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BRAC Annual Report 2010
BRAC Annual Report 2010 1




A member of our Ultra Poor programme
holding her child in Pirgacha, Rangpur.
2 BRAC Annual Report 2010                                                                                                                                                                                                                BRAC Annual Report 2010 3



                                             A Lasting Legacy                                                       Chairperson’s Statement
                                             Aminul Alam: Field Marshall and Changemaker



                                                                                                                    Bangladesh was fortunate in 2010 not to face the catastrophic
                                                                                                                    natural disasters of the preceding two years. Although cyclone
                                                                                                                    Aila struck in February 2009, all through 2010 we were witness
                                                                                                                    to its devastating impact on people’s lives. Millions continued to
                                                                                                                    be marooned, without safe drinking water, with neither homes nor
                                                                                                                    assets. Relief and rehabilitation have limited meaning for this Aila-
                                                                                                                    affected coastal region which is subject to the vagaries of climate
                                                                                                                    change as saline water intrudes deeper inland. Our efforts have
                                                                                                                    therefore been directed to helping the poor adapt to circumstances
                                                                                                                    not of their making. Innovative microfinancing and development
                                                                                                                    models combined with science and technology helped farmers and
                                                                                                                    fisherfolk build new livelihoods.

                                                                                                                    The global financial crisis had minimal impact on our microfinance
                                                                                                                    programme. But our borrowers were left struggling with larger
                                                                                                                    bills as food prices continued to climb. We noted the decline in
                                                                                                                    loan repayment rates – possibly as borrowers spent more meeting
                                                                                                                    basic needs rather than building up assets or embarking upon an
                                                                                                                    income-generating activity.                                                                                 Sir Fazle enjoying his question-answer
“an exceptional person with an exceptional    Aminul Alam (1949-2010) joined BRAC in 1975 and worked                The Millennium Development Goals (MDGs) continue to guide our
                                                                                                                                                                                                                                session in a reception by BRAC staff
                                                                                                                                                                                                                                on receiving the knighthood.
commitment to rural development. BRAC         closely with Sir Fazle Hasan Abed for more than thirty-five years     work. By most counts, Bangladesh is on the way to reaching the
would not be what it is without him”          helping turn vision into reality. Amin was at the heart of our very   MDGs. We need to work harder to bring every child to school and,
                                              first field programmes and eventually went on to become a             once there, ensure that the child stays long enough to complete
Sir Fazle Hasan Abed                          leading figure in the evolution and story of BRAC as we know          primary schooling. We also need to do much more to prevent
                                              it today. We want to celebrate his achievements and continue          mothers from dying in childbirth.
                                              to build on his efforts towards helping women and men realise
                                              their potential in Bangladesh and in developing countries             As the year drew to a close, we received encouraging news that
                                              around the world.                                                     fewer mothers were dying giving birth to their children. BRAC            Key MDG challenges remain in the areas of halving hunger and
                                                                                                                    health professionals and Community Health Promoters, working in          attaining gender equality. We must do all that we can to improve
“he has left a rich legacy to BRAC: of                                                                              close partnership with households, communities and functionaries         the production and distribution of food, to keep prices low so that
programs firmly in place around the world,   The story of Aminul Alam and BRAC began in 1975 with a young           in public facilities, were able to make a significant dent in reducing   the poor are not disproportionately affected, and we must harness
of staff and members inspired by his         man, recently graduated from Dhaka University, full of radical ideas   maternal deaths. Even if Bangladesh achieves the MDG target              the energy, strength and will of the State, the private and non-
                                             about helping the poor in post liberation Bangladesh. It was at this   (maternal mortality rate of 144 per 100,000 live births), the number     governmental sector to prevent all forms of gender-based violence.
pragmatic vision, and of practical           turbulent time, amidst devastating drought and famine, that Amin       will still be 50 times higher than it is in Norway! In order to          Achieving these goals will mean that there must be concerted and
solutions to many of the world’s seemingly   recalled he had seen truly poor people for the first time. Abed had    address this inequity, we need to create and expand the human            sustained action at every level and each partner must play its role
intractable problems”                        offered Amin a job in the Rangpur District as part of an emergency     infrastructure where it is most needed – close to the home – where       effectively. Men and women must join hands to bring about this
                                             relief effort, feeding 15,000 children two meals a day, marking some   the vast majority of mothers give birth. By making trained midwives      change in our homes and communities.
Marty Chen                                   of BRAC’s earliest work in Bangladesh.                                 available and accessible to surrounding communities, we can make
                                                                                                                    births safer for mothers. BRAC University’s School of Public Health      Bangladesh continues to make good progress in reducing poverty.
                                             Amin moved to Manikgang to continue his work for BRAC and              is planning midwifery education to create this category of medical       We were greatly heartened by the news that the proportion of
                                             ended up staying for eight years, leaving him with an experience       professionals.                                                           people living in poverty had gone down to 30%, but we were
                                             that would change his views forever. More than thirty years later                                                                               also sobered by the thought that millions more continue to live
                                             Amin went on to become a leading figure and much loved member                                                                                   dehumanised lives and that we must work even faster to bring their
                                             of the BRAC family, working closely with Abed and introducing                                                                                   condition to an end. On this 40th birthday of Bangladesh, we must
                                             pioneering ideas towards their shared mission to fight poverty.                                                                                 renew our promise to eradicate poverty from this land forever.

                                             Amin made his first visit to Afghanistan in 2002, leading a team of
                                             just four people, to start BRAC operations in post war Afghanistan.
                                             Tackling the returning flood of refugees, coupled with a challenging
                                             political situation, didn’t make for an easy task. More recently,
                                             Amin played a crucial role in leading BRAC’s efforts to help victims
                                             of Haiti’s earthquake and the devastating floods in Pakistan that
                                             ensued last year.

