The following was originally posted by BRAC USA President & CEO Susan Davis in the Huffington Post.
The UN has chosen today as a symbolic one on which the world's 7 billionth person might be born. The fact that it's Halloween is, as The New Yorker jokes, "presumably just a coincidence."
In the ideal world, reaching that psychological threshold would be seen as success for humanity, not a scare. We've heard warnings of a population bomb in the past, but in today's pessimistic world, lurching from one financial, economic and political crisis to the next, the voices are louder this time, questioning whether we're nearing the limit of what this shared earth of ours can support. Compounding fears, world food prices are high and volatile while 12 million in the Horn of Africa are in urgent need.
Long-term developments on the population front are a mixed bag, as the United National Population Fundjust reported. Concerns about the future should not obscure the gains made, particularly for the poorest among us. Life expectancy has shot up since the 1950s, while child mortality has more than halved. Yet almost everywhere, the gap between rich and poor continues to widen.
Let us not forget that a rising population of 7 billion means a greater pool from which genius and innovation can emerge. Among those born today in Lagos or Kampala could be a potential Nobel Prize winner -- someone who might end a war, cure a life-threatening disease or become the next Steve Jobs, improving life in a way that none of us can now predict. But if this person is born into poverty with no opportunity for escape, their potential will remain unrealized -- and it will be the world's loss.
What can we do to maximize the opportunities arising from a world of 7 billion? The organization I'm a part of, BRAC, a global development organization based in Bangladesh, knows a thing or two about improving life in crowded spaces. Of sovereign states with an area of over 300 square miles (that is, not counting city and island statelets like Singapore and Bahrain), Bangladesh ranks as the most densely populated country, with 162 million people squeezed into an area smaller than Iowa. Of these, a full 110 million are touched by BRAC in some way. Along with our growing presence outside our native Bangadesh, this make us the world's largest nonprofit.
Western philanthropies are increasingly taking note of the solutions BRAC has developed in Bangladesh as we expand to provide more opportunities for the poor elsewhere in Asia, in Africa and in Haiti. As I wrote last week, we're cultivating partnerships with like-minded groups like The MasterCard Foundation, which is helping to scale up our "microfinance plus" approach in Uganda -- the world's youngest country, with a median age of just 15.
Here's one of the main lessons of the BRAC experience: It's time to start favoring a bottom-up approach when it comes to employment and opportunity. We need to start looking at the developing world's growing pool of young people as an underutilized asset rather than a liability to society. As we've discovered in Bangladesh, and as we're increasingly finding in Africa -- of the 20 countries with the youngest populations, all but two are in Africa -- the poor will lift themselves out of poverty when they are given the chance to do so.
We can create these chances in many ways: microfinance facilities, health care provision, education and more. But at the heart of it, we need to approach development in a way that favors individual empowerment and entrepreneurship. BRAC, for instance, pilots and replicates workable models for self-employment. We create networks of micro-entrepreneurs to address social needs like the provision of basic but vital medical services. Rather than distributing free medicine, for instance, we'll create jobs using a business model that allows a woman in a village to earn money offering basic medical goods and services to her neighbors in a sustainable way that benefits everybody. And we routinize and replicate these processes over and over again, to eventually reach millions.
To maximize change, we should focus our efforts on girls and women. Adolescent girls, according to Maria Eitel of the Nike Foundation, another BRAC partner, "are unique change agents." Experts often point to empowerment of women as an end result of economic growth, but an increasing body of evidence shows the converse is also true. When we engage a girl starting at the age of 12, keep her in school, allow her to grow into a woman, to make her own livelihood and to choose if and when to have children, the knock-on effects are tremendous. The point isn't just slower population growth, but a stronger society as a whole.
The aim is to allow everybody -- rich and poor, north and south -- to bring about whatever change they may seek in their own lives. Innate talent is distributed equally around the world at birth, knowing no bounds of geography or class. Opportunity is not. We need to redress that imbalance if this world of 7 billion is to prosper as a whole.
Monday, October 31, 2011
Thursday, October 27, 2011
Trickle Up uses BRAC Development Institute's “life histories” research to enhance its program for the ultra poor
The following was originally posted on the CGAP Graduation blog by Janet Heisey, Director of the Asia Program at Trickle Up.
The research paper "And Who Listens to the Poor? Shocks, Stresses and Safety Nets in India and Pakistan" by Karishma Huda, Sandeep Kaur and Nicolina Lamhauge, offers an interesting framework for qualitative evaluation of livelihood programs, such as those we implement at Trickle Up. It posed and answered some interesting questions: what keeps extremely poor people trapped in cycles of deprivation? Does the Graduation Program address these constraints? How can programs allocate resources to ensure that the maximum number of participants succeed?
It features extensive case studies of 20 project participants who completed the India-based project in 2009. These rich life histories provides a much more nuanced picture of participants’ lives before and after the project, and makes clear that while all participants may have been equally poor economically at the start, they didn’t all begin with the same resources and vulnerabilities. While our strong poverty selection process helps us identify people who are more or less equally poor, it only provides a snapshot of the participants’ economic situation at that time: such as the assets they have on hand or the condition of the house at that moment.
For instance, for Indu (no real names are used) each day brought fresh uncertainty and difficulty. She lived in a village that was isolated and without services, even by the standards of her remote West Bengal region. Her husband was an alcoholic and worked sporadically. Indu’s field worker said that her house, health, and self-confidence at the start of the project were the worst he had ever seen. By the end of the project, however, she was one of the eight participants whose life path had changed significantly for the better.
Equally poor at the start was Sushila. But, unlike Indu, when she was young she and her siblings all attended school for several years. As an adult, Sushila has been active in local politics and respected in her community, and her uncle is a village leader. Sushila had more resources to draw on than Indu—right from the start. Sushila was one of the three women for whom Trickle Up’s program reinforced an already positive trajectory.
Huda, Kaur, and Lamhauge’s research reinforced questions that we at Trickle Up began to ask ourselves over the course of the pilot about how we allocate resources and assess participants’ progress. It may be that Indu required every bit of support the project provided—plenty of one-on-one support and handholding, and some careful field worker intervention to address her husband’s lack of support—to help her improve her opportunities. Sushila, however, may have needed more of a ‘nudge’ than a ‘push’, by receiving some, but not all, of the full complement of services. Could one or two program components (perhaps savings group membership, the asset and livelihood activity training) have been enough to enable her to succeed? Are there program components Sushila could have done without and still had a positive outcome? Knowing this, even mid-way through a project, would enable us to reallocate resources so each participant gets the kind of support they need to succeed. This is particularly important for the handholding component as it is purely a function of how much time a field worker has to visit each participant—time that could be focused more on those needing more support. Such an adjustment may have enabled more of the women who began with their lives on “a downward trajectory” to succeed by project’s end.
We’re trying to consider ways that qualitative research throughout the program cycle might give some indication of a participants’ trajectory so we can better tailor our program along the way. Next week we’ll look at more ways the research was valuable for us and may be for other organizations too.
Research on the CGAP-Ford Graduation Program has been done by the BRAC Development Institute with support from BRAC USA and The MasterCard Foundation.
The research paper "And Who Listens to the Poor? Shocks, Stresses and Safety Nets in India and Pakistan" by Karishma Huda, Sandeep Kaur and Nicolina Lamhauge, offers an interesting framework for qualitative evaluation of livelihood programs, such as those we implement at Trickle Up. It posed and answered some interesting questions: what keeps extremely poor people trapped in cycles of deprivation? Does the Graduation Program address these constraints? How can programs allocate resources to ensure that the maximum number of participants succeed?
It features extensive case studies of 20 project participants who completed the India-based project in 2009. These rich life histories provides a much more nuanced picture of participants’ lives before and after the project, and makes clear that while all participants may have been equally poor economically at the start, they didn’t all begin with the same resources and vulnerabilities. While our strong poverty selection process helps us identify people who are more or less equally poor, it only provides a snapshot of the participants’ economic situation at that time: such as the assets they have on hand or the condition of the house at that moment.
For instance, for Indu (no real names are used) each day brought fresh uncertainty and difficulty. She lived in a village that was isolated and without services, even by the standards of her remote West Bengal region. Her husband was an alcoholic and worked sporadically. Indu’s field worker said that her house, health, and self-confidence at the start of the project were the worst he had ever seen. By the end of the project, however, she was one of the eight participants whose life path had changed significantly for the better.
Equally poor at the start was Sushila. But, unlike Indu, when she was young she and her siblings all attended school for several years. As an adult, Sushila has been active in local politics and respected in her community, and her uncle is a village leader. Sushila had more resources to draw on than Indu—right from the start. Sushila was one of the three women for whom Trickle Up’s program reinforced an already positive trajectory.
