A Day in the Life

This is a typical day of operations research in the field, conducting Private-Community Skilled Birth Attendant (P-CSBA) interviews.

I quickly finish my aloo (potato) and roti (bread), carb-loading for the day ahead. My backpack is stocked with three water bottles (one containing coconut water for electrolytes), a protein bar, a voice recorder, a camera, a notebook, and rain gear. I sling my backpack on and hop into the heavy duty CARE pickup truck. We swing by the office to pick up a colleague and our planning for the day begins.

This is why we have a pickup truck

It is essential to optimize our time so that we can reach our target of 5 PCSBAs, dispersed throughout the sub-district. Our strategy is dependent on location and mode of transport – we will reach the farthest first and work our way back to the roadways, with consideration to limit travel by foot.

We stop to pick up our traditional field meal of bhalo (good) quality bread and bananas. I am told the bread counters the acidity of the bananas so you don’t throw up. The next couple hours are spent on the road, passing by paddies and paddies, everywhere green and watery. Finally, we arrive in the main marketplace.

We tread carefully towards the dock. I always find it is best to look down while walking to avoid stepping in the cow dung. The boat ride takes us gently along the still haor (wetland) waters to our destination. A P-CSBA is smiling and waiting to lead us to her home. We go the extra mile (well, kilometer) to her home so that we can deepen our understanding of the service area. We follow in her expert footsteps for a couple kilometers until we reach. The structure is quite modest with tin and bamboo-fortified walls and roof.

Typical home

She encourages us with “aashen, aashen” (come, come) and we take our seats. We introduce ourselves and as soon as I speak English, she looks surprised and asks “She is not Bangladeshi?” My colleague is always excited by this comment and replies, “No, but you cannot tell the difference!”

We then begin to administer the questionnaire. This is a very focused time for me as the message goes from English on paper to Hindi and hand gestures in my speech to Bengali in translation, and back again. Bengali and Hindi are sister languages, which has facilitated my communication here.

We listen and revelations come! We understand her challenges in moving over this tough terrain, in working while pregnant, in engaging with the community, in competing with Traditional Birth Attendants, in gaining her husband’s support.

We are humbled by her motivations behind this work. Her first child was lost in pregnancy complications, as no skilled workers were present at the clinic – she says this cannot happen to another mother. Her husband passed away and she has no sons, but she is working to pay for the education of her five daughters, her “best assets.” Her husband divorced her and she must raise her three children alone. She battles depression but doing this work helps her cope.

On the ride back I am full of thoughts, ruminating on the new lessons of the day. Health delivery here is a high stakes game on a rough playing field. The sun has set.

The heat is exhausting so I collapse on the bed under the fan.

WDI on a boat!