Clinic in SNOW

And here is the clinic!

Just trying to see how easy it is to post pictures in here from Picassa - it's pretty easy!

New Picture

So here is our crew at Commonwealth!

Friday

Today is Friday - and today Emma went home. :) She had a good night at the emergency clinic and ate well for me this morning - she peed and went number two - all that was required of her. So, I sent her home with tail wagging and proud papa smiling. :)

I'm pretty sure that her vet was smiling a little bit, too. :)

amazing. :)

Emma

Today is one of those days I want to remember. And due to the requests that I keep blogging - I thought this venue would do just fine for recording today's events. Actually, today started yesterday....

I saw a patient named Emma - she's an 8 year old female chocolate lab. She was injured in an accident (HBC - Hit By Car) the last week of January. She had some bumps and bruises, but recovered fine. But over the last 2 weeks or so, she's been losing weight, losing her energy, not eating with Gusto. According to her owner: "she's just not Emma." I examined her yesterday and knew pretty quickly what was going on. When she was bumped back in January - it was most likely with some force. Sometimes, a large amount of force in the abdominal cavity can cause a rip to occur in the diaphragm. This poses no immediate risk (usually) but over time things start to migrate into the chest that don't belong there. When I took an x-ray of her yesterday, I could see that her liver and a good portion of her small intestines were in fact in her chest. The liver gets mad being out of place like that, and oozes lots of fluid. This fluid eventually leads to the lungs not having enough room to expand - hence why Emma didn't feel up to snuff. This can be surgically corrected - but it is a risky surgery. Dr. Woolsey - the vet I worked for during high school and college did several while I worked with him. The prognosis was always 50/50. Dr. Bowman has done two in his career - one lived, one died - again, 50/50. I, of course, have not done a procedure like this before - and I really wanted to send Emma to a board certified surgeon in Richmond to provide her the best chance possible. I gave the options to the owner - and he said that he'd talk to his wife and call me back. I ended up calling him back, and when he answered the phone he said: "Doc, I have one question for you - are you a believer in Jesus Christ?" I answered, "of course!" - he said "then you are doing the surgery. We know this is new for you - and we know it's risky - but we trust God for the results." wow. So, ok, here I go. Try to prepare as much as possible. Read all my books. Call Dr. Woolsey - he gave me great advice! Talked with my tech who would be doing anesthesia - we both knew that this was going to be a large endeavor. It was that, indeed.

Dr. Bowman had today off - so I had arranged it so that Dr. Nice would be assisting me in the surgery. (He's never done one of these either....) Both of my tech's and both of us docs were very somber as we got started - but I told them I had been praying for Emma all morning (and most of the night, as I didn't sleep all that well!) We got started and there was so much fluid everywhere! (Dr. Woolsey warned me of that!) We couldn't see a thing. We suctioned and suctioned and I was finally able to see where the hole in the diaphragm was - we actually had to make the hole larger in order to get the liver back through it. Once the hole was unplugged, things started getting tense. She stopped breathing - but this is normal and expected as the normal negative pressure zone of the chest is now open to the world (no more negative pressure.) No prob - my tech was breathing for her (bagging her.) But then the heart started getting mad because I had disrupted it - no prob - "Jenny, give the lidocaine." This made it not so angry - but it still decided to give us probs and beat really, really slow. "Jenny - give the epinephrine." I placed my hand on her heart (THAT is a really STRANGE feeling!) and I immediately felt: thump.... thump..... thump, thump, thump, thump - all was well. Now, back to our hole. Dr. Nice had the better angle for making the first, very difficult, suture placement. Unfortunately, he nicked the vena cava with the needle (this is a large blood vessel going straight to the heart, just so you know) as he made his first pass. Lots of blood. No worries, deep breath, put a clamp on it. No more blood. Go Dr. Brown. I tried to put a suture over it, but Emma was trying so hard to breathe that there was too much motion for me to tie anything. Ok, leave clamp on, close hole, then come back to the vena cava. Dr. Nice did a great job of closing it up - I added a few stitches to close a few gaps - then we had Jenny bag her - no leaks. "Ok, Jenny, give the Dopram and let's see if she breathes on her own." This is where she lives or dies - this is where it's out of my hands. We wait. It seems like a long time. The carbon dioxide has to build up in her blood to signal to her brain to breathe. We wait. She starts breathing. We start breathing again. :)

So we use a syringe and needle to suck as much air as we can out of the chest to create the happy negative pressure zone again. Now, back to the hole in the very large blood vessel. I place an 'x' type suture over my clamp and as I tighten it, I ask Dr. Nice to remove the clamp. I tell him that whatever oozing we are left with - we are left with - I don't think I can place another suture. (This was VERY difficult!) As he pulls out the clamp, I see a stream of blood about the size of a coffee stirrer shooting out of the vessel (which is the diameter of a hot dog) - before I can even get my needle back into position to make another pass, the front part of the abdomen is full of blood. I can't see anything. I can't see where to clamp. Dr. Nice tried to swab away the blood but it was coming out too fast for me to have a visible window. I make a blind stick into the puddle and pull tight - we both watch - the puddle isn't growing. (!) We swab out the blood and look - a little bit of oozing - but nothing more! Oh, my goodness, I just closed a hole I could not see! WOO HOOO!!! Quit celebrating! Get out of there! We look through all the intestines to make sure everyone is happy, then we stitch her up. Dr. Nice starts on one end - I on the other. We meet in the middle and we are done. She's breathing! She's alive!

Then we hear a very sobering question. "Dr. Brown, I only have 5 lap sponges (large cotton sponges for wiping up blood, fluid, etc.) - how many did you start with?" I look at Jenny - "6." "Are you sure?" "Maybe." We look everywhere. No way - we did NOT leave one in her. No way. We take an x-ray of a sponge to see if it shows up - it does. Fortunately, M.D.'s have been sued many times for leaving sponges in people - so they added a little metal material to them so they show up on x-ray. We took an x-ray of Emma - there it was - glaring at me as if to say "you didn't think it would be THAT easy, did you?" Back to the table - open her up - take out the sponge - close her back up. She was still under anesthesia during all this - no worries. It's so fortunate that we found this now, and not 3 days from now. It would have been better, of course, to have found it was missing BEFORE we closed her up - but this is what we call a learning curve. :)

2 hours later Emma is up and wagging her tail. I tear up. She's alive. She got heads when the world called tails. God was involved - and he decided that Emma needed to be around for a few more years.

And I am overwhelmed that I got to be the instrument by which that happened. wow.

She's not out of the woods yet - but hopefully over the next 24-48 hours she'll continue her recovery. Stay tuned....

This is Holly and I in our Sharees! 

Last Days and summary

Loving the USA ...And all of it's technical wonders. I can't BELIEVE how FAST this computer works. It has been an extreme lesson in patience waiting to use the computers in Bangladesh - you just have no idea how long it took to get to this page so I could write to you all! But, it was so worth it to have you along on the journey - thanks so much for staying with me - reading everyday and praying for us! We certainly were beneficiaries of your faithfulness, for we feel that we were used by God - both in a physical and spiritual way. Since the jet lag is decreasing, I'm going to attempt to write a coherent summary of those last few days - and of my feelings about the whole experience that was 3 1/2 weeks in Bangladesh. :)

Ok, so actually it's now Monday - I have been a delinquent blogger - just trying to catch up with folks and adjust back to this time zone. Haven't been able to sleep well through the night (though did pretty good last night) - my body still thinks that night time is day time - but it's getting better. I was advised yesterday at church that coming home is harder to adjust to than the going over is. It's my first day back at work, and due to a snowstorm - things are slow. They are easing me back into work gently. :)

I've had several requests to finish (or re-create) my missing blog. I'm not sure I can do it justice, but I will certainly try. Those last few days were precious - very sentimental in allowing us to feel like we had an impact on the Bangladeshi people that we were priviledged to work with.

