What Am I Doing in Bangladesh?

As part of my Master's internship for Public Health, I'll be spending 6 months in Bangladesh, exploring local conceptions of malaria during pregnancy. This means that I'll be interviewing pregnant women and their families as to where they think malaria comes from, how you can prevent it, how you can treat it, and if there are any extra problems that arise if the patient is pregnant. 

My field work will take place in Bandarban, which is a district in the Chittagong Hill Tracts, on the SE nub of Bangladesh, bordering with Burma. The area is comprised of 13 tribal groups and, recently, and increase in the number of Bengalis. At the split of Bangladesh from Pakistan, this area wanted to stay with Pakistan, which created issues for a while. In 1997, the area reached a peace accord and so just recently has there been political stability and the development of health services. Apparently, the militants who have been there for the last 10 years will just start to move out in the next couple of months. So that should be exciting to witness. 

The area in which I am working has an average age of marriage of 14 and an average age of birth birth just under 16. The new health advisor of Bangladesh has taken maternal mortality as something the government should be investing resources in. Unfortunately, the girls do not use the antenatal care services that are in place, nor the emergency obstetric facilities that are equipped to do C-sections and blood transfusions, in case of emergency during birth. An additional part of my work will be to determine why these young girls are not using ANC, where they are going for advice, and if the system could be changed to accommodate their needs.

The project I am working on is a collaboration between an NGO in Bangladesh called ICDDR, B and the Hopkins Malaria Research Institute. Over the course of the next three years, the group is going to take blood samples and interview over 9,000 people in the area to determine the epidemiology of the different parasites that cause malaria and the parasitic prevalence in the general population. Bangladesh has the highest number of people at risk for malaria in the world, just because of the shear number of people who live in the country (it is the most densely populated country in the world), although the rates of infection are apparently higher in Africa. However, there has never been any active surveillance done before on malaria in Bangladesh, so this project should be super exciting and should outline what the disease burden is for future projects. 

Unfortunately, I don't speak any Bangla, but I'm learning slowly already. My supervisor here though is Bengali and says that he cannot communicate with the tribal people we will be interviewing, so I wont be able to do the interviews, no matter how much Bangla I learn over the next six months. Hopefully I will learn enough to integrate myself into the community, even if I can't use it for fieldwork!

The project hasn't actually started yet, so I'm sure there will be a lot of kinks to work out, but the program has tried to get as many local people to work on the project as possible, which is nice and I'm really excited to get started!