LAMB NEWS – AUGUST 16TH, 2011

Greetings from LAMB, where the monsoon season is helping to keep things cool - relatively. It is raining most days now, but often only at night. Although Bangladesh is the land of rivers and floods, a lot of rain is needed in most places to keep the below-ground water levels high, since so much water is taken for irrigation or people’s use

At LAMB, as-well established work continues – in clinics, in the hospital, in training, in community development – work on child nutrition is increasing.

Levels of malnutrition in Bangladesh are still amongst the highest in the world. According to a 2007 national survey, by 23 months of age nearly 50% of children are stunted and 41% are underweight. 15% of women of reproductive age are of short stature – less than 145 cm/ 4 ft 9 inches.

Stunting from malnutrition is a permanent missed opportunity for acquiring intelligence and better health. Vital organs never fully develop during childhood. It matters for all the individuals, and the loss of productivity and the health costs are also a big loss to the nation.

There is a “window of opportunity ”from conception to 24 months old for the highest impact in reducing death and disease and avoiding irreversible harm through malnutrition.

LAMB is involved with two research projects focusing totally on nutrition during this critical period, which covers pregnancy, the breastfeeding mother, and then other nutrition for the young child.

One of the research programs in which LAMB is involved, sponsored by the Gates Foundation, looks at how best to improve the knowledge of mothers on feeding. More than half of mothers in Bangladesh abandon breast feeding before 2 months, whereas recommended practice is 6 months. Most mothers report not knowing what are the best foods and how much very young children should eat.

The other research program, sponsored by USAID, focuses on food supplements in which are embedded key vitamins and minerals. The study is not only about measuring the benefits to the children of the supplement supply, but also to check the practicalities and economics for rural families.

LAMB is involved in these projects because we have a strong network of community teams across a fairly broad area, with expertise in health work and data provision, plus an existing research team as the basis for larger work. Although the benefits will take much longer to appear than some of LAMB’s other preventative work – antenatal clinics for example – it is all part of one of our objectives, to improve the health of those most in need – in particular women, children and the poorest of the poor.

This is one of the reasons that we are here as a Christian organisation, able to make a real difference to those in need.

LAMB NEWS – JUNE 17TH, 2011

Regular readers of this newsletter will have heard a number of times how busy LAMB is. These past couple of months things have taken a new leap forward in this way.

The reason we have become so much busier - at least for a little while - links to new projects. Three have started in the past three months.


The biggest, which we are just starting, is for a United Nations organization. It is probably only for 15 months, but means we have to recruit 280 new staff during just a few weeks, a very large step up from LAMB’s existing staff number of about 700. The project is trying to reduce mother and child deaths in this area through encouraging community members to follow better health practices, to use established health care facilities, and through improving the system of health care provision. Although Bangladesh has made very good progress towards the Millennium Goals to reduce mother and child deaths, the levels are still very high.

The other two projects started are both research related, although being implemented with the participation of LAMB community staff. A two year project supported by the Gates Foundation, looks at what are the most effective and cost-effective techniques to persuade mothers to provide their babies and young children with the best possible nutrition, within their budget. The other short project looks at the how decisions are made by poor families facing difficult choices. For poor families there are serious choices between survival or longer term benefits.

We are very privileged to have been entrusted with these projects. Our challenge now is to do them, and do them well, so that there really are good benefits from the work.

Other parts of LAMB are on-going busy. The number of patients coming to the hospital still continues to rise, and some departments are stretched to the limit. For the Training Centre, as I write, the number of resident trainees again means overflow into temporary accommodation.

LAMB has also during the past months been able to provide additional support to the Christian community in the area. 25 pastors from churches across a wide area came to LAMB for two days of training. The focus was on helping them to see how to broaden their ministry, not only caring for their churches and their members, but for a broader role for their churches in the community

For those of you who pray for LAMB, there are two requests. One if for the fortitude and wisdom to handle this period of being very stretched across more or less all parts of LAMB. The second is for stability in the country since times of disturbance almost inevitably hit hardest on the poor.

LAMB NEWS – APRIL 5TH, 2011

At LAMB we are very fortunate to get a lot of people from overseas who come to stay for weeks or months to support LAMB. Over the past 12 months these include

• Teachers and education experts
• Obstetricians/ gynaecologists
• Surgeons and anaesthetists
• Physicians and paediatricians
• A psychiatrist and a counselor
• A speech therapist, nurse, radiographer, laboratory expert
• Medical students
• An epidemiologist and an accountant

We also get overseas visitors who come for a few days, most commonly from LAMB support groups. For them, it is a chance to see the realities of the area where we work, and to see for themselves what LAMB does so that they can tell people back home.

All these exposures to the wider world are invaluable for what is done by LAMB. It helps to keep us all – Bangladeshi and expatriate – aware of current standards and practices internationally. Although we do not have the facilities or the funds to have the most advanced equipment, and our priorities are in any case different, nevertheless there are still many things that help us to improve and develop.

