Health Services Programme

As part of our integrated approach to health, care is delivered through both LAMB Hospital and through community centres and clinics.  Associated health workers and volunteers building community mobilisation through health promotion and disease prevention.

There are two main areas of health being addressed. The first focuses on Women and Child health, managing:

  • Reproductive, maternal, newborn and child

  • Cervical cancer screening

  • Fistula care

  • Disability rehabilitation

The second area focuses on communicable and noncommunicable diseases.

  • Mental Health

  • Non-communicable diseases

    • General medicine problems such as diabetes, heart disease, high blood pressure

    • Surgery

    • Vision and Dental

  • Tuberculosis

Reproductive, maternal, newborn, and child

LAMB Hospital

  • Maternity care: antenatal care, normal deliveries, and EmONC (emergency obstetric and newborn care) is provided 24/7 with C-section and blood transfusion capabilities.

  • A team called ‘vulnerable persons crisis management team is available to help victims of violence.

  • Gynecology: With resident obstetrician-gynecologists, and volunteers from Bangladesh and other countries, a wide range of gynecology services are provided. Elective vaginal and abdominal hysterectomies are available, obstetric fistula repair surgery and emergencies as needed - D&C, ERPC, ectopic pregnancy, etc.

  • Children: kangaroo mother care and Helping Babies Breath help improve survival of premature and other high-risk newborns; most children are admitted for infections; ‘Integrated Management of Childhood Illness’ (IMCI) guides outpatient care.

Community Managed Health Care

  • Maternity care: 24/7 Safe Delivery Units staffed by midwives and community skilled birth attendants. In 4 sub-districts, service delivery through 5 independent clinics and 22 within government Union Health And Family Welfare Centres, all with smaller satellite clinics in surrounding villages. Postpartum care is provided in clinics as well as by home visits by community health workers.

  • Children: outpatient care is guided by ‘Integrated Management of Childhood Illness’ (IMCI), a WHO-developed programme to support good household decision making and clinical care for children under the age of 5.

  • Service delivery is overseen by community committees to improve accountability of staff

Community Health Workers (Neighbourhood, Household)

  • Visit homes in their village at least once a month with health promotion advice.

  • They check the growth of infants, publicise free treatment, and act as first line identifiers of significant health problems suggesting referral to treatment.

  • Village member meetings are also a space for delivering basic health promotion training, encouraging men and in-laws in how to support their families well.

  • Mothers: encourage prenatal care and birth planning good nutrition for children

  • Children: discussions of ‘how to treat diarrhea’ and ‘how to prevent drowning’ - two of the leading causes of under 5 deaths in Bangladesh.

Cervical Cancer Screening

The Cervical Cancer Screening Project is improving service delivery in government clinics through facilitating community oversight committees to work toward increased accountability in 2 districts, Dinajpur and Nilphamari.

It is delivered through the United Nations Population Fund in areas where adequate diagnostic and treatment facilities are unavailable. The project is part of research done through Brown University, USA, whose researchers are adapting lessons learned from a similar screening project for garment factory workers, in hard to reach river areas of northern Bangladesh.

Fistula Care

Since 2005, LAMB has helped identify and treat women suffering from female genital fistula. Visiting specially-skilled international and national gynecologists provide surgical repair several times per year. Selected cured women with particular boldness are given training as ‘Community Fistula Advocates.’ They help the process of community screening, and are the #1 referral source for new patients.

Disability Support

Disability support for children is provided by LAMB Hospital and community clinics.

LAMB Rehabilitation Centre

  • A rehabilitation centre for short-term residential patients has 6 beds where children and parents can stay while they receive examination, therapy, or are fitted with assistive devices such as wheelchairs and limb supports.

  • Trained and skilled national physio assistants are available to analyse patients and develop therapy and exercise programs.

Community-based Rehabilitation Clinics

  • LAMB runs a day clinic every month for disabled children and their parents, in 22 different areas.

  • Disability team staff visit the homes of disabled children to provide advice, therapy, demonstrate exercises and to work on the behalf of the children to get them into normal schools.

