Unsung heroes: a day on a Bangladesh water ambulance

It may be the case when collecting case studies that the worse a day goes, the better material you collect.

Well, that’s what happened to me recently when I visited a region in nothern Bangladesh called Ajmeriganj. The area’s known for its enormous flood plains – called ‘hoars’ – which cover the region during the monsoon season.

I was visiting to find out about Save the Children’s water ambulances that healthworkers use to reach isolated mothers and newborn babies.

But the day started off badly…

Monsoon rain

On our drive to the first boat we needed to get to the water ambulance, we were involved in a car accident. We were fine, but I was quite shaken.

We were OK to continue and board the first boat. It was only 7am, but the monsoon rain was well and truly underway. It meant the journey took double the time it normally does. And it left us feeling slightly queasy when we finally arrived at the water ambulance.

Once on board the water ambulance we picked up the paramedic, Julia, who was in charge of the day’s trip.

Julia greets us all with a bright smile and lots of energy. She’s very focused on the day’s task and soon gets to work. She carries a kit bag that looks heavy and too large for her small frame. But it contains equipment that could be the difference between life and death in these remote flood plains.

As we set off the rain gets harder. My apprehension grows about whether this trip will be successful.

Stuck

I start to despair when, just before we reach the village we are visiting, the boat suddenly jolts and the engine shudders to a halt. We were stuck on a sand bank.

As with most of the situations we experienced that day, the crew on the boat take this completely in their stride. The boat driver and technician jump off onto the waist-high flood waters, and start pushing and pulling the boat to try to free it from the river bed. Julia carries on with her preparations for the clinic.

The pregnant women soon arrive, huddled together on a rowing boat. As they come closer it becomes obvious that they’re heavily pregnant. They awkwardly ascend the gangway.

The expectant mothers enter and sit patiently on the bed on one side of the ambulance. Julia examines each mother carefully to check the baby’s position, the woman’s blood pressure and haemoglobin count, and any other ailment the mothers have. Many complain of stomach pain and that they feel weak.

Banished

Julia works calmly and efficiently, keeping her eye on the task at hand – an impressive feat as the cabin fills up with more and more pregnant mothers trying to stay out of the rain. She also has to contend with my film crew who are yelling instructions at each other from the engine room – we were, quite rightly, banished to work there to get out of the way.

The boat is eventually freed from the sandbank. And it takes Julia three hours to work through 15 pregnant ladies.

She also urges all the women to try to go to a clinic or hospital to give birth as it’s much safer. Many say they’ll try, but it will cost them a lot and they’re not sure their families will agree to it.

Most just hope God will be good to them and they have an uncomplicated birth at home with a traditional birth attendant.

Relief

As the last woman leaves we realise to my relief that the day has actually turned out to be a success. The pregnant women were all seen to, and my crew and I got great footage of the water ambulance at work.

My strongest impression of the day was the amazing people who work to keep the boat and its services running. Julia and her helper worked ceaselessly and serenely, keeping the check-ups going despite all the mishaps and drama around them.

My crew were also bowled over by the skill and aptitude of the boat driver. He  seemed in three places at once, wading waist-deep in water to assess how stuck we were and instructing the technician and local boys on how to manoeuvre the boat out of the sandbank, while at the same time helping pregnant mothers get from the bank to the rowing boat and onto the water ambulance.

These people are inspirational – unsung heroes. Without their skill, dedication and ability many isolated and vulnerable women and their newborn babies could not access the basic healthcare they have a right to receive.