LAMB NEWS – DECEMBER 8TH, 2009

For us at LAMB, this past month has been a time with a lot of feel-good things. The lovely dry winter season has arrived, with temperatures of about 20^oC in the daytime and 10^oC at night. Nationally, and for LAMB except for the hospital and community clinic services, it has been a holiday time, as the majority Muslim community celebrates the example of sacrifice. At LAMB, the small US community seemed to expand hugely to celebrate Thanksgiving – we all had a lot to give thanks for. Around us, the second rice crop of the year is almost all safely gathered in. And LAMB itself now feels in a much more secure position than it did only 3 months ago.

The hospital for a couple of weeks has been very quiet. This is normal at Eid holiday time, but this year Eid also coincided with one of the rice harvests. The reaping, the threshing, and the gleaning of fields, is all by hand, and so even in this densely populated land, much of the population is very busy. Those not in the fields, or busy with the threshing, or at rice mills, may be involved in the transport of rice or straw. Rickshaws and trucks are all busy. At LAMB, baby deliveries keep happening, but beyond that, if a health problem can wait, it waits.

While the hospital has been quiet, other parts of LAMB have been very busy.

The Training Centre is at full stretch. Almost all of the training at the moment is related to maternity, with training ranging from 6 months for Community Midwives down to 10 days for Basic Emergency Obstetric Care. There is a huge demand for skilled birth attendants in the country, and their availability is essential if Bangladesh is going to be able to lower the rate of deaths for mothers giving birth. This is one of the global Millennium goals. Maternal deaths in areas where LAMB works are less than half of those in the country overall.

An indication of the increasing importance of the Training Centre is that the Head of Training has just been appointed as a Director. As such, she is one of the executive team with overall responsibilities for LAMB day to day management. The Director team of nine is made up of five Bangladeshis/ four expatriates, and, looking at it another way, five women/ four men.

As a sign of things getting better, LAMB is recruiting new staff again. This is linked to the trial phase of a new project in the MIS-Research Department area and is related to nutrition and heath. At this stage the work is only for a short term contract, but if the project moves to the second phase then staff will be employed for 5 years. The approximately 30 staff involved are mainly out in the community, but a small number are in the MIS-Research Department itself.

The recently started program to realign the foot or feet of children born with club foot is going very well. The program at LAMB uses the Ponseti Method and involves children first wearing plaster casts, around five casts over several weeks, gradually straightening the foot. The children then progress to wearing braces at night for the next 4-5 years to gradually embed the new alignment. The first children treated at LAMB are already out of their plaster casts – with straightened feet – it is marvelous to see them.

For this club foot realignment program, LAMB is supported by ‘Walk for Life’, an organization founded only this year. LAMB has been involved right from its conception, and is helping the national spread of the program. Walk for Life has already make remarkable progress in quickly getting the program introduced in several districts of Bangladesh. The LAMB therapist was away with them for nearly two weeks, both demonstrating techniques, and involved in discussions with the Ministry and with orthopaedic specialists.

With all these developments, as with many others at LAMB, we never stop being amazed at all the people and resources which God has provided to enable us to continue working.

LAMB NEWS – NOVEMBER 6TH, 2009

How things can change in a couple of months. In September, although in the community and the hospital the normal care continued as always, inside LAMB it was tougher times. Big projects were coming to an end, there was a growing financial hole, and there was a small cut back in the number of staff.

Now, at the start of November, there is one (big for us) project which looks highly probable to be approved, and may start almost immediately. One or two other projects look very promising. We also received one very kind, large, collective donation, and people from different countries have also sprung into action for support. There is tremendous energy around to overcome what was a worrying time for the short and longer term.

For people of faith – not only Christian – a prayer day across all departments and a prayer month for senior staff have really helped.

Another very visible change in the past couple of months has been in the Training Centre, where the quiet month or so is now over and everyone is very, very busy. We now typically have about 50 trainees in residence at the Centre, and more space would be useful. The quality of the LAMB courses is considered very high, and there is a huge need in the country for the particularly maternity related training that we are strong in. Hence both for government staff and staff from NGOs, large and small, we are getting booked up well into the future. An upwards extension of the Training Centre is one of our current dreams.