Our trip to the Bangladeshi national museum: a very nice museum, nothing like our Smithsonian, but very informative. It had displays covering the national wildlife and plants, to local art, to the history of the birth of the nation that is now Bangladesh. We saw a carpet stained in blood - this carpet was from the teachers' lounge at Dhaka University - and many teachers were killed in that room by Pakistani soldiers during a raid. We saw a torture chair - and I will leave the details out for your sake. The fight for independence for them was not unlike most wars of it's kind. The Bangladeshi people are very proud of their country. I never once heard a negative word from a Bangladeshi about the country or the people - only the government. It really strikes me that if they had honest people in power, the country could really rise above it's current state. But as things are now, it seems almost impossible... it has, afterall, been declared to be the most corrupt government in the world.

A sign going into the museum posed the following restrictions: No bombs, grenades, or weapons allowed. Kindly refrain from spitting. Talk noislessly. No running. No food. Important things, first. No bombs. :)

I also had to check my camera at the desk when I went in to the museum - this did not make me comfortable. I had not let that camera out of my sight since arriving - and here I was, at the end of the trip - with ALL our pictures on that camera (it's digital) - and I have to hand it over to someone who works for the most corrupt govt on the planet?!? I was anxious - but recovered it, none-the-less. :)

Anyway, we did have to hurry through the museum - to arrive back for lunch. We went on our last (very sad) client visit to re-check a cow to see if she was pregnant. She was not. :( She looked great on the outside, felt fine on the inside - we could find no reason to explain her infertility. The farmer was going to try fresh semen on the next breeding instead of frozen to see if that made any difference - we also suggested some vitamin supplements. Hopefully, she will be able to get pregnant and maintain it. The people's faces were so bright as they saw us again! Our Bangla lessons impressed them as we were able to have a small conversation with them - whereas the first time we met these folks, we couldn't even say 'hi.' :)

Have I mentioned how that everytime we said something in Bangla we got laughed at? It wasn't rude laughter, just pleasant amusement - I guess we sounded funny. :) Can't imagine that a girl from TN would sound funny trying to speak an asian language. ;)

The visit to the Fort was really very cool - they had a huge tomb and mosque and a living quarters building. The tomb was for the 'favorite' daughter of some really important person (didn't think you were supposed to have favorites?) It was beautiful. Finely decorated with hand-made ceramic tiles and marble. It was amazing to me that this place was built in the 1600's - made to last, indeed. The mosque is pretty famous - it appears on their 10 taka note. We did not go inside of it, though. Inside the living quarters there is now a musuem with quite a collection of memorabilia from the Monghuls - spears, sheilds made of elephant skin, some very old guns, books, paintings, etc. I was quite fascinated. There was a very large bathroom, complete with a hot water system (heated by fire.) The fort itself was made of an outer wall, a large moat, and an interior wall. There is a large pond for keeping fish - and now the grounds are all flowers and grass. In a very crowded city, this place is a bit of a haven. We spotted many couples there - probably getting to know each other following their engagement - with a wedding coming up VERY soon. :) Getting to and leaving the fort was a challenge. The streets are just soooo narrow!!! We got tangled up with a rickshaw and had to ask constantly which route was the best way out. It seemed like a maze. We also drove past a tannery - a place where leather is made. Now, I have a strong stomach - but the smell from this place was overwhelming!!! It was cool how they had so many hides laid out on the ground - they stretch and nail them out in order to dry them. We also saw large pieces of fabric laid out with some kind of powder (?) on them - when we asked Lawrence what that was, he commented it was for color. Possibly blood meal, possibly herbs and things used to color the leather. We never were quite sure.

Our last day at the office started with my leading Devotions. I was completely unprepared - for we had stayed up late sorting out our gifts for the staff (the M&M's were a HUGE hit!)and writing thank you cards. We had to say good-bye's in the morning to some of the YWCA staff - and then stop by the head office to get our printed out addresses that we had made. We sang "Victory Chant" one last time, then they sang a Bangla song - and I opened my Bible - still unsure of what I wanted to say. I opened to John 15 - the passage talking about Jesus being the vine, and us the branches - and how if we remain in Him, THEN we will bear much fruit. I told them the story of the starfish (I have this poster in my office and read it often) - I'll write it for you just in case you've never heard it:

While walking along a beach, a man saw someone in the distance leaning down, picking something up and throwing it into the ocean. As he came closer, he saw thousands of starfish the tide had thrown onto the beach. Unable to return to the ocean during low tide, the starfish were dying. He observed a young man picking up the starfish one by one and throwing them back into the water. After watching the seemingly futile effort, the observer said, "There must be thousands of starfish on this beach. It would be impossible for you to get to all of them. There are simply too many. You can't possibly save enough to make a difference." The young man smiled as he continued to pick up another starfish and toss it back into the ocean. "It made a difference to that one," he replied.

I asked these field officers if they ever felt overwhelmed doing the work they do. They all replied, 'yes.' Maybe I should do a better job explaining what they do, first. World Concern is a development organization - it is know as a 'NGO' - a 'non-government organization.' They have many projects in many countries - in Bangladesh they have a free school - where children from the slums can come and have a free breakfast and lunch, as well as a free education. They have a school for the deaf and the blind. They have a hospital. And they have the Women's Small Business Assitance Center - the WSBAC - and this is what I refer to as 'the office.' This is a team of people, mostly women, who provide small loans to women to start their own business. This could include making handi-crafts, jewelry, starting a grocery store, or buying a milking cow. The women are approved by loan officers - and it is the loan officers job to make regular visits to the client to make sure that all is going well, provide training and assistance when necessary, and collect their monthly repayment installment. The field officers go out every day - sometimes traveling very far to see their clients. Every field officer has 60-90 clients - and there are 49 (give or take) field officers currently. We were present during one collection from a 'problem client' and I watched as the field officer carefully inspected each bill - to make sure there were no counterfeit! There was!!! I know that I wouldn't be able to spot a fake bill - but this is their job. Most clients love their field officer - but some are not so kind. They are very brave to travel out to people's homes to collect money - they usually go alone. So, I asked if they were ever overwhelmed...

There are over 15 million people living in Dhaka. It is the most densely populated city in the world. It is the most polluted. It is the most corrupt. It is one of the poorest. So, yes, they feel overwhelmed. So, I told them the story of the starfish - to remember that they ARE changing lives, one by one, in Dhaka. And I reminded them that the energy comes from the vine - and He is the giver of fruit. Through very teary eyes I told them how I prayed that one day they would have the chance to see the fruit of their labor - that they would see the difference they have made. I was so blessed by thier attitudes - their courage and their compassion. And their friendship! In such a short time, so many of these women drew so close to us - saying to us upon our departure that they felt such 'deep sorrow in their hearts' because we were leaving.....

One very special friend - Rupali (which means silver) even came into work that morning to see us off - she had the day off, for she was studying for a large exam for her masters program - they just loved us. Instantly. We were sisters. And we were, in Christ.

We gave out our gifts after that, took tea, then traveled to the head office to talk with Prodip about our time, about Lawrence, our recommendations, etc. Prodip had actually been out of the country since Feb 8th - only returning on the 22nd. A World Concern meeting that was supposed to happen in Bangladesh got moved at the last minute to Uzbekistan due to all the strikes. So, he had to be filled in on all the things we had done. He read over our mastitis and stall design things - and we made our recommendations that the livestock program be enlarged - for it is a very profitable venture - and that Lawrence be given a cell phone so that clients can actually contact him when there is a problem. (They currently can't really get in touch with him.) Lippy (the WSBAC program director) and Lawrence and us talked for a good while - and we all were very pleased with how things went. We had lunch, then I typed that one blog.... I thought we were through. However, we headed back to the WSBAC for a farewell for Holly and I. They gave us roses and a picture and they stood up one-by-one and said something about our visit with them. Holly and I were so moved. They sang our song one more time - and they sang a special song for us - a traditional Bangla farewell song (apparently they had a poet from Bangladesh who won the Nobel Prize - his poems and songs are very famous throughout the country.) We took tea (no surprise!) and then gave lots of hugs and handshakes. We got several small gifts from some individuals - and 3 of the ladies stayed until everyone else was gone. They were Diba (who is a Christian), Teetu and Parvin - our muslim friends. For being so reserved at first - these two sure took to us at the end. We were so blessed to have that happen. Thanks again for praying for them.