Huda, Kaur, and Lamhauge’s research reinforced questions that we at Trickle Up began to ask ourselves over the course of the pilot about how we allocate resources and assess participants’ progress. It may be that Indu required every bit of support the project provided—plenty of one-on-one support and handholding, and some careful field worker intervention to address her husband’s lack of support—to help her improve her opportunities. Sushila, however, may have needed more of a ‘nudge’ than a ‘push’, by receiving some, but not all, of the full complement of services. Could one or two program components (perhaps savings group membership, the asset and livelihood activity training) have been enough to enable her to succeed? Are there program components Sushila could have done without and still had a positive outcome? Knowing this, even mid-way through a project, would enable us to reallocate resources so each participant gets the kind of support they need to succeed. This is particularly important for the handholding component as it is purely a function of how much time a field worker has to visit each participant—time that could be focused more on those needing more support. Such an adjustment may have enabled more of the women who began with their lives on “a downward trajectory” to succeed by project’s end.
We’re trying to consider ways that qualitative research throughout the program cycle might give some indication of a participants’ trajectory so we can better tailor our program along the way. Next week we’ll look at more ways the research was valuable for us and may be for other organizations too.
Research on the CGAP-Ford Graduation Program has been done by the BRAC Development Institute with support from BRAC USA and The MasterCard Foundation.
Wednesday, October 26, 2011
Girls Not Brides - Ending a harmful practice
In the collective effort to realize the “Girl Effect”, it is necessary to ensure that adolescent girls are free to access the resources and education provided to them by their respective national governments or by the NGOs based in their communities. But regrettably in many cases, this access is constrained by the cultural practice of child marriage.
Girls Not Brides is a global partnership of organizations working to end child marriage all over the world.
Girls Not Brides’ mission is to give a voice to girls at risk of child marriage, to defend their rights to health and education, and to give them the opportunities they need to fulfill their potential. This includes supporting children who are or have been victims of child marriage, to increase awareness of the scale and impact of child marriage, and to mobilize the support and resources needed to end it. As many NGOs are confronting this issue in disparate ways, GNB believes that the most effective way to maximize the success of this movement is to come together in global partnerships with NGOs to bring a collective and comprehensive approach to tackling this issue.
At the Clinton Global Initiative this past September, BRAC formally partnered with GNB, joining its team of over 60 international NGO members. Through collaborative efforts, GNB and its members will:
1. Actively contribute to the efforts of Girls Not Brides to end child marriage worldwide, recognizing that ending child marriage requires community engagement and action and that global and national efforts should ultimately support local change;
2. Positively and constructively engage with other members, as well as governments and other relevant actors at a local, national and global level;
3. Include girls’ and young people’s voices and representation in working to end child marriage;
4. Work towards ensuring that no child marries before the age of 18, in line with the UN Convention on the Rights of the Child, which all but two nations have ratified;
5. Commit to transparency, accountability and good governance in our work to end child marriage
Through the collective efforts of partner organizations like BRAC, the Girls Not Brides campaign looks forward to the day when child marriage is a relic of the past.
Click here to learn more about the campaign.
Tuesday, October 25, 2011
Letter From Uganda: Given the Tools to Fight Poverty, Africa's Women Tend to Win
The following was originally posted by BRAC USA President & CEO Susan Davis in the Huffington Post.
A ripple of laughter spreads through the room during Beatrice's prayer. We're in the town of Nansana, in central Uganda, taking part in a meeting of 25 micro-borrowers, all of them local women. Somebody translates: "Dear Lord, please make us strong and successful," Beatrice said before the group, before adding: "And put women above men for a change."
I'm here with BRAC, the global development organization based in Bangladesh that I'm proud to be a part of, on a visit with representatives of The MasterCard Foundation, which is helping to bring groundbreaking antipoverty solutions pioneered in Bangladesh to Africa. The MasterCard Foundation's partnership is an example of how private Western philanthropic investors are increasingly collaborating with large organizations based in the global South, like BRAC, to lift people out of long-term poverty.
Beatrice's joke cuts to the heart of much of what ails the poorest parts of our world. Women's secondary role is keeping whole sections of society, men and women alike, in poverty. So uplifting women is not just a matter of gender justice or "putting women above men;" As our work and that of other antipoverty organizations have shown, when we invest in girls and women, we end up with healthier families, a more flexible workforce, lower HIV rates and a more stable society.
Uganda is facing its own set of difficulties even as its regional clout rises. Washington sees it as a strategic ally, recently dispatching Green Berets to track down Joseph Kony, whose Lord's Resistance Army had long been a scourge on more remote northern parts of Uganda and South Sudan, terrorizing local populations with kidnappings, rape and child slavery. Meanwhile the economy is in turmoil, and protests in the capital, Kampala, have been simmering since April, asThe New York Times reports. Ordinary Ugandans have seen prices skyrocket, with the price of sugar more than doubling to 6,000 Ugandan shillings ($2.10) per kilogram from 2,600 shillings (93 cents) earlier this year.
There are people who only see hopelessness in Africa: unrest here in Uganda, famished refugees in Kenya, continued fighting in Somalia and withering crops across East Africa. And indeed, sometimes it does seem like the poor are trapped, with the causes of poverty -- meager capital, limited access to markets, lack of healthcare, and inadequate education --apparently too myriad to be addressed properly.
But the Bangladeshis I've worked with see things differently. They see opportunity where others see failure. To a development worker from Bangladesh, with one of the highest rates of land cultivation in the world, unplanted land is money on the ground. What they've also learned is that poor women can defeat poverty on their own when given half a chance.
Employing mainly Ugandan women, we're applying this Bangladeshi-led approach here thanks to The MasterCard Foundation, which has committed $45 million to helping us reach 4.2 million people by 2016, a target we're likely to reach ahead of schedule. We call this approach "microfinance multiplied": not just giving out loans, but improving livelihoods by providing higher-yield seeds, better farming practices and improved access to markets where poor villagers can sell their goods. By doing this, we create a network of micro-franchised entrepreneurs in agriculture, poultry, livestock and health. We train self-employed villagers to educate their neighbors and sometimes even treat simple diseases. And we create clubs for adolescent girls and open schools to educate the next generation.
Take Beatrice, a married mother of two school-age girls. Starting with a small vegetable stand selling produce from her own garden, she has taken progressively larger loans from BRAC to build inventory and open a new shop. Earnings have increased sevenfold. "I used to have a monthly income of 100,000 shillings," she told us. "Now it's 700,000."
Other numbers back up the BRAC-MasterCard approach. An estimated 1.2 million Ugandans are HIV positive, yet of the women and girls who have participated in BRAC's programs in Uganda, 67 percent report always using a condom if and when they have sex, versus only 38 percent of a random control sample. There's an apparent spillover effect, too: Even among those who don't participate, 54 percent of those in villages where we've set up programs say they use condoms, suggesting the spread of good habits among peers. Rates of early motherhood have fallen, too, with 12.4 percent of girls in the control group having children since an initial survey in 2008, versus only 8.7 percent of our program participants.
There's no silver bullet for defeating poverty, but there is silver buckshot. We've learned, for instance, that microfinance is useful on a large scale only when combined with other efforts to improve livelihoods, like the ones described above. But though the problems may seem insurmountable at times, our experience in Bangladesh, Uganda and elsewhere shows us the opposite. The trick is to find solutions that can be replicated quickly and effectively, so that the experience of Beatrice is repeated many millions of times. That means many millions of answered prayers.
A ripple of laughter spreads through the room during Beatrice's prayer. We're in the town of Nansana, in central Uganda, taking part in a meeting of 25 micro-borrowers, all of them local women. Somebody translates: "Dear Lord, please make us strong and successful," Beatrice said before the group, before adding: "And put women above men for a change."
I'm here with BRAC, the global development organization based in Bangladesh that I'm proud to be a part of, on a visit with representatives of The MasterCard Foundation, which is helping to bring groundbreaking antipoverty solutions pioneered in Bangladesh to Africa. The MasterCard Foundation's partnership is an example of how private Western philanthropic investors are increasingly collaborating with large organizations based in the global South, like BRAC, to lift people out of long-term poverty.
Beatrice's joke cuts to the heart of much of what ails the poorest parts of our world. Women's secondary role is keeping whole sections of society, men and women alike, in poverty. So uplifting women is not just a matter of gender justice or "putting women above men;" As our work and that of other antipoverty organizations have shown, when we invest in girls and women, we end up with healthier families, a more flexible workforce, lower HIV rates and a more stable society.
Uganda is facing its own set of difficulties even as its regional clout rises. Washington sees it as a strategic ally, recently dispatching Green Berets to track down Joseph Kony, whose Lord's Resistance Army had long been a scourge on more remote northern parts of Uganda and South Sudan, terrorizing local populations with kidnappings, rape and child slavery. Meanwhile the economy is in turmoil, and protests in the capital, Kampala, have been simmering since April, asThe New York Times reports. Ordinary Ugandans have seen prices skyrocket, with the price of sugar more than doubling to 6,000 Ugandan shillings ($2.10) per kilogram from 2,600 shillings (93 cents) earlier this year.
