Project Bangladesh: Rita

In the United States, we sometimes take for granted that we have access to a a great healthcare system. True, we don’t all have insurance. (I’ve been without health insurance, so I know what this is like firsthand). True, healthcare can be very expensive. But healthcare is there when and if we really, really need it. That’s not always so in other countries.

Rita, 26, and the mother of three children, has lived with two goiters since she was young. The lumps didn’t bother her when she was a child, but since she had her own children, the goiters seem to have grown larger. When she heard Americans were coming to this hospital in Bhairab, Bangladesh, she thought they might be able to help her.

“I’m afraid it might choke me or cause me to lose my life,” she said of her goiters. “I have to listen to all kinds of abuse because people make fun of me. I’m hurt inside and I feel very bad.”

Rita’s husband clung close to her. You could see the love and concern in his eyes as Dr. Ajmal Sobhan and I interviewed Rita just minutes before her operation. Rita’s husband was on the verge of tears when Dr. Mark Pomeranz, the anaesthesiologist, and Kathleen App, the nurse, escorted Rita from the bare, yellow waiting room into the operating room. No wheelchairs or gurneys here. Patients walked, hobbled, or sometimes got carried on stretchers, even up stairs and right after surgery.

Inside the operating room, Mark put Rita under. Mark found it didn’t take much to knock out Rita and other patients. He surmised that unlike Americans, most of the Bangladeshi patients had never taken drugs, not even aspirin or ibuprofen.

As Mark worked his magic, someone turned on the two wall-mounted fans. A window was cracked slightly open just a couple feet away from a tray of surgical instruments. Sharon Greene-Golden, a certified sterile technician, carried instruments in and out of the OR all through the surgery. In fact, doctors, nurses, surgical technicians and hospital personnel constantly walked in and out of the OR as if they were in their best friend’s home. Needless to say, the Americans had to adjust their sterilization expectations lower.

Dr. Liz O’Neil performed surgery for four hours. Rita’s two goiters weighed a total of one pound. According to the medical professionals I was with, you rarely see goiters of this size in the United States. Americans would have had this problem diagnosed earlier and taken care of immediately.

Fortunately, Rita will be fine and goiter-free. I saw her and her husband and son a few times after surgery. She looked like she was in a bit of pain but managed to smile once or twice. It was beautiful to see!

(Warning: There’s a slightly graphic photograph below)