Goodbye to All That

A beautiful piece by Joan Didion but in all honesty, there’s no good way to just wave goodbye to Bangladesh. Standing at baggage claim in Santiago, I half-hoped for the color and heat and craziness that would have awaited me outside in Dhaka. I still catch myself walking on the left side of hallways, though thank goodness I’ve stopped popping into acha and hehn instead of Spanish at inopportune moments. Without intending to, memories play over in my mind: I miss it all, every day.

“How was Bangladesh?” came the question again and again, over meals and coffee and office desks. And how was it? At once overwhelming, beautiful, touching, unjust, difficult, poverty-stricken, sweaty, frustrating, sparkling, fun, and unexpected. It’s impossible to capture it all in a few minutes and sometimes I do better than others. It’s hard to convey the impact of living in such absolute poverty, the rewards of connecting with the field staff, the humbling hospitality of the villagers, the frustrations and joys of working at DCH, and the amazing, amazing friends I’ve been lucky to meet. When I think Bangladesh, I will think of these wonderful people—and what great times we had! As David said though, “What do you mean goodbye dinner? This is a see-you-later dinner.”

It was a stark contrast to be back in the States after four months in Moghbazar. On the flight back to San Diego, I sat by this family of four. The little boy was watching some educational DVD (B for Bridge!) and the mom was trying to calm her younger daughter. “Honey, stop whining and sit still. Do you want Goldfish? Do you want a cookie?” I looked at those kids and couldn’t help but think of the little girl with the acid burn across her chest who begged in Gulshan 1 circle, the village children who ran around laughing and eating mango, but who will likely die in childbirth or from arsenic poisoning…these American children were so, so lucky, and they would probably never realize. I had become so numb after four months there. The poverty, the destitution, it doesn't affect you anymore because if you allow it to, in consumes you. But suddenly, in that airplane, all that numbness melted away and I just started crying—a little maudlin but that was how I arrived in San Diego. The kids who I lived around and worked with: most of them just didn’t have a chance. The world is a terribly unfair place.

You come back from Bangladesh with more of an understanding of the myriad headwinds to development in this kind of country—and also with a sense that we can never do enough. The day I left, 150 people died in a cyclone in the south of the country. Cyclones happen multiple times every year: any one step forward might be pushed three steps back by natural disasters, bureaucracy, corruption, change of personnel, drying of funds, anything. The neoliberal governmentality that exists there, with NGOs serving as a sort of quasi-government, doesn’t solve anything. I came to Bangladesh with many questions, and I left with more. Where do we go from here? Where do I go from here?

It’ll take other journeys, maybe back across to the other side of the world, maybe just to the other side of the Charles, to answer those questions. But to quote Mitch Albom again, “Every ending is a new beginning. We just don’t know it at the time.” And on that note, I will close this last Tale of Bangladesh. Thank you so much for reading.

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Dear Reader

This blog is about my experiences during four months in Bangladesh working on an arsenic mitigation project. It was—and is—intended for friends and family back home or on their own adventures in Africa, the Middle East, and other parts of the world. The opinions expressed are my own at that moment in time and like many things in Bangladesh, they sometimes changed drastically. Unless you know me very well, please take each entry with a grain of salt. The entries should be taken together, at the beginning, as a process.

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Eight to five

Well, those weren’t the exact hours and yes, I was well frustrated at first that I didn’t have enough work. As time went on though, I took more control of the project and guided it in the direction I thought best. And I appreciated the luxury of early mornings for the gym, of late drinks at the Nordic Club on a Wednesday night during finals period.

I came with the goals of 1) systemizing the process of data collection and management and 2) implementing a new daily low-dose chlorination protocol. I spent a good amount of time in the office and the field collecting existing data and trying to analyze it (“Impossible!” a statistician finally told me), then understanding the existing protocol of chlorination and testing. Not easy when you don’t speak the same language, and field staff are eager to tell you what you want to hear, not the truth. The old protocol was to chlorinate every month at very high levels that made the water taste terrible: not to mention the chlorine ceased to be active after 24 hours, and not surprisingly fecal coliform counts skyrocketed after two weeks. So kudos to us for having arsenic-free wells, but contaminated wells that could cause diarrhea, dysentery or worse, typhoid fever or cholera, were no better.