There are people who only see hopelessness in Africa: unrest here in Uganda, famished refugees in Kenya, continued fighting in Somalia and withering crops across East Africa. And indeed, sometimes it does seem like the poor are trapped, with the causes of poverty -- meager capital, limited access to markets, lack of healthcare, and inadequate education --apparently too myriad to be addressed properly.
But the Bangladeshis I've worked with see things differently. They see opportunity where others see failure. To a development worker from Bangladesh, with one of the highest rates of land cultivation in the world, unplanted land is money on the ground. What they've also learned is that poor women can defeat poverty on their own when given half a chance.
Employing mainly Ugandan women, we're applying this Bangladeshi-led approach here thanks to The MasterCard Foundation, which has committed $45 million to helping us reach 4.2 million people by 2016, a target we're likely to reach ahead of schedule. We call this approach "microfinance multiplied": not just giving out loans, but improving livelihoods by providing higher-yield seeds, better farming practices and improved access to markets where poor villagers can sell their goods. By doing this, we create a network of micro-franchised entrepreneurs in agriculture, poultry, livestock and health. We train self-employed villagers to educate their neighbors and sometimes even treat simple diseases. And we create clubs for adolescent girls and open schools to educate the next generation.
Take Beatrice, a married mother of two school-age girls. Starting with a small vegetable stand selling produce from her own garden, she has taken progressively larger loans from BRAC to build inventory and open a new shop. Earnings have increased sevenfold. "I used to have a monthly income of 100,000 shillings," she told us. "Now it's 700,000."
Other numbers back up the BRAC-MasterCard approach. An estimated 1.2 million Ugandans are HIV positive, yet of the women and girls who have participated in BRAC's programs in Uganda, 67 percent report always using a condom if and when they have sex, versus only 38 percent of a random control sample. There's an apparent spillover effect, too: Even among those who don't participate, 54 percent of those in villages where we've set up programs say they use condoms, suggesting the spread of good habits among peers. Rates of early motherhood have fallen, too, with 12.4 percent of girls in the control group having children since an initial survey in 2008, versus only 8.7 percent of our program participants.
There's no silver bullet for defeating poverty, but there is silver buckshot. We've learned, for instance, that microfinance is useful on a large scale only when combined with other efforts to improve livelihoods, like the ones described above. But though the problems may seem insurmountable at times, our experience in Bangladesh, Uganda and elsewhere shows us the opposite. The trick is to find solutions that can be replicated quickly and effectively, so that the experience of Beatrice is repeated many millions of times. That means many millions of answered prayers.
Monday, October 24, 2011
The Girl Effect is real, new data shows
If girls had the same access to resources as their male peers, went to school regularly, led lives free of domestic violence and avoided early marriage, agricultural output would increase 4 percent and the number of malnourished men, women and children would drop 17 percent. So says Girls Grow, a report on the world’s roughly 283 million rural adolescent girls that highlights BRAC's ongoing commitment to girls' empowerment.
The Coalition for Adolescent Girls' latest data -- part of its Girls Count series on developments in girls’ roles in rural economies -- appears to confirm much of the "Girl Effect," the idea that investing in adolescent girls in developing countries has profound effect on societies as a whole. Girls Grow, written by Catherine Bertini and the Chicago Council on Global Affairs, came out Oct. 7.
The report calls on national governments, NGOs and bilateral donors to provide services and opportunities that both improve girls’ lives and prepare them to become successful contributors to the economy. On several occasions, the report examines BRAC’s success in targeting and mobilizing this demographic and includes a highlight of BRAC’s Empowerment and Livelihood for Adolescents (ELA) programs:
BRAC has found that financial illiteracy is a constraint to adolescent empowerment and is working with its partners to help build the life skills, financial literacy and self-confidence of rural adolescent girls. In 2002 BRAC developed a specialized microfinance program aimed specifically at adolescent girls. Initially, [ELA] began by targeting rural Bangladeshi girls between the ages of 14 and 25. The program has been expanded to Uganda and Tanzania under the name Empowerment and Livelihood for Adolescents and continues in Bangladesh under the name Social and Financial Empowerment of Adolescents.
In Tanzania the ELA program targets vulnerable adolescent girls aged thirteen to nineteen with the goal of social and financial empowerment. The program combines innovative livelihood and life skills training with a customized microfinance program. Program features include:
Adolescent clubs—Safe spaces where girls can meet and interact and engage in skill building, sports, and other recreational activities.
Adolescent leaders—Older adolescent girls (of at least nineteen years of age) trained by BRAC to manage and lead the clubs and the training courses.
Life skills training courses—For all club members to build social skills and avoid early marriage.
Income-generation skills training—Older and out-of-school girls can select one income-generating training area of interest that is designed for the local economy. Central to this feature is training in basic market analysis and help in selecting training that suits a girl’s interests and skills.
Appropriately designed microfinance—Includes adolescent female loan officers, smaller loan amounts than those given to adults, and a minimum borrowing age of sixteen.
Community participation—Information about the program is provided to communities, including parents and guardians, to help them understand it and to encourage them to support their adolescent girls.
Many of the girls’ clubs are in rural areas and therefore linked to agriculture. Some areas of income-generation training that have been shown to work for first-time microloan recipients are vegetable cultivation, poultry rearing, food processing, tailoring, and other nonfarm businesses.
Girls Grow was commissioned by the UN Foundation, Nike Foundation and the Bill & Melinda Gates Foundation, and is chaired by Catherine Bertini, former Executive Director of the UN World Food Program.
Click here to read the full Girls Grow report.
Saturday, October 22, 2011
Creative space: the BRAC Social Innovation Lab
On October 19, the BRAC Social Innovation Lab was formally launched in an informal gathering called “Social Innovation Forum.” The event focused on a theme of “How does BRAC do social innovation—past, present, and future?” and was dedicated to the memory of Aminul Alam (1949-2010), one of BRAC’s earliest and most influential innovators. A clip of his retelling of BRAC’s initial activities in poultry was played to pay tribute to the passion and incredible dedication he brought to the organization.
The chairperson, Sir Fazle Abed, participated in the launch and offered inspirational reflections on innovation at BRAC. “Necessity is the mother of all inventions, as well as innovations,” he remarked with humor, and emphasized that BRAC’s goal at this point is not to reinvent the wheel, but to “do old things in a new, unique way.” There are many examples of these principles in practice in BRAC’s history; in the Oral rehydration Therapy Extension Program (OTEP) that BRAC launched in the 1970s, for example, BRAC took the “per-piece” payment scheme and applied it to health educators, tying their compensation to how many mothers they effectively taught how to make the lifesaving solution of water, salt, and sugar. Lay health educators reached twelve million mothers and significantly reduced child mortality from diarrheal disease, the major killer at the time. It used a similar model for education, considering students’ retention of knowledge in teachers’ pay. “No one had done it this way, but we did,” Abed commented. Innovation is one of BRAC’s core values, and there is no shortage of examples of how this looks in action. Abed closed his comments by reflecting on the many opportunities for innovation in the current global context, with particular excitement about gains that could be realized in education with creative usage of technology and expanding connectivity.
Few places in the world have a more apparent need for creativity in development than Bangladesh. At once a success story of economic growth, entrepreneurship, and public-private approaches to building durable strategies for providing social services, it continues to face a host of complex and significant changes: climate change, rapid rates of urban migration, to name just a few. Bangladesh must grapple with the growing economic and social inequalities, and mobile populations that challenge traditional delivery models for everything from TB treatment to microfinance. BRAC can be a leader in identifying ways to adapt and continue to combat poverty in the midst of these changes. And with its expanding presence abroad, there are increasing opportunities to translate these local innovations to new contexts. With 2.5 billion people still living on under US $2 a day, the necessity remains quite palpable.
With these possibilities in mind, the newly formed Social Innovation Lab team made a short presentation to further describe the state of innovation at BRAC. They called attention to how the organization has evolved over time to manage the incredible scale and scope of its activities—in introducing the necessary processes and specialized units that this operation requires, barriers to encouraging, testing, and evaluating innovative ideas have inadvertently cropped up. This is particularly true for dialog across programs, leading to missed opportunities to effectively harness the full magnitude of experience and wisdom at BRAC. In addition, there is often limited time to examine how others, in Bangladesh and abroad, are tackling dimensions of poverty, or to keep up with the ever-advancing state of knowledge, technology and research and global priorities. Innovation is a crucial competency to maintain, to continue to effectively combat poverty and sustain the energy and excitement of the caliber and talent of individuals that have built the BRAC that exists today.