Lawrence told us that he had a gift for us - but that he would bring it to the YWCA later. At this point, Holly and I were a little drained from all the good-bye's but knew that Lawrence's would be special. Sure enough, he came by with his wife and daughter - with shirts from Grameen bank. (Grameen bank is where the micro-credit loan originated - there was a special on it on National Geographic just last week.) Holly got a shirt, as did.... Matt. I didn't get a gift - my boyfriend did!!! :) I wasn't quite sure how to take that - but was very appreciative none-the-less. We said our good-bye's - though I know I'll be in touch with him - and then we went and packed up to leave.

Up and at em bright and early Thursday morning - at the airport at 6am for our 8:20 flight. We go to the end of the line - and for the next 4 hours we stayed at the back of the line. Americans are just not pushy enough. :) The delay was brought about because the security guy from British Airways was not satisfied with the scanners, so he ordered a hand search of all bags. This was a FULL flight on a 777 - and ONE security guy checking the bags!!!! I'm quite surprised that we made it out of there at 11 like we did! But, we missed our connections, and like I wrote, I caught a flight to D.C. while Holly stayed in London. I have heard from her - she is home safe. I have only received one of my bags - but they have the other one, and it's supposed to be here tomorrow. :)

There are some things about the culture that I wanted to write. First, I never explained the strike thing. There are two main political parties in Bangladesh - the BNP (Bangladesh National Party) who is currently in power, and there is the opposition party, the Awami league. In August of last year and then in the end January, two Awami league officers were assassinated - with no arrests being made. In protest, the Awami league called for country-wide strikes - stopping all commerce. By crippling the already broken economy, they hope to force the current govt out of office. They will attack any business that is open or any vehicle that is on the road that is private. Foreigners are a great target - for the object is to rattle people's cages to try and force a change. Hence Prodip's warning to us to stay indoors.

The population of the U.S. is around 300 million. The pop of Bangladesh is 150 million. The size of Bangladesh is around the size of Iowa. COZY!!! I spoke with one man who had visited the states - he commented that he felt lonely and scared because there were so few people around. Holly and I felt scared because there were so many people around!!! When I told people how that sometimes I go hiking and go an entire day without seeing a single other person, they literally could NOT imagine such a thing. People are everywhere to them. Most of them want to live with their parents - and the family connection is very strong. There are nursing homes, but most aged people are taken care of by their children.

The men of Bangladesh wear skirts - thin cotton that is tied together in a bunch at the waist. This is very convenient - for urinating (and defecating) on the side of the road or sidewalk is VERY common. :(

One day we passed a dead body on the side of the road - it was in a plastic bag and people were collecting money for it. We asked Lawrence about this - and he explained that he was most likely a poor man and they were collecting money to bury him. A word about burials... in a country with lots of people and little land, I inquired to Lawrence about how they do bury people there. He said most people are buried in a wooden box - and a new person in buried in the same spot after 5-7 years. They are not wasteful people - they even recycle gravesites.

I don't think I mentioned our visit to a Buddhist temple. It was a lovely place - but as we stood in that place full of literal idols, I couldn't help but be so sad - people actually do bow down and worship things made of wood and gold. It's quite an eye-opener to see that first hand. You hear of it - but to see it is just so stark. How blessed I am to know and worship the one true God - the One who exists, though is not seen. How grateful I am that I don't have to be bound by lies....

One thing I forgot to mention - everywhere we went we were offered chairs to sit on. Along with the command 'sit down!' We would be looking at cows and they wanted us to sit down! Sometimes they would go to their neighbors house to get a chair for us! And when we were offered food - they never ate with us. They always just watched us. This made us uncomfortable - but it is their way of showing honor to guests.

Several people have asked what I missed about home the most - I have a couple of answers. The first being space to breathe and move in. The second is music! I'm so accustomed to having music on during work (there is a radio in every room of the clinic!), listening to the radio in the car, and when I'm home, I almost always have music on. So, for a month I had hardly any exposure to music!!! Sometimes they would have music playing at the YWCA on the computer - but it was usually Hindi (from India) and occasionally some Celine Dion or Madonna. I was grateful to hear some Caedmon's Call again - as well as good ol country music!

And for those of you wondering - I did NOT lose weight while in a foreign land. Turns out that white rice, tea, and lots of sugar and fried foods are good for gaining weight. I gained 5 pounds! :)

Ok. I think this one is done. I've been told that I need to keep blogging - but I'm not sure that my ordinary life is much to read about.... :)

It's been a blast - thanks for coming along!

Dr. Brown - the 'poshu doctor'

"Pray for the homeless and the hungry - then pray for hearts that will do something about it." You can make donations to World Concern - just look them up on the web.

:)

Home Safe

Just wanted to say that I'm in the U.S. - after a very, very, very long day. 36 hours. I am still functioning to some extent, too. :)

We had a major delay in Dhaka - so our flight left THREE HOURS late - making it impossible for Holly and I to make our connection in London to fly to Chicago. I begged and pleaded and batted my eyelashes and got a flight to D.C. tonight. Matt picked me up at Dulles - Holly is still in London. :( But she'll fly out in the morning. All is well. I have cereal. :)

Shower and sleep. I'll write tomorrow.

Final Day

So we just had lunch with Prodip and the WC staff - it was our last lunch here. They made us a special meal - shrimp. :( I'm allergic to shrimp and Holly doesn't like it. Oh, well! We also had Mutton and veggies and rice and the usual Bangla food. Everything is fried in oil - they don't have ovens - I can't WAIT for raw veggies and baked food!!! (Remember how I commented that I liked the veggies here? That's because they are fried!!!)

We are wearing our Sharees today - we did manage to get them on ourselves - but as soon as we got to the office we got 'adjusted.' :) Prodip loves us in them!!!

We went to a Monghul fort built in the 1600's yesterday - built by a guy named Shasta Kahn - made me think of Disney's 'Mulan.' Very interesting stuff - I wrote you all about it - but it went 'poof.'

We also visited the Bangladesh National Museum yesterday - it was very good. Wrote lots about that too....

I made a HUGE list of odds-n-ends about Dhaka - but that is lost forever....

I'll make a shorter version once I get home. It won't be the same without Holly sitting beside me laughing, though. (Can you tell how SAD I am about losing my blog yesterday?)

We leave tomorrow at 6 am - I'll probably blog on Friday morning when I eventually get up. 30 hours of traveling is probably going to leave me a little tired.

It's been so good..... thanks for being a part of this with me by reading and praying for me.

sadness

I just typed the same blog - twice - 45 minutes of typing EACH - and they are BOTH gone. Power failures are bad things.

I don't have the heart to do it again.

It was really good, too!

so sad....

Finally!

So, I've been sitting here for like 40 minutes, trying to get to this page so I could write! Holly went first today - and then the power went out - and I have soooo much I want to type - BUT we have to leave in like 20 minutes to go have lunch with Benedict. I'm really frustrated! This is the last day I will have to write a large blog (most likely) and argh!!!

So, I've noticed that I've been leaving out the spiritual component of what we've been doing. That's mostly because it's so hard to write about spiritual things when you are ready to throw the keyboard out the window, when 2 people are trying to talk to you as you are typing (we type at the YWCA behind the desk - the receptionists are always talking to me as I try to write!), AND when you are very limited in your time. It's just easier to type about what we did that day. But, I want to share with you what God has been doing. I just have to do it fast. :)

One of the things we have learned about Muslim culture is that their perception of who 'Allah' is is good in many ways. They have a deep reverence for him - and would dare not even think of alloting to him characteristics that would lessen his awesomeness. (We tend to be lacking a bit in the 'reverence' dept.) However, they have no closeness to him - no sense that he cares for them. They have no understanding of Christ - and what He did for them. They are a moral people - BUT - some are quite prone to lawlessness and corruption - for in their faith, two nights (all night long) of prayer a year wipes the slate clean for them. Therefore, many live thier life as they wish, only visiting a mosque twice a year. Sounds very familiar to our CEO Christians - those who visit church on Christmas and Easter Only.