Another change from a couple of months ago is that seasonally we are into a very pleasant time of year. Bangladesh has six seasons, and we are now into ‘late autumn’, with winter to follow. The worst of the humidity has gone, and daytimes tend to be sunny warm and dry. Night-times the temperatures fall, which is also very pleasant – except for some of the poor, but perhaps more of that in a later newsletter. It is likely that we shall have (almost) no rain for the next four months or so. Little streams and even little rivers dry up, and the big rivers dramatically shrink.

All the good and big things happening in the past couple have months have happily covered over ‘small problems’. The LAMB email system was very sick for most of a couple of weeks, with two problems elsewhere being the main reasons. LAMB – like very many organisations – has come to depend on email, particularly being located where we are. So loss of email contact – now our main link to the outside world, except for locally – is a big extra problem. Happily, things are mainly back to normal.

We also had some unexpected delays for a while in getting entry approvals for some volunteers from overseas, both for the school and the hospital. For those coming, who in some cases had already given up their job at home, the uncertainty was a bit worrying. Here, the existing staff were eagerly awaiting their arrival, and rotas had to be changed and even more work taken on. Happily in this area too, approvals have come through, and more help is here or on the way. Despite occasional problems, LAMB has been very well supported with approvals, despite the considerable number of short term volunteers and long term expatriates who come.

This past couple of months has therefore been one which has brought new hope and cheerfulness, and we give thanks for this and for all that has been provided.

LAMB NEWS – SEPTEMBER 10TH, 2009

Greetings again from LAMB.

Here at LAMB, ‘baby season’ has arrived again – at just about the normal time of year. From end of August/ beginning of September, for a period of about 6 weeks, the number of babies being born at the hospital always seems to rise by about 25%. So, it is a very busy time – really hard work - for the already busy midwives and obstetricians. Some weeks on average 13 babies are being born in the hospital every day – compared to 7 per day or even less in quieter times. The maternity ward has overflowed into other wards, and the hospital beds are filling up.

It is not just the midwives and obstetricians that are busy, since many of the babies often have problems through being underweight or other sicknesses related to their environment. So the paediatricians too are very much occupied.

The Training Centre is also back in full swing, after a few weeks of relative quiet when the trainers could do some updating of their courses. It is now fully loaded for the next 6 months. The biggest demand by far is for training related to maternity. In general the training courses are not for qualified midwives, but rather are for lower levels of skill. The situation in Bangladesh is such that even providing a fairly limited level of delivery skills can make a big step up in saving lives compared to the current alternative, which is very often a family member or local untrained woman. It is a good feeling to be part of this big improvement for Bangladesh.

At the Hospital site, this has been a less happy week. Because of the financial situation, 15 out 370 non-field staff have been told that they are being laid off. A few are long-serving. There are several reasons for this action. The first is that because of a Government voucher scheme to encourage free care for pregnant women at Government facilities, the number of in-patients to LAMB has dropped, and is now below the number in 2006 when we expanded the hospital. Our costs have gone up faster than our income, in particular salaries and the Poor Fund subsidies to poor patients. Two large grants for work in the community have come to an end, with no other work yet to follow – although there are good possibilities in sight. And lastly, because of the global financial problems, and the fall in the value of the UK pound, there is a decline in the income we receive from overseas.

We are also taking other measures, including converting a separate area of one of the larger wards into an area without full nursing, for patients ready for discharge. We will still be able to bring the area back into full nursing use fairly quickly if so needed, and in the case of emergencies can staff it through extra working, but it will lower our costs in the meantime.

We hope that out of adversity will come strength for LAMB, but for those who will leave this is very difficult. So we would be very grateful for your prayers for them, and that we are doing the right things.

LAMB NEWS – AUGUST 6TH, 2009

Greetings once more from LAMB. This is a time when we are looking very much to see where God wishes us to work, but first in this newsletter a bit of an explanation about what is happening.

Here in Bangladesh as in many countries, the weather makes a big difference to life. Now in monsoon season here, we have been reminded of the realities.

At its simplest, we see the number of patients coming to LAMB Hospital drops a lot when it is planting season, as now. The same will happen at harvesting time – since both planting and harvesting, and the gleaning that follows, are all completely manual. Planting and harvesting, twice per year in this region, take priority over almost anything – good health can wait.

With the monsoon, in one of our community areas, maybe less than 20 miles from LAMB, the clinic which in the dry season is a pleasant walk or rickshaw ride from the road and a bamboo bridge, is now already extremely difficult to get to and by a long round about route, because of flooding and the fast flowing river. It is easy to understand why common the commonly used term here for such areas is ‘a remote area’, despite seeming physically close to help.

