Close encounter of the BRAC kind – II

September 2, 2012
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Some of you may have read the first of these two back-to-back posts recounting my first field visit since taking up what must be officially the world’s most cumbersome job title – Knowledge Management & Strategic Communications Specialist – at BRAC. People have been asking for my card over the past month, as you do.

Some of you may have read the first of these two back-to-back posts recounting my first field visit since taking up what must be officially the world’s most cumbersome job title – Knowledge Management & Strategic Communications Specialist – at BRAC. People have been asking for my card over the past month, as you do. Everyone has been subjected to the same withering joke: don’t have one as yet, and probably won’t. Looking to hire some billboards instead.Anyway, those of you who read the previous post will know I was there in Manikganj with Snigdha Ali, who herself joined not too long before me in a position titled with ruthless efficiency when compared to mine – Programme Coordinator, Communications.

It was a God-forsaken day really, if you go by the weather. I’ve already talked about the engagement with the microfinance programme in my previous post. I had the feeling that everything else might start appearing a bit blasé after that. Incessant rainfall had played havoc with our schedules already, which meant the ultra-poor program got pushed further back, and instead we met local representatives of BRAC’s health programme next.

The local programme organiser (with overall responsibility for 50,000 people, we learned) talked us through the programme structure, and introduced us to one of the many shastho kormi (health worker) who go around the villages providing various healthcare services as and when the need arises. Of course, not all complications can be cared for within the scope of these diligent kormis. Usually in such cases, the suffering patient gets referred to the sadar hospital run by the government. I was particularly impressed with the programme organiser’s grasp of the work assigned to her. From the number of positive tuberculosis cases within the population under her watch to the schedule for the group health meetings that are routinely held to promote established tenets of healthy living among the villagers, she had everything down pat, occasionally referring to a large register to fill us in on our queries.

One of the more remarkable successes of BRAC’s health programme, one that has garnered quite a bit of recognition recently, has been in winning the fight against tuberculosis amongst the rural population of Bangladesh. TB, a debilitative disease that affects the lungs, is completely curable through medication that is not covered by any patent laws limiting its dispersal. The challenge in developing countries like Bangladesh has always been to reach affected segments with the correct medicine, and ensuring that they stick with the prescribed course through to completion, which usually takes 6 months.


Health forum meeting in Manikganj

BRAC’s shasthya shebikas, who function as the third cog in the wheel of the health programme, have proven to be an invaluable asset in meeting this twin challenge. During the time we spent with the health programme in Manikganj, we were introduced to one such shebika- a quiet, unassuming woman whose small frame would give you hardly any idea of how her daily routine consisted of trawling through any number of households, of the 300 assigned to her, where there happened to be a TB patient, and making sure they were administered their daily dose of medicine to cure the disease. She showed us the contents of the ubiquitous bag shebikas carry around on their visits, which apart from the TB drug contained various other types of medicine as well, useful for treating fairly common diseases like cough syrup, and contraceptives.

Although we heard about the community-based approach and how it is adopted in the health programme, the foul weather didn’t allow us to see it in much more depth. Most members of the healthy living committee will not notice any sign of the image of the programme will remain the dedication and sense of duty that shone through in the faces of the programme workers that we met, from the programme organisers to the shasthya shebikas. Each one of them clearly took the work they were doing with utmost seriousness, and what is more, believed earnestly in the importance of their work.

It was next on to TUP- or more specifically an STUP programme. In my short time here, I’ve already noticed BRAC’s penchant for acronyms. I’m convinced some of the staff who’ve been around a while can carry off whole conversations in nothing but acronyms. For those not so well-versed in the art, STUP stands for “Specifically Targeted Ultra Poor”, through which BRAC aims to reach out to the very bottom of the pyramid, the most disadvantaged of them all, who not only fall through the government’s safety net, but are also missed by mainstream development programmes such as microfinance. An estimated 8 percent of the population of Bangladesh is said to fall within this category.

It was actually quite some distance from where we met the microfinance folks, and here beyond a point, we had to abandon our jeep.  As we made our way through the tranquil, verdant landscape, lush with the fertility that marks out the monsoon season in rural Bangladesh, I found myself wondering whether we must take it for granted that in the long run, development entails the discolouring of the picture that presented itself. As economies grow, it seems the easy camaraderie between green and bamboo must always give way to unforgiving slabs of grey piled on top of each other.

But I digress. It was apparent throughout the 15-20 minute walk to where the STUP representatives had gathered for the meeting that this was a more deprived part of the village. When finally we got there, the six women who had braved the elements to be there were not exactly in a mood to celebrate other people’s milestones. Yet with the passing of a few moments, once one of them had acted decisively, the danger was averted.

I am actually in the midst of writing more extensively on the TUP for purposes outside this blog, and this visit obviously helped as an initial taster of what to expect. My thoughts on the programme we engaged with in Manikganj will have to be collated with the other research I’m carrying out, so I shall leave it till then. With microfinance having established itself as an effective means for empowering a certain segment of the poor, a lot of the challenges for organisations like BRAC will come from defining – and proving – what they can do for those on the rung below – the poorest of the poor, or “ultra-poor” as they’ve come to be termed, a bit unflatteringly in my opinion. But let’s get real here now – there can never be anything even remotely flattering about the conditions that define grinding poverty. So let’s not comfort ourselves even that little bit by resorting to euphemisms.

By Shayan S. Khan,
Strategic Communications Specialist at BRAC

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