                                             Today, BRAC is the largest NGO in Afghanistan offering education
                                             and health services across the country reaching more than 24
                                             million people. Amin’s leadership in expanding BRAC programmes
                                             across Bangladesh, and then to 9 countries around the world is
                                             undoubtedly one of his most important legacies to BRAC’s work.
4 BRAC Annual Report 2010                                                                                                                        MDG                                                                                                                  BRAC Annual Report 2010 5



Reaching for the
Millennium Development Goals: 2010-2015

 The Millennium Development Goals (MDGs) are eight international development goals                                                               in a range of programmes in a direct effort to help Bangladesh
 that all 192 United Nations member states have agreed to achieve by the year 2015.                                                              achieve the eight goals. Our approach aims to complement
 The aim of the MDGs is to encourage development by improving social and economic                                                                Government efforts and now with five years to go, it’s time to
 conditions in the world’s poorest countries. From the beginning, we have been investing                                                         review and accelerate progress.


ERADICATE EXTREME                     ACHIEVE UNIVERSAL                 PROTE GENDER EQUALITY                REDUCE CHILD                        IMPROVE MATERNAL                     COMBAT HIV / AIDS MALARIA         ENSURE ENVIRONMENTAL                  GLOBAL PARTNERSHIP
POVERTY AND HUNGER                    PRIMARY EDUCATION                 AND EMPOWER WOMEN                    MORTALITY                           HEALTH                               AND OTHER DISEASES                SUSTAINABILITY                        FOR DEVELOPMENT




                                                                                                             Target: 31 (per 1000 live births)   Target: Maternal mortality 144
Target: 29% population below          Target: 100% net enrolment in     Target: 1% gender parity in          infant mortality                    (per 100,000 births)                                                   Target: Use of safe drinking
poverty line                          primary schools                   secondary schools                                                                                             Target: Detection of TB cases     water 89%                             BRAC Programmes involved:
                                                                                                                                                 Contraceptive prevalence 75%         90%
Progress: On track                                                                                           Current status: 41 (per 1000                                                                                                                     International Programmes;
                                      100% primary students reach       50% women in wage employment                                             per couple                                                             Use of improved sanitation facility
                                                                                                             live births) infant mortality                                            Use of treated malaria nets 90%                                         Training Division; Research &
Current status: 30% population        grade 5                                                                                                                                                                           70%
                                                                                                                                                                                      hotspots                                                                Evaluation Division; Advocacy for
below poverty line                                                      Current status: 1.2% gender                                              Current Status: Maternal
                                                                                                             BRAC Programmes involved:                                                                                                                        Social Change
                                      Current status: 92% net           parity in secondary schools                                              mortality 348 (per 100,000 births)                                     Current status: Use of safe
                                      enrolment in primary schools                                           Health; Water, Sanitation &                                              Current status: Detection of TB
BRAC Programmes involved:                                               29% women in wage employment                                                                                                                    drinking water 86% [2009]
                                                                                                             Hygiene                             Contraceptive prevalence 60%         cases 70% [2009]                                                        Closing the gap:
BRAC Programmes involved:             55% primary students reach                                                                                 per couple                                                             Use of improved sanitation facility      Negotiations are underway
Agriculture & Food Security;          grade 5                           BRAC Programmes involved:                                                                                     Use of treated malaria nets 81%   54% [2009]                               between BRAC and key
                                                                                                             Closing the gap:
Community Empowerment;                                                  Education; Community                                                     BRAC Programmes involved:            hotspots [2009]                                                            development partners to enter
                                                                                                                Our Shasthya Shebikas,
Microfinance; Targeting the Ultra     BRAC Programmes involved:         Empowerment; Human Rights                                                Health; Advocacy for Social                                            BRAC Programmes involved:                into a Strategic Partnership
                                                                                                                Shasthya Kormis, newborn
Poor; Gender Justice & Diversity;     Education                         & Legal Aid Services; Gender                                             Change                               BRAC Programmes involved:         Disaster, Environment and Climate        Arrangement, which will result
                                                                                                                health workers and skilled
Advocacy for Social Change                                              Justice & Diversity; Microfinance;                                                                            Health; Education; Advocacy for   Change; Water, Sanitation &              in greater flexibility in resource
                                                                                                                birth attendants all work
                                      Closing the gap:                  Advocacy for Social Change                                               Closing the gap:                     Social Change                     Hygiene                                  allocation for our development
                                                                                                                together to deliver child
Closing the gap:                         Develop the professional                                                                                   We are working with the                                                                                      work
                                                                                                                immunization and essential
   Create self-employment                capacity of teachers from      Closing the gap:                                                            Government and partners           Closing the gap:                  Closing the gap:                         Collaborative efforts with
                                                                                                                health care services to the
   through our microfinance              Government primary schools,       Empowering adolescent                                                    to scale-up our maternal,            TB treatment success in           Priority is given to the arsenic      international organisations in
                                                                                                                community
   programme                             increase community and            girls through our specially                                              neonatal and child health            2010 in BRAC covered areas        affected areas and saline             the areas of research, training
                                                                                                                Our birthing huts provide
   Maximise the role of farmers          parent participation in           designed microfinance                                                    programmes to maximise               was higher (almost 93%)           prone areas to increase               and impact monitoring
                                                                                                                clean and private birthing
   in the implementation of              children’s education              scheme and life skills training                                          coverage of regions with the         compared to the national          access to safe drinking water
                                                                                                                places for slum women
   agricultural practices and the        A total of 252,040 students       clubs                                                                    worst mortality records              average (almost 85%)              Awareness raising sessions
                                                                                                                Developing behaviour change
   use of new technologies               of BRAC primary Schools           Emphasising issues such as                                               Our health centres have been         Our TB-HIV collaborative          regarding water, sanitation
                                                                                                                communication tools to
   Provide grants of small assets        participated in the grade 5       women’s right to property,                                               upgraded to offer emergency          project also offers HIV           and hygiene practices for
                                                                                                                address issues such as
   to carefully selected ultra-poor      completion test of 2009 and       gender culture change                                                    caesarean sections, newborn          screening tests for TB            different target audiences
                                                                                                                health and hygiene practices
   households                            97.4% of them passed the          at household levels and                                                  care and services like               patients                          Imported two desalination
                                         exam against 89% of national      strengthening systems that                                               electrocardiograms and ultra-                                          plants from China to help
                                         pass rate                         address gender based                                                     sonograms                                                              support the availability of
                                                                           violence and abuse                                                       Preventive and curative                                                clean drinking water amongst
                                                                                                                                                    practices are promoted                                                 affected people in disaster
                                                                                                                                                    through targeted household                                             prone areas
                                                                                                                                                    visits and engaging local
                                                                                                                                                    communities
6 BRAC Annual Report 2010                                                                                                                                                                                                                                                    BRAC Annual Report 2010 7
                                                                                                                                                                                                                                                                                  BRAC