How can a massive organization practice innovation? BRAC has been reflecting on how to ensure that its investment in innovation matches the scale of its operations, and out of these conversations, the initial idea of a “Social Innovation Lab” was conceived. Housed in the Communications Department, this unit will seek to institutionalize innovation at BRAC and create an accessible space for all where ideas are shared, generated and nurtured. It will support programs in identifying existing innovations, running pilot programs, and facilitating dissemination of experiences, as well as seeking new partners with promising solutions to work with BRAC in tackling complex issues. Through its activities, the Social Innovation Lab will build program capacity for managing internal innovation and foster cross-program and organization-wide dialog and support for new ideas on how to advance BRAC’s mission. Already, a variety of exciting opportunities are emerging for consideration, from better serving “floating people” (transient slum dwellers) in urban areas, to utilizing technology for effective data utilization in integrated initiatives, to exploring reproductive health for adolescents to adopting an innovative model of private high schools from Kenya. The Social Innovation Lab will evaluate these proposals and their overall alignment with BRAC’s strategy and activities, and work with the programs to prioritize which to pursue. Many more exciting suggestions were offered by BRAC staff who attended the event, confirming that there is a wealth of innovative spirit and potential to harness and build on.Friday, October 21, 2011
Petition against the Vagrancy Law in Bangladesh
Last week, the Director of BRAC Human Rights and Legal Aid Services, Dr. Faustina Pereira, wrote an article calling for a protest against the "Vagrants and Shelterless Persons Act 2011".
Dr. Pereira's post prompted Care2 to start an online petition against the new law.
Already, more than 8,000 from all over the world have signed their name asking to Government of Bangladesh to repeal the "Vagrant and Shelterless Persons Act 2011."
Click here to see the petition and add your name!
Dr. Pereira's post prompted Care2 to start an online petition against the new law.
Already, more than 8,000 from all over the world have signed their name asking to Government of Bangladesh to repeal the "Vagrant and Shelterless Persons Act 2011."
Click here to see the petition and add your name!
Thursday, October 20, 2011
BRAC Green Enterprises: bringing green solutions to the corporate world
A major initiative of sustainable businesses is to eliminate or decrease the impact made on the environment by harmful chemicals, materials, and waste generated by processes to manufacture products and services. The impact of such human activities, in terms of the amount of greenhouse gases produced, can be measured in units of carbon dioxide often referred to as the “carbon footprint”. On a higher level, sustainable business practices can include reviewing processes in order to eliminate or recycle waste, making all products recyclable, and eliminating the use of non-renewable resources via alternative energies.
Sustainable businesses, or green businesses, are enterprises that have no negative impact on the global or local environment, community, society, or economy. In general, business is described as green if it incorporates principles of sustainability into each of its business decisions, supplies, environmentally friendly products or services and is greener than traditional competition.
BRAC Green Enterprises, with its enduring commitment to environmental principles in its business operations, is participating in environmentally friendly activities to ensure that all processes, products, and services adequately address current environmental concerns. BRAC Green Enterprises is a combination of three enterprises, which work under an umbrella to provide green solutions for the corporate urban market: BRAC Solar Enterprise works for power solutions, BRAC Nursery for landscaping and plant rental, and BRAC Recycled Paper for office stationeries. Together, this group of green enterprises is engaged in the production of environment-friendly products, and are consequently aiding in the social uprising of green initiatives in both rural and urban communities. This initiative in our opinion is unique - many enterprises in the renewable energy sector sell exiting products in existing markets, but BRAC Green Enterprises has introduced a complete office solution and its widespread usage can accelerate the process of greening the corporate world in our country.
BRAC Solar Enterprise started its journey towards rural electrification through solar home systems in 1998. The enterprise, in collaboration with the Infrastructure Development Company Ltd, has so far installed 73,000 solar home systems all over Bangladesh. As a part of its responsibility towards society, BRAC Solar has come up with energy-efficient and affordable solar solutions, which is now being offered to customers in rural, semi-urban and urban areas. BRAC Solar is using micro-inverter technology, which dramatically improves the performance, decreases the cost by 50% and saves energy by as much as 90%. For Office Solution, BRAC offers line-UPS and can uninterruptedly run valuable office equipment like computers, switches, hubs, routers, and other crucial office electronics. Additionally, this system can illuminate office interiors. In 2011, BRAC Solar has proudly participated in 2nd Solar Bangladesh 2011 Fair, which has recently been hosted at Bangabandhu International Conference Center on October 13th-15th.
BRAC Nursery focuses on the importance of global social aspect of “greening" and environmental improvement of the office and workspace. Additionally, the popularity of interior office landscaping has grown heavily in the last three decades, so we speculate that this endeavor has come at an opportune time. Recently, with the objective of taking green everywhere in the city of concrete, BRAC Nursery has introduced a range of indoor and pot plants, as well as landscaping services for homes and businesses. BRAC Nursery now runs commercial activities to increase awareness in creating a greener planet. The enterprise aims to increase the number and variety of trees in Bangladesh, to meet the nation’s basic needs for timber, fuel and fruit, as well as to restore the ecological balance. This year, BRAC Nursery has been awarded the First Prize in the National Tree Plantation and Tree Fair by the Bangladesh Forest Department, Ministry of Environment and Forest.
For the last one decade, BRAC Recycled paper has been contributing towards the prevention of environmental degradation by producing recycled products for the corporate urban market. It produces synthesized paper products from recycled materials, such as used paper, stalks of wheat, hay, water, hyacinth, caustic soda, dye, barley, glue and cotton. These materials are gathered from various BRAC projects and branch offices, thus helping to reduce the amount of waste produced by BRAC.
Whether it is to light up your life or help your business to go green, BRAC Green Enterprises has a solution for you available at BRAC Kanon - an outlet that serves the green solutions for your office. For more information, you can visit BRAC Kanon at 205/1/B Gulshan Tejgaon Link Road (opposite of Gulshan Aarong), Dhaka.
by Ashik Imtiaz and Shams Ahmed (Interns, BRAC Communications)
Friday, October 14, 2011
Rana, the garment worker: No longer stigmatized, TB patients open up about their experiences
On the occasion of the launch of its book Making Tuberculosis History: Community-Based Solutions for Millions, Bangladesh-based BRAC is sharing stories about those taking part in its successful approach to combating TB. The following is the third in a series; previously we featured the stories of Shanta and Shahida.
By Maria A. May, BRAC Health Program
A chronic smoker, Rana wasn’t too alarmed when he first developed a persistent cough. Within a few weeks the Bangladeshi garment worker’s health had worsened, however. He began vomiting and found himself unable to go to work at the factory. A local doctor suspected tuberculosis (TB), but Rana couldn’t afford the recommended X-ray diagnosis.
It’s a typical story in Dhaka, and one where BRAC, the world’s largest antipoverty organization, plays a crucial and potentially life-saving role. The doctor recommended Rana seek a free diagnosis at the local office of BRAC, whose successful anti-TB efforts are the subject of the forthcoming Making Tuberculosis History: Community-Based Solutions for Millions. First developed in the 1980s, BRAC's anti-TB program now covers 91 million people in Bangladesh alone.
The nearest BRAC office lay several kilometers from Rana’s home in Badda, a slum in northern Dhaka, but he wasn’t sure exactly where. Asking for directions along the way, he made his way through the labyrinth of narrow streets – a sprawling neighborhood of informal shops and dwellings that has cropped up beside the main road and factories as Dhaka’s population soars due to migration from the countryside.
At BRAC, the test results came out positive for TB. Thanks to a BRAC-administered government program, Rana would have access to daily drug treatment for six months, but it would need to be supervised. Rana worried that he’d be unable to get to the BRAC office every day for treatment, so Mofiz, the local program organizer, connected him with Sirina, one of BRAC’s community health promoters (or shasthya shebikas) living near his house.
Now, on his way to work each morning, Rana stops by Sirina’s to quickly swallow the pill with a glass of water. Mofiz has also visited occasionally to make sure his health is improving. With four of six months of treatment already complete, Rana no longer experiences any symptoms, yet the system ensures that Rana and other patients finish their prescriptions, thus eradicating the bacteria completely and preventing the growth of drug-resistant TB strains.
Rana also faced the matter of employment. Upon diagnosis, he duly informed the factory supervisor that he’d contracted TB. His manager suggested that he take a few days off to begin the treatment; Rana was relieved at not being isolated from either his employer or the other workers on his floor.
Stigma is often cited as a concern for avoiding diagnosis and treatment of TB. Before medication became widely available, many considered it a fatal disease. Even those who recovered often experienced continued alienation. Some thought the disease had a genetic component, so a husband might abandon a wife who survived the illness, while unmarried survivors faced challenges finding a partner. That Rana and other patients, such as Abhur, a rickshaw driver who successfully completed his treatment, openly shared their condition with others in their community marks huge progress in combating the social dimensions of the disease.
Women in Bangladesh still experience greater levels of psychological and social consequences, however, which is one reason communications and social mobilization activities remain a central part of BRAC’s strategy for TB control. The organization’s all-female cadre of 80,000 shasthya shebikas, who sell health products while proffering advice on diagnosis and treatment, creates a frontline option that gives women access to TB services without having to travel, get money from their husbands, or see a male provider.