In our devotional time with the staff at World Concern, Holly and I have inadvertandly covered the same topics over and over. She and I are taking turns leading the morning devotions - and we haven't really PLANNED on things coming out the way they have - so we know God has been at work through us. :) The topics we keep driving home are about Grace - God's gift so that we can KNOW Him. The fact that Christ is God. They only see him as a prophet. Side story: one night earlier in the week, one of the receptionists at the YWCA was reading some material that I thought was questionable. I advised him to be careful what he reads (he is a Christian) for sometimes lies can be cleverly disguised to look like the truth. He made the comment that Jesus was not the same as God. I ruffled. I finished my blog - told him I'd be back in a minute - then went upstairs to get my Bible and prepare to debate this with him. I asked Holly to pray for this - then I prepared my heart for what I thought was going to be a battle. Bangladeshis can be quite stubborn. :) I went back dowstairs, and we opened our Bibles together. I read from

Colossins 1:15-22

He is the image of the invisible God. The firstborn of all Creation. For by Him all things were created; things in Heaven and on earth, visible and invisible, whether thrones or powers, or rulers or authorities; all things were created by Him and for Him. He is before all things, and in Him all things hold together. And He is the head of the body, the church; He is the beginning and the firstborn from among the dead, so that in everything He might have the supremacy. For God was pleased to have all His fullness dwell in Him, and through Him to reconcile to Himself all things, whether things on earth or things in Heaven, by making peace through His blood, shed on the cross. Once you were alienated from God and were enemies in your minds because of your evil behavior. But now He has reconciled you by Christ's physical body through death to present you holy in His sight, without blemish and free from accusation.

I John 5:20b

... and we are in Him who is true - even in His son, Jesus Christ. He is the true God and eternal life.

I ask Milton - "who created the world?" He replies: 'God.' I say: "Colossians says that Christ created the earth. Colossians says that Jesus is God." He then says to me - so does I John 5:20 (he hadn't mentioned it until this point - I was talking first - go figure!) He says to me, 'see - Jesus is God.' I was confused for a second then realized: I had misunderstood his English - and we were trying to convince each other of the same thing. :) I loved that!!!

I read this same passage for devotions the next day. Trying to help the non-Christians in the room to see that Jesus was so much more than a prophet!!! Then the illustration of Grace - God's free gift to us that we have to take, just like taking a gift. I borrowed Matt's illustration of holding out some money (THAT got their attention!) and offered it to anyone who wanted it. When I asked who wanted it, 15 hands went up. But no one got out of their seat to come and get it! I repeated my question of 'who wants it?' several times, until finally someone understood that to get it - they had to get up and take it! What a good visual for them - a lot of people here come from Christian families - but the term 'Christian' can just mean that your great, great, great grandfather converted from being a muslim to being a Christian. It may not mean that you yourself have made the decision to follow Christ. Most have attended church at some point - and most know the story of Christ very well. But knowing someone has some money that they want to give you and actually getting off your tail and taking it are two different things. :) They say that they understand English just fine - and Holly and I try to speak very slowly and clearly and avoid slang - but sometimes all we get are blank expressions in return. We always have someone read the Bible passage in Bangla, so we know that they at least understand that.

We have also been trying to drive home the fact that God cares deeply and personally for EVERY person. I've read to them the Psalm (can't remember it at the moment) about being 'knit together in my mother's womb.' We have told how that once we have 'received Christ' we have the right to be called Children of God (somewhere in John.) That the passage in Colossians tells us that when covered with Christ's blood, God sees us as holy and blameless! How my faith has been lifted as I gain a fresh new understanding of all that has been done for me!!!

Two of the women we have wanted to interact with - two that we metioned after we first got here(Jihn Tu and Teetu) we have NOT had much chance to talk to. They usually don't come to devotions - and have not been very friendly. (I have currently taken over Jihn Tu's desk and booted her out of her office, so can't say I blame her for not being all smiles and giggles towards me!) However, the day we went to the national monument they both were at devotions! They both accompanied us to the national monument - and after breaking the ice with my question of whether or not they wanted to try palpating a cow - we were friends!!! Jihn Tu was one of the ones who helped Holly and I put on our Sharees. Just a small connection - one small step - but it is more than we expected. :) Thanks for your prayers.

Another side story: (I have time to write now - it's 8 hours later and I'm back at the YWCA - bad keyboard, but I'll persevere!) The day we went to the national monument, we visited a little 'fast food restaurant' across the street. They ordered us fried chicken sandwiches and Holly and I were thrilled! They looked just like Chick-Fil-A sandwiches! We bit in with gusto only to realize there were bones!!! This minor detail took some work... take the chicken off the bun, pull some meat off, put it back on the bun, then bite. :) The Bangladeshis, however, ate the sandwich - BONES AND ALL!!!! I don't quite understand that....

So, lunch with Benedict was good - we visited with several people there for many people live in the same house. One is a medical doctor - she just finished her internship and is looking for employment. One is a pastor - of the growing Bangladesh Christian Church - and both of them speak English very well. The doctor is trying to get a visa to the US - he parents already live there. Most of the educated people we have met are either in process or hope to be in process to apply for a visa to the US. It's remarkable - one girl told me of her brother who has his masters in computer science - and he drives a taxi in NYC - and is thrilled!!! He got his visa to the US via a lottery. The money he makes in NYC is enough to support him - and I'm pretty sure he sends some home. This is a very common story. Anyway - after lunch we were served a fruit drink - 'wood apple', water, and milk - it has made me quite ill. I had diarrhea for the first time since arriving here - and it was quite unfortunate that it hit while I was still in their house. I tried my best to contain it.... but I had to go! Fortunately, they did have a regular toilet (no squatty potty - for it is quite a feat to use a squatty potty in this get-up!) but alas, no toilet paper. Just a little pot full of water. Wash hands well. :) I still felt ill, though - and we went to Tripti's house for dinner. I explained to her my plight - and she understood. I only ate a little rice - but brought some food back to eat tomorrow.

So, to return from Tripti's house to the YWCA, we 3 women piled onto a rickshaw for a short distance, then flagged down a CNG. It's dark, and the first time we have been out in the dark with no male company. We didn't really want to be still very long - moving is good. The CNG was headed the wrong direction, however, so we needed to backtrack a little (very narrow streets) in order to find a place to turn around. He pulled forward into a large space with sand - however, the sand got deep, and as he stopped in order to go in reverse, he found himself to be stuck. He asked us to get out - and I did the most natural thing I could do - push. Holly helped me and we got him pushed back, then we pushed him forward onto the road again. When we got in, he exclaimed "Thank you, sisters! Very nice! Very nice!" Women here don't do things like that. :) Holly even commented to me "Leslie isn't one to just sit by and do nothing! Just jump right in!" We thought our fathers would be proud. :) We laughed about it after the fact - just another story for the blog. His headlights (and taillights and etc.) went out after 20 minutes or so, so our first night time CNG ride was a bit precarious. Fortunately, we didn't get hit. There are enough vehicles on the road to keep us visible.

Ok, off to bed. Maybe I can write tomorrow. Maybe not - we'll see.

Holi, holi, HOLLY day!

That was the tune yesterday from Diba (at the WC office) to Holly. :)

We spent 1 1/2 hours at the office today trying to connect to the internet - we were not successful - so, this will be short. (But we did have tea!)

Today and tomorrow are national holidays. Today was a bit slow - but it was ok. Holly and I just talked and finished our shopping and had our last dinner with our Norway friends, Anne and Turid. They are leaving tomorrow and won't return until after we have left. :( We have so been blessed by their company.

Tomorrow we will have lunch at Benedict's house - he has been our wonderful cook here at the YWCA - and we are having supper with a field officer from WC tomorrow evening. Her name is Tripti. She is super sweet! :)

My feet look like I have the chicken pox - apparently, my blood is tasty. The mosquitos like them - a LOT!!!!

My tooth seems to be absolutely fine. I'm not kidding. Rach, no need for that appointment on Friday. If that changes, I'll let you know.

Thanks for the prayers - I'll try to write in the am!

