Sunday, July 5, 2015

Sunamganj in Numbers

Surabhi Rajaram

Today I started my last week in Sunamganj.  It is hard to believe that my two months in the field have passed. These are some stats from my time here. Some of these are of equivalent estimation accuracy to the assumptions in my financial model.

7 sub-districts traversed. The health delivery system has a service area of 10 out of 11 sub-districts of Sunamganj. I travelled extensively through the 7 that were yet accessible this season

Lessons: You must live in the field to learn the field. Be relentless.
The field
6 modes of transportation utilized. Boat, foot, pickup truck, auto rickshaw, motorcycle, cycle rickshaw. These are ordered from least painful to most.

Lessons: There is no place worth getting to without hard work. Transit time is observation time. Quicksand(mud) is real.

If the boat doesn't come to you, you go to the boat
80 stakeholder interviews conducted. These past two months have been filled with nonstop research to learn everything and anything about this system and inform recommendations towards sustainability. I have spoken to skilled birth attendants, mothers, family members, community health workers, drug shop owners, traditional birth attendants, village doctors, government officials, community leaders, transporters, suppliers, field team staff, franchisors, nonprofits, the list goes on.

Lessons: Primary sources are the best sources. Just listen. You cannot refuse tea no matter how many cups you have had.

30 ORS packets consumed. Oral rehydration system (ORS) is a soluble electrolyte powder to prevent dehydration, which is crucial in this heat. The feelings I had buying my first ORS-Saline for 5 Taka will probably rival that of purchasing my first car.  I get a smile on my face when I see those orange packets sitting in a small shop in a most remote village of the most remote Sunamganj. You see, it took many strategic years for this life-saving commodity to be universally accessible and affordable. The BRAC-SMC ORS scale-up in Bangladesh was my hook into the health delivery niche and will always be one of my favorite stories. I also get really excited seeing the SMC Blue Star and Smiling Sun franchise clinics.

Lessons: Health access is possible here. I am in the right field. The taste of ORS is not exciting.
SMC Blue Star clinic
0 tomatoes spotted. My mind has fixated on wanting to see one glorious red tomato. For all the water, Sunamganj is a food desert. The wetlands are only conducive to growing rice and breeding fish. Vegetables and fruit are few and expensive. As a vegetarian this means being content with the same meal three times per day. For many of the poor and extreme poor quintiles though, this can mean high rates of malnutrition and  long-term health consequences. The government provides free vitamin supplements for mothers and children to attempt to aid this crisis, but there is still a long way to go.

Lessons: Gratefulness for food. Happiness in little things, like a tomato.

Fishing contraption
50 mosquito bites received. The mosquitos here are as welcoming as the people. I received many greetings, my favorite of which were on my eyelid and pinky toe. And although this is mosquito paradise, the rates of malaria in Sunamganj are very low due to a highly effective malaria control program. Insecticide-treated bed nets are widely distributed through public health, nonprofit, and private sectors. Residents are quite resistant to getting bitten – many kids had good laughs at my itching as they pushed the burning incense closer to me.

Lessons: Prevention is the best. Children laughing sound the same everywhere. Incense does not really work.

Insecticide-treated net
Unquantifiable: What I have gained from the devoted people of Sunamganj. The love I have for the CARE family that made me their own. The number of tears shed, laughs laughed, and thought boundaries crossed.
Some of the best

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