We have arrived! The road to Malumghat hospital from Detroit contained many unexpected twists for us these past few days. Out flight to NYC was delayed four hours, but then the connecting flight to Dubai was cancelled, so we really didn't miss it... We ended up with a later flight to Dubai that evening, allowing us about 10hrs in NYC. We took the subway out to Manhattan for a surprise visit with Rachel's family, the Rimbos. Upon returning to the airport, we found out that our new flight to Dubai had a layover in Hamburg, Germany for 2-3hrs. Hmmm. Eventually, we did make it to Dubai, and caught our flight to Dhaka, only to find out....out luggage was still in Dubai. Oh well...our luggage did catch up with us on Wednesday.

We were met at the airport by a very welcome friendly face—one of the American nurses at Malumghat hospital was returning from a trip to Bangkok. She picked us up and took us to the guesthouse. Unfortunately, the change in flights brought us into Dhaka in the morning instead of the evening, and we wanted to wait as long as possible before going to sleep. So we ran errands with her.

Anyone reading this who has been to a developing world country will appreciate stories about foreign drivers. Dhaka driving is

pretty crazy, with lanes full of rickshaws (drivers on bicycles w/ a seat for several people on the back), baby taxis ("motorcycles" with a metal carriage plopped on top for riders), and cars, all who regard lanes and traffic lights as abstract ideas. We had lunch at an A&W restaurant, enjoying cheeseburgers and frosty mugs of root beer….surreal.

Dhaka has been in the news lately for student riots, and the city had been placed under curfew from midnight to 5am. The curfew was lifted our first full day there. Bangladesh has also been mentioned for the significant flooding—we posted a picture from the flight down to Chittagong. It is monsoon season, but fortunately the hospital remains unaffected due to its position on a hilltop.

These first few days at Malumghat hospital (aka Memorial Christian) have been spent attempting to get over jet lag, orienting, meeting tons of new faces, and adjusting to a completely different way of doing things.

We both started at the hospital on Thursday, mainly shadowing our mentoring docs (Eric works w/ a family practice doc and Rachel w/ an OB-GYN). Although we are becoming fairly comfortable taking care of US patients in a US hospital with US diagnoses and technology, all bets are off here where a patient with a fever after her surgery is just as likely to have typhoid or malaria as a bladder infection. Rachel did get a chance to assist in her first fistula surgery, though, which was very exciting.

Today, Friday, is the first day of the Bangladesh weekend. We went to Bengali Christian church with some fellow Americans who have been here for 20 years, who were gracious enough to translate for us, and then to a Bengali woman's home afterwards for tea. A small village has sprung up around the hospital, and we enjoyed walking through on the way to church, seeing the blacksmith's shop (a hot occupation esp in Bangladesh!), snack shops, barber, and countless other little shops. In the days ahead, we look forward to adjusting to the hospital, caring for patients, and figuring out how to cool off in this very steamy country.

Bangla-lessons learned thus far:

*Weekends are Friday and Saturday, and church is on Friday.

*Water buffalos live in the nearby rice patties, and we're planning a hike down to them soon.

*Rude things to avoid doing include giving a thumbs-up, showing the sole of your foot to someone (esp touching your foot to anyone else without apology), and any contact between opposite genders.

*Cricket is the national sport, but there's a full-blown soccer/football tournament going on behind the hospital every day.

*When we are needed on call, the hospital will send a "peon" to come get us. Not kidding, this Bengali word describes a very important office.

*Many of the common meds at the hospital are referred to simply as a number, e.g. Rachel was told to prescribe 3, 6, 17, and 25 for all the postpartums. ("Prescribe" being a loose term, since no script is required for pharmacies, just money, a med name, dose, and amount, and it's yours for the taking.)