Juliette Cohen, owner and creator of Above and Beyond Scheduling Services, LLC, came back in mid-October from a 10-day trip to Dhaka, Bangladesh. The Boothbay Harbor resident traveled through a program called Partners for World Health (PWH) with two other nurses and four physicians to the country’s capital to train and provide medical services to the struggling National Institute of Cancer Research and Hospital.

“What we found when we were there was people that have the knowledge and the willingness to treat cancer as we would here, but they don’t have the resources,” Cohen said.

The three nurses worked with Bangladeshi nurses on training toward chemotherapy certifications with American standards. Aside from training, Cohen worked mainly in wound care and infection control and said she would like to go back when PWH goes back next year. The Rotary Club of Dhaka Mavericks was the organization’s sponsor.

“They are trying to make improvements in their country, so they supported our visit and made the connections while we were there,” said Cohen. “We had dinner with the ambassador from the United States which was hosted by the Rotary Club.”

Cohen said a Bangladesh-based film crew shot a documentary of PWH as they worked and that the Rotary Club even arranged a television special about the hospital’s services.

“They’re really trying to draw public attention because (the hospital staff members) do not have the preventative tools at their disposal,” said Cohen.

Easily screened cancers can become life-threatening due to cultural taboo, said Cohen. Some people will not seek treatment out of fear their families will leave them, which often has to do with cost, but also with the nature of some of the illnesses such as breast cancer. Bangladesh is tremendously Muslim, she said.

To work with all the patients is “beyond overwhelming” for Bangladeshi hospitals, Cohen said. Bangladesh has just over 163 million people – over half of the United States – in an area about the size of Iowa, explained Cohen.

“It’s not like anything you would see here. It’s almost like turning back time 100 years ago.”

Part of the issue of cancer treatment in Bangladesh is that people have to travel for hours from the rural parts of the country and once they reach the hospital, they have to stay until their treatment is through. Between the bumper-to-bumper traffic on roads about as wide as Townsend Avenue and the nature of Bangladeshi culture – traveling as a family – the financial situation often comes to a head before the patients even reach the hospital.

“Their families live there. They sleep outside the hospital on the ground or by the bed. The children can’t go to school for the time they are there … They spend all their money on the treatment which isn’t a lot to us, but it’s everything they have.”

Oftentimes, families will be forced to eat convenience store food – if they can afford it – and the patients may only get a small breakfast consisting of a banana and an egg. Sometimes, it’s the patient’s only meal of the day.

Cohen also explained that where the doctor-nurse relationship in the U.S. is very much a give-and-take, mostly equal and personal connection, it is almost like a class issue in Bangladesh. Nurses are very much on their own and do most of the work, and their medical opinions and observations are not valued, she said. “It’s sad.”

However, Cohen said the country is slowly improving with the help from Western hospitals. Some physicians are becoming more forward-thinking, inviting the abundant feedback from nurses and putting to use preventative measures and treatments as they become available.

“We tried to advocate for that over there – advocate and educate with not a lot of time to learn the culture, see the resources, meet the people and see the patients’ needs.”

Another great issue for hospitals in Bangladesh is the lack of proper equipment to accommodate a patient, including dressing wounds and the general accommodations most Americans would take for granted. That is why PWH ships donations of equipment like used or unused crutches, bandages, and gently used hospital beds. Cohen said PWH has even been supplying children with school supplies so they do not fall behind in study while their family member seeks treatment.

“What I took away was ‘What can we do to change (the suffering) without invading their culture?’ … My personal goal is to not interfere with their culture and try to figure out a way to provide education and make their lives better without changing who they are.”