A few weeks ago I was in Bangladesh leading a team of 6 therapists in an effort to provide medical service in Dhaka, the capitol. Our mission: to aid college-age (and a few youngsters) students injured in the July 2024 protests. The protests originally began in response to the government giving ‘unfair’ advantages to certain citizens over the last 16 years. The students were tired of living under the conditions this had produced. They decided to stand up and fight for change.

The students were successful and revered for their efforts. The prime minister fled to India and the new government grew from scratch, giving freedom of speech to the people of Bangladesh, where they had previously had none. The injured students became known as ‘Freedom Fighters’ (FF). For many, the cost of their efforts was high: blindness, severe deformities of the face, a body filled with shot pellets, shattered bones, paralysis, and for many, death. The new government, in appreciation, promised that the FF would be sent abroad for intensive treatment.

Cue the Tafida Raqeeb Foundation (TRF) (and me). Contacted directly by the government of Bangladesh, shortly after TRF contacted me. It was requested that we respond quickly with a team of therapists.

They called in September.

We arrived at the end of January.

Between therapist availability and Bangladeshi efficiency, we made it in time for more unrest.

While we were received with joy and appreciation by all of the hospitals, FF and families we visited, this effort was not fulfilling the government’s promise. The young people exercised their new-found self-expression, demonstrated again, this time, against our arrival.

On the fifth day in Bangladesh, we hopped into the van to see our new, brave friends at the hospital. I could feel something in the air as we loaded up. This wasn’t going to happen today.

At the gate, we were pulled aside. The energy in the van among the therapists began to go slightly into static.

We spent the next three days at the hotel, waiting for the protests to stop. We were in lieu of traveling for international treatment. This wasn’t what they were promised. They would no longer accept our presence (although they loved having us at the hospital). They were still fighting.

After being called to sit and speak towards 20 rounded black lenses, 50 unknown people and to several reporters in an attempt to placate the FF, we met with the Health Minister herself. She reported that they just didn’t have the funds to send the FF for international treatment as they had originally intended. The FF continued to fantasize about finding their salvation beyond the country borders. We were caught in the middle of politics. How exciting!

As we idled in the hotel, I could feel the unrest building amongst the therapists. They displayed great adaptability and patience, but they had flown so far to help and their time and skills were being used to play uno while in bustling, lively Dhaka.

As far as I was concerned, I was still serving. Over all of my time of traveling, especially with my recent experiences in India and Bangladesh, I’ve learned to be excited and curious when the unexpected shows up. As a rule in countries like Bangladesh and India, culturally, the unexpected quickly becomes your old pal.

Service work requires you to be flexible and adaptable yes, but to be willing to serve what the moment is asking of you is to truly be successful…and by that I mean have fun and bring joy in the midst of uncertainty and chaos.

For our little troop of medical service workers, the universe, present moment, FF, the government of Bangladesh, TRF and beyond needed us to sit still. They were asking us to watch and wait. The situation was so much bigger and more complex than us and our little therapy parade through the hospitals of Bangladesh. We were in the middle of something real and serious. Staying put was the best service we could do.

Often, I hear negative reports of medical service experiences from therapists and doctors. They feel that they weren’t able to be effective in such a short visit and that if anything, they caused more chaos than good. But ‘good’ is a very subjective thing.

People often try to help in the ways they know work for them, or help others in ways they want to be helped themselves. Haven’t you noticed that people often buy gifts for you that they would like to receive themselves? This is no different. They’re serving themselves while trying to serve you. Both end in disappointment.

Medical service, and life in general, requires you to show up without expectations and to serve the moment in front of you in the best way you know how. To say yes to something different than your expectations. That means, that you use your skills to meet the needs and norms of the people you meet, as well as the facility that’s hosting you. It becomes unfulfilling work when you fail to see and meet what the true, not perceived, need is.

Now, safety is something else. I understand that if you’re not skilled at ‘eyeballing it’ as an anesthesiologist, you may want to resist what’s being asked of you. The key is to know that in serving each moment presented to you, sometimes serving it to the best of your ability means saying no to the moment all together.

I think it comes down to understanding your own personal limits and boundaries. People often confuse limits and boundaries. Limits are how much you can handle internally without burning yourself out or putting yourself into terror, while boundaries are how you tell someone else what you’re willing to accept.

Boundaries are about the other person. No one can ‘step on your boundaries’, however, you can allow them to push you past your limits. You set a boundary, a stop, and the other person chooses to meet you or leave. It’s an opportunity to create a better space for communication and union. Respecting your own limits and firmly expressing boundaries allow you to be in community with others, showing up the best you can, rather than keep you out of situations.

As we sat in our hotel room, the energy was ‘slightly antsy’. We weren’t doing what we came here to do. But to me, we were there doing exactly what we came there to do: this moment wanted us to sit still. We were helping best by keeping still. By causing less stress to the authorities in power. By letting the FF get their word in. By not making it about us. After three days, the collective limit was reached however, and it was time to express our own desires.

The next day, we loaded in the van and we were off to the Army hospital to treat their group of FF with spinal cord injuries. We were received with hesitation, but as soon as we were unleashed on the floor, we had sealed our fate: they asked us how soon we could come back again.

Finally, we were in an environment that suited us as well as we were fit to help. The people of Bangladesh give great importance to hosting guests well and they also give great importance to respecting authority and honored guests.

As I worked, the Major asked me to come have tea and rest. The others were already in a room eating. He asked me to stop well before I had reached my limit. I pushed back.

“I am doing well, thank you. I appreciate it. I am still working though and I’d like to continue. I will join them when I am done.”

Our Bangladeshi hosts loved having tea breaks. My team did not. I could imagine them grumbling over food they hadn’t asked for as I continued to work.

I learned last trip the times to respect the tea requests and the times when I could push back. It just took a little bit of reading the present moment and deciding what would be in best service of it, not what would be in the best service of me or my ego. You can set boundaries without offense that way. There were times where I was ready to work and we sat in two hours of tea and sandwich meetings, and others where although I was being asked to eat, the line of patients was endless and I had more energy to serve.

As I finally joined the others in the room where they sat with half-eaten plates of pasta, sandwiches, fruit and other goodies laid in front of them, I felt satisfied. They looked tired and dragged down by having to accept yet another tea break before feeling done with working (or maybe I was just seeing the feeling of being over-full on their faces).

It is hard enough to learn limits and boundaries as an American human in our own culture. The added dynamic of a whole new culture brings a new level of learning. Somehow, I found it easier to do in Bangladesh than in my regular life.

Successful medical service requires you to balance limits and boundaries, and to balance serving yourself and what is being asked of you. When you find it, you’ll feel content, energetic and free. It becomes easy to serve the moment in front of you the best that you can.

*The group of therapists I took to Bangladesh were wonderful and extremely adaptable. I can say this about any ‘first’ experience I’ve had working with people, but I could not have asked for a better group to lead in my first attempt at leading a group of people in medical service work. Dhan’yabāda to the group.