Sharee Queens

So, today has been fun. :)

We went out in the morning to visit a livestock client - we had 6 people from the office with us - quite a crowd. The client only had one cow - no problems - and the client said she was 8 months pregnant. They normally don't ask us to verify that - unless there are problems. But, due to our large crowd, I asked if it would be okay if we palpated her. (The ART of vet med!) I checked her, and she was indeed pregnant. We had a HUGE crowd by then - for we were next to a school - I'm guessing there were 50 people there! (I'm pretty sure I've never had that much of a crowd watching me put my arm up a cow's rear-end!) :) That led to another farmer (not a client) asking us to check his two cows - one was pregnant, one was not. It was a good time for us to show off what we do - and for Lawrence, as well. (For he also palpated them.) We told the ladies from World Concern that they could try... but that only brought shrieks of laughter and disgusted looks. :) Guess it's not for everyone.

We then traveled to the National Martyrs Monument - their monument celebrating their liberation and freedom from Pakistan in 1971. It was a very beautiful place and we took LOTS of pictures with the gang from WC. We then traveled back to the office, had lunch, and THEN.... we were dressed in our Sharees! It took 2 women and about 20 minutes for each of us to get properly dressed! (We photographed the whole process.) We then were adorned with bracelets, ear rings, neclaces, DARK purple lipstick, and tips (the dots between our eyebrows.) We then literally PARADED around the office to the tune of 'Koop Shundar!' 'Koop Shundar!' (which means Very Beautiful!) The single guys are funny - one made the comment that he saw 'two angels' as he was coming down the stairs... that would be us. We SOOO didn't know how to respond to that - so we just laughed. :) These sharees are the gift to us from World Concern - and they were absolutely DELIGHTED to see us in them!!! They told us it was a gift of love - and we were asked to please wear them in our home country. We told them we would try - but I'm not sure we can actually get them on quite like this again! It's quite a process - with a little bit of art and skill thrown in. :) We will wear them again on the 23rd - the day before we leave. Oh, side note - there was a third woman in the room as we were getting dressed (we literally felt like brides getting ready!) - and she left as I was getting taken care of - she patted my bare (starkly white!) belly and commented that it was 'so beautiful!' They LOVE the white skin! While we spend money trying to look brown - they spend money on creams to make them white. We never like what we have been given.

After our tour of the office - we headed off (on foot) to the park. This is the first time we have walked anywhere with people from the office. They wanted to show us off! If we felt like celebrities before - today we felt like ROYALTY!!! Everyone we passed just stopped and STARED!!! One rickshaw driver passed us, then turned around so he could look at us again. To be white and in a sharee is quite the spectacle. We were the tourists - but also the main attraction. Kind of cool - kind of creepy. :) We then walked around the Parliament House - a building we drive by everyday - and everyday if there is someone new with us - they comment 'This is our Parliament House!' I'm serious, I think someone has said that to us EVERYDAY!!!! Holly and I have made a joke of it. :) 'Hey Holly, you know what that building is? - NO! Well, it's the Parliament House!' It's quite funny to us.

We feel like Barbie dolls in these get-ups. They do make you stand up straight, though - and feel very feminine. We can dig them.

I forgot to mention the most touching part of our visit with Lawrence's family. He gave his daughter money for lunch in the morning. She didn't eat so she could buy roses to give us. She gave them to us right before we left 'with her love.' I almost teared up at such sweet sentiment and such generosity.

Ok, tomorrow's a holiday so I'll write more. :)

The past 36 hours....

....have been very different. But good! :)

So, when I last left you, Holly and I were heading off to the Central Veterinary Hospital (Largest in Bangladesh!) to teach Lawrence how to set up a fecal and use a microscope. We met with 2 women vets and their technicians in the Parasitology research dept. We went through the usual shop talk - introductions, tea, etc. Then we showed them how to do a sugar float. The vets had read about doing flotation fecals in school, but have only ever done direct smears using water!!!!! Dr. Patton would be SOOOO proud (UT vet school parasite prof) to see me teaching Bangaldeshi vets how to use gauze, a small cup, and sugar solution to prepare a fecal. No centrifuge - but we got very good results just the same. They were very excited to learn this 'new' technique. Lawrence learned quickly - he's very interested to start doing research of his own to find out what dewormers are most effective. Flukes are a huge problem here (they have flukes I've never heard of!) and they don't have fenbendazole OR ivermectin in useful/affordable formulations. This makes life difficult. But, they are pretty good at making due with what they have. After our teaching session, we had tea again and talked about what these two vets do. They do 'research' in the parasite dept. Ok. 'Do you compare dewormers to find out which is most effective in treatment?' "No." 'Do you look at a sample, treat the animal, and then re-check the sample to see if it is clear of parasites?' "No." 'So, what kind of research do you do?' "We look at samples and see what parasites are there - then the vets at the hospital (practicing vets) prescribe treatment." This is not exactly my definition of research. Come to find out, these two vets don't even look at the fecals - only the techs do (in our country, it's the same) - and the vets sign their name to the paper saying what parasites were found. That's all well and good - BUT THAT'S ALL THEY DO!!! AND they get paid BY THE GOVERNMENT the SAME salary as MD's!!!!! They complained that they get the same salary as MD's, but not the same status and respect. But they don't do anything more than sign their name to someone else's work all day long. Incredible. Now, my techs read fecals and I sign my name to them - but rest assured that I'm doing plenty of other things in the course of a day. :)

After visiting with these lovely, pristine and clean ladies, we were allowed to visit the actual hospital. (We did ask them what THEY wear out on cow calls - and if their scarf got in the way... they said they wear a plastic apron... ahhh) We saw our first horses here and the first dogs of distinguisable breeds that we've seen (saw a Boxer and a Rott.) FYI - the boxer we saw was no where NEAR as cute as Jenny Cobb's 'Jordan'. :) We visited the head guy for a while (tea) and Lawrence was very surprised to realize that he worked with this guy for 2 years on a huge cattle project 25 years ago!!! This is a HUGE connection for him, for up until now the vets at the gov't hospital have not been friendly or helpful to Lawrence at all. Now he has a connection - for supplies as well as advice. Praise God for His provision! We weren't even supposed to get to visit the actual hospital - but they invited us once we were there. :) We asked the head guy about what he does there, what kinds of anesthesia he has, what kind of diseases they see, etc. I won't subject all of you to those details. :) Then we visited for quite some time with another vet - VERY friendly - very good English. He introduced us to numerous vets as well as a few veterinary students there for an internship (they looked like your typical deer in headlights!) We finally left about 2:30 to head to the vet pharmacy. (No lunch - just lots of tea and cookies and some coke somewhere in there.) Traffic was worse than usual - but we finally made it to the pharmacy and the way people shop here is just the strangest thing!!! Every store sells a specialized item. There are shoe stores, clothes stores, furniture stores, cleaning supply stores, soap and shampoo stores, you get my drift. There are also vet supply stores as well as human pharmacies. The strange thing is that there may be 20 of them in the whole city - but they are all right next to each other - and they all have the same thing!!!! I don't understand that! They are along this alley way - and they are more like booths than shops. You can only see the items - you have to ask the clerk to hand you something if you want to see it. The alley way in between the booths is very small - and VERY crowded. Got a little clostraphobic and hot and dizzy in there. But good news - we found a great product to use as a teat dip - two forms of Chlorhexadine totalling about 4% as well as a small amount of isopropyl alcohol. Lawrence bought 6 bottles. :) Then we left.

An hour plus later (and more honking than I can even explain!) we arrive back at the office to take our lunch (4:15 or so.) We ate, took tea, then went to Lawrence's house. We had tea (is anyone else keeping count?) and these wonderful little fried cakes (like a funnel cake, only solid, and no sugar), this warm milk, sweet noodle thing, and 7up. (SUGAR!!!!) An hour later we had some very good, but very spicy food. It's the first really spicy stuff I've had - apparently my face got very red - my eyes and nose were running.... but I ate ALMOST all of it. :) I was just so full! We had so much food in just a few hours!

One bad thing happened, though. While eating some of the rice, I bit down quite hard on a bad piece of rice that was as hard as a bone. I had found several of them while eating, but missed this one. I'm pretty sure I cracked a filling in one of my molars. In a word.... ouch. I'm loaded up on Advil and Ambesol right now - just hoping that I can make it till I come home. Please pray that it doesn't get worse. I can cope with the pain as it is - but I really don't want it to hamper my last few days. Rachael, can you please see if Dr Adams can see me the Friday after I get back (the 25th, I think)? I don't care what time - as long as this gets fixed!