  • Disability teams carry out awareness raising activities in communities, sharing the message that disabled people are a regular part of communities.

  • Staff spend time case-finding patients with specific needs such as clubfeet and burn contractures for which restorative surgery is available at LAMB hospital.

Mental Health Programme

Mental health services are still scarce in Bangladesh, though the incidence of suicide and gender-based violence are high. LAMB is committed to opening pathways of care for persons with mental health challenges, at neighborhood, community and hospital level.

Trained listeners sit with inpatients and outpatients, providing therapy for persons needing mental health support.

We also provide basic mental health training for people in the community and health workers/staff to promote good mental health and to raise awareness about mental illness. At community level we piloted an "Aunties bench" approach in one sub-district. This is an adaptation of the "friendship bench" model in Zimbabwe.


Communicable and Non-Communicable Diseases

Tuberculosis - TB

LAMB works with the Government in delivering TB treatment and prevention programmes. Funded through Global Fund for AIDS, Tuberculosis and Malaria, in a project of BRAC.

The largest part of LAMB’s TB activity is in the communities:

  • Awareness raising of the symptoms and effects of TB

  • Identification of possible TB cases for patients attending community clinics and during Village Health Volunteer visits to homes.

  • Sputum testing in community clinics to confirm the presence or absence of TB.

  • Treatment is initiated through a hospital visit and examination by a doctor. There is a 94% rate of success for treatment by medicine.

  • LAMB Hospital has an 8-bed TB ward for in-patient care.


Non-Communicable Disease (NCD)

LAMB is addressing the demographic transition of the increase of NCDs among the neglected rural poor. Heart disease, strokes, diabetes, and cancer are the leading causes of death. These diseases share common modifiable factors and are a major cause of poverty. They have been highlighted in the UN Sustainable Development Goals, and while chronic and costly they are largely preventable.

Promotion activities about not smoking, a healthy diet and exercise can impact heart diseases, diabetes and cancer. While health promotion is in very early stages in Bangladesh it can have big implications for the future.

Collectively our health promotion activities target the whole village - the functional unit of lifestyle and social structure in Bangladesh. LAMB was recently part of a WHO Model Village initiative, and lessons learned will inform future disease prevention activities for staff and local residents.


Medicine

Adult inpatients commonly visit the hospital because of heart disease, stroke, chronic kidney disease, diabetes, tuberculosis complications, self-poisoning, typhoid fever or diarrhoea. And outpatients typically have gastritis, pneumonia, skin problems, asthma, arthritis, or high blood pressure. Most are also offered worm treatment.


Surgery

LAMB Hospital usually has one resident senior General Surgeon and one resident senior Gynaecologist. Surgery is carried out during normal hospital day hours, Saturday to Thursday, but emergency surgery may be possible. The main work carried out by the General Surgeon at LAMB is:

  • Abdominal surgery

  • Cancer Surgery

  • Hernias

  • Burn contracture (release and skin grafting, followed by use of pressure garments)

A variety of other work is carried out including tumour removal and amputations. The Gynaecologist is largely involved with maternity work, but also carries out obstetric fistula repair and elective and emergency procedures.

Occasional ‘surgical camps’ add to LAMB’s capacity to carry out surgery. While obstetric fistula repairs are often done by the resident Senior Obstetrician/Gynaecologist, the more difficult cases and greater numbers are carried out at a dedicated surgical camp by a visiting consultant. Fistula repairs are sponsored by Engender Health, and so again, all patients receive free treatment.


Vision Centre

LAMB has a primary eye treatment centre, where initial treatment of eye patients is provided by a trained and experienced medical assistant. In need of advance treatment, patients are referred to other hospitals.


Dental Unit

At LAMB Dental, we aim to provide high quality, comprehensive, affordable dental care and oral health education to all people, in an environment that fosters respect, compassion, and dignity. We care deeply about our patients and what we do to help them maintain dental health for a lifetime. We seek to share the love of Jesus Christ through our profession and our hearts.