Saving our
Mothers
LOVELY’S STORY

Baby Sumaiya sits wide eyed and smiling in her mother’s arms. She has just been given a                                                                As they grew up, Lovely and her sisters were faced with typical
                                                                                                                                                       adolescent issues. Despite their father being a village doctor
check-up by Farida, a BRAC Shasthya Kormi (Community Health Worker), as they sit in the                                                                (quack), puberty, sexuality and reproduction were taboo topics.
courtyard of their home. Her mother, Lovely Akhtar, gave birth to baby Sumaiya a year ago and                                                          The BRAC Kishori Club (club for adolescents) provided a safe
                                                                                                                                                       space for Lovely and her sisters to learn about being a woman,
all signs show that mother and baby are thriving.                                                                                                      receive sanitary pads and have regular contact with a Shasthya
                                                                                                                                                       Kormi. The club also provided a social space to learn, understand
                                                                                                                                                       and protect their rights, through a process that encouraged
                                                                                                                                                       independence and leadership. It was at the Kishori Club that
Across the rural villages and urban slums of Bangladesh, all too       Our story, therefore, begins not with healthy baby Sumaiya                      Lovely first learnt what ‘eve teasing’ meant. She began to realise
often the stories of mothers and babies are unlike that of baby        but with the birth of her mother Lovely.                                        that what she had accepted as part of everyday life was verbal
Sumaiya and her mother Lovely. On average, for every 100,000                                                                                           sexual abuse and something that she did not have to put up with.
mothers that give live births, 194 of those mothers will die. Whilst   A baby girl, who comes into the world underweight, is not                       Today, Lovely feels confident about asserting her rights and is better
every year, 171,000 babies like Sumaiya perish before reaching the     exclusively breastfed for the first six months and does not receive             informed about gender equality and justice. Our Human Rights
age of five.                                                           adequate nutrition in her first two years, is likely to grow up to be           and Legal Aid programme helped Lovely and other young women
                                                                       anemic and have stunted growth. This means that when she is                     in her community to equip themselves against discrimination and
The good news is that Bangladesh continues to make impressive          ready to have her own baby, the likelihood of her dying at childbirth           violence.
gains in reducing maternal mortality. The last 9 years has seen a      will be 40% greater. Whether she dies or lives, she will give birth to
40% drop in maternal mortality putting the nation on track to meet     her own underweight baby and the cycle will continue. To break                                                                                                                          Baby Sumaiya and Lovely, both healthy and
                                                                                                                                                       BRAC’s Adolescent Development Programme encourages girls                                                happy, in Bakshimul, Mymensingh.
Millennium Development Goal (MDG) number 5 by 2015 – but we            the cycle and prepare a girl for adulthood, we must intervene at key            graduating from BRAC schools to retain their literacy and life skills
must try to reach every Lovely and every Sumaiya.                      points throughout her life starting with her birth.                             even if they leave school early.