We had a wonderful time with his family - he has a 17 year old son and a 12 year daughter - so precious!!! The daughter sang for us - even though she was very shy. One thing about kids here - they may not speak to us for they are shy. But they start singing - and wow! - they SING! Loud!!!! It's incredible. The son was very shy - but one thing finally got him talking.... Cartoon Network and the Powerpuff girls!!! Once I made that connection with him, he really started chatting with us. In English! Guess TV is good for some things! :) We had coffee (what?!? More caffiene and sugar on a very sore tooth? Boo!) But it was ok. Coffee is quite the luxury - twice the cost of tea. No way I could turn them down. Lawrence got us a cab and rode with us home (safety first!) and we crashed. Well, I layed there twitching for about an hour or so and then fell alseep. :)

Today was church - and it was wonderful. I would like to write more about that, but I'm on the bad keyboard and my fingers are SOOO tired! We went to Prodip's for lunch then finished our shopping. I had pineapple ice cream - the most incredible ice cream ever! Then we came back here for supper and now I have typed for an hour. Time to go to bed!

No new blue? VERY sad face!!!

Matt - you alive? Any phone card news?

Quick note

Hey - just wanted to write a quick note. Holly and I are leaving soon to go out for the day - off to the government vets!

We are having supper tonight with Lawrence and his family so there will be no time for blogging. Just wanted to let you know that all is well! :)

Dr. B and Dr. Nice - it warms my heart (and is good for my ego!) to know that I am indeed missed - not just for me - but for my technical skills. :) Thanks!
Cephalexin for everything!!!

Hey, did 'Super New Blue' arrive yet? Can't wait to get back behind the wheel of Old Blue....

All's fair in love and hartal

Hey there - stole the title from Holly's last email she sent out. The topics she covered included Valentine's Day, bombings, hartals, and.... arranged marriages. I hadn't discussed that with ya'll yet - will do a little later.

Thanks so much for all the emails! (And blog comments! BTW, my homepage says that you don't have to be a 'blogger' to post comments anymore - just a name and web-info - so try it!) The feedback helps me to feel close to home - though a half a world away! I would probably be a little homesick if not for that - but knowing that I will have some reply to my blogs or my emails keeps me going everyday!

Our day today was good - the gang is learning the song very quickly and it warms our hearts to hear them walking around singing all day long: "Hail, Jesus, You're my King!" Seems everyone loves the tune. Marta - the woman who normally leads the worship time during devotions - walked up today (only 2nd day she's heard the song) and played the organ with it!!! Just by ear!!! I totally don't understand how people do that!

We spent our morning (after tea) shopping for gifts for those of you at home. Two ladies from the office went along to do the bargaining for us - and they purchased our two Sharees for us. This is the office's gift to us. The fabric we purchased is gorgeous - we'll see if we are able to keep them on. We might end up exposing ourselves!!! MAYBE we can find some duct tape for keeping them on..... :) We visited the largest shopping mall in all of Southeast Asia - but we didn't find much there. It was too much like our malls - we wanted to buy things that were actually made in Bangladesh - so we found a 'handicraft' store and bought quite a few things there. We still have more people to get gifts for - hopefully Prodip's wife and daughter will take us out on Friday. The prices are sooooo low!!! DVD's for less than $2! But - we haven't bought any of those, either - we want to help support the local economy by buying local items.

We visited one farm this afternoon - large farm - good farmer! He has two cows milking 30L each per day - one of which is 7 mo bred! He feeds the most green grass of anyone we've met - and we actually saw his cows..... lying down!!! We explained to Lawrence how happy we were to see this - hoping that the sand will encourage the other cows to lay down!

We took a couple of stool samples. Tomorrow we visit the pharmacy AND the government veterinary center. We will use their microscope to teach Lawrence how to read fecals and hopefully get to talk with these guys a bit. Lawrence said there is one 'lady doctor' there and he arranged for us to talk with her. I was shocked! I did NOT expect there to be a female vet here! :) We'll be interested to see how SHE dresses! (maybe she'll have a tip about how to keep our scarf out of the manure!)

Ok, arranged marriages. Very, very commonplace here. Pretty much the only way you get married. Dad picks him. You meet him - say ok - then are engaged the next day or so. (!) Engagement lasts 2-3 months - and voila! You are married. And most likely move in with your in-laws. yippee. Divorce doesn't happen. Illegitamate (sp?) children don't happen, either. This is likely due the fact that it is not tolerated here - but also because you may get married as young as age 14 if you are a girl. We met a girl just the other day - 14 years old - who has been married for 2 months. Away from her parents, she has moved in with her husband and ALL of his family. I have pictures of her - and though they don't capture it perfectly, you can see the sadness in her eyes. We have heard stories of how commonplace prostitution is here. How a young girl like that is married into a family - and then forced to be a prostitute to provide income for them. While not all marriages are like this - I am just so thankful (!) that that is not the way it has to be for me. But most of the Christians that we have had time to get to know have arranged marriages, as well. They call them 'settled marriages' - and they boast that their success rate is 99% - while we in the U.S. (even Christians!) have a divorce rate of 50% or more. We can't knock their way, entirely - but it sure seems odd to us. I guess it's kind of like the way you don't get to choose your siblings, but after enough time with them, you truly do love them. That seems to be the way it works. There is a deep commitment on all sides.

Let me know about the microscope - if you can get it for that price, I'll pay to have it shipped here. They do have FedEx and DHL here - I think that would be the only trusted way to ship it. (Theft is common in the mail.) If you do send it, please also send 2-3 fecal devices (the plastic white things with the little filter in it - I don't know what they are called!) Lawrence can wash and re-use them. We brought slides (which he can also re-use.) If you get the goods - I'll give you the address. :) Thanks for trying!!!

Hope you at CVC aren't TOOO busy! I do miss you guys! Though when I return, I might expect to take 'tea' breaks every 2 hours or so like I do here. :)

Sam - got the recipe for the teat dip - though I don't think I've seen a blender ANYWHERE around here.... or clorox for that matter..... but I'll see.

Ok, time to go. Bye-bye!

Miracle received!

For those of you praying for a miracle for us (following my prayer calendar - I THINK it was on Monday's request that we witness a miracle...) - we do believe we have seen one.

Following our meeting the other night with Campus Crusade for Christ, the country director asked if we would like to participate in one of their campus outreaches - handing out Valentine's day candy to students on the Dhaka University campus. While we were grateful to be asked - and would have very much liked meeting with college students - the 14th was declared a hartal (strike) day and we suggested that we didn't feel it was safe for us to do so. This greatly upset the country director and he persisted in trying to convince us to go - even adding the guilt trip of asking if we 'didn't trust him.' We explained our desire to follow Prodip's orders to stay inside - and he suggested that Prodip was being overly cautious for our safety. The CCC leader told us that he drove around and worked as normal on the last hartal - and he assured us that we would be safe. He didn't appear to be taking our 'no' for an answer. Holly and I just really didn't feel good about this AT ALL!!! When we got out of the van after the meeting, he reminded me that 'where there is a will, there is a way!' and I reminded him that while that was true - we were also warned to be as 'wise as serpents.' (Thanks, Matt!) We thought all was well and understood, until yesterday when he called and told us that he could pick us up on foot and take us to the university - and that he could be there in a few hours. I just had to be as blunt (but tactful!) as possible and say that we were not going to go! We had work to do at the office (all that typing from yesterday) and we still did not feel it was safe for two white women to be on a university campus on a hartal day!

Here comes the miracle part: we trusted our instincts. We were right.

There was a bombing at the University yesterday. 4 bombs went off during the Valentine's Day festivities. 16 people were sent to the hospital. (No one was killed, fortunately!) We WOULD have been there. When I saw the headlines in the paper this morning, I was almost sick - so overwhelmed with thankfulness for our safety, and dread realizing what COULD have happened.

Thank you for your prayers. Holly and I believe that our 'gut instinct' was a direct result of your faithfulness to pray for us. Please continue to do so.

