Bangladesh: Dhaka

The airport departures screen tells me I have just an hour before I begin my 30- hour journey home.

It has been an amazing, exhausting, inspiring week here in Bangladesh.

We traveled far and wide, north and south, from big cities to rural villages, in speed boats, seaplanes, vans, cars, and rickshaws. We came all this way to see how our programs are making a difference in one of the poorest countries in the world.

Our visit began with a 10-year-old girl and a teddy bear. It is 6:00am. We are up early on our first day on the streets of Dhaka, the capital of Bangladesh steps from our hotel and we come across this little girl, all alone, sleeping on the street clutching a dirty teddy bear.

Bangladesh is the 8^th largest country in the world with 170 million people and 700 rivers. One third of it is underwater.

This is one of the most densely populated countries in the world. Imagine if you took half the population of America and put them all in Iowa. New York City has 27,000 people per square mile. Dhaka has 115,000. It is the 14th most dangerous country in the world.

Officially, the income per capita in Bangladesh is $1,400 a year. (U.S. income per capita is $57,000/year.) But the children and families that we help are much poorer than this.

Bangladesh has more children suffering from malnutrition than any other country. 60% of children under 5 suffer from stunted growth. The literacy rate is just 65%.

We saw laborers that make less than a dollar a day.

Families that live on less than that. People living on the street, in tents, sleeping on sidewalks.

And children scavenging through trash and sewage rummaging for food.

Afterwards, we visit the Ispahani Eye Institute & Hospital. They’re the oldest and largest eye hospital in Bangladesh and one of our very best partners. We’ve been working with them since 2012.

Together, in Bangladesh alone, we’ve helped restore the eyesight of more than 10,000 blind children and adults. Ispahani’s mission is to restore the eyesight of 100 blind children and adults every day and our goal is to help them achieve that.

Their main goal is the same as ours: help the poorest of the poor get access to surgery they never would be able to afford otherwise.

Afterwards we go to the biggest burn ward in the country. It’s in a government teaching hospital, but it looks like a prison.

When we get to the burn ward, it’s a nightmare – overflowing with patients. They have 300 beds – but more than 500 patients. All the hallways are overflowing with beds.

We go bed to bed with a surgeon and hear one heart-breaking story after another. A female factory worker was cleaning a large tank when someone lit a match, causing a huge explosion. Many of her co-workers died. She is alive but 50% of her body is covered with 2^nd and 3^rd degree burns. Her prognosis is grim.

We meet a boy who was electrocuted when he touched a power line. His left arm had to be amputated. He will live, but surviving in a developing country with one arm is not easy.

We meet a woman whose cheap cook stove exploded while she was making dinner for her 5 children. She is covered in bandages like a mummy. And she’s 7 months pregnant. Her mother sits on the end of her bed and cries.

Onward we go.

Learning all the ways someone can become severely burned. Scald burns: caused by children falling into or tipping over pots of boiling water or tea.

Flame burns: caused by open fires used for cooking and heating, tipped over kerosene lamps used for lighting.

Acid burns: caused by spurned lovers, insane relatives or enemies.

Self-immolation burns: suicide and depression are big problems in developing countries.

We leave the burn ward tour thoroughly depressed, horrified and helpless. The life-changing burn surgery we provide is for the survivors of severe burns. But less than half the patients we meet will survive.

We visited a lot of slums and poor neighborhoods to see where and how our patients and their families live.

We walk along a railroad track where thousands of people live in squalor and wretched conditions. Inches from the tracks are tents, shacks, hovels surrounded by rotting garbage and sewage.

Suddenly we jump out of the way as a train comes barreling through at 40 miles an hour.

Dozens of children are riding on top of the train which ploys through a neighborhood with many young children wandering around.

We wonder how many are killed by trains every year.

We come across a 7-year-old girl selling her wares right in the middle of the tracks.

Over the past 20 years I’ve visited many of the biggest and poorest slums in the world in India, Gaza, Haiti, Brazil and all over Africa.

The slums of Bangladesh are as bad as any I have ever seen.

As the sun sets, we end up in Korail slum, the largest slum in all of Bangladesh.

To get there we have to ride on a small, makeshift raft about the size of a king size mattress across a polluted lagoon.

The conditions in this slum were just as horrible as the railroad tracks.

Families of 6, 8, and 10 crammed into tiny one room dwellings with dirt floors, walls made out of tin, plywood, aluminum, with no plumbing and very limited electricity.

Families get their water from communal water pumps. The toilets were dark and dingy closets with two planks surrounding holes in the ground. One toilet for every 1,000 people.

We soon had a large gang of enthusiastic, laughing and screaming children following us. They don’t see many tourists in Korail. They were friendly and welcoming. Hard to think of what kind of future lay ahead for these kids.

In each slum we came across, every one was working hard doing something – nobody was sitting around. Vendors were selling fish, vegetables, spices, shoes, you name it. Young kids were carrying tea to workers, loading carts, or herding goats. Men were tanning hides, recycling plastic, pounding steel.

It was clear that if you don’t work– you don’t eat.

There is so much water in Bangladesh, it is no surprise they have an amazing array of things that float. Floating schools, floating libraries, floating farms, and floating markets, just to name a few. This day, we were flying down river to a very remote location to visit a floating hospital.