                                                                       The care that is provided to a baby at birth is critical for survival.          Over 8,800 Kishori Clubs across the country provide a safe               helped deliver the baby safely at home. The IMNCS and Manoshi
                                                                       In the first hour after delivery, BRAC Shasthya Kormis and skilled              space for adolescent girls to socialise, learn about health,             programmes ensure that rural and urban deliveries are attended by
“We must do all we can to stop the unnecessary                         birth attendants are on hand to teach ‘kangaroo care’ (skin- to-skin            develop life skills, receive vocational training and become              a skilled birth attendant and that they take place in a safe and clean
deaths of mothers and babies. We want to improve                       contact), distribute a specially designed thermal baby jacket to low            involved in their communities.                                           facility.*
women and children’s health not only to reach the                      birth-weight babies and encourage early initiation of breast feeding.
Millennium Development Goals by 2015 but to                            Our trained Shasthya Kormis are on hand to provide regular visits,              When Lovely was 15 years old, her father pressured her to accept a       Baby Sumaiya came along when Lovely was 23, with one
                                                                       vaccinations and micronutrients to babies until they reach the age              good offer of marriage from a local boy, but Lovely was determined
exceed them”                                                           of five.
                                                                                                                                                                                                                                safe birth behind her, Lovely was well prepared to give her
                                                                                                                                                       to stand up for her rights. She reminded her parents about the ills      second baby girl a healthy start in life.
BRAC Founder and Chairperson, Sir Fazle Hasan Abed                                                                                                     of early marriage. One of her sisters had married young and given
                                                                       With a healthy start in life, a young girl is ready for school. An              birth at 17, after which her health had deteriorated.
                                                                                                                                                                                                                                Shasthya Kormi Farida visited Lovely and baby Sumaiya regularly
                                                                       education early in life will not only benefit girls in building their futures
                                                                                                                                                                                                                                for the first 42 days, then weekly and then monthly. Lovely is
                                                                       but will contribute directly to the development of their families and
From its earliest days, BRAC chose to focus its attention on the
                                                                       communities. Girls with some level of schooling are more likely
                                                                                                                                                       “I told my parents that I didn’t want the same                           now taking the contraceptive pill and does not plan to have more
needs of poor, disadvantaged and socially- excluded women.                                                                                             happening to me. I could not stop my sister’s                            children for at least another five years. When Farida first started
                                                                       to use proper contraception methods, get married later and have
Over the next five years, we plan to provide millions of poor                                                                                                                                                                   work as a BRAC health worker in 2006, young women didn’t want
                                                                       fewer and healthier babies than girls who don’t go to school. The               marriage, but I could do it for myself…I told my
women in rural and urban areas with effective maternal and child       same girls are more likely to seek medical care for themselves and
                                                                                                                                                                                                                                family planning, pre-natal care or vaccinations, but attitudes have
health interventions.                                                                                                                                  father, if you do this, I will run away and that will be                 changed now, she says. Lovely’s husband Tarul agrees,
                                                                       their families, be better informed about nutrition, teach hygiene and
                                                                                                                                                       humiliating for the whole family. My parents were
                                                                       sanitation to their children and send their children to school. For
Throughout the country, 80,000 Shasthya Shebikas (Community            30 years our Education programme has been providing accessible                  finally convinced.”                                                      “Even if we have another girl, we will stick to three
Promoters of Health), Shasthya Kormis, skilled birth attendants        learning opportunities to girls whose parents are poor, who have                                                                                         children. In this age, girls and boys are equal.”
and BRAC doctors combine their efforts to provide mothers              special needs and are from ethnic minorities.                                   With nine years of schooling behind her, Lovely was ready for
with access to family planning, early detection of pregnancies,                                                                                        marriage at 19. She married a local boy and had their first child        When her children are old enough, Lovely hopes to continue
pre and post natal checkups, skilled deliveries, hygienic              Sumaiya’s mother, Lovely, was a student at a BRAC non-formal                    within a year. Farida, a BRAC Shasthya Kormi , who Lovely knew           her studies and perhaps become a BRAC teacher or health
birthing conditions and hospital referrals. Our urban and rural        primary school in the village of Baksimul in Mymensingh. Baksimul               from her Kishori Club days, identified the pregnancy early on            worker like Farida.
programmes presently reach 25 million women.                           relied on vegetable growing and fishing for income and many poor                and provided pre natal care offered through BRAC’s IMNCS
                                                                       families could not afford to send their children to school. When                programme. Her pregnancy progressed normally and Farida                  Lovely’s story is important because it tells us that it is possible to
We have a holistic approach to poverty alleviation which means         BRAC set up the one-room school in the village, Lovely and her two                                                                                       bring about positive changes in the lives of mothers and children if
that it is not enough to provide maternal child health services but    older sisters were offered their first chance at an education.                                                                                           we can support them at key points in their life cycles.
to ensure that poor women and children have access to
education, the means to build a livelihood and protect
themselves from exploitation. Our support is designed to place                                                                                         *Go to the Health section to learn more about our Improving
every young girl in the best possible position to realise her                                                                                          Maternal, Newborn and Child Survival (IMNCS) programme and its
potential as a woman and as a mother.                                                                                                                  urban counterpart Manoshi
8 BRAC Annual Report 2010   Health                                                                                                   BRAC Annual Report 2010 9



BRAC Programmes
Health


                            Improving health and providing essential healthcare
                            Our Health programme combines promotive, preventive, curative, rehabilitative health care. We
                            focus on improving maternal, neonatal and child health, combating communicable diseases
                            and common health problems. BRAC’s Health programme is the result of an integrated
                            approach, including several interventions, to provide a health service that supports human
                            development and works in partnership with our comprehensive approach to development.
                            The key areas of the programme are: essential health care; tuberculosis and malaria control;
                            maternal, neonatal and child health; health facilities and limb and brace centres.




                            Our Approach

                            An awareness of the changing health needs, adaptation of
                            technology, cost effectiveness, sustainability and delivery through        Achievements 2010
                            partnerships with communities and Government are key features in
                            our approach to providing health care to poor people.                    Essential Health Care
                            We have adopted an epidemiology-experimentation-expansion                100 million people reached across 64 districts
                            evaluation model in how we develop and deliver the programme.            1,650,673 patients treated by our Shebikas
                            Lessons learned from our experiences in public health, like the          31,174 Ultra Poor patients given health care
                            bare-foot doctors of the 1970s, Oral Therapy Extension and Child         subsidies
                            Survival programmes in 1980s, Women’s Health, Reproductive
                            Health and Disease Control programmes in 1990s, have enabled
                                                                                                     Maternal, Newborn and Child Health
                            us to expand sustainable and accessible health care to more than
                            100 million people across Bangladesh. We also collaborate on             5.7 million people served in urban areas
                            national projects such as Vitamin-A supplementation and family           8,317 deliveries made in birthing huts
                            planning initiatives.                                                    426 delivery centres in urban areas
                            By choosing health volunteers, or Shasthya Shebikas, from our            11 million population reached in rural parts
                            Village Organisations (VOs), we are making effective use of resource
                            and are able to ensure sustainability unlike other programmes in the     Tuberculosis Control
                            health sector. Volunteers receive basic training and provide door-to-    89.5 million people reached
                            door health education, treat basic illnesses, refer patients to health   23,771 cases diagnosed
                            centres and provide essential health items and medicines; which
                                                                                                     92% patients cured
                            contribute towards an income for the volunteer.