In other news, we have enjoyed our evenings these past two nights by being the only guests in the YWCA guest house and watching movies. It's the first TV we've watched since we've been here, and it was a good distraction from all the work we've been doing. We were joined by our good friends Anne and Turid - the ladies from Norway. Anne lives at the YWCA (she's doing a year long internship) and Turid visits Bangladash 2-3x a year for she is a secretary for the YWCA and a donor from Norway. This place is home for them - so they don't really count as guests. :) We enjoy their company so much - and I do believe this trip would not be as fulfilling as it has been if not for them. Sunday night we watched 'Robin Hood: Prince of Thieves' and last night was 'How to lose a guy in 10 days.' Chick flicks!!!!! :)

On to the technical stuff: Dr. B and Mark - thanks for the info. I thought the milk WH for pen was 48 hours (you probably taught me that!) and I capesh on the other matters. Holly is getting credit for her time here, so we will make sure that a copy of our mastitis stuff gets into her professors hands. I have learned so much about stall design! Thanks to the U. GA's site (via Mark) and the U. Wisconsin's site - and Holly, of course.... I didn't even know what a 'brisket board' was. :)

Jenny's - no need to mail the microscope - just wanting to know the price and where to get it. You have access to more distributers and info than we can get here. So, the name and phone number and price are all I need. Prodip will see to buying it for Lawrence's use. As far as the sugar float - do I need to heat that at all? Or is it really just sugar dumped into water? Thanks a million!!!

Ok, time to write about rabbits - good thing I brought along a Merck Manual!

Shubho Dupur! (Good Afternoon!)

ps - duct tape. Heh. They don't have duct tape. :( We are truly in a 3rd world country.

Techno speak!

Ok, this is a technical blog. Holly and I have spent our Hartal day typing up some protocols to leave for Lawrence. Sorry for the masses - but I need some input from Dr. B., Dr. Nice, and Mark as far as suggestions and corrections.

Also, a couple of questions: I know the 'right' answer but I need to know the real answer: if you use only an intra-mammary infusion of antibiotics, are the other three quarters REALLY affected by the antibiotics and in need of disposal? Also, our source says no milk witholding for IM procaine pen G - is that true? Ok for calves to drink AB treated milk - I thought no, but is it a prob? Normal dosing of intra-mammary AB - how many times a day, how many days? (Of course, we are using Genta mast.... you may not have info on that.)

Just so you know - Lawrence says there is a 20 day milk witholding on the magic cure all injection - hence why he doesn't use it. :)

This is all we've done today, so nothing else to report!

- Happy Valentines Day!


Mastitis Prevention


Mastitis is most often caused when bacteria is allowed to enter the end of the teat. We call this environmental mastitis. The best way to treat this is to prevent it! Bacteria will enter the end of the teat when given a chance – most often this is during, or just after milking. So, there are several important factors that can help reduce this exposure to bacteria.

1) Water, while good for cleaning, if left on the udder or teats, can act as a vehicle to carry bacteria into the teat.
a) Washing of cows acts to clean them and cool them – but we recommend washing a couple of hours before and a couple of hours after milking (midday) to ensure that the end of the teat is closed to prevent contamination.
b) Mustard oil should be applied prior to bathing to act as a barrier to the water.
c) Udder and teats should be COMPLETELY dried with a clean cloth after bathing to remove all water!
d) Before milking, teats and udder should be cleaned and DRIED before milking.
e) The farmer should wash his/her hands with soap before AND after milking EACH cow. The hands should be dried completely before milking. No wet hands on the teats!

2) After milking, the teat canal is open and is most likely to be infected with bacteria at this time. The strongest preventative measures need to applied here for optimal success.
a) When finished with milking – DO NOT CLEAN TEATS WITH WATER!!! Apply a post-milking dip with a disinfectant to all 4 teats.
b) The post-dip should cover the entire teat and there should be a drop left hanging at the end of the teat.
c) Do not wash, rinse, or wipe off the post-dip until the next milking. (The calf can be allowed to drink 2-3 hours after post-dip without having to wipe. If it appears that a lot of residue is present on teat, wipe with a clean cloth before allowing the calf to drink.)
d) Feed cows AFTER milking to encourage them to remain standing for at least 30 minutes while the teat end closes. (Laying down exposes the teat end to bacteria following milking.)


3) A clean environment and clean bedding are very important for udder health and cow–comfort (which leads to more milk!!!) Manure, as well as wet bedding, should be removed as often as possible.
a) Sand is an available and inexpensive bedding that cows really like!
b) Sand provides a soft, clean, cool place for the cow to lie down on.
c) Sand must be used in a stall layout to prevent waste and contamination of the bedding.
d) Stall design should be as follows:
1) Two dividing rails keep cows in their own stall. The bottom rail should be no higher than 12 inches. The top rail should be at least 48 inches from the bedding.
2) There should be a brisket board to keep sand out of the food and keep the cow lying far enough back so that she can rise easily. This can be made from bamboo tied together or other wood material. It should be placed 30 inches away from the feeding space and should be 4-6 inches in height (2-4 inches above bedding) and placed at a 30 degree angle away from the cow (toward the feed space.)
3) Depth of sand should be 6-8 inches. New sand should be added as often as necessary to keep a deep, clean surface for cows.
4) Length of stall (and length of sand bedding) will vary depending on size of the cow. Sand should go far enough back to allow cow’s udder and back legs to be on bedding, while allowing her manure and urine to be expelled on a non-sanded area.
5) Width of stall will also vary according to cow size and barn dimensions, but should be at least 46-48 inches (cows up to 450 kilos) or 50-54 inches (for cows over 450 kilos.)
6) Cows need an unobstructed area in front of their head to allow for rising. If a concrete feed bunk is used, the brisket board may need to be further back than 30 inches.
7) Because cows will be lying down (hopefully) more than they are now – the length of rope and the way they are tied will likely need to be changed. The rope should be long enough that when the rope is tied to it’s post and allowed to hang freely; it should be 8-10 inches from the bedding. If it is too long, the cow’s legs will get caught when rising – too short, and she won’t be able to lie down.
8) If a cow is close to having a calf, she should be moved to a different area – these stalls are not big enough for her to calve in.

Mastitis Treatment

Most mastitis seen here in Bangladesh is environmental. This type of mastitis is caused by exposure to bacteria through the end of the teat and is not contagious to other cows or people. It can be identified by the following symptoms: sudden decreased milk production, fever, swollen and hot, painful udder, loss of appetite, and brown, watery, or clear milk secretions. It can be a very severe disease resulting in dehydration (skin tent is slow and eyes sunken in) and sometimes death if not treated quickly and appropriately. The affected quarter will most likely not resume milk production after treatment for the current lactation period – but should be able to function normally during the next lactation.

1) The affected quarter (nipple) should be completely milked out (stripped) every 4-6 hours if possible. (Note: since the cow is painful, it is wise to tie her leg so you won’t be kicked!)
2) After stripping, the teat should be dipped using a post-dip disinfectant (unless treating with intra-teat antibiotics, then the dipping can be done after the treatment.)
3) Antibiotics should be used in the teat for no more than 6 treatments – the milk should be discarded after treatment for as many days as needed, according to the label of the specific treatment used. This milk should not be drank by people, nor fed to calves.
3b) To use intra-teat antibiotics: after stripping, the end of the teat should be cleaned with a disinfectant. The plastic tip of the tube of the antibiotic ointment should be inserted completely into the end of the teat – taking care not to touch the end of the tube with ANYTHING (it will be contaminated). Squeeze the contents of the entire tube into the teat. Remove the tube and hold the end of the teat closed (clean hands!) Gently massage the medicine up into the udder. Apply teat dip.
4) Oxytocin injections can be used (IF the cow is not milking out properly) for a maximum of 3 days in a row.
5) Injectable or oral antibiotics should be used if the cow has a fever or has stopped eating. (If the cow is not sick – only the udder affected – just use antibiotics in the teat.) Penicillin or sulfas can be used for 4-6 days maximum. ALL milk should be discarded if these are used for 4 days following last treatment with sulfas, and 2 days (?) following penicillin. Terramycin can also be used, discarding milk for 4 days after last treatment.
6) This is a painful condition, so pain relief is important to get the cow feeling better as quickly as possible. Antihistamine injections can be given once a day for 2-3 days, and aspirin by mouth twice a day for 5-7 days. Aspirin should always be given after the cow has eaten, should not be used in pregnant cows, should not be used if the cow is severely dehydrated, and should be stopped if manure becomes black in color.
7) If the cow does not start eating quickly, appetite stimulants (Digivet, Zymovet, Anorexon) and yogurt (doy) should be given.
8) If the cow is very sick and appears dehydrated, fluids should be given IV (hypertonic saline, dextrose, Calcium, etc.) and then she should be allowed access to as much water as she wants. This is very important!