But there are more difficult places. In the past month, LAMB has been asked by two international organizations if we would be interested in setting up health systems in new areas much further away from LAMB. For one, we are told that much of the district is under water for 6 months of the year. For the other area, two of our Directors visited to understand the challenge of getting healthcare to the communities. From the road in a fairly remote spot, it’s a good long walk, then a 30 minute small boat journey across the big wide river to one of the small islands. On this island alone there is a village of 5,000 people – and all the islands are similar. Life for these people is very tough, and if the river floods high and all the island goes under water, then it gets tougher. They have no real money, even to travel by boat, so they need healthcare to come to them. But in emergencies it is very difficult. People would live elsewhere if they could but it is a small country with 150 million people, so there is little choice for land. It is easy to see why mothers, and babies, die in childbirth at much higher rates than in more developed countries.

We wait and see if these are places are where God leads us to work.

Trying to do God’s will is a normal way of life for LAMB. It is sometimes easy though to get sidetracked into ‘interesting areas’ of work. In these, we no doubt do good, but are they what we are here for. There is now new effort both by management and the LAMB Board to refresh the focus on those areas that we believe we are here for – health and justice, and focusing on the disadvantaged, in particular women, children, and the poorest of the poor. As we look afresh at the direction that LAMB overall should be heading, we keep needing to be reminded - and fortunately there are many who will remind us - of what we are here for.

LAMB NEWS – JULY 5TH, 2009

Greetings from LAMB.

Here at LAMB the monsoon season is with us. That doesn’t mean it rains all the time, but we do have some very long, heavy downpours. It is all part of the annual cycle, and is in truth a blessing – even if for the community outside of LAMB, roads and paths become mud walks. The thunder and lightning which is often a problem at this time of year has so far done no damage to LAMB.

As is often said, times of adversity are often times when new growth starts. That is how it feels at LAMB at the moment. We are being challenged by big funded projects coming to completion, the world financial woes, and a reduced number of patients because of a Government voucher scheme.

But it is extremely pleasing to see the energy, fresh thinking and action now under way. Senior managers in particular are proving to be leaders indeed – getting out and about to find where we can help in the future, looking at the things we do to find ways of doing things better, and then actually making the changes. Simple examples are in making the hospital more patient friendly by setting up an information desk – using existing staff; looking at fairly simple changes to the out-patient clinic so that we can increase the numbers of Training Centre students able to get practical experience at any one time; and at the community clinics publicizing their services better so that community members know what help they can get.

At the big scale, senior managers are now all active talking with other organizations for whom we do work to see what else we might do for them. In truth, LAMB’s high quality reputation is very helpful to us in that.

For us serving here, we often never know in depth the effect that we are having on others through demonstrating God’s love. Sometimes the results come in less direct ways. A US citizen who was at LAMB for a few weeks recently has since commented that she had not previously seen Christians putting their faith into action as at LAMB. After her time here, she wanted to start reading the Bible and exploring her Christian beliefs

We pray that we will continue to be a positive influence in God’s world
And lastly, attached is a photo from the session last month when 30 children had their feet put in plaster as the first stage of repairing their club feet. They will wear the plasters – in this heat and humidity – for maybe 5 weeks, and then wear shoe braces, for a short while all day, and then at night for 4-6 years. A big commitment, but it is a proper cure, low cost, and enables the children to lead a fully normal life thereafter.

LAMB NEWS – JUNE 6TH, 2009

Greetings from LAMB.
In our part of Bangladesh, we escape the damage of cyclones which hit near the coast. The first rice crop of the year has been harvested, and the fields are full of stubble. The villagers are busy with the straw and grain. Although sometimes a bit troublesome, rains and higher temperatures are starting to be with us, a blessing for this country where so many people depend on agriculture.
At LAMB, it is a time where extra good things seem to be happening for children with disabilities. A generous and enthusiastic Australian businessman has set under way a program in Bangladesh, starting at LAMB, to tackle the problem for children born with club feet. It is using a non-surgical method developed in the 1950s by Dr. Ponseti of Iowa, but only more recently becoming widely accepted.
With the help of another organization which focuses on people with disabilities, LAMB will now also be able to increase its production of assistive devices. Usually – at LAMB – made of wood, these are items of equipment which help the mobility of children (and adults) with disabilities.
We also have the good news of a small grant from a UK charity which will help us with the work to get children with disabilities integrated better into society.
As usual, we have good news of short and long term Christian workers coming to LAMB. Although the most common image is of doctors, teachers and those trained in Bible studies, the support from young, but experienced specialists in such areas as Finance and Epidemiology are making a huge difference to the effectiveness of LAMB’s research and accounting. For them, to see God’s work in this very different environment is a mutual blessing.
This month, we are not without challenges. We would very much appreciate your prayers that God will grant us the wisdom and creativity to find ways to adjust for the future. The number of in-patients at the hospital has fallen by a tenth, as has the number of ante-natal visits and the number of babies being born. This is because in one of the areas from which LAMB patients traditionally come, the Government has started a voucher scheme providing free care, so patients are going to Government hospitals. Although their approach to care is different, if the scheme encourages people to seek care who otherwise would not, and so saves lives and misery, then it is a good thing.For LAMB, we pray for wisdom in how to manage the modest change in the short term, but more importantly to see into the long term as to how we may best be used to bring about God’s vision.