Having visitors from outside sometimes also helps to remind those every day working here of the many positives that happen. It is very easy to get lost in the practicalities and problems of day to day work, and not see the eventual end results on peoples’ lives.

Like most hospitals, we do not have the resources to follow up on what happens to the majority of patients when they leave the hospital after treatment. In the community also, we see the statistics about lower rates of mothers being lost in childbirth, and lower rates of child deaths. But it takes time to see the human meaning of these.

Some of what is seen is unhappiness and sorrow. It is very hard for the hospital staff who see so many cases come to the hospital far too late – whether because of lack of understanding, trying alternative treatment first, fear of costs because the family has no funds, difficulties of transport, or simply other priorities. It is hard seeing young girls and women coming in damaged by abortions; to see children and adults come with disabilities which could easily have been overcome if treated earlier. It is frustrating when family members will not allow life-saving treatment, or, through fear or whatever reason, will not help by donating blood.


But there are many, many cases which show what can be done with a little. Imagine the relief for a family where the father has two club feet, and his son was born the same, but with paid-for low cost treatment at LAMB now has two normal angle feet. He will wear braces at night for a while yet, but that is a small thing in his total life. Imagine the delight for a young mother who could go home after 2 months treatment paid for by a church for serious burns. (Burns happen often here because of open fires and saris). Both of these cases had very supportive families, and for the staff at LAMB it was one of those real pleasures.



Imagine the difference living in villages on river islands where there is no access to healthcare. And then someone on the island is trained enough to help organise basic health care, and with a mobile phone can consult on matters which look more important. Imagine the pleasure for a little boy whose muscles are wasting, but almost every day for weeks was carried around the LAMB compound by one of the visitors from overseas.

When we stand back and look at what is being done, with not so much considering the number of people affected, then those who visit and see, and help, and point out the good things being done, are great motivation for the staff here.

These things are far from being LAMB doing things on its own. We are just God’s pair of hands. Without people and organizations who fund the work, we could not do it. But, when we look we are able to see the changes in people’s lives – and not just the patients.

LAMB NEWS – FEBRUARY 7TH, 2011

Winter is on its way out, here at LAMB. We are up to lovely sunny days of around 22ºC/ 72ºF, and nights of 15ºC/ 60ºF, and not too humid.

Only a month ago though it was the usual very cold period by local standards, down to 6ºC/ 43ºF. Many people don’t have clothes for the cold, and some suffer seriously. So LAMB was involved in the provision and distribution of blankets and warm clothes. Nice to note was that some individual staff members – Bangladeshi and expatriate - on their own initiative arranged extra supplies.

A reflection on poverty is that sometimes those who have blankets sell their much needed blanket because food is a greater priority.

So, welcome back warm weather.

LAMB’s community activities have since January 1st taken another step forward. This is via a three year project on Disaster Risk Reduction – minimizing the damage done to communities by flooding and by drought. There are several new things for LAMB about this work. The first is that it will actively involve working with churches out in the community areas so that they may take on a more supportive role in their communities. Secondly it is taking us into another of Bangladesh’s 64 Districts, Lalmonirhat, which starts about 25 miles (40 km) from LAMB. In some ways this may not sound far, but rural travel is not always easy and even to the main town in the area takes about 2.5 hours from LAMB. To villages it takes much longer – even without floods. Thirdly, disaster preparedness work as a speciality is new for us, but working with communities and passing on skills is an established expertise for LAMB and we now have trained specialists in disaster preparedness.



We note that for our community work, LAMB is usually working as an arm of larger international partners, some Christian, some not. We recognize that without their overall support and funding we would not be able to work

Back at the main LAMB site, things have been busy as always. At the Hospital, another surgical camp was held for women suffering from an obstetric fistula, (typically damage caused by delay in giving birth). We were fortunate to have a visit by another expert gynaecologist, and financial support to make it possible. Another 15 women were operated on – in this case including some from much further away than is normal for LAMB Hospital, since most of those suffering in the moderately close region have already been seen. Bangladesh still has many thousands of sufferers, so a lot more work is needed.

Also at LAMB site, there has been a change in the way we organise the disability related activities. The activities such as club foot realignment work, therapy, and therapy training for ongoing rehabilitation at the site have now been connected directly into the hospital. All the care of the hospital is more easily available for the affected children. It will also allow the hospital to have better access to the therapy skills in the rehabilitation unit.

At the School, for the last five months of 2010 both the School Director and the Headmaster had to be away. (It was not planned that way). Very pleasing for all at the school was that things continued to run well, and it was a good learning opportunity (if busy and challenging) for all involved.

Lastly, to close on a cheery note, there seem to have been a lot of visitors to LAMB in recent times, and it is very nice to hear that people still have good things to say about LAMB and the way things are done – and ideas about what else could be done.

If you would like to pray for the work that is done here, then a particular request would be the new areas for community work and for the churches with whom we will work.