The control of basics by a powerful minority elite, the vast numbers of needy enduring deprivation and frustration, mirrors the overall Bangladesh situation and indeed the whole international scene. It is easy to see how unstabilising and even explosive the effects can be.) Kailakuri’s sustainability requires ideology, simple low cost methods, training ordinary village people as staff, outside funding and committed leadership. The present major concerns are security of funding and leadership transition.
Funding depends on communication in English, requiring an English speaker. I can not be there for ever. The ideal leadership to take the project through to its next stages would be a medical doctor of sufficient commitment to immerse in the work for a long time at a salary level not too different from the other staff. Failing this the answer may need to be:
This introduces a number of new concepts and will need to go through the decision making process by the community discussion which is so essential to the project’s success.
Almost all of Kailakuri’s support comes from New Zealand and USA. A Link Support Group is set up in New Zealand which sustains interest, sends out newsletters and receives and transfers donations.
We are very grateful to Libby Laing for her many years both of service to the project and as co-ordinator of the Link Group. Libby has now resigned and we wish her well in her new ventures for the poor. We also thank my parents for their many years of devoted assistance. As new co-ordinator we welcome Mr Peter Wilson of Auckland who brings many years of experience from his work in development in the Asian region. Other members of the group are Glenn and Anne Baker, Hilda England, Hilary and Nelson Lynch and Peter Reid.
We are deeply grateful to the Rotary Clubs at Newmarket and Half Moon Bay in Auckland for funding the enlargement of our outpatient facilities. We also give very sincere thanks to Gareth Morgan of the Morgan Family Charitable Foundation, the Rev. Douglas Venne, the Asia Connection Incorporated, The Quail Roost Foundation and our many other supporters. We welcome the short term help of Dr Mariko Inui from Japan.
While recognising the impermanence of everything around us, yet the Christmas Season gives birth to new hopes of relationship and sharing – good news which makes health for the poor by the poor possible and raises to action those who might be ready to give up. We wish you all a very happy, hopeful and blessed Christmas. Please continue to pray.
Message from Peter Wilson
I have been told that some people have been asking who is this Peter Wilson and how did he become involved with Edric. Well, here is the answer!
As most of you will know, Edric worked in South Vietnam while the war was on in the late 1960’s and early 1970’s. I also worked there for a year - with the NZ Red Cross. At that time 20% of the population were homeless and I was involved in a re-settlement programme. I met Edric socially on one or two occasions and he came and visited the Red Cross team in the field to see what we were doing. After Vietnam, I did not come back to NZ. Until recently I worked on projects in poor areas of Asia, mostly aimed at overcoming hunger and poverty.
In 1998 the United Nations Development Programme asked me to go to Bangladesh, a country I had never been to before. From my sister, who at that time was working for CMS, I heard that a Kiwi nurse, Libby Laing had just gone there and was currently doing language training in Dhaka. She told me that Libby would be working with a Dr. Edric Baker. I then remembered that I had heard many years before that Edric had gone to Bangladesh. In Dhaka I met Libby and at the end of my six week assignment she accompanied me on a visit to the health centre where I met Edric again for the first time in 29 years!
Although I am an agriculturalist by inclination and training, working on community problems in rural Asia over the years I had to became something of a jack of all trades. This included struggling with the issues of under-funded, under-staffed and poor performance by government run health centres. So I could immediately see that the approach developed by Edric had a lot of merit! Subsequently I have been able to go back and visit the heath centre two times and it is my privilege now to play a small role with the Link Support Group.
Message from Glen Baker Link Group Treasurer
I have received a number of donations by mail which have no return address. This means I can not post you a receipt. If you have made a donation and not received a receipt, please get back in touch and give me your name and postal address.
Media Exposure for the Kailakuri Health Centre Project
(1) Real Life
Please listen to Real Life on Newstalk ZB at 8p.m Sunday 6th December. This is a live programme produced by the Christian Broadcasting Association. Edric will be interviewed by host John Cowan. Besides being a broadcaster, John is a director of Parenting Inc., which was founded by Ian and Mary Grant.
(2) Sunday Morning With Chris Laidlaw
While Edric was in Wellington, he was interviewed by Chris Laidlaw. This interview will be played on air on Radio NZ National on Sunday morning 20th December.
Please tell, others about these two radio programmes.