First day of Spring

It's the first day of Spring in Dhaka city (Falgoon in Bangla.) Women are dressed in their brightest sarees and sular camis - with flowers in their hair. It's a nice sight. We were told today that we will be given sarees to wear for pictures and for showing off in the U.S. Holly and I expressed concern at this.... this is a 6 meter piece of fabric wrapped intricately around the waist with a very pretty pleat, then the end thrown over one shoulder and back around the waist. A very tiny top is worn under it, but the mid-section is exposed (! - how is that ok?!?) Holly and I agreed to wear them, but advised Florence that she would have to dress us - for we had no CLUE how to put that thing on! :) She only laughed and said 'of course!'

So, we visited 2 farms today to recheck 2 cows that have been sick. One is a small calf with an infected naval - Lawrence has been doctoring it (daily penicillin injections and draining the pus out, as well as flushing the area with a sulfa powder/water mixture.) The calf is fine - the infection is almost all gone. I think he just wanted us to see it again, and the family wanted to see us again. :) We had tea and looked at family photos. They laughed at our pitiful attempts to speak Bangla. Wonderful people.

The next place was new for us - it was a farm with a cow with a bad case of mastitis - Lawrence began treating it 7-8 days ago with a Gentocin/Penicillin intra-mammary infusion as well as injectable sulfa antibiotics. They were only stripping her out 2-3 times a day. We advised 3 days ago that they increase the stripping, and give her some pain relief! They don't have Banamine here (!) but Lawrence has an antihistamine injection and they have aspirin. We saw her today, and they said that she was sooo much better after the injection and aspirin - her milk is still a little watery, but her production is coming back up and she's eating well. :) A success! The only people who will really be interested in this next part will be Dr. B and Mark (and any other dairy people reading this that I don't know about...) Lawrence has a drug in his box that is seriously a cure-all! It has 500mg/mL Oxytetracycline, Prednisone, DMSO, AND Chloramphenicol!!!! Lawrence says it's what the government vets use for everything - can you imagine why?? :) Woo - seriously illegal in our country! He's only used it in one cow - but she got better! :)

Ok, more about the driving conditions: All major roads are void of lane lines. There is no need for them. It's like a giant tetris game - seeing who will fit where. Most roads will fit 6-7 vehicles wide - that's a mixture of buses, cars, CNG's, and rickshaws. And it is normal and expected that people will cross a busy highway as if it's no big deal. Just keep moving - and you won't get hit. (!) Oh, they also have giant speed bumps just right in the middle of the highway. Odd.

So, the song we are teaching them is the 'Victory Chant.' For those of you who don't know, this is a great echo song. It's got a fun beat - and they really seemed to like it. Unlike us, they sang with great enthusiasm. (Most of the time, when we are learning a new song, we don't sing very loud - but they did!) Since tomorrow is Hartal (boo!) Holly and I gave out all the valentine's day candy that we brought with us. They were very reserved about taking any at first, but then they swarmed! All was gone within a few minutes! :) I think the universal language is chocolate. Everyone understands it! :)

Ok, enough for today.

Must haves/Can't stands

Ok, I'm at Prodip's office - non-possessed keyboard. I can type longer today. :)

Dr. B and Jenny's: I forgot about peroxide! We are going to a pharmacy tomorrow so we can actually find out what they have here. Hadn't thought about wicking water post bathing.... good call! They generally just use boiled water (!) as a pre-wash - hence our urgency to find an alternative! Holly and I have been discussing free stall size and lunge room - every barn is different, but I think we have gotten across to Lawrence the importance of proper width and lunge room and all that. We also gave him the warning that these cows will most likely lay down with the sand. (We have yet to see a cow laying down!!!!) Lawrence already told a farmer about using sand and setting up free stalls - he's loving the idea!!! He's a smart cookie, he is. He is the one that designed most of the barns - so slope and drainage are great. The cows come in ALL kinds of different sizes - so the size may be more on an individual cow basis. Little bit of a learning curve. :)

Techs: please send recipe for sugar float medium!!! (minor detail!)

I thought we were going to get to have a dystocia (calving prob) today! Alas, the presentation was normal and all was well. The cow just hadn't started pushing yet. Too many people around to keep her attention diverted. She didn't appreciate me checking her without lube, though. Our usual 'lube' (manure) has been working quite well for the rectal exams, but no poop allowed in the birthing hole! I was gentle, no worries!

We continue to be blessed by your prayers. We not only have not gotten killed by the driving here - but we are not even bothered by it anymore! That is a miracle!
Though, I did get in a rickshaw accident the other day. Fortunately, I was with Pintu - a male field officer from WC. He quickly pulled me out of the rickshaw and put me promptly on the sidewalk while the rickshaw drivers swapped what I could only imagine to be Bangla profanity. Our driver's wheel was badly bent - meaning no work for him for the rest of the day. We just got another rickshaw and went on our way.

Let's talk a little bit about Rickshaw's, shall we? These are 3 wheeled bikes with a seat bench on the back. The front gear is large, with a chain running to a small gear to turn the axle between the rear wheels. (Hope that makes sense!) The driver pedals around all day (6 hours max) carting people around for around 33 cents per ride. Sometimes that ride is 20-30 minutes long!!!! We have seen as many as 4 people loaded on a rickshaw!!! And it's getting to be sooo warm! Very hard work - very little pay. This is the way of life in Bangladesh.

Our taxi cab broke down again today. We are the curse to the little black taxi.....

Now for my list of must haves/can't stands. This is an eharmony reference. :)

Things I like about Bangladesh:
Eating with my fingers!
Taking my shoes off when entering someone's home
Warm sunshine
Very friendly people
Good tea (though sometimes too much of it!)
Sleeping under a mosquito net is quite cozy
Nice cows and nice people who care for them
Feeling like a celebrity everywhere I go
Learning a new language (and getting a new nickname - I am now known as "Leelee" which is flower. :)
Our cook at YWCA - he likes us and makes us 'special' food (that no one else gets!) :) His name is Benedict.

Things I don't like about Bangladesh:
Dirty air
Dirty cars
Dirty looks
(the people are surprisingly clean)
Honking - all the time. A honk can mean one of a few things: "I'm turning." "I'm coming up behind you so move or I'll run over you." "I'm stuck in a traffic jam and just need to express my frustation." "I'm a bus - I'm bigger than you - so I will honk all the time." "I thought of something funny - so I'll honk." "The sun is shining - there's no one in my way - I'm happy - so I'll honk." "The light is red, but I'm running it anyway - honk." "Everyone else is doing it! - HONK!" "Oh! Look! There's another car - honk." "Honk if you are in Dhaka!" And the number one reason for honking: "I'm a Bangladeshi, I am not prone to wastefulness - so I use ALL parts of my car - including my horn." HONK!!!
Mosquito bites on my toes.
TINY bones in the fish we have to eat - hurts the throat.
Having the same meal - every day.
Possessed keyboards
Not being able to call home when I want to ;(
Naughty Bangladeshi boys
Trying to work on cows with a stupid scarf around my neck!!!
Having to drink hot tea on a hot day - because you know the semi-cold water they are offering will give you the runs!

Just so you know, the runs have not been a problem. The rice is keeping us bound up quite nicely. (Sometimes too much!) Then, the hot tea is your friend. :)

That'll do. Holly and I are proposing that we make a t-shirt or a bumper sticker or something about "Top ten reasons to honk in Bangladesh." We are laughing hysterically. Hope you at least got a giggle. :)

Ok, time to go. We are working well and hard. No shopping time - no tourism time. But that will come before we leave.