                            Our Shasthya Shebikas are assessed and monitored by Shasthya             Reading Glasses
                            Kormis who are paid a monthly salary to supervise 10-12 Shebikas.        7.9 million people covered
                            Kormis conduct monthly health forums and provide antenatal               36,739 people screened
                            and postnatal care. Around 7,000 Kormis are supervised by                9,573 glasses sold
                            Programme Organisers who are supervised by the Upazila and
                            District Managers. Medical officers provide overall technical
                                                                                                     Vision Bangladesh
                            supervision whilst Kormis are supported by a team of public health
                            professionals.                                                           612 cataract surgeries completed




                                                                                                                               First spread
                                                                                                                               Parul receives an ante-natal
                                                                                                                               check-up from a BRAC health
                                                                                                                               worker in Gazipur.
10 BRAC Annual Report 2010                                                                                                                         Health                                                                                                                 BRAC Annual Report 2010 11




Programme Components                                                     Manoshi: Maternal, Newborn and Child Health Initiative
                                                                         (Urban) launched in 2007 in Dhaka and provides community
Essential Health Care (EHC) forms the core of our health                 based maternal and child health care services in urban slums, with
programme, combining preventive, promotive, basic curative               the support of slum volunteers, skilled community workers and
and referral care, aimed at improving the health of poor people,         Programme Organisers based in nearby hospitals for emergency
especially women and children. EHC has seven components:                 cases. Birthing huts provide clean and private birthing places for
health and nutrition education; water and sanitation; family             slum women who usually live in small shacks, with large numbers of
planning; immunisation; prenatal care; basic curative services and       family members, which offer unhygienic conditions for giving birth.
tuberculosis control. In 2002, EHC was adapted to fit the needs          Each of our huts have two birth attendants, covering around 2,000
of the Ultra-Poor, our poorest members, by offering basic health         households (approx 10,000 people), whilst community midwives
care and health awareness services as well as financial assistance       are on hand to provide skilled care during deliveries.
towards clinical care.
                                                                         Shushasthya (Health Centres) provide accessible and quality
                                                                         outpatient and inpatient services, general laboratory investigations
Malaria Control Programme operates in 13 districts across                and essential life-saving drugs to the local community. We have
Bangladesh including the Chittagong Hill Tracts (CHT). Our               also upgraded nine centres to offer emergency caesarean
Shasthya Shebikas receive a 3-day training course on malaria             section or newborn care and advanced diagnostics such as
treatment and prevention to help achieve early diagnosis and
                                                                         electrocardiograms and ultra sonograms.
prompt treatment of cases.

                                                                         Limb and Brace Fitting Centres provide low cost, accessible,
Tuberculosis Control Programme using a community based
                                                                         quality artificial limbs and braces. We provide physiotherapy
approach, our Shasthya Shebikas are trained to provide DOTS
                                                                         services and education and counselling to patients and their family
treatment (Directly Observed Treatment Short-Course), diagnose
                                                                         members. Our work aims to improve the livelihood capabilities of
cases, distribute information on TB and refer suspected cases
                                                                         the physically challenged and help their integration into mainstream
to nearby outreach smearing centres. Medical Officers initiate
                                                                         society. We currently have centres in Dhaka and Mymensingh.
treatment, whilst the Shebikas conduct the DOTS treatment of TB
patients, either at their own home or during home visits. Our TB-HIV
collaborative project also offers HIV screening tests for TB patients.   Reading Glasses for Improved Livelihoods working with Vision
                                                                         Spring, covering 15 districts, specially trained Shasthya Shebikas
Improving Maternal, Newborn and Child Survival Project                   use simple charts to identify near-vision deficiency. They sell
                                                                         ready-to-use spectacles at a nominal price, educate people on eye                                                                                  Shomola Khatun, a Shasthya Shebika from the village of Chankanda in
(Rural) has been successfully scaled up to ten rural districts across                                                                                                                                                       Jamalpur explains how to use contraceptives to the women in her community.
Bangladesh since its launch in 2005; working with the Government         problems and are trained to refer complicated cases to medical
and UNICEF. This project aims to provide quality maternal, newborn       professionals.
and child health care using a community based approach to reach
the rural poor. Major interventions include capacity development         Vision Bangladesh is a partnership programme between BRAC                 Challenges
of community health resources, empowerment of women                      and Sightsavers aiming to eliminate preventable blindness in Sylhet                                                                                New Initiatives
through support groups, provision of maternity and child health          by 2014. To date, 1,300 poor people have undergone cataract               There is an emerging need to tackle the increase in non-
related services and referrals to nearby health facilities. Shasthya     operations and 7,000 people have been successfully screened.              communicable diseases, alongside the ongoing burden of                   We have developed a Mobile Health Project, in partnership with
Shebikas, Shasthya Kormis, newborn health workers and skilled
                                                                                                                                                   communicable diseases, coupled with a lack of accessible and             Click Diagnostics Inc, where Shasthya Kormis can use mobile
birth attendants all work together to deliver these services to the
                                                                         Alive and Thrive is an initiative to reduce malnutrition in children      quality health care and medical facilities in Bangladesh. Lack of        phones to share real-time information about their patients, mainly
community. Preventive and curative practices are promoted through
                                                                         under the age of two by promoting exclusive breastfeeding                 coverage, skilled workers and accessibility to remote parts of           pregnant women and newborns, helping to improve the process
targeted household visits. Our approach has significantly improved
                                                                         and healthy feeding practices. This includes community level              the country continue to present major challenges in how we can           of diagnosis and treatment.
pregnancy identification and antenatal care as well as ensuring safe
                                                                         counselling, coaching and demonstrations. Following a successful          provide health care to poor people. Developing effective referral
and clean deliveries in rural communities.
                                                                         year long pilot this initiative has been expanded to 50 rural Upazilas.   facilities with adequate human resources and logistics will prove        Working in partnership with GE Healthcare, we plan to introduce
                                                                                                                                                   essential in reducing maternal and newborn mortality.                    a portable oxygen support device, at community level, in an
                                                                         Micro-Health Insurance is a sustainable community health                                                                                           effort to fight birth asphyxia in newborns. The pilot will launch in
                                                                         financing model, to empower and improve the well being of poor                                                                                     January 2011.
                                                                                                                                                   Future Plans
                                                                         women and their families, giving poor people access to affordable
                                                                         and quality health care.
                                                                                                                                                   Our approach in developing community based interventions
                                                                                                                                                   recognises that workplaces and urban slums are becoming
                                                                                                                                                   new settings for delivering effective health interventions. Our
                                                                                                                                                   approach with EHC, continuing as our core health programme,
                                                                                                                                                   will be adapted to accommodate the emerging needs of non-
                                                                                                                                                   communicable diseases, elderly health care, climate change and
                                                                                                                                                   nutritional initiatives. In our shared effort to build a more ‘Digital
                                                                                                                                                   Bangladesh’ we have identified the mobile phone as a key medium
                                                                                                                                                   for exchanging information. Using ICT will enhance our ability to
                                                                                                                                                   provide efficient and effective health care, whilst opening up new
                                                                                                                                                   channels of communication for a lower cost higher reach service.
12 BRAC Annual Report 2010   Education                                                                                           BRAC Annual Report 2010 13