Personnel Assistance for Kailakuri
For some time feelers have been put out unsuccessfully within Bangladesh and internationally for a Dr to replace Edric as Medical Officer in Charge. As an interim measure it now seems likely that the Japanese Overseas Christian Medical Cooperative Service (more commonly known as the Japan Christian Service or JCS) will supply a Dr for a minimum of one 12 month assignment. Dr Mariko Inui has now visited Kailakuri twice, staying there for three weeks on the second occasion. Recently she has been interviewed by JCS and everything is looking good for her to be accepted for the posting. If the Dr Mariko does come to Kailakuri, it will be necessary to build a residence for her at an estimated cost of about NZ$1,700.
Further help will also come in the form of an intern from the USA. This young man has completed his pre-medical science degree and will spend six months working at Kailakuri.
Although having these extra personnel will make demands on Edric, it is also hoped that they will free up some of his time which can be devoted to preparing for the future.
A Big Thankyou
Over the past three months, Edric has travelled extensively from Whangaparoa in the North to Invercargill in the South. He has addressed over 30 groups and held numerous other meetings. Thanks to everybody who has played a role in making this all happen.
Donations
Donations in NZ for the Kailakuri Health Care Project are received by the treasurer of the KHCP Link group. All money received is transferred directly to Bangladesh with no administration costs deducted. Cheques should be made out to: Kailakuri Health Care Project - Link Group(or KHCP Link Group) and posted to:
KHCP-NZ Link Group, C/- D G Baker, 33 Waiewe St., Whakatane.
November 2009
Link Group Executive Meeting.
A meeting of the Kailakuri Health Centre Project Link executive group was held on at Libby Laing’s beach house at Pukehina in the Bay of Plenty, NZ, on11th October. Highlights of the meeting follow for your information.
Resignation and Tribute to Libby Laing
An important item on the agenda was to acknowledge the untiring support Libby Laing has provided over the past 11 years. Libby first went to Bangladesh in Sept. 1998. Airfares and insurance were provided by Church Mission Society (CMS). After language training she worked with Edric for four years at Thanarbaid and the (then) out-centre of Kailakuri. At that time there was a very weak and not very effective village mother and child health care programme. Libby undertook to develop and strengthen this. Drawing on a life time of NZ nursing experience including Plunket work, she built this up. Today a highly skilled team of some 14 village workers provide support and advice to mothers and children in 17 villages. The benefits of this work have flowed beyond the families directly dealt with. It is notable that the number of outpatients coming to Kailakuri from these villages has dropped significantly. The whole community has benefitted.
At the end of 2002, Libby came home and resumed Plunket nursing. In 2004, and each year since, she has returned to Bangladesh for up to three months at her own expense and worked with the village mother and child health care paramedics.
Back home in NZ, as many of you will know, Libby has been a tireless supporter, travelling the country to show pictures and talk about the people of Bangladesh and the Kailakuri Health Centre.
Libby we salute you! None of us could have done what you have done. You were the right person at the right time. Thank you for sharing your boundless energy, your formidable skills and your bountiful love. We are sad, but recognise that it is time for you to move on to new challenges. "life has its seasons, and God has the reasons". Our love and prayers are with you in whatever it may be that unfolds for you in the future. In the meantime we wish you well for your trip back to Bangladesh late November and December.
Link Group Coordinator
Peter Wilson agreed to take over from Libby as Link Group Coordinator.
Kailakuri
Edric gave a brief outline of the current situation. The past couple of years have been quite difficult with political uncertainty, rampant inflation, constant pressure from increased demand for services. Although Bangladesh now has a new elected government, corruption has returned and if anything is worse than it has been previously. Inflow of money for project support has been increasing, but is unpredictable as to when it comes and how much.
Within this framework, an attempt has been made to restrict growth so that standards can be maintained within the available budget. Over-all there has been a small increase in the numbers of outpatients, inpatients and diabetics in the diabetes programme.
For some time feelers have been put out unsuccessfully within Bangladesh and internationally for a Dr to replace Edric as Medical Officer in Charge. As an interim measure it seems likely that the Japanese Overseas Christian Medical Cooperative Service (more commonly know as the Japan Christian Service or JCS) may supply a Dr for a minimum of one 12 month assignment. A lady Japanese Dr has now visited Kailakuri twice, staying there for three weeks on the second occasion, and she has indicated a willingness to work there. Advice from the JCS is that they will be interviewing her in November. Please pray for a positive outcome.
