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Discovering JiVitAland

Photos by Saikat Mojumder

Discovering JiVitAland (continued)

Mondol is kneeling beside the newborn, measuring her head, when the baby’s father arrives home for lunch. Rezaul Alam is barefoot, his cotton lungi (sarong) splattered with mud. Alam has spent the morning drying jute grown on the family’s quarter acre.

He glances toward the kitchen shed, then escapes the glare of the sun as he enters the family’s one-room house. He sits on one of the two beds. Besides farming, Alam sells jute seeds, and the cotton bedcover is made of seed sacks sewn together.

Alam says that he and his wife had not planned for a fourth child, “but as Allah gave her to us… .” He does not complete the sentence, but he looks content. He wraps his arm around the younger of his two sons, Mominul Islam, whom his father estimates to be “maybe 5 years old.” Alam thinks that he and his wife are about 25 years old. (Few village residents can confidently say how old they are. “How can we know our age?” asked one woman with amusement.)

Shahinoor and Alam’s oldest child honors the visitors by offering a tray of paan—chopped areca nuts, green betel leaves for wrapping around them, and powdered lime. At 11, Sajeda is young enough that she does not yet have to wear a sari or a complete salwar kameez (loose pants and a knee-length tunic worn with a long scarf). Instead she wears a yellow tunic over shorts, more comfortable on a day with temperatures in the low 100s.

Unlike her mother, who never learned to read, Sajeda goes to school. She is cheerful and confident, with a short haircut that accentuates her bright eyes. She tells her father: “We should name the baby Renu.” He nods but makes no promises.

The grandmother watches from the courtyard as Shahinoor cradles her newborn; the baby is peaceful again after the annoyance of swallowing vitamin A.

In rural areas, most babies are born at home and without a health care professional attending. In Jivitaland, only 8 percent of women gave birth attended by a nurse-midwife or doctor. Half the women had help only from relatives or neighbors, or they gave birth alone.

For Christian, a visit to Bangladesh means hours and hours in meetings. On this sweltering afternoon, she sits under the ceiling fans in the conference room of the project’s four-story office building in the town of Gaibandha.

A dozen senior staff members are discussing a JiVitA-3 sub-study that seeks to understand the movement of micronutrients from mother to fetus. To do this, six nurse-midwives will soon begin attending births, sampling umbilical cord blood and weighing placentas immediately after delivery.

This afternoon’s scientific task is to agree on standardized conditions under which the midwives will refer mothers and newborns to emergency care. The administrative issue: how much to pay the midwives for 24-hour on-call duties. The group arrives at all decisions by consensus.

Between field visits and meetings, sometimes late at night, Christian confers with graduate students working on the project—three at the moment. To keep morale high, she’s brought them a box of Lindt chocolates. She says, “I feel that they’re being deprived when they’re just eating a dal-bhat meal [lentil gruel and rice]. They’re probably craving chocolate.” Good chocolate is scarce in Bangladesh, but there are compensations: During afternoon meetings, the head cook arrives in the conference room with plates of luscious local mangoes and cups of sweet tea.

The Gaibandha office building is home base for many of the project’s 180 scientific, supervisory, logistics and administrative staff. Among others, they include 15 people who enter data, six physicians, four translators, two cooks and a mechanic to look after the project’s 53 motorcycles.

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  • Benoit Labrique

    Belgium 11/20/2009 11:45:37 AM

    A great project.

  • Habib Chaklader

    Arlington, VA 01/22/2010 11:39:46 AM

    I think that Jivita is doing a great job in two fronts: 1) Conducting a valuable research that will save life not only in Bangladesh but also in other countries around the world once the research has been validated, 2) developed an infrastructure in a developing country for further research that is hard to come-by.

    The question is how to sustain such an infrastructure where public health funding is always hard to come-by. Since I was born in Gaibandha, and completed my MPH from New York, I. personally, can understand the need for such projects. I think opening up this Jivitaland to other research institute (i.e. Harvard, Oxford, Columbia, and local public health schools) will benefit both the researcher and the staff working for this project. Since these staff has an intimate knowledge of this population, just having researcher visiting this area will help researcher either develop a good research question, or find a way to solve their existing research question. I would also urge to open this area up for valuable clinical study. Few ways Jivitaland can survive and benefit others would be recommend this area to major research/ scientific journal, advertise to the research/ clinical trial institutes, and invite prospective researcher. I am not sure Johns Hopkins can, also, benefit from lending their already developed infrastructure to these potential teams in the form of realty fee/ contribution or not.

    Thanks for the good work.

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Images from Jivitaland

Images from Jivitaland

Experience the on-the-ground realities of the JiVitA project in Bangladesh through the images of Bangla photographer Saikat Mojumder.

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