BRAC Programmes
Education



                             Education as empowerment
                             Our carefully developed pre-primary and primary schools provide free education to children
                             who are left out of the formal school system and, in particular, reach children who are from
                             extremely poor families or ethnic minorities, living in remote areas or have special needs.
                             Working with partner organisations we offer our guidance and technical support, to help
                             schools replicate our successful primary education model in hard to reach areas, like the
                             Chittagong Hill Tracts, haors, baors, chars and coastal areas, and work with non-government
                             rural secondary schools to improve their techniques and curriculum.




                             Our Approach

                             Our non-formal schools offer flexible timings and make room for
                             students of varied age whilst operating on a low cost but effective     Achievements 2010
                             model. The classes are small, with around 33 children per class,
                             and are taught by a female teacher selected and trained from the      4.66 million boys and girls have graduated from
                             local community. Free educational materials are given to students     our schools
                             with a more hands-on approach to teaching, focusing on student
                             participation, whilst less homework and longer holidays aim to help   21 children received essential eye operations,
                             accommodate children who may never have enrolled in school or
                                                                                                   40 children given cleft lip and plate surgery
                             had previously dropped out of the formal schooling system owing to
                             family or work commitments.
                                                                                                   1,298,516 students have enrolled to date in both
                             Preparing for a successful education A pre-primary education          our pre-primary and primary schools
                             has proven to be a significant factor in promoting the success
                             of primary education. Our pre-primary schools aim to familiarise      8,715 clubs for adolescents operate across the
                             children, under the age of 6, with the alphabet, numbers and a        country reaching 225,631 young girls
                             curriculum that focuses on Bangla, Maths and Science over the
                             course of one year. This year 11,765 pre-primary schools were         Special needs students participated in the
                             opened with 329,184 students, 61% of them girls, including 13,654     Special Olympics trials and Afsana Akter, from
                             children with special needs.                                          a BRAC school, was awarded first place in ball
                                                                                                   throwing qualifying for the official Bangladesh
                                                                                                   team
                             Programme Components

                             Supporting the Government Our efforts are to complement the
                             work of the Government and help improve the quality of mainstream
                             formal schools in Bangladesh. In 1998, the Government in fact
                             handed over 44 community schools to us to help improve the
                             quality of education being provided – there are currently 7,940
                             students, around 54% of them girls, and 231 teachers, around 97%
                             of them female across these schools.


                                                                                                                          Previous spread Ahki Khatun, in
                                                                                                                          Grade 3 at a BRAC Primary School in
                                                                                                                          Jamalpur.
14 BRAC Annual Report 2010                                                                                                                         Education                                                                                                              BRAC Annual Report 2010 15




BRAC Schools Our first primary schools opened in 1985 and                women on the path towards financial independence – activities             Shah Alam’s story
have since expanded and been developed to cover a 5 year                 include poultry and livestock rearing as well as vegetable farming
curriculum across 4 years of teaching. A total of 31,670 schools,        or beauty therapy skills. Financial literacy courses give girls some
including 2,308 urban and 1,950 ethnic schools, are currently in         insight into managing a small business, along with access to credit
operation across Bangladesh. We also support 3,089 secondary             and savings facilities which provide seed capital to help start small
schools across the country to help Government efforts in improving       businesses.
the quality of secondary education.

Education for Ethnic Children The use of Bangla as the main
                                                                         12,000 girls, between the ages of 11
language, when teaching children across primary schools in               and 21 years are reached through SoFEA
Bangladesh, was standing in the way of a proper education for            in 360 clubs across Bangladesh
children from ethnic minority, or indigenous, backgrounds. So
that these children could feel free to speak their native languages
and receive effective schooling, we established schools for ethnic
children in 2001.                                                        Supporting Higher Education

