It can be extremely difficult to imagine or understand all of the variables that impact public health without being in the situation. The flooding and water damage that we’ve experienced in the last few weeks have made it more apparent how everything in society is part of the health system. If we had been anywhere else watching the news on the floods and landslides in Bangladesh, I don’t think we (maybe Zahra was a couple steps ahead of me on this) could have properly grappled with the causes and effects of flooding, specifically on health. We will both leave Bangladesh more attuned to how natural elements and man made constructs jointly impact public health.
Monsoon weather began exactly when it was predicted to start. The rains from the first day of the season were very different from the light rain showers that preceded them. The sound of the water alone signaled that we would all be dealing with the after effects. As we predicted, the first set of rain was damaging. We rode to the hospital the next morning with the Hope Foundation Hospital Director, Jalal Shoaib. On our way to the hospital we gawked at the height of the water in the rice paddies, the pools of water on the roads, and the puddles that seemed to creep on every doorstep. As we commented in awe on the newly formed streams and pools of water, Jalal, spurred by our concern, provided some foreshadowing for the weeks ahead. We were told that soon enough the standing water we had observed would rise even more. If the weather acted as expected, we would experience significant flooding. He explained that the water falls and collects the sand and dirt on the ground, which subsequently travels with the water and obstructs its flow to the few existing drains and natural streams that would carry it elsewhere. Once the drains are blocked, the water continues to rise. Jalal assured us that we would be seeing this for ourselves soon —and he was right.
I can’t quantify the impact that poor drainage systems had on the floods that swept through our region in the last few days. It cannot be denied, however, that the drainage system does not have the capacity to effectively handle the amount of rainfall that occurs during this time of year. Prior to arriving in Cox’s Bazaar, I probably could have speculated about the extent of the damage caused by the flood, the effects of our hospital being closed for two days, or about the increased risk for vector borne and water borne diseases in monsoon season. But the issue of drainage is something that has come to my attention only because I have been here to witness it. The coming days and weeks will be incredibly informative as Zahra and I observe first-hand the impacts of the flood on the community, particularly in terms of healthcare needs and access.
So it took a flood and general annoyance of standing water for me to start thinking about drains and sewer systems. Either way, what I’m realizing is that pinning down one infrastructural issue only indicates that there are more to be found.