If the Japanese Dr does come to Kailakuri, it will be necessary to build a residence for her at an estimated cost of about NZ$1,700.
Further help will also come in the form of an intern from the USA. This young man has completed his pre-medical science degree and will spend six months working at Kailakuri. Although having these extra personnel will make demands on Edric, it is also hoped that they will free up some of his time which can be devoted to preparing for the future.
Turning to the future, Edric laid out a three point plan aimed to strengthen Kailakuri and deal with the issue of somebody to replace him. (i) Administration and Funding Liaison. A weakness of the present operation is that Edric is the only person on the staff who is fluent in spoken and written English. An English language capability is needed for: · Liaison with Donors · Correspondence, newsletters and reporting · Dealing with visitors and the Bangladesh Government.
Edric’s proposal is that a volunteer Mission Administration/Liaison person be sought to undertake these tasks for a period of about four years, including language study. The volunteer Administration/Liaison person would also assist with non-medical project management.
(ii) Strengthen Local Staff Leadership. Senior staff to undertake part time formal training in Mymensingh.
(iii) Bengali Senior Nurse as Medical Officer in Charge. Assuming no Dr can be found to take over from Edric, a religious order within Bangladesh will be approached with the aim of attracting a senior experienced nursing Sister who would undertake a period of training and familiarisation in each of the Health Centre departments before taking over as Medical Officer in Charge.
The group discussed this and agreed that this was a pragmatic and workable plan, with the proviso that it should be approached flexibly so as to respond to any changing circumstances.
NZ Tour
Edric has been back in NZ since the beginning of September and has already travelled to and addressed gatherings in Hamilton, Te Kuiti, New Plymouth, Stratford, Wanganui, Hastings, Gisborne Whakatane and Tauranga.
At the end of this week, after spending time with his Mother in Whakatane, he will travel again, this time to Wellington and the South Island. After this Edric will return to Whakatane for about two weeks before proceeding to Auckland and Whangaparoa for more meetings and departure back to Bangladesh on December 7th 2009.
June 2009
Dr. Edric Baker will be returning home to NZ to visit his elderly mother later this year. He will also tour to parts of NZ to speak to interested groups and share with them news about the Kailakuri Health Centre.If your group would like to have Edric visit, please email: kailakurihealthcentre@gmail.com
March 2009
Dear Friends of Kailakuri – Bangladesh,
We join with the Staff at Kailakuri in extending our sincere sympathy to Edric, his mother Betty, his two sisters, three brothers and extended family, on the recent death of John, a loving husband, father, grandfather and great-grandfather. (13th February 2009)
Edric was unable to return to New Zealand in time for John’s funeral service, but hopes to come for a private visit in approximately 4-6 weeks, to spend quality time with his mother and family members. Our thoughts and prayers are with them all.
Edric reports from Kailakuri that:-
a) the work continues to go well – no shortage of it.
b) the Bangladesh general election at the end of December was very successful with an absence of the usual violence. The winning party was elected with a large majority and there is a general mood of optimism throughout the country.
c) the last two rice harvest have been good ones and if this continues with the crop being presently planted, then the country will have food security for the next 12 months.
d) prices of some of the basic commodities (cooking oil, rice, and fuel) have started to fall.
e) thanks to Roton’s firm encouragement, the 2008 annual report is well underway.
f) financially we are still running the project on the wonderful response of last years appeal. This should cover us for a good part of this year.
Libby reports:-
During my visit to Kailakuri at the end of last year I was once again impressed by the level of commitment and dedication of the staff. I was also very impressed by the level of knowledge of the senior paramedics. This was brought home to me during the visit of two Australian and one New Zealand nurse (Judy) who were part of a team of 12 from the Australia - New Zealand Burn’s Association. They came to Dhaka to give seminars to health professionals (mainly doctors) on the latest treatment for burns. Judy, who heard Edric speak in Auckland last year, expressed a strong desire to visit Kailakuri when in Bangladesh, and her two friends were happy to accompany her. They came for three days and very kindly offered to share their knowledge with our senior staff. This necessitated two sessions. At the beginning of the second session, as the staff were being questioned to check their level of understanding, it became very obvious that our senior staff were right up with the play, including the mathematical calculations, and knew and understood exactly what was expected of them. The senior staff have now used other teaching sessions to pass on what they learnt to the rest of the staff members. This means the gardeners and cooks as well as the care givers know how to treat burns in the first 24 hours of their occurrence- the critical period for a healthy outcome. I now wonder if instead of a doctor to replace Edric we should be looking for an overall administrator, preferably with a health background. Somebody who is bilingual and with a heart for the poor, will more realistically be found in Bangladesh than a registered doctor. For western doctors and other health professionals to maintain their registration, they must now continually update their skills within a very small timeframe in approved countries. A long term commitment in a third world country is therefore precluded.