Treatment of male TB patients, meanwhile, carries its own set of concerns, including an alarmingly high rate of tobacco product usage among men. The long-term health consequences of smoking or chewing tobacco are not immediately visible, so individuals are unlikely to try quitting on their own. BRAC is informally piloting tobacco cessation support as part of its TB treatment package in a few areas of Dhaka, including Badda. Both Rana and Abhur, for instance, have smoked for years but are attempting to quit after counseling from Mofiz and their shasthya shebikas. “It’s not easy to quit,” Rana says, “but BRAC told me if I want to live, I need to try.”
In Bangladesh’s transition to a middle-income country, chronic disease prevention and management will likely replace infectious disease control as top priorities. Supporting Rana and Adhur in quitting smoking is yet another example of BRAC’s experimentation with shasthya shebikas to extend its community-based approach so that it continues to have a powerful impact even in changing times. In Making Tuberculosis History: Community-Based Solutions for Millions, the authors also explore how BRAC might apply its anti-TB methods to other pressing health issues, including HIV/AIDS and hypertension.
Making Tuberculosis History, the comprehensive book on BRAC’s experiences with TB, comes out on October 27. For more information, write to makingtbhistory@bracusa.org.
A chronic smoker, Rana wasn’t too alarmed when he first developed a persistent cough. Within a few weeks the Bangladeshi garment worker’s health had worsened, however. He began vomiting and found himself unable to go to work at the factory. A local doctor suspected tuberculosis (TB), but Rana couldn’t afford the recommended X-ray diagnosis.
It’s a typical story in Dhaka, and one where BRAC, the world’s largest antipoverty organization, plays a crucial and potentially life-saving role. The doctor recommended Rana seek a free diagnosis at the local office of BRAC, whose successful anti-TB efforts are the subject of the forthcoming Making Tuberculosis History: Community-Based Solutions for Millions. First developed in the 1980s, BRAC's anti-TB program now covers 91 million people in Bangladesh alone.
The nearest BRAC office lay several kilometers from Rana’s home in Badda, a slum in northern Dhaka, but he wasn’t sure exactly where. Asking for directions along the way, he made his way through the labyrinth of narrow streets – a sprawling neighborhood of informal shops and dwellings that has cropped up beside the main road and factories as Dhaka’s population soars due to migration from the countryside.
At BRAC, the test results came out positive for TB. Thanks to a BRAC-administered government program, Rana would have access to daily drug treatment for six months, but it would need to be supervised. Rana worried that he’d be unable to get to the BRAC office every day for treatment, so Mofiz, the local program organizer, connected him with Sirina, one of BRAC’s community health promoters (or shasthya shebikas) living near his house.
Now, on his way to work each morning, Rana stops by Sirina’s to quickly swallow the pill with a glass of water. Mofiz has also visited occasionally to make sure his health is improving. With four of six months of treatment already complete, Rana no longer experiences any symptoms, yet the system ensures that Rana and other patients finish their prescriptions, thus eradicating the bacteria completely and preventing the growth of drug-resistant TB strains.
Rana also faced the matter of employment. Upon diagnosis, he duly informed the factory supervisor that he’d contracted TB. His manager suggested that he take a few days off to begin the treatment; Rana was relieved at not being isolated from either his employer or the other workers on his floor.
Stigma is often cited as a concern for avoiding diagnosis and treatment of TB. Before medication became widely available, many considered it a fatal disease. Even those who recovered often experienced continued alienation. Some thought the disease had a genetic component, so a husband might abandon a wife who survived the illness, while unmarried survivors faced challenges finding a partner. That Rana and other patients, such as Abhur, a rickshaw driver who successfully completed his treatment, openly shared their condition with others in their community marks huge progress in combating the social dimensions of the disease.
Women in Bangladesh still experience greater levels of psychological and social consequences, however, which is one reason communications and social mobilization activities remain a central part of BRAC’s strategy for TB control. The organization’s all-female cadre of 80,000 shasthya shebikas, who sell health products while proffering advice on diagnosis and treatment, creates a frontline option that gives women access to TB services without having to travel, get money from their husbands, or see a male provider.
Treatment of male TB patients, meanwhile, carries its own set of concerns, including an alarmingly high rate of tobacco product usage among men. The long-term health consequences of smoking or chewing tobacco are not immediately visible, so individuals are unlikely to try quitting on their own. BRAC is informally piloting tobacco cessation support as part of its TB treatment package in a few areas of Dhaka, including Badda. Both Rana and Abhur, for instance, have smoked for years but are attempting to quit after counseling from Mofiz and their shasthya shebikas. “It’s not easy to quit,” Rana says, “but BRAC told me if I want to live, I need to try.”
In Bangladesh’s transition to a middle-income country, chronic disease prevention and management will likely replace infectious disease control as top priorities. Supporting Rana and Adhur in quitting smoking is yet another example of BRAC’s experimentation with shasthya shebikas to extend its community-based approach so that it continues to have a powerful impact even in changing times. In Making Tuberculosis History: Community-Based Solutions for Millions, the authors also explore how BRAC might apply its anti-TB methods to other pressing health issues, including HIV/AIDS and hypertension.
Making Tuberculosis History, the comprehensive book on BRAC’s experiences with TB, comes out on October 27. For more information, write to makingtbhistory@bracusa.org.
Thursday, October 13, 2011
Not missing a dose: Shahida, a patient, recounts her experience with BRAC
On the occasion of the launch of its book Making Tuberculosis History: Community-Based Solutions for Millions, Bangladesh-based BRAC is sharing stories about those taking part in its successful approach to combating TB. The following is the second in a series; click here to read the previous story of Shanta, neighbor and care provider.
By Maria A. May, BRAC Health Program
Shahida usually speaks quickly, her raspy voice sharpening every word. But she smiles and softens when asked if she’d rather just take her tuberculosis medications at home. “No,” she says matter-of-factly. “I’d forget to do it every day.”
As it stands, Shahida has yet to miss a single dose, a testament to the effectiveness of the anti-TB program of Dhaka-based BRAC, the world’s largest development nonprofit, as detailed in an upcoming book Making Tuberculosis History: Community-Based Solutions for Millions.
Halfway through her six-month treatment course, Shahida, a resident of the northern Dhaka slum of Badda, continues her treatment under the watchful eye of her neighbor Shanta, one of BRAC’s “community health promoters,” or shasthya shebikas – an army of 80,000 trained lay practitioners who form the centerpiece of BRAC’s anti-TB strategy.
Shahida’s symptoms have already disappeared. In fact, she feels completely cured. For many, this would be the signal to stop taking the medicine, but Shahida knows the importance of finishing the full course from her conversations with Shanta. Not only will it prevent relapse, but failure to complete the treatment would encourage the emergence of dangerous drug-resistant strains of the bacteria that causes tuberculosis. The growth of drug-resistant strains is one of the greatest fears of global health advocates as TB continues to kill 5,000 people daily worldwide.
So Shahida continues her daily visits to Shanta’s house. She sees the positive side: “It’s nice to see her every day,” Shahida says. “It provides a short break from all my daily chores. We usually end up talking about other things going on in the community.”
It all began with a persistent fever. Shahida fell ill in May with a high temperature that didn’t subside even after several days of medication. She wasn’t coughing, so when she approached the doctor at a nearby clinic, TB wasn’t even on her mind. But X-rays clearly indicated she had the disease.
Recognizing Shahida might be unable to afford the required treatment, the doctor recommended a visit to BRAC, which provides medications at no cost thanks to its partnership with Bangladesh’s National Tuberculosis Program. A sputum test at Shahida’s local BRAC branch office confirmed the diagnosis. Here, Shanta entered the picture: The patient and her shasthya shebika neighbor agreed on a time for daily visits.
Shahida prefers to keep her illness private, sharing it only with family. Though she does not buy anything else from Shanta – the shasthya shebikas have a basket of health products for sale, like vitamins and sanitary napkins – she’s able to visit her regularly without eliciting suspicions from others in the community. The two women have developed a comfortable rapport.
In urban areas, local pharmacists, physicians and drug sellers (often untrained) are the first place poor people go for health care. These are often conveniently located in or near the slums and are open in the evenings, when public facilities are closed. A strategy employed by BRAC and other organizations working with the National Tuberculosis Program is to engage these providers in training and orientation to teach them about TB, the importance of adherence, and the availability of free treatment options.
Within the neighborhood of Badda alone, diverse options exist. BRAC tries to reach as many of these providers as possible, from the proper pharmacy shop to the individuals selling health products in rickshaw garages. Particularly in the complex context of Dhaka’s unregulated and fragmented health care system, these partnerships create important pathways for patients to access quality TB services.
Partnership and engagement with health care providers are just two of many strategies BRAC is using for urban TB control. Learn about how BRAC works with garment factories to reach another vulnerable population.
Making Tuberculosis History, the comprehensive book on BRAC’s experiences with TB, comes out on October 27. For more information, write to makingtbhistory@bracusa.org.
