In order to mark the tenth anniversary of 9/11, “The Stories We Tell” has shifted its focus to examining the way in which the event has been remembered in the decade since. Check back throughout the week for features on the way narratives on the event have been shaped, both at home and abroad.
I’m a strong believer in the power of sleep and ibuprofen. Headache? Head to bed early and pop a couple pills. Back pain? Same deal. Fever? Again, early night and two tablets.
But after my latest fever stint hadn’t disappeared after five days of first rearing its ill-timed head – Eid break, with lots of work on the to-do list – every nurse I had called back home had switched from that rest-and-ibuprofen tune to one of getting myself to a doc, pronto.
And after a slew of tests and a few days of waiting, back came a positive typhoid test and a doctor’s order to be admitted to the hospital – immediately – for a hefty dose of intravenously-administered antibiotics.
Typhoid. One of the many vaccines I had gotten sometime in the past few years, part of the laughably long list for which the Resident Nurse at Somerville’s Harvard Vanguard had called me a pin cushion. And one that is – take note travelers – only 50 to 80 percent effective. Meaning not very. And especially not during South Asia’s monsoon season, when the prevalence of diseases like dengue and malaria and hepatitis and, you guessed it, typhoid tend to spike.
So after nearly two weeks of trying to navigate this whole sick abroad thing, here’s a few notes that I’ve collected on the experience thus far, for any expats or long-term travelers or others who might just be interested in knowing what negotiating healthcare abroad is like.
A quick disclaimer – I am not a professional or expert on any of these things (you knew that!), and these are just a few of my own personal recommendations, things I would have found helpful in knowing a couple weeks ago. Hope you find them to be so, too.
1. Have a medically-knowledgable someone you can call back home. Whether it’s your general practitioner, or your lovely aunt who happens to be the world’s best nurse (thanks, Auntie Mariann!), having someone who knows more about health and sickness than you do is not just reassuring, but can be downright vital in deciding what’s the best course of action to take. Plus, it just makes you feel better knowing there’s someone on the other side of the line.
2. Go into the doctor sooner rather than later. Yes, it’s a pain, especially if there’s traffic and it’s inefficient and takes all day. But having test done and results analyzed will (likely, hopefully) make for a faster diagnosis and less stress for you and all interested parties. Maybe it’s nothing! But maybe it’s not. And for some illnesses, timing really is everything, and the sooner you can catch it the better.
3. Don’t just go to any doctor. If you’re really sick, it’s worth calling your health care provider from home (or a family member’s, or a friend’s if you’ve given yours up) and seeing if they can refer you to someone in their international network, if they have one. Otherwise, do some research online or ask around locally before making an appointment with someone. Not all doctors are created equal, and the right doc can mean the difference between a real diagnosis and an order to just go home and sleep it off. Which in some cases, you can’t.
4. Come with a copy of what your ‘normal’ blood results are, if possible. Good for comparison’s sake, as not all reference ranges (the ‘normal values’ you should fall within on diagnostic tests) are the same for all people all the time. A lot of healthcare providers now have online centers at which you can create an account and track your health history; check and see if yours does, and if they do, set yours up and get tests and vaccine information from as far back as possible uploaded.
5. Get international health insurance. Just do it. If you’re abroad in a disease-prone place for long enough, there’s a pretty good chance that you’re going to get sick, and it’s probably going to pay for itself in the end. So. Just do it.
6. If you have a bacterial infection, have a test done to see which drugs it is susceptible to. I think it’s called a ‘panel’, and it’s important in determining what treatment you need. For example, the South Asian strain of typhoid is resistant to Ciproflaxin (known to most as cipro), the antibiotic of choice prescribed by most doctors back in the US for most all bacteria-related travel ails. Which means it just wouldn’t work on the strain of the disease here, and so you need a different drug. Most doctors will automatically test for drug susceptibility when they do your bacterial culture, but it’s worth asking for it just to be sure.
Which brings us to…
7. Ask questions. And don’t feel dumb or embarrassed for doing so. For me personally, just being informed makes me feel better, and most doctors will be quite understanding – and even amused – at the string of questions fired off by a wide-eyed foreigner. They know you’re far from home, they know you’re not used to this, and most likely they know the answer to what you’re wondering about.
And that’s all I can think of for now. There is far more advice to give, and much of this many would consider excessive, but again, a few extra queries and a bit more info can’t hurt, ya?
Time in the hospital has put me in the market for entertainment – music or emails or blogs or articles or whathaveyou – so if you have anything good, or have been feeling like writing an email, feel free to send it over my way. And thanks to everyone who has been checking in from so many miles away, it absolutely brightens days in Room 2435.
