A Matlab Odyssey

by Jean Sack

A famous poem proclaims that a journey itself is the essence of life, not just the intended destination. This is certainly true of the trip to Matlab, south of Dhaka. Matlab is world famous for its public health community intervention sites begun over 40 years ago by the Cholera Research Lab, known as ICDDR,B since 1978.

The trip begins from ICDDR,B in Mohakhali, where researchers and Swiss Embassy guests board project vans for fascinating conversations about low-birth weight, arsenic studies, child health studies and social changes in family planning. Early morning traffic jams are rare and the air feels fresher after the first massive bridge. Soon, we reach the mighty Meghna River.

Awaiting us there are ICDDR,B speedboats, pulled up on the riverbank, with little boys eager to load the medical supplies and backpacks of passengers. In the speedboats we race across the wakes of passing double-decker ferries and avoid the floating soda bottles marking fishing nets, looking for the roll or jump of fresh water dolphins and admiring the occasional sailboat.

Most river traffic these days is heavy-loaded wooden boats full of sand, bricks, bamboo, pumpkins, or freshly harvested potatoes and driven by spewing outboard engines. Towering smoke stacks of brick factories dot the shores between the palm tree clusters of villages perched on eroding banks. Conferences of cormorants perch on the dip nets and fishing bamboo enclosures. Egrets stalk the shores and Brahminy kites soar overhead while flocks of ducks cling closer to the edges.

We stop at a river town with clusters of sawmills, gawking passengers, and pit latrine manufacturers hovering on a Meghna tributary. School children try to keep our Bideshi pace as we march to the ICDDR,B health subcentre.

At the clinic we visit with Shilpi Lipi, a 33-year-old mother of a newborn girl. Safely delivered just a few hours before by a young Bangladeshi female doctor and Shilpi’s mother, I record the valiant team of four women with my digital camera. Considered impossibly old for her first child, the mother radiantly breastfeeds her hungry infant. I meet six other young mothers who are part of the low-birth weight study and are waiting for their first echosonagram (observing fetal growth during 9 months gestation).

This first trimester prenatal checkup will include blood tests for anemia, weighing, counseling and at least one of several randomized interventions with micronutrient supplements. The Naorgaon subcentre is now performing many more safe deliveries and sending complications to the Thana hospital in Matlab, via an emergency speedboat service provided by ICDDR,B. Previously, this area was like most of Bangladesh with few women seeking prenatal care and 95% of deliveries done in the home by traditional birth attendants.

Maternal mortality remains high in this country. ICDDR,B closely monitors changes as the family size reaches three births per woman. Children are surviving childhood thanks to the immunizations, diarrheal disease care and better information about safe water. We also visit the children’s clinic and the men’s reproductive health care in this subcentre.

Our adventures are not over. We board the speedboats again and continue down the rivers past fishermen and birds and boats to the port of Matlab. At the ICDDR,B hospital I meet four other newborns. One home-delivered, three-day old baby was not yet able to suckle. His village mother traveled to the hospital for help and receives enthusiastic, careful breastfeeding counseling right away – positioning the infant, expressing milk, stroking cheek, waking to feed more.

Another tiny child is fed mother’s milk by an eyedropper. Less than two pounds and developmentally challenged, he is bound for heaven soon, I fear, but hope was in that room. A sadder meeting was the young mother who had experienced the stillbirth of a seven-month fetus. Again, comforting by the staff was a phenomena not witnessed in other facilities in this country.

I go to the computer room where data is recorded on maternity, demographic surveillance of life events and health status, and vaccine and nutrition studies. Researchers around the world use Matlab data in studies.

Walking by the palm-lined pond to lunch, I stop by the old Matlab barge. We hope to transform it into a developing country health museum as part of the 40th year celebration of CRL/ICDDR,B in Matlab. The new Japanese-funded Training Centre hosts groups from around the world in its 12 bedrooms, two meeting areas and computer rooms. We have lunch before we board speedboats for the trip back to Dhaka.

A rainstorm pelts our blue ponchos on the one-hour river trip to the vans. On the journey back to Dhaka, we brainstorm the next ICDDR,B hospital fundraising art show to include a string concert group in November.

The beautiful voyage to Matlab and the “pleasure, and joy entering ports seen for the first time” was a worthy odyssey indeed.