Next in the series, we’ll feature the story of Rana, a garment worker who contracted TB.
Wednesday, October 12, 2011
The story of Shanta, neighbor and care provider: How BRAC is making tuberculosis history
On the occasion of the launch of its book Making Tuberculosis History: Community-Based Solutions for Millions, Bangladesh-based BRAC is sharing stories about those taking part in its successful approach to combating TB. The following is the first in a series.
By Maria A. May, BRAC Health Program
Shanta, a resident of Badda, a vibrant slum in northern Dhaka, is a face of the new Bangladesh. Every day she finishes her morning tasks at home and heads out into the bustle to begin her work. Around her, the streets pulse with energy: vendors offer freshly cut grapefruit and guava, stores and stalls spill over with cheap household items imported from China, cell phone ring tones sound endlessly. Once a country of villages, Bangladesh has been transformed as the promise of economic opportunity draws the rural poor to Dhaka, population 15 million and rising.
Rapid urban migration has squeezed the capital. Increasingly horrendous traffic chokes the roads, and power outages, a lack of basic sanitation and a dearth of public services are the norm here. Conditions are ripe for the spread of tuberculosis (TB), an airborne bacterial infection that kills about 5,000 people every day around the world. But there is also hope and opportunity: It is here in Bangladesh, that BRAC, the world’s largest anti-poverty organization, has developed a successful approach for confronting the threat of TB, described in its upcoming book, Making Tuberculosis History: Community-Based Solutions for Millions.
Shanta is a living embodiment of the organization’s success. She is part of BRAC’s all-female army of 88,000 “community health promoters” (shasthya shebika in Bangla) – lay practitioners who form the pillars of BRAC’s anti-TB strategy. Shanta and tens of thousands like her visit households in their communities every day, selling simple health products like vitamins and sanitary napkins, while inquiring about persistent coughs, fevers, and other symptoms of TB. These women identify individuals with symptoms, and with BRAC’s help, facilitate testing and diagnosis.
For those who test positive, a lengthy course of drug treatment begins. This is where Shanta’s work becomes crucial, for one of the most worrying aspects of TB treatment is the potential development of dangerous drug-resistant strains. In order to prevent that, patients must complete the full course of drug treatment. Though medication is provided for free by the government, BRAC requires new patients to hand over a small deposit, returned only after taking the medicine regularly for six months, ensuring the bacterial infection is eliminated completely. Shanta, like other community health promoters, makes sure the patients take their medication each day as prescribed.
“Patients usually want to stick to the treatment,” says Shanta. But unexpected disruptions, mobile lifestyles and stress often make it difficult. People need a support mechanism that’s nearby and flexible. Patients, too, admit that without her help, they’d likely forget to take the medication sometimes. If they need to travel outside the slum – back to their home villages for a few days, for instance – Shanta gets involved, helping them plan the trip, often identifying a temporary guardian to make sure they continue to take the required medication.
For those TB patients living in the surrounding streets of Badda, Shanta is both a friendly neighbor and care provider. Patients confide in her, often sharing personal matters during visits to her home, where they come for daily treatment. (Most live within a five to 10 minute walk and like to stop by on their way to work.) If unable to come, they call her mobile phone, and she usually responds with a personal visit. For every patient of hers that successfully completes treatment, Shanta receives 150 Bangladeshi takas (US$2) from BRAC, helping her support her own three children.
Building on its success in providing health care to rural communities, BRAC has trained an urban cadre of health promoters to reach slum dwellers as villagers increasingly pack up for the cities. The organization now accounts for about 66 percent of all TB cases treated in Bangladesh.
Emerging from its earliest experiments providing TB treatment to rural villages lacking access to government health care in the 1980s, BRAC’s method has brought it under fire. Numerous public health experts, government officials, donors and human rights activists pushed BRAC to change its delivery strategy, which usually involves a bond system whereby patients put down a small deposit prior to beginning treatment, returned only if they complete the full course. The organization refused, citing program data and research that supported its approach.
Simply put, BRAC’s model works. With adherence an Achilles' heel for treating infectious diseases like TB, BRAC has found a way to engage patients and motivate them to continue the full course of treatment. It has tested the model in the field, defended it from critics, and scaled it up to become one of the largest such programs in the world – thanks, in large part, to women like Shanta. BRAC has brought similar methods to Afghanistan with great success, and has promising pilots underway in Uganda and Liberia.
Since 1994, Bangladesh’s National Tuberculosis Program has led a consortium of non-governmental organizations in creating systems that offer free treatment to all. This partnership has expanded since the arrival of resources from the Global Fund to Fight AIDS, Tuberculosis and Malaria in 2004, reaching deeper into communities across the country. In 2010, over 45 partners participated in national anti-TB efforts, treating 150,000 patients.
BRAC launches Making Tuberculosis History, on October 27 at the 42nd Union World Conference on Lung Health in Lille, France. For more information, write to makingtbhistory@bracusa.org.
Next in the series, we’ll feature the story of Shahida, one of Shanta’s patients.
By Maria A. May, BRAC Health Program
 |
Rapid urban migration has squeezed the capital. Increasingly horrendous traffic chokes the roads, and power outages, a lack of basic sanitation and a dearth of public services are the norm here. Conditions are ripe for the spread of tuberculosis (TB), an airborne bacterial infection that kills about 5,000 people every day around the world. But there is also hope and opportunity: It is here in Bangladesh, that BRAC, the world’s largest anti-poverty organization, has developed a successful approach for confronting the threat of TB, described in its upcoming book, Making Tuberculosis History: Community-Based Solutions for Millions.
Shanta is a living embodiment of the organization’s success. She is part of BRAC’s all-female army of 88,000 “community health promoters” (shasthya shebika in Bangla) – lay practitioners who form the pillars of BRAC’s anti-TB strategy. Shanta and tens of thousands like her visit households in their communities every day, selling simple health products like vitamins and sanitary napkins, while inquiring about persistent coughs, fevers, and other symptoms of TB. These women identify individuals with symptoms, and with BRAC’s help, facilitate testing and diagnosis.
For those who test positive, a lengthy course of drug treatment begins. This is where Shanta’s work becomes crucial, for one of the most worrying aspects of TB treatment is the potential development of dangerous drug-resistant strains. In order to prevent that, patients must complete the full course of drug treatment. Though medication is provided for free by the government, BRAC requires new patients to hand over a small deposit, returned only after taking the medicine regularly for six months, ensuring the bacterial infection is eliminated completely. Shanta, like other community health promoters, makes sure the patients take their medication each day as prescribed.
“Patients usually want to stick to the treatment,” says Shanta. But unexpected disruptions, mobile lifestyles and stress often make it difficult. People need a support mechanism that’s nearby and flexible. Patients, too, admit that without her help, they’d likely forget to take the medication sometimes. If they need to travel outside the slum – back to their home villages for a few days, for instance – Shanta gets involved, helping them plan the trip, often identifying a temporary guardian to make sure they continue to take the required medication.
For those TB patients living in the surrounding streets of Badda, Shanta is both a friendly neighbor and care provider. Patients confide in her, often sharing personal matters during visits to her home, where they come for daily treatment. (Most live within a five to 10 minute walk and like to stop by on their way to work.) If unable to come, they call her mobile phone, and she usually responds with a personal visit. For every patient of hers that successfully completes treatment, Shanta receives 150 Bangladeshi takas (US$2) from BRAC, helping her support her own three children.
Building on its success in providing health care to rural communities, BRAC has trained an urban cadre of health promoters to reach slum dwellers as villagers increasingly pack up for the cities. The organization now accounts for about 66 percent of all TB cases treated in Bangladesh.
Emerging from its earliest experiments providing TB treatment to rural villages lacking access to government health care in the 1980s, BRAC’s method has brought it under fire. Numerous public health experts, government officials, donors and human rights activists pushed BRAC to change its delivery strategy, which usually involves a bond system whereby patients put down a small deposit prior to beginning treatment, returned only if they complete the full course. The organization refused, citing program data and research that supported its approach.
Simply put, BRAC’s model works. With adherence an Achilles' heel for treating infectious diseases like TB, BRAC has found a way to engage patients and motivate them to continue the full course of treatment. It has tested the model in the field, defended it from critics, and scaled it up to become one of the largest such programs in the world – thanks, in large part, to women like Shanta. BRAC has brought similar methods to Afghanistan with great success, and has promising pilots underway in Uganda and Liberia.
Since 1994, Bangladesh’s National Tuberculosis Program has led a consortium of non-governmental organizations in creating systems that offer free treatment to all. This partnership has expanded since the arrival of resources from the Global Fund to Fight AIDS, Tuberculosis and Malaria in 2004, reaching deeper into communities across the country. In 2010, over 45 partners participated in national anti-TB efforts, treating 150,000 patients.
BRAC launches Making Tuberculosis History, on October 27 at the 42nd Union World Conference on Lung Health in Lille, France. For more information, write to makingtbhistory@bracusa.org.
