Johns Hopkins Gazette: May 20, 1996

Senior Fights
Disease in
Her Homeland

Leslie Rice
News and Information
One day two years ago, when Hopkins senior Saminaz Akhter was spending the summer in her native Dhaka, Bangladesh, both she and her mother were suffering from diarrhea. She went into her kitchen to prepare a jug of saline solution to ease their symptoms. As she mixed the solution together, she noticed she was being watched by Kalpanama, her maid, who lived in the sprawling slum a mile away. The maid asked Akhter what she was doing.

After Akhter explained, the maid grew quiet.

"My two children and my husband died of cholera," she said. "They just kept going and going, all day and night. I brought a pir (herbalist) and a fakir (religious spiritualist) and they said prayers and broke glass, but nothing worked. And within a few days, they died. It was just my fate. Now I am alone."

Akhter stared helplessly at the jug filled with the solution. A fist full of sugar, a pinch of salt, a half cup of water. It was so easy.

It has been estimated that 25 percent of the deaths of children under age 5 in Bangladesh are caused by diarrheal diseases, despite the existence of the widely available and easy-to-make cure called oral rehydration solution, which prevents the deadly dehydration associated with the disease.

Last summer, Akhter won a $2,500 Provost's Undergraduate Award for Research Excellence to study the Mohakhali district of the Dhaka slum in an attempt to learn why so few mothers take advantage of ORS and, instead, rely on ineffective folk remedies.

What she learned--and how she went about learning it--led Hopkins sociology professor Andrew Cherlin to call Akhter one of the most promising undergraduate researchers in Hopkins history.

"[Saminaz] is extraordinary--really off the charts," wrote Cherlin in a letter, recommending Akhter for a $10,000 Echoing Green undergraduate research grant, which will fund a return trip to Mohakhali this September so that she can implement a program that may very well eradicate child deaths due to dysentery. "In my 20 years of teaching, I have never encountered an undergraduate with as much ability to design and manage projects related to social issues."

Mohakhali lies next to Dhaka's garment district, where both mothers and fathers of the slum often work well into the night. After interviewing countless mothers last summer, Akhter learned that because fierce gangs prowl the slum, most parents don't leave their adolescent girls in charge of the younger children. Instead, they send to the home villages for their children's grandmother who will provide child care. When a child becomes sick, the parents tend to heed the advice of their respected elder--who relies on folk medicine--rather than listen to the healthcare workers who might visit the slums once a year.

Akhter's research has led her to believe that if healthcare workers target the influential grandmothers, training them to use ORS, then the children are more likely to benefit from the life-saving mixture.

So this fall, Akhter will defer her first year at the Yale University School of Public Health and work for Echoing Green, a foundation that provides undergraduate public service grants. She will hire and train women within the slum to hold evening classes and outreach services. One of the women Akhter has hired is her family maid, Kalpanama, who was instrumental in introducing Akhter to the grandmothers in the slum.

Besides training the grandmothers in the use of ORS, Akhter will incorporate local spiritual and herbal healers in the education process by encouraging them, through incentives, to persuade mothers to administer ORS.

The final part of the project will be the purchase of latrines and proper hand-washing facilities for the worst areas of the slum. This alone could dramatically cut deadly bacteria transmissions and diarrhea, she said. Akther anticipates the money for that project will come from her Muslim relatives who donate 2.5 percent of their income to the poor.

Both her mother, who works for the Australian High Commission, and her aunt, a retired teacher anxious for a new project, have offered to help Akhter with some of the fieldwork. Like Akhter, they won't make a penny from the project.

Those who know Akhter believe that she may very well eliminate child deaths due to dysentery in the Dhaka slum.

"I believe that Saminaz will save many, many lives," said Rita Kerrick, director of the Baltimore City Office of Adolescent Pregnancy Prevention, where Akhter interned for a year. "She is one of the most fantastic persons I have met in my 46 years on this earth.

"We hired her to work on a project, which she did, and then she decided she wanted to study the male role in pregnancy prevention. From there she got her own funding and went completely above and beyond for this study, a study with results that we continue to use all the time. She has this way, nonjudgmental and accepting of diversity, which made her accepted wherever she went, [whether she was talking to] cab drivers, elementary school students or men hanging out on street corners. Her results gave us a glimpse of a true cross section of Baltimore City males."

Akhter said she just tries to choose projects she's passionate about.

"I also try to target specific issues," she added. "I can't make all the problems in the slum go away. I can't lift all their burdens. But I can save a few lives. I can be part of the solution to this problem."

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