So, I created based on Dr. Wilson’s draft a new chlorination process that involves adding small amounts of household bleach to the wells every day. This new protocol came with a chain of command that effectively got information from the field, to Dhaka, to neat Excel files following templates I created, to Dr. Wilson at Harvard. I consulted with experts in the States, Dhaka, and a project in India to figure out chlorination levels and protocol design. We involved two new (four total) water quality tests to follow WHO guidelines. I searched for where to buy these reagents and kits in Bangladesh and in my bedroom made two turbidity tubes because they’re not sold in the country. I pounded out the logistics of numbers, ordering, prices, and how to get these tests to the field.

Next came the field trials. It was incredibly rewarding to teach the field staff how to do these water quality tests. They took a lot of care in doing the tests right and quickly learned how to take data in detail. I still remember being in St. Martin’s on vacation, getting texts at 5 pm every day that read along the lines of “WELLCOME TRACY TO THIS HOT DAY. TURBITY 5, DEPTH 39.7, CLORINE 0, AQUACHECK BLACK. HOW MUCH CLOTECH MIX WELL WATER?” I would instruct them to double the amount of chlorine, then double again, then double again the amount we originally started with. Still, there was no free chlorine residual or antimicrobial effect. This happened in three other wells in Pabna. After three weeks of trials, it was clear our daily low-dose chlorination wasn’t working. But why?
I started some email chains and phone conferences with a chlorination expert at the CDC in the States, and soon we learned why. It turns out that directly chlorinating dugwells is ineffective because 1) there is too much organic matter on the sides and bottom of the well: the chlorine clings to the organic matter and doesn’t stay in the water to disinfect and 2) there is a constant influx and outflow of water, which dilutes the chlorine you add.

Based on this information, we canceled the new protocol but kept the weekly field tests so the field staff and data manager could get used to measuring for and keeping good data. Now, thanks to a connection forged by the CDC expert and Harvard, we are receiving guidance and designs from Innovations for Poverty Action to build chlorine dispensers (see last entry). It will be an exciting pilot to run in Bangladesh and I feel certain it will be acceptable and effective for villagers, and that DCH is the right organization to present it. I just wish I could be there to supervise the project. As it turns out, a Harvard ’12 student who is Bangladeshi will be there to work on this for a month, and DCH is designating someone else to be in charge of it permanently. We’re also looking to engineer some mechanism that can chlorinate the overhead tank for the bigger wells that have tanks.

So: background research, project design, organizational structure, implementation logistics, field trials, failure, finding new directions, taking advantage of a great opportunity that comes – it’s all there. It’s been an incredible project to be part of, and a huge privilege to be at the helm of it as a college sophomore.

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I leave Dhaka in exactly nine hours.

It's been a sad series of goodbyes. I can't write the concluding entry right now--it might come in a couple of weeks--but I will miss the people here very, very much. The friends, the work, the field, the poverty, the rickshaws...it's all come together for an incredibly formative four months. The good times were amazing, the bad times were very low, but I've learned so much here and would live it all over in a heartbeat.

The end of a (too-brief) chapter.
But, as Mitch Albom writes, every ending is also a beginning. We just don't know it at the time.

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The last week

I honestly wish I had four more months here and, if I weren't already committed to Chile and Bulgaria, I would stay.

Innovations for Poverty Action is very interested in partnering with us to start a pilot project for the chlorine dispensers here. This could be a breakthrough for chlorination in this project--we've tried chlorinating dugwells at different dosages and frequencies for years with no success--and, with the right contacts and connections, may garner the attention needed to push off the idea of chlorination in Bangladesh. I want to be here to make that happen. I've spent four months building relationships, gaining trust and respect, fighting through the frustrations of understanding how things work here. It feels like now, after that investment, I am leaving and letting slip this great opportunity to lead another project using the tools I've gained.

