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10-22-05 Doctor delivers help to Third World country

By Margie Wuebker

  MINSTER -- Kris Prenger feels her services as a doctor are needed in a Third World country where some women still give birth in cow sheds because the natural process is considered dirty.

  The 45-year-old Prenger, daughter of Bob and Doris Prenger, 42 E. Fourth St., has spent seven years in Bangladesh working in satellite clinics and a hospital affiliated with Lutheran Aid and Medicine in Bangladesh (LAMB).

  "Being a female doctor in a Muslim and Hindu country is a different experience," she says. "You quickly discover how little some societies value women."

  Prenger, a 1979 Minster High School graduate, learned about the plight of the Bengali people while enrolled at the Ohio State University College of Medicine. She remembers the day a medical missionary spoke to the Christians in Medicine organization on campus.

  His message touched the heart of the Auglaize County native who already had decided at the age of 13 to serve God by helping his people overseas. At college, she decided the ambitious goal could be achieved best as a family practice specialist.  The first trip to Bangladesh came as part of a two-month rotation during her final year of medical school.

  "I remember walking along village streets seeing buffalo, goats and chickens doing their duty wherever they pleased," she says. "That didn't gross me out but seeing babies suffering from tetanus certainly did."

  Prenger shakes her head at the memories of helpless infants unable to nurse due to clenched jaws. A common practice -- rubbing cow dung on umbilical cord stumps to hasten the drying process -- introduced disease-causing organisms. The ones who survived faced the likelihood of tuberculosis or a host of other maladies.

  Women gave birth in cow sheds because Bengalis considered childbirth dirty. They faced the impending arrival of a baby with fear instead of anticipation.

  "So many died from complications that birthing was viewed as having one foot in the grave," Prenger says. "Culture dictates women cannot be examined or treated by a male doctor, and there were few female doctors around."

  Prenger returned to the States, where she graduated from OSU in 1987 and completed a family medicine residency in 1991. Following Bible training at Cedarville College, she worked as a medical missionary with the U.S. Indian Health Service at a Navajo reservation in Shiprock, N.M.

  "I still felt a desire to serve the poor in Bangladesh," she says. "I went back in 1997 to help the people help themselves. In addition to basic health care, they need instruction in preventive measures as well as assurance God loves them and intends their life to be different."

  The government instituted an immunization program in her absence in the hope mothers would pass antibodies to their offspring. Billboards and public service announcements promoted family planning, pointing out smaller families tend to be healthier. However, practices steeped in folklore continue in spite of public health programs, but more pregnant women are coming to the hospital to deliver.

  The hospital, which contains facilities for men, women and children, has grown from 50 to 100 beds in a walled compound at Parbatitur. Plans for a second-floor maternity unit will add another 100 beds with the hope the facility will become a teaching hospital to prepare medical personnel for work in outlying areas.

  "There was a time when two-thirds of all pregnancies involved complications due to limited prenatal care," Prenger says. "The figure has been cut but one in 10 mothers still die in childbirth."

  Pregnant women come to the hospital with their mothers or other female relatives while husbands pass the time at local tea shops. Guards occasionally track down the men when medical problems arise requiring blood transfusions.

  "We do not have refrigeration facilities to store blood," Prenger explains. "The fathers round up relatives to donate or staff members roll up their sleeves."

  Cases involving botched abortions show up regularly after back-room procedures referred to as menstrual regulations. Crude tools wielded by untrained people sometimes fail to dislodge the fetus. Women show up at the hospital still pregnant but hemorrhaging.

  "We get criticized for not performing abortions,": she says. "Our compromise is to provide a maternity waiting home as well as instruction in natural family planning."

  Occasionally a woman will decide to give up a baby for adoption. The only orphanages in the country are those run by Christian organizations.

  Prenger, who spent the last year studying at the London School of Hygiene and Tropical Medicine, admits there will be much to do when she returns to Bangladesh this month.

  While life expectancy has gone from 47 to 60 years since 1987, there is room for improvement. Continued emphasis on better sanitation and nutrition will lead to better health standards. However, she has learned change does not occur overnight.

  "The longer I'm in Bangladesh, the more I realize I need to be there," Prenger says. "I want to see more change and make things more equitable. I'm doing the work God wants me to do."


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