Thursday Doors

Doors? Well, an open flap in a massive tent would be a more appropriate description.


We take hygiene and hand washing seriously in the health facility. There are half a dozen blue barrels filled with water around the hospital. Each barrel is mounted on a metal frame. Beside the tap, there is a pink plastic string bag containing a bar of soap. Beneath the tap there is a bucket to catch the sullage.

I had just finished a ward round in the measles isolation tent and stepped outside to cleanse my hands. I turned on the tap, but there was no water. I glanced down into the bucket and saw there was a couple of centimetres of water. I really felt I needed to wash my hands so I decided to cheat, to use the waste water and throw it away afterwards. After I’d started washing my hands, I realised that this short cut was a big mistake. I noticed that the water wasn’t clear. I expected it to be soapy but instead there were half a dozen gobbets of phlegm, floating like stranded jellyfish.

Just beside the measles tent is TB Corner. This is where patients with suspected tuberculosis queue up to give sputum samples for testing. I could see patients crouching down by the tent trying to cough up a sample. It didn’t take long for the awful truth to dawn on me.

Initially it reminded me of “Îles Flottantes” – meringues floating in custard, but it’s one of my favourite desserts, so I banished the memory immediately before any lasting associations could be made. I replaced it with the image of a prairie oyster – I never drink enough alcohol to require a hangover cure.

There are no towels to dry your hands because of the risk of infection, so I couldn’t wipe. Twenty metres away, outside the toilets, there was another blue barrel, but this was empty, too. I stretched out my dripping, doubly-contaminated hands and walked like a zombie to the Emergency Room, where I gave my hands a good scrub under the tap in the sink.

I mentioned this experience at the Hospital Hygiene Committee meeting this afternoon and we came up with a plan to ensure that patients knew where to spit, where to wash their hands, and how frequently the barrels need topping up with water. I found it comical that my colleagues were bemused why I hadn’t just used alcohol gel to clean my hands in the first place.


6 Replies to “Thursday Doors”

  1. Hi Ian – thanks for your post. Ali and I think of you very often. She is in Chiang Mai for a Myanmar language course and gets back Saturday. We just celebrated our 33rd wedding anniversary there last weekend. We are following the situation in Rakhine very closely from our home base in Yangon. You are always welcome here anytime you can take a break. Just a short flight from Dhaka. In the meantime we look forward to your next post. Love and prayers – Duncan and Ali

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