Bangladesh : Rural Life

The following was reported by LAMB’s General Surgeon in April 2009. It warms the heart and gives an insight into life in the villages of Bangladesh:

“I was asked to see five year old little boy with a draining sinus from the middle of his back and a collapse of the vertebra giving him an extremely pronounced hunch back. He was unable to walk because of weakness. But he always had the most delightful grin on his face.

The very poised young lady sitting beside him identified herself as his sister.

Parents? Both dead.

Who took care of this little boy? She did. And also a nine year old brother.

How old was she? Fifteen.

How did she manage? Worked as a maid whenever she could get work. But also had help from neighbors for food from time to time. Wow!

The next day the little boy was playing on the hospital porch outside the pediatric ward with three or four ladies sitting around. Who were these women? The neighbors. How wonderful to have such supportive neighbors!!! “

LAMB Hospital 25th Anniversary

Just before winter, 7th November 2008 was a bright day with the most comfortable weather Bangladesh can offer. Just repainted, LAMB Hospital was glowing. Around the hospital and around the site there were decorations, big collages of photographs and information, and lots and lots of people.

7th November 2008 was a day for celebrating - celebrating all that LAMB Hospital has achieved in its 25 years of service - and a bit of dreaming about the years to come.

The day started with LAMB staff gathered in the Hospital Outpatients area for devotions and thanksgiving. Then hundreds of the staff and their families paraded around the LAMB compound and out into the lanes around LAMB playing music and dancing with banners-festoons. These were just the start.

Under a canvas roof, the main morning session started with recitations from holy books and then moved onto speeches of many types. Some speeches referred back to the late 1960s, when the idea for LAMB Hospital was first conceived, some followed through the history, and some referred to the LAMB of today, and the work it does and its people. Nineteen speeches in all, yet the time flew by for the audience of 500 guests and staff be cause of the variety and energy.

Gary Hafvenstein had who came all the way from USA, representing the World Mission Prayer League founders of LAMB, noted that “Today we celebrate 25 years. But, the birth of LAMB goes back many years earlier. And it was not birthed by man. Rather, I believe that LAMB was born out of love flowing from the heart of God, a love for the world, a love for Bangladesh and her people. And it is the love of God that motivates the work even today at LAMB.”

Representing the Board of today, Ms. Elisabeth Blanc, praised Lamb's leadership as a model for the country in that its first desire is to please God and serve Him through the work at Lamb, without aspirations for a personal career or personal financial gain.

Representatives from partners, donors, and local government praised LAMB for its work and its achievements and recommended it as a fine example for others working in the field.

The session closed with LAMB chairman, Richard Waddell’s speech commending the green shoots of growth at LAMB followed by the surprise cutting of a HUGE cake with 25 candles .

Lunch was a massive exercise – feeding nearly fourteen hundred people. Much to the relief of LAMB it went remarkably smoothly.

More than a thousand gathered in LAMB compound field for the afternoon. The afternoon session was the main fun part, with lots of performances – mainly humorous – by LAMB staff and their children. FOUR AND A HALF HOURS of fun and talent – and yet there were still more than 600 people sitting and standing as the day was brought to a close.


It was a great day at LAMB, like nothing before, with so many people contributing so much energy and creativeness (and preparation).

“25 years of service” is what LAMB Hospital has been about. LAMB Hospital has proved that “Quality Healthcare for the Poor Is POSSIBLE”. LAMB hospital has indeed become a part of the community as a “Friend In Need”.