Just down the railroad tracks

is a spread of slums. You can see it from the window of the DCH office: makeshift shelters of corrugated tin and woven fiber. Children play in the dirt, peering at us, the strange men and woman walking down in pants and collared shirts. Their water comes from an uncovered well just by the tracks--dust floats down, dead bugs and animals, maybe scraps of trash--I don't even want to know what a microbial analysis there would reveal. It's hard to believe that all of it is right there. Because DCH is free for poor patients, the slum dwellers and train accident victims wind up in the emergency room and wards of this hospital.

David, Steve, and I went for a little foray down the tracks, but of course did not go into the slums. There are little cha shacks by the railroad track, full of grimy-looking men who stared as I walked by. These are the stores David and Steve usually go to but I asked that we go to the more official looking (in a permanent building!) tea house across the street. We had this delicious chai latte drink, not quite the same as Starbucks but really good, as well as moglai, this fried dough with egg and vegetables on the inside.

We started talking about our days and I heard about the David's struggles with teaching the nurses. "It should be part of their routine," he said, exasperated, "to look at the wound every day and write down 'dry, clean' or not. But they don't because they're too lazy." Maybe they just weren't taught to make it part of their routine, I suggested. But no, he insisted, it just doesn't stick in their heads, there's nothing he can do about it. "Lazy," "non-compliant," "too primitive to understand"...it sounds just like what the WHO said about multi drug resistant TB. I could hear and understand his frustration--no doubt I would share some of those feelings--but why the dismissal? Why has he given up? Someone who signs up for eighteen months of service in a developing country does so with some sense of goodwill, of a desire to make a change...what I see, though, is a sense that nothing can be accomplished in this godforsaken country, a haunting reincarnation of Rudyard Kipling's "White Man's Burden."

Haunting not because I want to be dramatic, haunting because I wonder how I will feel at the end of my time here, and haunting because I don't want to say and think those things, ever. Call me wide-eyed and naive, but I do believe that where there is a will, there is a way for change, if only on a small scale. A couple of millions of dollars and one team is bringing preschool education and respiratory disease control to thousands of Chilean children; MDRTB is being successfully treated in the slums of Peru; antiretrovirals are provided for free to every citizen of Brazil. These changes require innovation, grit, failure, and determination to push past that failure, but show that the "impossible" is rarely ever really that. The arsenic crisis in Bangladesh will continue for as long as the government is unable and unwilling to take leadership in mitigation--that I cannot begin to change--but what we can change are the lives of the people living in sixty-six villages in rural Bangladesh. Thanks to DCH, their arsenic crisis is already over. And for me, at this moment, that alone is more than worth the effort. Maybe I, too, will become hardened and pessimistic with time, but maybe I won't.

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Note: a serious post, but today was actually AMAZING. Steve and I had a Bangla lesson with Basit, which was incredibly fun, was productive reading about chlorination and the RAAMO study [mostly bullshit, bullshit which we will refute to the World Bank reps who are visiting DCH this month-- more on this later, this is a much bigger deal than I imagined I'd be involved with], met this wonderful British-Bangladeshi couple who were freedom fighters in '71 and have been involved in a lot of NGO work here, and, last but not least made my first independent purchase. The purchase, by the way, was six mandarin oranges. In honor of a certain volleyball playing friend and one beautiful weekend in Valparaiso, Chile.