My 2023 visit – (1) the year dengue fever hit Bhola
It was fortunate for several reasons that other commitments compelled me to postpone my annual visit to Bhola from June/July to September. Of these reasons the biggest was dengue fever.
What is dengue?
Dengue fever, malaria and chikungunya are mosquito-borne diseases which have long been endemic in Bangladesh. But until this year cases on Bhola island were rare and we had never had a case within the boundary at Bhola’s Children.
Mosquitos carrying other diseases normally breed in stagnant water but those carrying dengue can only breed in clean water. For that reason, dengue is more prevalent in the rainy season and in built-up areas where there are more receptacles holding rain water – half coconut shells are a favourite!
In 90% of cases symptoms are mild – a few days of fever – or not even noticeable, but in 10% of cases the disease enters a second more acute phase, which requires hospitalisation and is often fatal in a country like Bangladesh where many have weakened immunity and/or inability to access medical treatment.
Dengue fever was already on the rise in the spring but when a heavier than normal monsoon arrived in June, infections rocketed right across the country. Medical facilities were completely overwhelmed – worse than during Covid. Dengue arrived in the boundary and probably all our children and staff caught it, although only the two who were hospitalised were tested and confirmed to have it. The Government had declared a national emergency and the police were making random inspections of the roofs of buildings in Dhaka and fining those where they found receptacles like plant pots which could be breeding sites.
By mid-September when I arrived the worst of the rains were over and the rate of new infections had dropped sharply. In fact, everywhere was still being sprayed so frequently that I saw far fewer mosquitos than normal and only got one bite in ten days! That said, the hospitals were still overwhelmed, so it could have been very serious if I had caught dengue on the island.
Thankfully, I found that both children and staff came through this ordeal safely, although a few were still suffering some after effects.
The lesson for us is that being on the island no longer provides a cordon sanitaire. The greatly increased human traffic between the mainland and the island means more infected people arrive, more disease-carrying mosquitos catch a lift on the ferries, and when the bridge to Barisal opens in two years time the island will effectively be part of the mainland.
My 2023 visit – (2) New faces and much to be proud of
As always there were plenty of new faces among the children to get to know – which is such fun.
Another benefit from postponing my trip to September was that I got to meet the newly recruited physiotherapist Nasmul. I was very impressed by how well he was settling in, how he interacted well with the internal and external, children and adult, patients and how he was already bringing increased professionalism to the operation of the Physiotherapy Department.
I also had the opportunity to meet the new District Commissioner and Superintendent of Police. We invited them to a barbecue and the children put on a display of dancing. It was their visit to the boundary and they were impressed. The DC presented plaques to the Olympic medal-winners. The media were invited and two television channels subsequently included reports in their news broadcasts.
At a meeting of the BCSB board I met Apu who was attending for the first time. He replaces his father Manik who died in the summer. The other trustees were still in shock from Manik’s unexpected demise. His sage advice will be sorely missed both locally in Bhola and by us in London. Apu brings welcome continuity and a more youthful vigour.
There had been no chance to properly celebrate the success of our children at the Special Olympics in Berlin in July prior to the DC’s visit. We followed that up by taking them out to dinner at a local restaurant. They dressed up in their finest and had a whale of a time taking hundreds of photos. The restaurant even had a beautifully decorated stage set for taking social media pictures.
A lot of building work had been done in the spring before the monsoon. The remaining section of the boundary wall on the south side had been rebuilt and the opportunity taken to build a showroom opening on to the road. This will be a place to display metalwork, woodwork, tailoring and craft products made by our children and young adults.
The workshop roof had been raised and a new secure store built for the tools.
The spiral external staircase on the main hostel building had been extended up to the top floor. The guest suite now has a fire exit!
The first phase of a programme to raise the level of the ground inside the boundary to that of the road had been completed. This is to deal with flooding which has become an increasing problem as land outside the boundary has been raised.
Subsidence damage to the old tailoring building at the back had been remedied.
These and other works were a considerable achievement in the time available given our limited financial resources and the demands the work makes on Zakir’s time.
The Sunshine School (for slow learners)
The slow learner class had doubled in size since my last visit with new non-residential children attending on a daily basis. We now have a partnership with the Indian charity Mann who have provided valuable training for the Director and the teaching staff in dealing with autistic children. It was a joy to see how Tasnur, Lima and their team create a wonderful supportive learning environment for each individual child.
There is a big demand for us to provide more non-residential places but we have reached the limits of what we can do with the present staff. The next step will be to raise standards and capacity by hiring a professionally qualified teacher paid for from the fees charged to the next cohort of slow learners.
Hand in hand with expanding the Sunshine School we have expanded the Physio Department. The slow learners need occupational therapy, so the two Departments have to grow in tandem. But the Department is also expanding by treating external fee-paying patients with a view to the Department paying for itself in due course. Remarkably this is the only physio facility on the island, so there is plenty of demand. Recruiting Nasmul has put the operation on to a much more professional basis and, as I said above, the initial signs are very encouraging.
After the building work in the spring was completed, Zakir turned his attention to developing the children’s capacity to produce handicrafts. This is now more formalised. Up to the age of 12 the children are in education, from 12 to 15 they receive training in basic technical skills, from 16 to 17 their skills are raised focusing on products which can be sold, and finally those aged 18+ make products for sale (the proceeds are shared between the individual making the product and BCSB). The aims are to raise standards, to make the training more self-financing, and to better prepare those leaving as young adults for the world of business.
As an example, I saw children painting intricate geometric and flower designs which transformed a simple wooden stool (made in the woodwork department) into something very pretty. OK, not of saleable standard yet but improving fast.
Staff morale was particularly high because during my visit they completed the purchase of a near by piece of land, which has long been their dream. With the economic development based on the island’s new gas fields and the imminent building of a bridge to the mainland land prices are rocketing and should continue to do so. The ultimate dream is for them to build housing for themselves on the land but, whether or not that ever comes to fruition, they each have an individual share which they can sell in an asset rising in value.
Previously the money they saved in the staff saving scheme had been lying in a bank current account, because they have strong religious objections to investing in interest-bearing deposits. Now with the help of £6,300 which BCUK contributed last year they have an alternative pension scheme. And already the value has jumped thanks to the boundary of Bhola City being expanded to include this land.
The less good news is that they are now struggling to make ends meet on their current salaries, let alone save. They are receiving the market rate for staff of their mostly minimal qualifications, but the soaring cost of food and other basic items has far exceeded salary increases since the pandemic. BCSB, of course, struggles to cope with the same rising costs.
All in all, I was very impressed by what Zakir and the staff had achieved since my last visit in July 2022.