In spite of the great response for Project funding last year we cannot afford to become complacent. With the huge drop in the exchange rate and the dismal international economic forecasts we continue to rely heavily on donations which may be harder to come by this year. Please continue to remember the work at Kailakuri which is reliant on your generosity.
A gentle reminder :-
a) that the Kailakuri Health Care Project is registered with the New Zealand Charities Commission. There is now no limit to the amount of donations that are eligible for the 33% rebate. To claim all rebates for the year to 31st March 2009, phone the Inland Revenue Department, have your IIRD number ready, and ask for a rebate form to be sent to you. After the initial form they are sent automatically each year.
b) cheques for donations should be made out to Kailakuri Health Care Projector – Link Group and sent to our treasurer:- Glenn Baker, 33 Waiewe St., Whakatane, 3120.
c) direct credits can be made to Kailakuri Health Care Project – Link Group Whakatane ANZ account no 010 486 0185024 46 If followed by an email ( kailakurihealthcentre@gmail.com ) then receipts will be sent.
d) up to date information on Kailakuri can be found on the internet at http:/sites.google.com/site/kailakurihealth
e) if you are happy to receive newsletters by email, please email us at: kailakurihealthcentre@gmail.com
f) I am happy to speak to groups any time – anywhere, about the work at Kailakuri.
Thank you all for your ongoing interest and support. Please continue to remember Kailakuri, its work, and staff in your prayers.
Libby Laing,
Coordinator, Kailakuri Health Care Project – NZ Link Group
Home Leave for Edric Baker
During August-September 2008, Dr Edric Baker spent time on home leave in New Zealand He spent the first month with his parents, both now in their mid-90s.
He then spent a month travelling around the country talking to groups interested in the work at Kailakuri. During this time he spoke to groups in Whakatane, Te Puke, Tauranga, Rotorua, Auckland, Whangarei, Whangaparoa, Hamilton, Taupo, Napier, Raumati, Porirua, Lower Hutt, Christchurch, Halswell, Lincoln, Nelson and Wellington. He also gave media interviews for TV Shine, Radio Rhema and Radio NZ National and New Zealand Catholic.
On his return to Kailakuri at the end of September he found that activities had carried on as normal. A tribute to the staff, the training they have received and their commitment to their community.
Significant New Supporter
While in Wellington, Edric met with Mr. Gareth Morgan who was impressed with Edric’s track record and what is being achieved. He committed the Morgan Family Charitable Trust in principle to provide some financial support to Kailakuri health Centre for a period of five years.
Cost of Living in Rural Bangladesh
In October the staff of Kailakuri completed a study of their personal living expenses which found that their cost of living had increased by 73% over the past year. As a result they have now received a significant pay increase (but not 73%).
Libby Laing Working at Kailakuri
In mid-October 2008 Libby Laing retired paediatric nurse from Taupo, New Zealand travelled to Kailakuri and will work there for 2.5 months. Libby has volunteered two months of her time almost every year for the past ten years and has been instrumental in establishing the village mother-child health care programme. This programme has proved to be very beneficial. Babies lives are saved and Mothers are raising healthier children.
Edric says that it is very noticeable that after three years of the programme working in a village that the number of outpatients coming to the Centre for treatment drops off significantly. This is because simple messages of better nutrition and hygiene have been learned and applied by the villagers.
New Zealand Cricket Team Honours Edric Baker
While in New Zealand, Edric met with the Executive Committee to the NZ-Bangladesh Friendship Society which provides services to the Bangladesh community in NZ.
They were very interested to learn that Edric had lived so long in Bangladesh and what he has achieved in service for the poor. They pointed out that the NZ Cricket Team (he Black Caps) would soon be visiting and playing in Bangladesh and suggested that contact be made. The result of this is was that on the evening of 19th October, the team Captain, Daniel Vettori, honoured Edric in a ceremony in Dhaka by asking him to present test caps to each of the NZ players selected to pay in the second test match. The team presented Edric with BGD Taka20,000 and seven Black caps shirts. |