There are a number of friends here I'd love to spend more time with: a few are people who I know I will keep in touch with for a long, long time and meet up with in New York or Boston or some other city on the other side of the world years from now. They are the people who have made Bangladesh what it is for me, and as much as the work, they are what make me want to stay. I've started getting into the social scene a lot more--this weekend, went to a few fabulous parties, one at this sleek new club (yes, a club in Dhaka!!) that opened up at the Regency. I met friends before, walked in and knew a surprising number of people, danced, chatted... there have been some great nights and days to remember.

All that said, I can't WAIT to see my parents and friends in San Diego, and then the Bellolios and other friends in Chile, and BFTF friends in Bulgaria. And of course, dear old Harvard and all the wonderful, wonderful people that have defined the past two years. Legit Mexican food, In-N-Out, carmenere, driving, fast internet, shopping, movie theaters, and summer dresses are also all on that list.

Cheers to the last week.

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Last night

I played VOLLEYBALL. And it was amazing. The end.

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Birthday! --From the field to Dhaka

Thanks for your messages--wish I could be celebrating with you all! I had a great dinner party, though, on this side of the world, with a group of about ten good friends who have been so essential to my experience here. We had it at Kozmo, this hip little lounge/restaurant in Banani, Dhaka. Afterward, Piya, her boyfriend, and her brother played guitar and sang for all of us...we ended on California Dreamin'. It was a fantastic night.

I got back to Dhaka the night before, a five-hour bus ride in a non-airconditioned bus with 100 degree weather outside. SHOWERED, then went straight to two other birthdays (May is the time!), one on the rooftop of the American Club, where most of the American circle was, and some Bangladeshis who I knew or knew of. Another California girl and I westsided it out to 2Pac, good times.

As far as the fieldwork-- we discovered, after three weeks of trials and a long phone conference with a chlorination expert at the CDC, that directly chlorinating dugwells with daily low-dose chlorination does not work. Because there's a lot of organic matter in the water give it's a hand-dug well with cracks to the soil, and there is a constant influx and outflow of water, the chlorine a) attaches immediately to the organic matter on the lining of the well without disinfecting the water and b) becomes very diluted with the influx of water.

So that means we have to change our entire approach. The trial protocol I've worked on for about two months is out the window, and we move on to alternative solutions. It's too bad, but such is science! The water quality tests, though, and the meticulous record-keeping we have taught the field staff will not be in vain. I hope. We've been put in contact with this Harvard-Berkeley-Google (what a fantastic combination!) team that makes stands where you pour in the water, and it automatically calculates and adds drops of chlorine, and the water comes out a spout fully chlorinated and disinfected. We're also looking into chlorinating the overhead storage tanks, but as the World Bank visitors pointed out, if you're going to be calculating DALYs based on diarrheal disease from contaminated water, and long-term health risk from arsenic poisoning, you will have to factor in risk of falling and injury or death from climbing up to a tank 25 feet above ground. These are all tangles we must comb through in the next two and a half weeks before I leave.

The World Bank visit was eye-opening. The people who visited are consultants to the World Bank--they will write the policy proposal for ALL water and sanitation in Bangladesh, on a governmental, non-governmental, and private sector level. This is called the Water and Sanitation Program. They came to our project to learn if dugwells really do have fecal coliform counts in the thousands, as another study suggests. The standard for fecal coliform count is zero by WHO, and 10 by Bangladeshi government... we were able to show them that chlorination works in killing bacteria, but we are still working to figure out a way to implement that successfully. In the past, monthly high-dose chlorination at a quarter of the EPA shock chlorination standard has worked in keeping down bacteria for a few days, but by week two the coliform count starts to double every day, which is very dangerous especially during the monsoon season when there are a million contaminants in the environment and people are more prone to falling ill. I hope they come away with the impression that dugwells, and especially large Indara wells, CAN be an effective arsenic mitigation solution, more research needs to be done on how to chlorinate them effectively.

When working in the field, it's easy to get in a bubble and it's easy to feel alone. Interacting with people who you can have those more big picture policy or science-based discussions with, though, is absolutely invaluable. Seeing the big picture and sharing our findings have renewed my drive. It was a great week in Pabna.

Last note: I taught Mahi (the two year old little boy in the family I was staying with) to say O-ba-ma!

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