I recently started something of a photo mini-series called “On the Street,” which involves setting up a makeshift studio – or, three pieces of white paper taped to a wall – on the side of some road with nice light, and taking portraits of whoever passes by and will let me. Thus far I’ve done this little experiment in Dhanmondi, Dhaka at the end of my road, in Sylhet City (far northeast Bangladesh), and in Comilla (about four hours east of Dhaka). Each time has been an interesting process – of watching people react, first uncertainly, then excitedly, to the prospect of having their portrait made; of seeing which individuals become the unofficial ‘helpers,’ of taking it upon themselves to wrangle new subjects and make sure that they provide the right information (name, age) afterward; of noting patterns that emerge, seeing who steps forward in the first place, who chooses to look – or not look – my way.
While this process is slightly complicated by my lack of fluency in Bangla, and by my being a female photographer, it is otherwise pretty much the most ideal environment and set up for this sort of project. Overcast monsoon days make for perfectly even light – no artificial light used in any of these shoots – and roads that are always jam packed with people. Most Bangladeshis that I’ve come across during my time here have wanted their photo taken if I’ve had my camera out, have often not let me pass until I do, so it’s no surprise that so many people willingly step up to the little white backdrop. Doing this in New York, or Paris, or Lagos, or anywhere else would yield all sorts of other challenges (and advantages, certainly – more women willing to be photographed, for example), but that is exactly what’s making this interesting. Seeing how this process unfolds, how the street sessions become little parties in and of themselves. They’re a great way to mobilize a crowd, if you should ever need one. Just fyi.
Still working on the edits and getting the photos online, but will post them here as soon as possible!
Then just check out Shea Hembrey‘s TED talk. Playing make believe at its best.
Upon telling people that I was moving to Dhaka, many replied that I couldn’t have chosen a place less like home. In some ways, they were right; saying that it’s been a cultural adjustment would be putting it lightly. Yet at the same time, this city has revealed itself to share many characteristics with something that I found quite familiar.
Namely, Jewish grandmothers.
While imaging a hoard of windbreaker-clad eighty-somethings hurtling their way down a Dhakan alley leads more to images of dissonance than of harmony, over the course of my ten months here I’ve found many areas of overlap. So here are the top ten – in some sort of order – ways in which Bangladesh is like a Jewish Grandmother.
Top 10 Ways in Which Bangladesh is Like a Jewish Grandmother
10. She never drives within the lanes. While one might be doing it because of reduced eyesight and/or depth perception and the other because traffic laws hold no sway, both lead to the same white knuckles on dashboards. Basically, Dhakan traffic is like that of West Palm Beach if it had a population of 17 million and a much less well manicured road network. Oy is right.
9. She’ll talk about what’s for dinner while you’re eating lunch. More for the love of food than for the necessity of planning what’s next, meals are a hallowed time not to be taken lightly. And that’s meant in an emotional and nutritional sense. Luckily, the brick-like feeling in your stomach after the meal is generally justified by the deliciousness of what just caused it.
8. You’re wearing that!? Anything too low, or too short, or too tight will likely draw a few choice words or looks designed to dissuade you from walking out the door in your ensemble of choice. Looking for something more fitting? Try something a little less so.
7. She will talk you off your rocker. Here it’s called adda, there it’s called playing mahjongg at the club with the girls. Both roughly translate to an hours-long chat about anything and everything. Cha (tea) and shinghara accompany the former while coffee and rugulah might go along with the latter, but – as is generally the case – food plays a starring role in each.
6. She has an opinion on everything. And will not hesitate to make it known, often more loudly and more frequently than you’d prefer. From commenting on how you’re still not married yet to letting you know just how under-rested you look, she’ll be sure to fill you in on what’s filling her thoughts. Smiles and nods, kids.
5. She likes her clothes shiny and bright. From magenta tops with sequined necklines to shoes that glint in the sun with silver and gold accents, she’s bound to have something shiny and blingy somewhere in her outfit. Well, probably in many places.
4. She constantly warns you about potential impending sicknesses. While antibacterial handwash hasn’t made it big in D-town yet, worries about maladies certainly have. Changing seasons loom large on both collective minds, and warnings about taking a jacket along to protect you against the vicious changing seasons translates well between Bangla and Bubby. And if you do happen to catch the sniffles? For whatever’s ailing you she’ll always have a fix, whether it be chicken noodle soup or frying garlic in sesame oil and then rubbing it all over your chest (bonus points if you can match those remedies to their respective owners).
3. She has a penchant for tacky decoration. I’m just going to say: there are entire markets dedicated to fake flowers here. Imagine the look on the Hadassah gals’ faces.
2. She won’t stop feeding you. If you sit down at her table, don’t even bother declining the plate of afternoon sweets she offers; it’ll be in front of you in 30 seconds no matter what you say. You’re completely stuffed from the meal you just finished 30 minutes ago? Well surely you have some room for this large bowl of fruit and some of that brisket in the fridge. The words not and hungry are simply not available in the same option together. Kapiche?
And the number one reason?
1. She loves her family. If you couldn’t figure as much from the plethora of photos of relatives adorning her home, then it will be immediately evident as soon as she starts chatting you up. The conversation, no matter where it starts, will most likely turn to her kin – often even beating out foodspeak – and she’ll beam with pride as she tells you where her grandkid goes to school or shows you a picture of her doctor son. And most importantly, she’ll treat you like family, too, whether you share her DNA or not. The bear hugs and hospitality extend well beyond blood relations, and she’ll be more than happy to welcome you into her larger clan. As long as you eat this plate of sweets first.
