DUBLAR CHAR, Bangladesh (SFSU) – Aboard a U.S. Marine CH-53E Super Stallion Helicopter, I watch as the waters of the Bay of Bengal meet the coastline of Bangladesh. The aircraft is flying along the same path used 19 days earlier by a deadly tropical cyclone.

Sidr, a Category 4 cyclone, struck Bangladesh’s southwest coast around 9:45 p.m. on November 15, 2007. With maximum sustained winds of 240 kph (150 mph), the cyclone unleashed lethal floodwaters upon the impoverished country. The death toll stands at 3,167. An additional 1,724 people remain missing.

The Bangladesh government estimates that 360,000 people have been left homeless. For thousands of cyclone survivors, life has become an ongoing search for clean water, food, shelter and medical aid. This search has led hundreds of Bangladeshi fishermen to a remote landing zone on the low-lying island of Dublar Char.

As the Marine helicopter pilot orbits the area and prepares to land, several small fishing villages emerge from a vast maze of mangrove trees. A reduction in altitude reveals the scarred landscape of the island. Many of the tropical trees were unable to withstand the winds of Sidr. Fractured trunks and broken branches litter the exposed intertwined roots of the coastal evergreens.

Lieutenant Commander (LCDR) Lu Le, the 11th Marine Expeditionary Unit (MEU) Surgeon is seated across from me in the aircraft. LCDR Le is leading a small Mobile Medical Team (MMT) in support of Operation Sea Angel II. The team quickly exits the helicopter and regroups nearby.

Kneeling in the tall windswept grass, LCDR Le ensures that his team and their equipment are accounted for. The team, comprised of both Marines and Sailors, guard their medical equipment from the strong rotor wash created as the departing helicopter briefly hovers overhead.

"Lets go, we have a limited amount of time," LCDR Le announces to his team. "We want to ensure that these survivors receive treatment today.”

The MMT lifts their equipment and walks towards the large crowd of fishermen. Within minutes, the team begins treating the first of 160 patients. Several of the men sustained traumatic injuries while clinging to trees during the cyclone. Oral rehydration salt is provided to dozens of patients suffering from diarrhea and dehydration. Both conditions are attributed to drinking contaminated water.

“ I was glad to see the American helicopter this morning,” Rabiul Islam, a young fisherman, proclaims. “Today we are not forgotten.”

In an interview at the nearby Alar Koal Shelter Station, Lieutenant Johir Raihan, Contingent Commander of Dublar Char conveys that more than 300 fishermen from the area were killed during the cyclone. Many were drowned by the violent floodwaters.

“The shelter was full beyond capacity. There was no room to sit down. Everyone remained standing throughout the night.”

As the afternoon air fills with black dragonflies, I speak with Krishnapada Chakraborty, a Project Management Specialist with the United States Agency for International Development (USAID). He explains that floodwaters are not the only devastating forces that threaten the people of Bangladesh. The powerful winds of Sidr have temporarily uncovered conditions that preceded the cyclone.

“The Bangladeshi people are hungry. There are limited job opportunities in this country. The men in the Dublar Char fishing villages are working in very dangerous conditions. They risk their lives for little pay. These are very poor men.”

Early the next day, the MMT is inserted into the sprawling city of Barguna. More than a thousand people quickly surround our U.S. Marine CH-46E Sea Knight Helicopter. A security detail from the Bangladesh Military directs us to a row of waiting vehicles.

Our convoy speeds through the crowded streets towards the nearby Barguna General Hospital. Standing in the back of a military truck, I watch as our Bangladeshi driver forces countless rickshaws and pedestrians off the narrow dirt roads.

As we arrive at the hospital, a sea of patients quickly floods the lobby. The Bangladeshi Military resorts to using furniture from the lobby to create a barricade between the MMT and the growing crowd. A group of hospital officials directs the MMT to three isolated examination rooms located on the ground floor of the hospital.

LCDR Le lifts a sheet of X-ray film up to a beam of light shining into the examination room through a barred window. The film reveals a spiral fracture of the left tibia. If not treated properly, a young child could be disfigured for life. LCDR Le applies a splint to the injured fragile leg. As the child is carried out of the room, LCDR Le and his team are unaware that many critical patients are on the overcrowded floor above.

Two locked metal gates separate the MMT from desperate patients located on the second floor of the Barguna General Hospital. I hear keys rattle against the gate leading to the west wing of the second floor. A staff member slowly pushes an empty steel gurney through the unlocked gate. I move alongside the gurney and pass into the long shadows of the west wing.

Approximately 200 patients occupy the two wings. That number of patients is twice the maximum capacity of the floors original design. Many of the people on the second floor have sustained serious injuries from Cyclone Sidr.

An unattended patient extends her open hands towards me as I walk across the trash strewn concrete floors. The faces of the Bangladshi patients are concealed by a sudden power outage. However, their pain-filled voices continue to resonate through the shadows and stale air.

While I continue photographing patients, an unidentified staff member declares that the Barguna General Hospital is grossly mismanaged. In addition, he identifies conditions that expose the health of patients to unnecessary risks.

“We have only one janitor. The hospital is not clean. We are unable to care for our patients. A decentralized medical system would better serve the sick and injured. Our operating budget should be based on need. All over Bangladesh, from the city of Barguna to the city of Chitagong the government is not the same…it is not the same.”

My conversation with the unidentified staff member abruptly ends, under the direction of Dr. Abdur Rashid, the Barguna District Surgeon. Dr. Rashid refuses to answer questions or comment on the conditions in the hospital.

Late in the afternoon I see the MMT standing at the front of an endless line of Bagladeshi patients. "Stop screening patients," LCDR Le announces to his team. "Leave all the medical supplies behind. Our ride home is already in the air.”

We are loaded back into military vehicles and transported from the hospital to a landing zone in a nearby field. “That is a solid copy,” Sergeant Cochise Fripp, shouts into a satellite communications handset. “The helicopters are overhead and circling.”

Within minutes we are flying over the city. I watch as we pass over the Barguna General Hospital. The sound of our U.S. Marine CH-46E Sea Knight Helicopter thunders unimpeded through the barred windows and locked gates of the hospital. The Bangladeshi patients on the second floor listen as the helicopters head southwest towards the Bay of Bengal.

While in the City of Barguna, over 300 patients received medical evaluations and/or treatment by the Marines and Sailors of the MMT in less than five hours. The MMT was not provided access to the patients on the second floor of the Barguna General Hospital during the medical aid mission.

James Lee is an undergraduate student at S.F. State University. He is currently embedded as a photojournalist with the 11th Marine Expeditionary Unit aboard the USS Tarawa (LHA 1) in the Bay of Bengal. Stay tuned for more from his journey.