It’s called the Jibon Tari and it’s operated by one of our longtime partners, Impact Bangladesh.

This boat brings medicine and miracles to rural, isolated villages that desperately need both.

The Jibon Tari truly is a “ship of life.” it provides life-saving surgeries for the blind, crippled, burned and disabled.It has a full-time staff of surgeons and nurses that live on the boat year-round and they’re supplemented by volunteer doctors that come and operate for short stints.

The most common surgery this ship provides is eyesight restoration for blind adults and children.

This represents 70% of the 2,500 surgeries provided annually. We met a bunch of blind patients who were waiting for surgery, as well as a large group of children receiving treatment for clubfoot.

Over lunch, we asked the Jibon Tari leadership team what their biggest challenges were. I was surprised to hear that one of them is that their microscope – crucial for eye surgery – is almost 20 years old. They are in desperate need of a new one, but don’t have the funds.

They told us some surgeons won’t come and volunteer anymore because of their “antique” microscope. A new one would cost $25,000.

Their total operating budget is around $500,000 a year so they don’t have a lot of money for capital investments.

It is amazing to think that with that budget they can provide 2,500 surgeries in the poorest, most remote areas of Bangladesh.

That’s $200 per surgery.

These same surgeries cost $5,000 – $10,000 each in the U.S.

When we get back home, we are going to figure out how to get them that microscope!

Next we visit a rural eye hospital managed by the same Ispahani Eye Institute we visited in Dhaka. Ispahani is pushing more of their programs out into rural areas where the need is the greatest.

Most villagers don’t even know that surgeries exist that could solve many of their largest health problems.

Even if they did, poor villagers living on a dollar a day can’t afford to travel to find a hospital in a big city. Plus, very few hospitals offer free surgery for the poor. There is no health insurance or Obamacare here.

The Bangladesh government spends just $26 per person a year on healthcare. The U.S. spends $10,000 per person.

We traveled a lot by boat up and down the river.

We visit an eye camp where hundreds of blind and visually impaired adults and children have come for help. We visit a brand new eye care outpatient clinic and a small eye hospital and surgicenter created in an old house.

Traveling by speed boat in this remote area is a surreal experience.

We pass hundreds of wooden fishing boats with men fishing the same way they have for hundreds if not thousands of years

We pass farmers plowing the earth with oxen and wooden plows – the same way they have for hundreds, if not thousands, of years.

It is almost as if our speed boat is a time machine, taking us back to biblical times as we pass these fishermen, farmers, mothers washing clothes with rocks in the river, children herding goats or doing chores, they all stared at us just as we stared at them as we flew by in our speedboat with our fancy iPhones and thousand dollar digital cameras.

I can only imagine what they thought of us.

The saddest sight we saw were many, many fishing boats that have now become homes because so many families recently lost their homes to flooding.

It was heartbreaking to watch these boats go by with children huddled inside.

You can see the little girl in red on this boat to the right.

At the eye camp, hundreds of blind and visually impaired adults and children are lined up. Some only need glasses. Many need surgery. Most had never been to a doctor before. None of them could ever afford the screening, never mind the surgery they desperately needed.

This 75-year-old maid was almost completely blind.

She was all alone, no family, no husband, no kids. She was terrified that she was going to be fired and starve to death.

She was trembling and fighting back tears when she told us her story. The doctor gently put his arm around her and promised her she was going to get her eyesight back and everything was going to be okay.

In many developing countries, a blind person is called “a mouth with no hands.” They can’t work or contribute — all they do is eat. For many, going blind in a developing country can be a death sentence. The WHO has reported that up to 60% of children die within a year of going blind.

While surgery can help the majority of blind kids and adults we meet, it’s a problem if a child waits too long.

We meet a girl who was born blind. Her mother didn’t notice she was blind until she was 3 years old. But now she is almost 9. We ask the mom why she waited four years to bring her for help. “I have no money,” she said looking down. The surgeon shakes his head and tells us it’s too late: this girl will be blind for life. You can see the mom’s reaction.

Can you imagine watching your daughter remain blind for life because you couldn’t afford a $300 surgery?

The eye camp was taking place at a school and all the kids flooded out of the classrooms when they spotted us.

They surrounded us with questions and requests for photos. I’m sure we were the first outsiders they had ever seen.

We shook a lot of hands and took a million photos.

This boy on the right was my favorite.

You can see his ribs showing.

Every child we met had stunted growth due to malnutrition.

But you would never know it by their laughter and big smiles.

I wanted to give him a hug but he was so tiny I was afraid I’d hurt him.

I am leaving tonight with great respect and admiration for the people of Bangladesh.

Against incredible adversity, extreme poverty and unrelenting hardship, they don’t complain, they don’t quit, they don’t feel sorry for themselves. Facing cyclones, famine, political corruption, religious riots and annual flooding, they always keep going.

They get up every day, they go to work and they try and make the best of the hand they have been dealt. I’ve never met so many selfless doctors and nurses who are as hard-working and dedicated to helping the poor.

This experience has reminded me of just how lucky I was to have been born in America, and all the opportunities I have been given.

Where would I be today if I had been born in a rural village in Bangladesh?And how lucky we all are to live in the richest country in the history of the world.

I want to leave you with another, happier story about a 10-year-old girl with a teddy bear.