Chittagong Hill Tracts Our Multi Lingual Education (MLE) model,          Medhabikash Uddyog (‘Promoting Talent’) is a scholarship
adapted from our primary schools model, has been specially               programme that targets bright students from disadvantaged
developed to suit the learning needs of children from indigenous         backgrounds and offers them financial support to help pay for
communities. The students’ native languages are adopted as the           tuition fees. Young people from poor rural communities, who
main teaching medium; the aim being to help children become              want to study, often find themselves struggling to cover living
proficient in Bangla on their own terms. We have been piloting           expenses, despite working part-time jobs or even taking loans
‘mother tongue’ based primary education for Chakma children at           from family members, let alone pay for tuition fees. Earlier this year,
ten schools in the districts of Rangamati and Khagrachari since          we celebrated the success of graduates with a two day event that
2008.                                                                    recognised their achievements and role in helping build a stronger
                                                                         nation.
An Inclusive Education We are committed to increasing
the enrolment of children with special needs and through the             Chhatrabandhu is a Volunteer Tutor programme initiated to offer
programme we provide essential support to families and children          tuition support to poor students who cannot afford private tuition.
including corrective surgeries, wheelchairs, crutches, hearing aids,     We believe that promoting volunteer activities like this, in poor rural
glasses and ramps to make schools more accessible to physically          communities, can contribute to better student access, higher
challenged children. We adopt classroom policies like sitting in         success rates and better teaching; which in turn can improve the
front or studying in pairs, coloured border boards whilst highlighting   quality of schools and the teaching-learning process.
special needs issues in textbooks to help raise awareness amongst
classmates and teachers.
                                                                         Community Learning Centres These are multi-purpose                                                            Shah Alam has learnt to write with his
                                                                         community learning facilities, known as Gonokendros, which                                                    wrists and take part in all his exams.
Empowering Girls                                                         we have set up in non-government secondary schools across
                                                                         rural areas of the country. The centres reach out to everyone,
Adolescent Development Programme (ADP) The ADP works by                  from children to adults, to promote a learning society in poor rural
providing clubs, life skills based education, community participation    communities. The centres are essentially community libraries, as
                                                                         well as giving internet and computer access, offering a range of          Shah Alam is in grade 7 at Parulia High School in Hatibandha. He             dexterity and recently received an A+ in his grade 5 completion test.
and livelihood training to young girls. Adolescent boys can also
                                                                         reading material that students and members of the local community         goes to school like many other children his age but, for Shah Alam,          Shah Alam now dreams of going for higher education. His parents
attend the clubs, which not only hold reading materials, but also
                                                                         can borrow. To make them self-sustaining, centres are usually             his journey there was not an easy one. Shah Alam lost both his               have overcome their past fears. They are very proud of their son.
offer a safe place for young people to socialise, play indoor games,
                                                                         transformed into trusts and managed by a Board. In collaboration          hands when he was twelve months old after unknowingly putting                Shah Alam says,
sing, dance and exchange views and experiences – all of which
                                                                         with the Ministry of Youth and Sports, centres organise skills            them into the stove. Severe burns took away both his hands. His
may prove difficult or impossible in their family homes.
                                                                         development training for the youth.                                       parents were in despair. As Shah Alam grew up his parents were               “I want to pursue higher studies at university and
                                                                                                                                                   unable to get him admitted to a school because of his disability. His
Social and Financial Empowerment of Adolescents (SoFEA)                                                                                                                                                                         become a successful professional, BRAC has helped
                                                                                                                                                   parents did not know how to offer their son a normal life or a basic
The SoFEA initiative is about empowering adolescent girls through        Currently 80% of Gonokendros are self sustaining                          education.                                                                   me lay the building blocks”.
financial and social support. By giving young girls life skills and      40% are equipped with computer and training facilities
livelihood training, coupled with an understanding about saving and                                                                                Shah Alam’s parents came to know about the primary schools
financial services, we can help them become self-reliant and build                                                                                 run by BRAC in the local area. They were reassured that he would
a better future for themselves and their families. Training sessions                                                                               receive special care and attention for his individual needs from
held at clubs aim to raise awareness on social issues, to help girls                                                                               the teachers. Shah Alam soon started his education at the BRAC
understand and protect their rights and make informed decisions,                                                                                   primary school in Hatibandha. His parents were very happy with the
whilst income generating activities are promoted to put these young                                                                                care he was given.

                                                                                                                                                   Today, Shah Alam smiles. He can write with his wrists and loves
                                                                                                                                                   drawing geometrical shapes. He can finish exams with amazing
16 BRAC Annual Report 2010                                                                                                                       Water, Sanitation and Hygiene                                                                                       BRAC Annual Report 2010 17



BRAC Programmes
Water, Sanitation and Hygiene

                                                                                                                                                 priority to arsenic affected and saline prone areas. We raise awareness       Nur’s Story
                                                                                                                                                 in villages on how to keep water clean until drinking it, by keeping
                                                                                                                                                 glasses clean and keeping water covered or sealed.

                                                                                                                                                 Supporting the Ultra-Poor The VWC are responsible for identifying
                                                                                                                                                 ultra-poor households in the village that may be eligible for Annual
                                                                                                                                                 Development Programme grants from BRAC and the Government. They
                                                                                                                                                 will also select poorer households that qualify for microloan support,
                                                                                                                                                 which can go towards installing sanitary latrines and constructing tube
                                                                                                                                                 well platforms.

