Life in the Haor

Surabhi Rajaram

For two weeks now I have been field-based in Sunamganj, where the CARE-GSK Community Health Worker Initiative operates. This is a remote district in the northeast and about a seven-hour bus ride from Dhaka. It has the highest maternal and infant mortality rates in the country, with only 25% of births attended by a skilled provider. I will be here for the next couple months to carry out my project.

Here is a small collection of thoughts from the past couple weeks.

On air.

My take on the Haystacks

It has been a smooth re-entry into the familiar airs of my beautiful subcontinent. Although remote, there is a purity here that is lost in the city. The air is fresh so I am breathing deeper but holding my breath through the fish market.

Singing and working

I have made all necessary adjustments to take care of myself. I have arranged for vegetarian meals of rice with vegetables. I set up a clothesline to air my clothes. I have sprayed everything with mosquito repellent. My WDI flashlight stays by my bed for frequent load shedding.

No complaints to air.

On water.

Cattle herding

Sunamganj is a haor area, meaning wetlands. Water flows down from the Meghalaya hills to fill this region. There are low-lying bodies of water everywhere, dividing the land into millions of island-like portions. Traveling often includes a boat.

The monsoon season will hit soon. Although I am no stranger to this, I am bracing myself for the especially powerful rains that will submerge most of the region. I recall my interview in which I was asked, “Can you swim?” Hopefully this will not be necessary.

Main mode of transport

Although crucial to the fishing and farming lifestyle, the water presents a unique challenge of isolation. In Sunamganj, access to health services and communication is sparse, resulting in devastating health consequences. I have heard stories of women in labor being carried in fishnets and by boat just to receive untimely help.

It is heartache to see this. I will have to do lots of thinking on how to make peace with the water.

On fieldwork.

Stomping the rice

This is the harvest season. Farmers are busy all day in the fields collecting their precious crops before the monsoon rains wash it away. They are the hardest workers for a most foundational output, sustenance. So much is put towards even grains of rice, as they are stomped, sifted, husked, and bagged. I am eating more consciously as I see this work around me. I am also aspiring to their work ethic.

Demoing scale for birthweight

My “fieldwork” has begun too. I have developed a survey to assess threats to service delivery in the current P-CSBA system and completed the pretest. I have observed performance reviews, skill labs, and ANCs. I have listened to P-CSBAs, Program Officers, Field Trainers, mothers, and local government members. I have traveled by car, boat, CNG, cycle rickshaw, and foot. My understanding grows daily as I learn the nuances of health delivery here.

Looking forward to posting an update after surveying! I will have seen more of this region and met some great people by then.