Bangladesh: Losing Some Battles, but Winning the War

NGO development rights women empowerment
Thursday, 18 July, 2013 - 09:48

In this article, the author writes about Bangladesh, a country in which communities continue to make progress in tackling the development challenges they face without depending on their government

We are searching for leadership in every corner we know, but it may be where we least expect it - on the ground, in the simplest of solutions.

In a time where we desperately search for heroes and heroines, I found a generation of leaders and legions of activists who qualify, led by extraordinary human beings like Professor Muhammed Younis, who founded the Grameen Bank, and Sir Hasan Fazle Abed, who built BRAC (formerly Bangladesh Rural Advancement Committee), the largest and most admired non-governmental organisation (NGO) in the world.

Perhaps we have been searching too long in the wrong place. It is time to refocus our gaze and look downwards to our people, where we will find legions of Mandelas who are working selflessly among the poorest, bringing hope to their doorway everyday - in a world that may seem to have stopped caring.

Bangladesh has achieved a number of the Millennium Development Goals already. Poverty has been halved, child and maternal mortality reduced dramatically and girl enrolment in school is almost universal; between 1990 and 2010 life expectancy rose by 10 years, from 59 to 69. Human well-being has improved.

I try to understand why.

Bangladesh is poor. It is not hidden. There is no visible enclaves of sheltered privilege like we are used to in South Africa. The teeming mass of humanity pours out of every corner of the country. Population pressure is overwhelming. Twice the density of China or India, this country is the most populous state in the world. And it is reflected in Dhaka's infamous gridlock of competing traffic that pits rickshaw pullers against the plush 4X4s and battered buses of a bygone epoch. Driving is not for the faint-hearted here.

To decode Bangladesh's development trajectory, we have to go back to the War for National Liberation in 1971. Dominated by Pakistan as part of its eastern territory, the Bengali people rose in revolt at authoritarian rule that sought to destroy its culture, language and heritage. In the ensuing war, an estimated three million people perished. The institutional and intellectual class was largely slaughtered. Independence was won, but the founding father Sheik Mujibur Rahman, the newly-elected Prime Minister, a political activist of great integrity, was assassinated shortly after victory in 1975. The country, in turmoil, slid towards a failed state.

Out of this hardship arose great leaders of the people. With no party-political agenda, they began to reconstruct the social fabric through painstaking community-based work. Today, leaders like Sir Fazle Hasen Abed and Professor Younis, and the institutions they founded, BRAC and Grameen Bank, are celebrated as models of participatory democracy that have lifted millions out of poverty.

In June 2013, I spent a week with BRAC. They are a household institution. With over eight million members, they reach close to a 120 million rural people and over six million in the urban slums.

I am in the crowded urban Korail slum of Dhaka, with its narrow streets, open gutters, a mass of human beings crammed in an impossibly tight space. It is navigating a maze lined with traders meeting every imaginable need the community has for food, medicines, airtime, tea and services. It is another universe far from the air-conditioned comfort of the middle classes. There is a familiarity that the people escorting us have with the community.

The heat is rising. The air is humid. Already I feel the rivulets of perspiration running down my body. We arrive at a BRAC Delivery Centre. It has neatly laid out rows of sandals outside. I really admire this tradition. Respect for the home; it also keeps diseases picked up, outside. In a squashed space we are crammed with a score of women, they are resplendent in their simple but colorful garb. They are the 'Mothers’ Club', reviewing activities of the past week. I listen carefully.

The meeting reminds me of the union meetings of the 80s. It is an essential part of painstaking social organisation at the community level. Coordinated by Shasthya Shebikas, the healthcare volunteers, they bring the pregnant and lactating mothers together. There are close to a 100 000 in this cadre of leadership in BRAC. Like shop stewards on the factory floor, they know everything that happens in this community. They are from the community. And every week they have to meet every mother who is pregnant, lactating or raising a young child.

I ask Kohinoor, a Shasthya Sebika, what her job is. “I live here in the slum. I was trained. I visit 10 households a day. I monitor all mothers and children and track progress of pregnant mothers. We bring the mothers to the central delivery centre to receive regular education. Each mother has a book detailing the progress but also providing simple information about the dos and don’ts during her pregnancy. I spend time with the husbands, educating them about pregnancy and also involving them as fathers.”

