For Dr Mohammod Jobayer Chisti, his first night shift as a medic was the most harrowing.
The year was 1996 and the location was the paediatric department at Sylhet MAG Osmani Medical College Hospital. He describes how the wards were inundated with children suffering from pneumonia.
“Up to 20 of them were in a critical state (and) three of them did not recover,” says Dr Chisti. “I tried my best to heal them, but to no avail. Their condition continued to deteriorate, until they eventually died in front of my eyes.”
The repeated failures of his attempts to heal the children left the doctor frustrated and concerned.
“I felt so helpless. I was thinking what the point of studying medicine was. I felt that we had missed out on something, but we were unsure about what that was. Maybe it was a lack of knowledge or insufficient resources,” Dr Chisti said.
“Then I thought of what could be done if such a situation was to arise again in the future. I was determined to do something that would cut the child death rate. At that very moment, I just wished to be a paediatrician.”
Dr Chisti then began a 10-year journey which would eventually lead him to a pioneering new discovery for treating pneumonia.
In 2002 he became a medical office at the International Centre for Diarrhoeal Diseases Control, Bangladesh (ICDDRB), where the rate of pneumonia diagnosis among children - and subsequent mortality rate - were both very high.
He participated in a training programme and told everyone that he wanted to become a “paediatric respiratory physician”.
Afterwards, Dr Chisti secured a scholarship from The Royal Children’s Hospital in Melbourne, focusing on paediatrics and children’s lung function.
While in Australia, he came into contact with a paediatric respiratory physician called Dr Trevor Duke, who had worked in a number of developing countries. Before Chisti returned home, Duke suggested that he to do “something which would bring a significant impact to the people and change the policy (of treatment).”
On finally rejoining the ICDDRB in 2012, the death rate among children due to pneumonia was around 10%, despite there being sufficient oxygen and antibiotics supplies as well as routine supportive care.
“Children with pneumonia and oxygen deficiencies in the bloodstream accounted for 21% of the patients,” Dr Chisti recalled.
It was then that the doctor developed an innovation which would be of great use to such children, even in remote parts of the country.
Keeping in mind the purchasing power of the most poverty stricken families in mind, the physician started working with shampoo bottles collected from the intensive care unit (ICU), engaging some of my colleagues at the ICDDRB for help.
“We carried out experiments on some of the children using the shampoo bottles filled with water, and a plastic tube inserted into one end. The children then inhaled oxygen from a tank and exhaled through a tube, producing bubbles in the water in the bottles,” he said.
“Surprisingly, we noticed that some of the severely ill children started recovering in the span of a few hours. It dawned on me then that it was a groundbreaking invention.”
Small air sacs in the lungs were kept open due to the pressure generated by the bubbles, which prevented the lungs from collapsing and smoothed the respiratory system. He continued the trial with his colleagues for the next two years.
Findings of the experiment over the period showed a 75% decrease in the death rate of pneumonia-affected children who used the device. The trial ended in July 2013, and the method of treatment has been in practice at the ICDDRB ever since.
An article on the “life-saving shampoo bottles” was published in respected medical journal The Lancet in 2015, when the Global Pneumonia Network bagged the Most Promising Childhood Pneumonia Innovation Award.
Chisti said he wanted to spread the new method of pneumonia treatment at the grassroots level, as well as in the hospitals which had the highest child mortality rates owing to pneumonia.
Ethiopia, Myanmar and Nepal have already showed their interest in this form of treatment, and even the World Health Organisation (WHO) has taken note . Inspired by the innovation, WHO is reportedly going to bring changes to their policy.
Hoping that the method would be used worldwide, Chisti said: “I am waiting for the day when Bangladesh will earn the recognition as the pioneer country in this treatment method.”
This article was first published on Bangla Tribune