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TANGENTS

Unsung Heroes

BY IHTISHAM KABIR
In the midst of the constant barrage of news about bad people doing bad things in this country, it is easy to forget about the dedicated people here doing good work. This is the story of one such effort.
In the paediatric Intensive Care Unit at the Dhaka's Shishu (Children's) Hospital, the first such unit established in the country, a team of doctors saves the lives of seriously ill children who would otherwise have no hope. They have been doing this every day for twenty years.
The ICU was established in 1992 with Japanese assistance. It started with eight beds and now has twelve. It provides monitoring, ventilation, and other life-saving services for children who are in serious trouble due to premature birth, pneumonia, encephalitis, birth asphyxia, meningitis and other diseases. Approximately forty five children arrive through its doors every month. Most are saved. The unit is served by six to eight doctors and a dozen nurses.
I met up with Dr. Abdul Qader who has worked here since 1993. "What changes have you seen in twenty years?” I ask.
"Back then, most parents had no notion of children's intensive-care. Treatment at the ward was the last resort. But now parents know that if the child is too critical to be in the ward, they can be sent here. Over the years, our doctors have also become skilled and confident about ICU treatment. Thus, many childrens' lives are saved."
Indeed, Bangladesh recently won a UN award for dramatic reduction in child mortality.
Inside the ICU, I meet two doctors, Fahmida Islam and Afrin Jahan, who
work here on an honorary basis to gain experience. In addition to the senior doctors who work here full-time, 25-30 younger doctors do shorter stints every year for exposure in children's ICU treatment.
Afrin and Fahmida point me to a bed which I had not noticed before, and when I look closely, I catch my breath, for inside the incubator is the tiniest human I have ever seen, perhaps a foot long. He weighs 820 grams. Here he will get all the support and nourishment to grow and, hopefully, survive in the world.
I ask Qader how patients are admitted.
“They are referred. There are two groups: those already in the hospital, and those who are referred from outside. Since most patients are neonatal, we require mothers to stay in the hospital,” he says. The ICU costs Taka 2500 per day; if the stay exceeds seven days, needy families can apply for free treatment.
For operating costs, the hospital relies on its own earnings, government subsidies, and donations from foreign and local sources.
Since demand for the ICU is high, I ask about future expansion. “It would be good to add more beds, but that is complex because you must furnish the entire support system around each bed. You start with space - each bed requires eight square feet of floor space - and add expensive equipment for each bed. You must add the skilled doctors, nurses and support personnel,” says Qader.
I left filled with hope and convinced that the good work of this institution is worthy of our sustained support.
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