Next in the series, we’ll feature the story of Shahida, one of Shanta’s patients.
Tuesday, October 11, 2011
Vagrants Law 2011: Why we are calling for a protest
Faustina Pereira,Director, BRAC Human Rights and Legal Aid Services
In the early hours of 24 August, after several futile attempts to sleep, I found myself doing the opposite of what sleep experts recommend – reading the news. I was scrolling down the online edition BDNews. It’s a good thing I did what I did then, because within a few seconds one news item got me fully awake. It stated that a few hours before a new law on vagrants had been tabled and passed in Parliament! The report stated that this law “Vagrants and Shelterless Persons Act 2011” now permits, amongst other things, forcibly instituting the poor, the shelterless, beggars and vagrants into “shelter homes” through arrests, and would make it a punishable offence with imposition of jail term and fine for attempts to leave the shelter homes. This defied belief!
The original law on vagrancy was passed in 1943, and human rights organizations have been decrying the utter oppressiveness of this law for decades and have been calling for its repeal. And now, not only do we find this draconian law not scrapped, we see it resurrected with even more horrendous provisions, and that too passed in a late night session of Parliament without even a semblance of debate, analysis or taking into account citizen’s and civil society concerns. Had no one noted the significance of the year 1943, the year when anti-poor, anti-begging laws came about – on the heels of the Bengal Famine of 1943 and the precursor years of the Swadeshi Movement that brought the fall of the British Empire in India? Removing the “scourge” of the poor, the weak and the helpless from the imperial streets of British India may have been a poorly masked and unapologetic Colonial agenda. But to have a democratically elected Government six decades later take that agenda even futher, all in the name of poverty eradication – this is unacceptable! Is this then the formula for us to achieve our Millenium Development Goals – exterminate the poor in order to eradicate poverty!
What further defied belief was the almost non-existent news coverage of the issue in the media, as if it was not as news worthy as the latest squabbles of political leaders, or new cosmetic and electronic products being launched that day. As soon as I saw the news item on BDNews, I circulated a message to friends with the comment “Old wine in new bottle, let’s meet in the morning, we need to act fast." But by 9 that morning colleagues started to ask whether I had in fact dreamt up the story because they could not find anything on the issue of vagrants, either on BDNews or other news sites. True enough, I checked again, and I too couldn’t find the news on the website anymore! For a while I started second guessing myself, but in fact the news was removed. It took us another couple of days to track the news item from BSS (Bangladesh news agency) and a whole week to get a copy of the law and any information on its status. Finally through a contact in the ministry of social welfare, we were confirmed that such a law had indeed been passed and was awaiting the President’s assent and signature. Not a word about consultation or debate or citizen’s participation. Not a word about how such a law came about in the first place.
On September 17, 2011 BRAC’s Human Rights and Legal Aid Services Programme together with other leading rights based organisations such as Ain o Shalish Kendra(ASK), Bangladesh Legal Aid Services Trust (BLAST), and Action on Disability and Development (ADD) and Nijera Kori organized a roundtable- our first initiative to protest the law- titled "Vagrants and Shelterless Persons (Rehabilitation) Act 2011: Protest and Assessment," in which the Chairman of the Bangladesh Human Rights Commission, Dr. Mizanur Rahman was present as the chief guest. He was as indignant as we were. He also offered to raise our concerns with the Government and visit the vagrant homes himself.
In calling about this protest, through this round table, it is not only that we are critiquing the law; we are also critiquing the way in which this law came about. It came about in a highly questionable and non-transparent manner. If there were any steps taken to include the voice of the people most affected by this law, we are yet to discover them. We find this law to be highly discriminatory, hostile and humiliating towards poor citizens. We protest the law, its process and the perverse mind- set that brought it about.
Click here for more details about the round table discussion.
Monday, October 10, 2011
Women Like Sirleaf and Gbowee Clear Africa's Path to Prosperity
The following was originally posted by BRAC USA President and CEO Susan Davis in the Huffington Post.
I was heartened to learn Friday morning that the Nobel Committee had awarded this year's Peace Prize to Ellen Johnson-Sirleaf, Liberia's current president, and the bold Liberian activist Leymah Gbowee, two women I admire tremendously for their pivotal role in advancing the cause of peace in Africa.
That they, along with another brave woman, Yemen's Tawakul Karman, have earned this accolade speaks not only to the enormous scale of progress made in securing peace in former conflict zones but also the crucial role women have played in achieving these goals.
This announcement comes as we mourn the loss of Wangari Maathai, another African icon and the continent's first Nobel Peace Prize laureate. As we reflect on their achievements, it is impossible not to acknowledge the adversities women leaders have faced in the struggle leading up to this moment.
Wangari Maathai's life and legacy spurred many movements, not only in her native Kenya but on the entire African continent. Her unwavering dedication allowed her and her African laureate successors, including Sirleaf and Gbowee, to rise to prominence on the international stage.
For BRAC, the organization I am privileged to be a part of, these leaders symbolize everything we stand for: The empowerment of women clears the path to peace and prosperity.
At the Clinton Global Initiative in 2007, President Sirleaf urged BRAC, a Bangladesh-based organization and the largest anti-poverty group in the world, to bring its proven strategies to her country as it put the legacies of conflict behind it once and for all. As she put it at the time, BRAC's "inspiring story gives us hope that Liberia can use citizen power to rebuild and transform the lives of the poorest to bring about health, wealth, and greater well-being." Since her invitation, BRAC and other organizations have made huge strides in creating sustainable development amongst previously deprived communities in Liberia and elsewhere.
Founded in 1972, BRAC is on a drive to apply solutions created in its native Bangladesh to defeating poverty in Africa. We do this by removing the causes of poverty and hunger at the root with a comprehensive approach geared toward individual empowerment. This includes providing millions of micro-entrepreneurs with better opportunities via micro-loans, improving access to markets, and building institutions to provide better health care and education.
The great achievements of these women serve as reminders that we need not be overwhelmed by news of war and poverty. Solutions to the world's more pressing problems do exist, and those with the ears to hear them will find success stories -- songs of hope instead of cries of war, and pictures of prosperity instead of images of hopelessness -- often in the unlikeliest of places.
Our goal is not to dispense aid to impoverished people but to create conditions under which individuals can realize their full potential. "We are dancing," said a spokesman for Sirleaf in response to the award. So are we. Not just for Africa, but for the future Wangari Maathais, Ellen Johnson-Sirleafs, Leymah Gbowees and Tawakul Karmans of the world. May their potential soon be unleashed.
Click here to read the original article in the Huffington Post.
I was heartened to learn Friday morning that the Nobel Committee had awarded this year's Peace Prize to Ellen Johnson-Sirleaf, Liberia's current president, and the bold Liberian activist Leymah Gbowee, two women I admire tremendously for their pivotal role in advancing the cause of peace in Africa.
That they, along with another brave woman, Yemen's Tawakul Karman, have earned this accolade speaks not only to the enormous scale of progress made in securing peace in former conflict zones but also the crucial role women have played in achieving these goals.
This announcement comes as we mourn the loss of Wangari Maathai, another African icon and the continent's first Nobel Peace Prize laureate. As we reflect on their achievements, it is impossible not to acknowledge the adversities women leaders have faced in the struggle leading up to this moment.
Wangari Maathai's life and legacy spurred many movements, not only in her native Kenya but on the entire African continent. Her unwavering dedication allowed her and her African laureate successors, including Sirleaf and Gbowee, to rise to prominence on the international stage.
For BRAC, the organization I am privileged to be a part of, these leaders symbolize everything we stand for: The empowerment of women clears the path to peace and prosperity.
At the Clinton Global Initiative in 2007, President Sirleaf urged BRAC, a Bangladesh-based organization and the largest anti-poverty group in the world, to bring its proven strategies to her country as it put the legacies of conflict behind it once and for all. As she put it at the time, BRAC's "inspiring story gives us hope that Liberia can use citizen power to rebuild and transform the lives of the poorest to bring about health, wealth, and greater well-being." Since her invitation, BRAC and other organizations have made huge strides in creating sustainable development amongst previously deprived communities in Liberia and elsewhere.
Founded in 1972, BRAC is on a drive to apply solutions created in its native Bangladesh to defeating poverty in Africa. We do this by removing the causes of poverty and hunger at the root with a comprehensive approach geared toward individual empowerment. This includes providing millions of micro-entrepreneurs with better opportunities via micro-loans, improving access to markets, and building institutions to provide better health care and education.
The great achievements of these women serve as reminders that we need not be overwhelmed by news of war and poverty. Solutions to the world's more pressing problems do exist, and those with the ears to hear them will find success stories -- songs of hope instead of cries of war, and pictures of prosperity instead of images of hopelessness -- often in the unlikeliest of places.
