This post is a reflection of Saman Nizami’s experiences and observations during her internship for BRACâ€™s â€œTargeting the Ultra-Poorâ€ program in Bangladesh.
To recap on my previous post, BRACâ€™s â€œTargeting the Ultra-Poorâ€ (TUP) program takes an integrated approach towards empowering women at the bottom of the poverty ladder. In addition to providing income generating assets and enterprise development training, the other four components of the program play a subtle but vital role in lifting these women out of poverty as well. In this post, Iâ€™ll discuss two of these powerful catalysts (i.e. healthcare support and social development) and the other two (i.e. financial discipline and subsistence allowance) in my next post.
Preliminary Healthcare Services and Education
Meet Tasmeena (above). She is a domestic servant, who was recently recruited into the TUP program. Tasmeena suffers from fever frequently, which hinders her from working. Even when I met her, she had a high fever – which I had to diagnose by touching her forehead and wrist because she couldnâ€™t afford basic healthcare essentials like a thermometer. In the past, she has met physicians who suggested she get blood tests, but she never followed through because, again, she could not afford it.
Her weak livelihood and poor health condition were inter-dependent. Her meager income would not allow to her seek formal medical care for treatment or purchase medication. Similarly, her poor health condition was pushing her into further destitution by limiting the manual labor she could perform or making her take days off from work. For Tasmeena and her family, not going to work for a day meant forgoing a dayâ€™s income which had dire consequences. Her family may have to starve for the day or she may have to resort to begging for cash and food. Fortunately, BRAC will provide her healthcare services to improve her health condition which will ultimately strengthen her livelihood.
Another strategy of the program is health education. I sat in on one of BRACâ€™s health education sessions with the TUP members where BRACâ€™s health volunteers were discussing the importance of feminine hygiene and family planning. See my picture below.
These women are also given hygiene education and essential items like sanitary latrines and tube-wells for safe drinking water to protect them from communicable diseases.
BRACâ€™s integrated health services aim to improve the nutritional and health statuses of these women and their families. As a result, this improvement in their familiesâ€™ health plays a key role in stimulating any improvements in the householdsâ€™ economic conditions.
- Above: TUP member, Madhu Bi, wearing sandals and using a tube-well she received from BRAC for safe drinking water. She explained that in the past, her children have suffered from diseases like jaundice and diarrhea, but now they have been much healthier as a result of changing simple practices and receiving key facilities (i.e. sanitary latrine and tube-well).
Another important mechanism propelling the programâ€™s success is mobilizing the community and building the human social capital of the rural poor (particularly women). The first time I went to a Gram Daridro Bimochon Committee (GDBC) meeting, a local rural elite committee formed to protect these vulnerable families, the leadership proudly described their responsibilities including information dissemination on health issues, protection of the womenâ€™s assets , and advocacy of their rights to the local government. At the meeting, the TUP members were closely following the meetingâ€™s agenda and openly expressing their thoughts on how to address their communitiesâ€™ needs. Towards the end, the women and the GDBC gifted a tin house roof to an ill widow purchased through collective donations from the community.Â I was amazed to see this strong affinity and urge to help others among these women, despite the difficult conditions theyâ€™re in themselves.
Here is a short video I took from one of the GDBC meetings:
[youtube http://www.youtube.com/watch?v=U1CiM9KwvpY&version=3&hl=en_US] As an additional effort in socially empowering women, BRACâ€™s field staff trains them on social issues that plague their communities. This includes teaching them how to write their name, the importance of marriage and birth certificates, and laws on early child marriage, dowry, etc. These women are then encouraged to uphold their rights, play a more active role in their communities, and strongly resist abuse and exploitation.
I met a TUP graduate (2006) named Masooda who has progressed significantly in terms of social development.Â When she was recruited to the TUP program, Masooda felt alienated as a poor widow living on her own. Further, she had no time or energy to interact with people because of her arduous manual labor as a domestic servant. However, after graduating from the TUP program, she plays an active role in her community. She frequently gives her community members advice, and even stopped two early child marriages among her relatives by vehemently protesting against it. She is approaching local government representatives to secure her entitlements (i.e. widow allowance) as well.
Another TUP graduate, Afreena, used to be physically tortured by her husband, but she felt like she had no one to turn to. However, now that she generates income and has assets in her ownership, she has authority within the household and her husband treats her with respect. Now, the question that arises is if her husband is treating her well because he considers her to be a source of income, or have his fundamental beliefs about women changed? Will this change be sustained unconditionally in the long term even if Afreena decides to sell her assets and stop contributing to the household? A little too soon to tellâ€¦
Nevertheless, itâ€™s clear that lifting these women out of poverty requires the need to intrinsically empower them, where they learn how to protect themselves from marginalization and control their own lives. It also involves instilling perception changes among men and women and dismantling the entrenched ideology of gender inequality.
And it doesnâ€™t stop hereâ€¦more to come in my next post!
Saman Nizami graduated from UCSD with a Bachelorâ€™s degree in Economics and History. She is currently working for a Pakistan-based NGO, HOPE (Health Oriented Preventive Education), primarily in disaster response projects aimed to help the victims of the recent 2010 floods. Sheâ€™s also a Project Team Lead for ADP (Association for the Development of Pakistan). During her spare time, Saman enjoys trying new restaurants (particularly sushi), learning North Indian classical singing, watching Bollywood movies, and most recently â€“ tweeting. You can follow her @saman_nizami.