Iain Guest

Iain founded AP in 2001 after many years of writing about and working with civil society in countries in conflict. He was a Geneva-based correspondent for the London-based Guardian and International Herald Tribune (1976-1987); authored a book on the disappearances in Argentina; fronted several BBC documentaries; served as spokesperson for the UNHCR operation in Cambodia (1992) and the UN humanitarian operation in Haiti (2004); served as a Senior Fellow at the US Institute of Peace (1996-7); and conducted missions to Rwanda and Bosnia for the UN, USAID and UNHCR. Iain recently stepped down as an adjunct professor at Georgetown’s School of Foreign Service, where he taught human rights.

A Question of Health

20 Aug

Banari Pana district, August 20: Today we drive to the district of Banari Para, where BERDO is lending about 300,000 taka this year to 387 group members. Seventy-four were severely affected by the typhoon and they included several families with disability. The Danish Embassy in Dhaka has given BERDO 100,000 taka to help run the program. As noted in a recent blog, The Advocacy Project launched a small appeal for these families last Christmas.

The BERDO staff comprises several field officers and assistant, one of whom is himself disabled. The big difference with the Barisal office is that this team includes a doctor – Rafiqul Islam. Rafiqul accompanies us on our next visit with the Kali group in Rayarhat village. His presence will result in some important insights.

This group has 20 members, 11 of whom are receiving loans. Only one of them, a 12 year-old girl, Popi – is disabled. But seven other people with disability have received loans and all are here to meet us.

There is a much stronger sense of disability at this meeting. Perhaps it’s because people are sitting around the walls, instead of in a group on the floor as in Barisal. This makes it easier to single out individuals.

Perhaps it’s the presence of Ridoy (“Heart”), a 12 year-old boy with cerebral palsy who is quite a handful for his mother Rina. Eventually, she brings him up to sit with us at the table, until his father arrives to help him out. Rina has two other children, and after the meeting I watch her carrying Ridoy back cross the narrow bridge to the village.

Of the others present, Biti’s daughter Purnima, 5, has a severe hearing impediment. Purnima has not received a loan but has just joined the group with her mother. Hafiza and her daughter, Mukthar, are also new members. Hafiza saves 20 taka a week and sells ducks’ eggs in the market. If she gets a loan, she plans to buy more ducks of a sewing machine. He husband drives a bus and they have two other children.

The other mothers watch carefully as we have these discussions. When preparing for this visit, we were interested in whether villagers would treat disabled people as normal people. But here this seems the wrong question. Ridoy, Purnima and Mukthar are clearly accepted by the other villagers, but they are also living proof that disability can strike anyone, at any time. “We know that they can study and work with assistance,” says Salaheh, the group leader, but that is not really the issue. The issue is why people fall victim to these ailments, and whether others can be protected against the same fate. Can BERDO’s program help?

Rafiqul Islam, the BERDO doctor, explains why there appears to be so much disability in these villages. Many of them fell ill to “fever” which seems to be used generically to describe typhoid or influenza (of which there is plenty, particularly in the rainy season). There are many other factors – poor clothing, rapid changes of temperature, lousy sanitation and a lack of tube-wells to provide fresh water.

Rafiqul also blames poor nutrition, which results in a lack of vitamin C, and sheer ignorance. By a show of hands, it becomes clear that most of the women here consult local (traditional) doctors, who rarely diagnose medical problems correctly. Add to this a powerful amount of superstition.

But these women can hardly be blamed for their superstition. According to Rafiqul, doctors in the local hospital rarely leave the hospitals and charge 50 taka for each visit. There is only one government health center, on the main road. Patients pay 60 taka for medicine, which they buy from private shops.

These charges are beyond the means of many of these villagers. One is reminded, again, of Bangladesh’s overwhelming poverty: in a country of 3 million blind, there are said to be just 600 ophthamologists. Only 120 are practicing in rural areas.

But this would seem to present an opportunity for BERDO’s own experiment with micro-credit. These group meetings offer an opportunity to provide basic training in health and hygiene, and so make a small start towards preventing disability. BERDO is aware of this, but is not yet pushing aggressively in this direction.

Rafiqul, the doctor, goes out into the field for three days a week. He advises group members to eat vegetables, visit mainstream doctors, and be careful during maternity. In June alone, he dispensed 85 prescriptions. So far this year, he has sent about 6 women to hospital for treatment.

But this falls far short of a concerted program. Just as the groups in Barisal could be more active when it comes to working with husbands, so the groups here could do much to preach the message of nutrition and hygiene.

On its own, this would not be enough to prevent the catastrophic disease that overwhelmed those we have met on this trip, including even Saidul Huq himself. But it’s a start, and in this area of Banari Pari, BERDO’s groups would seem to be one of very few opportunities to provide consistent health education.

For this to happen, BERDO needs to invest in more training for the groups. It should also consider more alliances with other organizations which work on health. This could bring BERDO closer to achieving Saidul’s dream of using microcredit as a tool for development.

Filed under: Bangladesh | Tagged: Advocacy Project, Bangladesh, BERDO, blind, micro-credit | Leave a comment »

Posted By Iain Guest

Posted Aug 20th, 2008

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