They are the on the ground surveillance system. Every step has been standardised. Any complication is a telephone call away. A local midwife, a Shasthya Sebika or her supervisor, a Shasthya Kormi, is available within minutes. The logistics chain is seamless. A rickshaw ambulance, navigating the narrow rutted streets, gets the mother to the main street, an ambulance or the local hospital which is already alerted and waiting with all the history of the mother available. The referral system is as elaborate in its simplicity. I understand why the maternal and child mortality is so dramatically down.

Women’s empowerment is the core. And mothers are the centrepiece of this community organising strategy of outreach. Haemorrhaging, a scourge of maternal mortality, has fallen dramatically and 90 percent of women breastfeed their children in the first hour. Today, women have access to safe deliveries in a hospital or BRAC delivery centre.

The next day I visited a village. I met with another group of Shasthya Shebikas. I wanted to interrogate this model and understand it. How does it work, I ask?
“I was a mother. I saw the value of the education I received. I applied and was selected. After my training, I was allocated an area to work. My job was monitoring and educating the pregnant mothers and also the families, especially their husbands. I also teach women about their rights, family planning, the law and justice,” replies Sumaya, a Shasthya Kormi, a supervisor of Shasthya Sebekas.

Was there resistance from your husband’s? There is an excited response.

“Yes, at first. But our children were always sick. Now they are healthier. We showed that some of our cultural practices were not right for the child or the mother. For example, some mothers did not breastfeed in the first hour and give the baby the colostrum because they thought it was bad for the child. Now 90 percent of the mothers’ breastfeed in an hour and exclusive breastfeeding is above 65 percent for the first six months. Now we are respected by our husbands and our community. We have dignity. “

I see them all carry a black bag. I ask Sumaya to show us what is in her bag. The Shasthya Sebekas are trained in dispensing 10 over-the-counter medicines, from dehydration fluid, micronutrient sprinkles, painkillers to iron tablets, in addition to sanitary pads, female contraception and condoms; for those trained further there are eye tests – the most expensive costing less than US$2 - and treatment of hypertension. There are 22 products that are accredited by BRAC. The Shasthya Sebika earns a percentage of each item that is sold. It is a fully sustaining model of social entrepreneurship with a conscience of service at its core.

Next we visited Nurmahar, a mother at her home. It is a simple mud adobe structure, spotless and proud. Her baby, Turna, now seven months, is about to eat her first meal of solid food. Sumaya leads the lesson. The first step is hand washing. Then the ingredient: dhal lentils, fish, rice, green herbs and one teaspoon of soya bean oil are mashed carefully in a measuring bowl. A sachet containing micronutrients is mixed into the food. Turna is unperturbed by the gaggle of strangers on the stoep of her home. She smiles and chuckles, wondering what the fuss is. She swallows and turns her head, to her mother, waving her hands wildly and demanding more.
I find this model of social organisation so familiar. It is a model from community and union organising around the bread-and-butter issues affecting the poor. The objective is to build community power and cohesion through systematic education and co-creating tools that are useful. It has standardised processes and creates an ecosystem that is plugged directly into the ‘mothership’ - BRAC. It is a democratic closed loop that is constantly monitoring, evaluating and feeding back.

I ask the BRAC founder, Abed Bhai, how he steers the institutional bureaucracy. “We must never be arrogant that we know everything. Even the best ideas fail in implementation. We must learn to listen to the voices of the community.”

He gives me an example of the simple saline dehydration solution that BRAC introduced with great fanfare to deal with the epidemic of dysentery, especially when the monsoon season hit. “We were targeting the mothers, and it was a simple solution that mothers can do themselves at home by combining salt, sugar and water in the right proportion. But we failed because we did not bring the family, the husbands and the in-laws into the discussion."

I find that there is so much to learn in Bangladesh. The country remains politically divided and fragile. But there is glue of community giving that holds it together. Bangladeshi live in villages that are self-sustaining, it is a life of hardship subjected to periodic ravages of tsunamis, cyclones, floods and drought - it breeds a resilience because they are less dependent on government.

If we listen carefully and tap the soul of our people, we will find a deep and persistent desire, especially among mothers and women, that the new generation of children should have a better life than the previous one. That desire is the motive force that must be fuelled, and the improved rights, productivity and incomes of women will be translated into major gains for our development vision of a world free from poverty and inequality

- Jay Naidoo is founding General Secretary of Congress of South African Trade Unions, former Minister in the Mandela Government and Chair of the Global Alliance for Improved Nutrition (GAIN). You can follow him on Twitter, or visit his Facebook Page or www.jaynaidoo.org.

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