Our goal is not to dispense aid to impoverished people but to create conditions under which individuals can realize their full potential. "We are dancing," said a spokesman for Sirleaf in response to the award. So are we. Not just for Africa, but for the future Wangari Maathais, Ellen Johnson-Sirleafs, Leymah Gbowees and Tawakul Karmans of the world. May their potential soon be unleashed.
Click here to read the original article in the Huffington Post.
Sunday, October 9, 2011
From Struggle To Savvy Entrepreneurship: BRAC Hosts 'Adolescent Livelihood Conference'
On September 14 BRAC Adolescent Development Programme arranged a 'Livelihood Conference' at Mohakhali BRAC center. Participants came from 70 sub-districts across the country. All teenagers, these women are newborn entrepreneurs in the beautician industry. It was an opportunity for them to enrich their knowledge from the experiences shared by the reputed leaders present at the conference. I was thrilled to find out that most of these girls were from either from our training sessions or my previous field visits. These girls had some wonderful stories to share:
Kohinur is a village girl from Hatirdia, Norshingdi. In 2007, she received her training in a beautification course from BRAC. She started working from her home, later on taking a BRAC loan and opening her own salon. Her business thrives; consequently she recently opened a second branch. Currently, her two sisters help her with the business and along with six other female employees. Kohinur expresses her gratitude-"I'm thankful to god, I never thought, I could attain something like this!" She explains, "I grew up in a village. My dreams were very plain- getting married and having kids BRAC changed that dream. Now that I've training form BRAC, I have an ambition to be a successful entrepreneur, a beautician. I have met Kaniz Almas Khan in this conference, she is my idol I am very inspired!"
Jhuma Rani Sarkar from Mohongonj, Netrokona couldn't continue her studies after class ten because of poverty. She received training through BRAC adolescent club in 2009 from BRAC training center in Dhaka. She is now a successful entrepreneur and beautician. The experience of the conference and presence of the famous personalities such as journalist, Munni Shaha, Kaniz Almas Khan (Entrepreneur, Beautician) and the esteemed businesswoman, Rokeya Afzal Rahman highly motivated her. She feels more confident. "Everybody knows me by the name 'Beautician Jhuma' in my village, I wish that one day the whole district will recognize me by that name," said Sarkar.
Krishna Dey is the owner of the only beauty salon in Khutakhali village, initially starting the service from her home; her popularity demanded she shift to a location inthe town's market. Dey's father lent her the initial capital to start her business. A truck driver by profession, Mr. Dey retired in order to help his daughter with her increasingly successful business. Krishna's earning alone is now enough to provide all the family members, including educational expenses of her younger siblings. Krishna said, "My father is very proud of me, he broadcasted to the whole village of my attending this conference! No one from my family has ever participated in a conference. I'm very proud and thankful to BRAC for helping me to become what I am today."
Hearing their stories, I think to myself, change is possible. Provided they are given a chance, the girls in our country can elevate themselves into extraordinary situations. It was only in 2007, when we started our work experimentally by providing beautification training to 20 adolescent girls. 500 girls thus far have been successfully trained. Of this 500, two have joined as government trainers in the Ministry of Women and Children Affairs' and 375 are working in the path to become self-sufficient and successful entrepreneurs.
By Rashida Pervin, Manager, BRAC Education Programme
For more information on this event visit-
http://theindependentbd.com/paper-edition/city-life/72542-a-conference-with-a-difference.html
Tuesday, October 4, 2011
Ethiopia National Level Workshop on Building Pathways for the Poorest
Relief Society of Tigray (REST), BRAC Development Institute and The MasterCard Foundation, are convening a workshop on the Graduation Model in Addis Ababa, Ethiopia on October 12, 2011.
The Ethiopia CGAP-Ford Foundation Graduation Pilot is being implemented by REST in Tigray with 500 participants to test if the Graduation Model’s potential to build sustainable pathways out of extreme poverty, building around the Ethiopia’s Productive Safety Net Program. REST, BDI and the MasterCard Foundation will bring together donors, practitioners and policy makers to discuss lessons from the CGAP-Ford Foundation Graduation Program, share the specific experience of the Ethiopia pilot implemented by REST, and discuss challenges and ideas for working with the poorest in Ethiopia.
Click here for more information on the Graduation Program and research results.
The Ethiopia CGAP-Ford Foundation Graduation Pilot is being implemented by REST in Tigray with 500 participants to test if the Graduation Model’s potential to build sustainable pathways out of extreme poverty, building around the Ethiopia’s Productive Safety Net Program. REST, BDI and the MasterCard Foundation will bring together donors, practitioners and policy makers to discuss lessons from the CGAP-Ford Foundation Graduation Program, share the specific experience of the Ethiopia pilot implemented by REST, and discuss challenges and ideas for working with the poorest in Ethiopia.
Click here for more information on the Graduation Program and research results.
Innovative steps towards Primary Education in haor area
A haor is a permanent marshland, distinct to the North-eastern Bangladeshi region of Sylhet. Although most would say the famous tea gardens are iconic here, they only comprise of twelve percent of the region, while a massive 30.2% of Sylhet is permanent marshlands.
Disregard the adverse conditions and isolation; people have managed to live in the haorsof Sylhet for hundreds of years. One gets around by boat in the haors. Unfortunately, the distance of settlement to settlement often creates massive isolation.
One of the biggest problems here is easy access to education. School age children in the marshlands often are faced with the difficulty of huge distances in travel to school. Often the nearest schools will be around two miles. Many simply do not go. That is where BRAC Innovation comes in.
We created the concept of Floating Schools for children in this region. Consequently, education is brought to them. Dholerpurvillage, was the sight of our latest inauguration.
Newly admitted students named MuktaRani Das (10) said: “I am very happy to attend this school. We had never thought of going to school as the nearer primary school is two miles away.“.
We sadly encountered a few parents and found that they were not aware of the laws regarding mandatory school attendance for children.
On 26th September 2011, BRAC Education Programme launched two primary schools on boats in two villages: Dhorerpar and Rahamatput Each boat will pick teachers and 30 registered students from nearer ‘hati’. After finishing class they will be dropped in their home.
At the launching event, Dr. MahbubHossain,
Executive Director of BRAC said, “BRAC works to support government. Our values
are reflected in our work.”
Muhammad YaminChowdhury - Sunamgang District Commissioner was present there as Chief Guest SafiqulIslam and other well-known locals were present in the event.
The Sylhet region has flash flood problem. In these flash floods, water level rises and falls quite rapidly with little or no advanced warning.. Children as well as teachers face trouble in reaching schools. Fishing often becomes the last resort for most of these “trapped” villagers.
Economic deprivation and social inequalities arising from their geographical isolation keeps children away from school and education. In a research by Education Watch in collaboration with BRAC it is found that compared to 38.5% overall in Sylhet division.. The head teachers reported that over a fifth of the students had to face bad transportation during dry season that doubled in the wet season.
According to research statistics, 42% of the villages in Sylhet have no primary schools. In terms of literacy rate, also it lags far behind the national average. The literacy rate for 7+ populations is 40.7% and for adult population it is 44.4% but the national rates are 48.5% and 52.1% respectively.
Assisting and alleviating those plagued by marginalization, be it through natural or social constructs; is a fundamental principle of BRAC. We believe in the necessity of education especially in communities with weak infrastructure. For us, education is one of the biggest weapons in the fight against poverty, ignorance, and opportunity shortage. Consequently, we invest heavily into our educational facilities. At our schools, 1.2 million students are currently enrolled, most of them being female students. So far, almost 5 million children have graduated and received basic education from these schools, while nearly 95% continue on to secondary schools.
Muhammad YaminChowdhury - Sunamgang District Commissioner was present there as Chief Guest SafiqulIslam and other well-known locals were present in the event.
The Sylhet region has flash flood problem. In these flash floods, water level rises and falls quite rapidly with little or no advanced warning.. Children as well as teachers face trouble in reaching schools. Fishing often becomes the last resort for most of these “trapped” villagers.
Economic deprivation and social inequalities arising from their geographical isolation keeps children away from school and education. In a research by Education Watch in collaboration with BRAC it is found that compared to 38.5% overall in Sylhet division.. The head teachers reported that over a fifth of the students had to face bad transportation during dry season that doubled in the wet season.
According to research statistics, 42% of the villages in Sylhet have no primary schools. In terms of literacy rate, also it lags far behind the national average. The literacy rate for 7+ populations is 40.7% and for adult population it is 44.4% but the national rates are 48.5% and 52.1% respectively.
Assisting and alleviating those plagued by marginalization, be it through natural or social constructs; is a fundamental principle of BRAC. We believe in the necessity of education especially in communities with weak infrastructure. For us, education is one of the biggest weapons in the fight against poverty, ignorance, and opportunity shortage. Consequently, we invest heavily into our educational facilities. At our schools, 1.2 million students are currently enrolled, most of them being female students. So far, almost 5 million children have graduated and received basic education from these schools, while nearly 95% continue on to secondary schools.
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