So the next time G-Ma calls and tells you about her plans with the gals for the weekend, be sure to let her know she has roughly 160 million potential friends in what she might consider to be the least likely of places. Miss you, Grandma!
After the rave reviews that came in for my Mom’s debut blogging endeavor, Daughter in Dhaka (Mama, finish uploading your posts!), I knew that she would be leaving a travel-account sized hole in far too many people’s RSS feeds. Well, you’ve waited long enough; now introducing Big World, Tiny Backpack, the escapades of one Miss Becca, who’s currently on her way to meander across S/SE Asia and collect elephant sighting along her way.
Her destination list is long and her backpack small, and she’s one of the swellest gals I know and definitely worth a bookmark. You’re gonna wanna know when that elephant sightings counter ticks.
On a flight heading the other way around the world only a few days prior was Miss Laura Curren, one of Paris’ newest and most fabulous residents. Google Maps tells me it’s a mere 11,523 km away from Dhaka town, and only requires one ferry (in addition to all the winding roads, of course).
I spent weeks planning. Looking at maps, considering which route would be most efficient to take, which sites were most important to visit, which contacts were in the selected areas. It was to be my longest-running out-of-Dhaka research excursion yet, and I wanted to make sure that I tried to spend the time wisely.
And then BNP called for a two-day long hartal, and my carefully planned route flew out the window.
Hartal is the term used to describe a general strike in Bangladesh, in which most everything closes down for a day (or in this case, two). Think politically-charged snow day. Most Bangladeshis tell you to keep off the streets, and certainly out of cars (they have a thing for torching larger vehicles here), but walking and taking cycle rickshaws are generally an okay way to get around, depending on the area you’re in and the strength of the protests. The strikes are always called by one of the opposition parties, or a combination of them, to make a point about some grievance they’re most recently upset about. For example, a few weeks ago, a coalition of opposition parties called for a strike against women’s rights. That is, to protest the renewal of the 1997 Women Development Policy that would legalize women’s rights, including women’s rights to own property. Thankfully, that one wasn’t widely “observed,” as it is said, at least not in Dhaka city. There was one about a week ago to protest the abolition of the caretaker government system, in which an interim government takes control of the country for what is to be a three months period to administer elections. This time, the protests were called to protest the last protest (right?), or the arrests that were made prior to and during them.
There is no doubt that each party has its own grievances, especially when it comes to their relations with the other, but the tradition ofhartals (or agitational politics, as it’s known in Poli Sci speak) is not only pretty frustrating to anyone trying to get anything done, but also deeply costly. Between 1995 and 2002, there were 611 hartals, an average of one every four days. And in the year prior to when the caretaker government had to assume power in 2006, they were a near every other day occurrence. In 2001, UNDP calculated that for each ‘successful’ hartal, the country loses close to $18 million dollars – and that’s a long obsolete number, calculated using economic figures from the 1990s.[i] To consider the cost to Bangladesh at its current (significantly increased) rate of productivity would be far more significant.
The hartals are also, oddly enough, fairly predictable. The political terms here are five years long; for the first 2 to 2.5 years, things are relatively calm, but as you approach that 2.5 year mark, the opposition party starts to make waves in the hope that they can a) create enough chaos that the general populace will naturally want the ruling party out by election time, b) create enough chaos that they will be able to (more) legitimately call for early elections, or c) unseat the government.
In a country fond of national traditions, the hartal is one that is as old as Bangladesh is. But in terms of efficient and productive political dissent, hartals do little more than disrupt the workweek and give whoever is the current ruling party the mandate to use them when it becomes their turn to be the scrappy opposition. It’s zero-sum politics through and through. As Akhtar Hossain writes in his “Anatomy of Hartal Politics in Bangladesh,” “These parties fail to cooperate not only because they underestimate each other’s political strength but also because each has an urge to establish a monopolistic rule by knocking out the other, believing that the losing party would simply fade away.”[ii]
So while the political parties at be duke it out, I’m using the forced vacation to catch up on some writing and file away what we’ve done thus far on the trip (ironically, much of which has to do with why exactly these big kids continue to vie for these positions of power in the way that they do). And to eat mangoes. So many mangoes. We’re currently in Bogra, which is in Rajshahi division, the mango capital of Bangladesh. So, while it may be guesthouse arrest, at least the rations are quite tasty.
[i] The Daily Star Staff Correspondent. “Hartal eats up 3-4pc of GDP.” The Daily Star, 11 March 2005. http://www.thedailystar.net/2005/03/11/d5031101011.htm (accessed 12 June 2011).
[ii] Hossain, Akhtar. “Anatomy of Hartal Politics in Bangladesh.” Asian Survery 40:3 (May – June 2000): 521.