                                                                                                                                                 Promoting Hygiene We realise that simply providing access to safe
                                                                                                                                                 water and sanitation facilties isn’t enough – we need to educate people
                                                                                                                                                 on good hygiene practices too. In our practical approach, to understand
                                                                                                                                                 how best we can promote good hygiene in communities, we look at
                                                                                                                                                 everything from socioeconomic factors to any traditional practices,
                                                                                                                                                 and use innovative communication tools that target women, men,
                                                                                                                                                 adolescents and children . We work with Imams and the Masjid Council
                                                                                                                                                 for Community Advancement (MACCA) to help us develop khutbas,                                            Nur shows off the sanitary latrine installed
                                                                                                                                                 based on verses from the Quran and Hadith, which refer to cleanliness                                    at his home – one of the few and earliest
                                                                                                                                                 and hygiene, and work as effective communication channels when                                           in his remote village of Alokdia Char.
                                                                                                                                                 working with Muslim communities. School teachers are engaged about
                                                                                                                                                 teaching children the importance of health and hygiene and are given
                                                                   BRAC provide and help install sanitary latrines and water filters in remote   special flip charts and posters developed by BRAC to use in schools.
                                                                   areas of the country.                                                         Children can play a crucial role in helping to spread the knowledge of
                                                                                                                                                                                                                               Nur Muhammad is a teacher at Manikganj Sadar Hafizia
                                                                                                                                                 good and safe hygiene practices to their families and within the local
                                                                                                                                                                                                                               Madrasa. He lives with his wife in Alokdia Char in Manikganj –
Providing access to clean, safe water for everyone                                                                                               community.
                                                                                                                                                                                                                               an extremely hard to reach area in Bangladesh. Char Alokdia
Building on years of experience working with communities, providing water and sanitation facilities, we                                                                                                                        cannot be reached by public transport and, after crossing
started our Water, Sanitation and Hygiene (WASH) programme in 2006 in partnership with the Government.                                             A Girl Problem                                                              the river, the only way to reach Nur’s home is a five kilometre
                                                                                                                                                                                                                               journey by foot.
Our aim is to provide sustainable integrated WASH services to rural areas and break the cycle of                                                   Research tells us that schools in rural areas lacking separate
contamination caused by the use of unsanitary latrines, contaminated water and unsafe hygiene practices.                                           washroom facilities will experience significantly higher drop-out           Char Alokdia is home to many families and households that
                                                                                                                                                   rates and absenteeism of female students. This issue is primarily           don’t have access to sanitary latrines. The private sector
                                                                                                                                                   associated with the discomfort many young girls feel, when faced            does not provide sanitary latrines there, as it is not profitable
                                                                                                                                                   with inadequate washroom facilities during their periods. By                whilst transportation to and from the area is challenging. As
  Achievements 2010                                          Our Approach                                                                          improving sanitation facilities, providing separate washrooms and           a result many people like Nur suffer from diseases such
                                                                                                                                                   waste management facilities in schools, we can help improve the             as diarrhea. People were not aware of personal hygiene
                                                             The core of the WASH programme lies in the Village WASH                               enrolment rate of adolescent girls in secondary education.                  practices such as using soap. Our staff approached Nur and
174,487 monthly meetings were held where at least 80%        Committee (VWC). This committee, made up of people from the                                                                                                       offered him a subsidised latrine. We also gave him advice
of members attended                                          village, helps us to identify and assess the needs of individuals and                                                                                             on hygiene awareness. Like Nur, other residents in the
6.62 million people were given access to sanitary latrines   families living in the community. Working with the VWC, along with                                                                                                Char Alokdia area, realising the importance of hygiene and
                                                             other local committees, agencies or local NGOs, in the planning                     Sanitation in Schools We work with rural schools to help set up               sanitation, also decided to install latrines and BRAC agreed
through WASH                                                                                                                                     Student Brigade made up of 24 students who are each selected from
                                                             and implementation of projects, we ensure the entire village is                                                                                                   to cover transport costs.
694 deep tube wells were installed                           represented.                                                                        classes 6 to 9. Along with ensuring the overall cleanliness of the school,
                                                                                                                                                 the brigade is responsible for the proper use and maintenance of
7 pond sand filter installed                                                                                                                                                                                                   Today, issues like diarrhea have been greatly reduced in
                                                             The VWC is made up of 11 members, 6 females and 5 males,                            washrooms for their classmates. The school Headmaster and a female
                                                                                                                                                                                                                               the area and people are better informed of safe hygiene
Celebrated Global Hand Washing Day across 39,870             who meet twice every month to assess the water and sanitation                       teacher, also trained as a part of the Student Brigade and along with its
                                                                                                                                                                                                                               practices. Nur feels, as a teacher and Imam, he understands
Village WASH Committees and in 7,808 secondary               situation of the entire village and identify any issues that need urgent            student members will meet monthly to review and discuss the school’s
                                                                                                                                                                                                                               the importance of good hygiene and is grateful for BRAC’s
                                                             action. We choose two key members from each committee, one                          sanitation needs.
schools                                                                                                                                                                                                                        work to help improve sanitation conditions in Char Alokdia.
                                                             female and one male, and provide them with leadership training
                                                                                                                                                                                                                               Nur says,
5,348,194 meetings held to promote hygiene awareness         helping to build the capacity of the committee. They select sites                   Building Partnerships To help Bangladesh realise the MDGs, the
in segmented sessions targeting 59,294,509 men,              for community water sources, collect money from borrowers and                       Government has formed WATSAN (Water and Sanitation) committees
women and children from ages 9 to 11                         monitor usage and maintenance of latrines.                                          across the country. As a member of the National Sanitation Taskforce          “I am a religious teacher and hope to teach my
                                                                                                                                                 we actively participate in these discussions to support the Government’s      students how to be good human beings and
38.8 million people were given hygiene education                                                                                                 work. We are working with UNICEF, collaborating with UNJI (United             follow the path of goodness. BRAC is helping
                                                             Programme Components                                                                Nations Joint Initiative), to improve water and sanitation in Ukhiya, Cox’s
                                                                                                                                                                                                                               improve sanitation and hygiene. I hope they keep
                                                                                                                                                 Bazar. Free sanitary latrines will be provided to 2,500 ultra-poor families
                                                                                                                                                 and 40 schools in the area.                                                   on working.”
                                                             Safe Drinking Water After installing deep tube wells we regularly
                                                             run water quality tests to ensure drinking water stays safe, giving
18 BRAC Annual Report 2010                 Disaster, Environment and Climate Change                                                                  BRAC Annual Report 2010 19



BRAC Programmes
Disaster, Environment and Climate Change




                                           Helping communities cope with disaster
                                           Frequent natural disasters induced by climatic change adversely affect the lives of tens of
                                           millions of Bangladeshis each year. The effects of climate change are threatening to slow
                                           down, perhaps even reverse, the progress made in alleviating poverty. We were already
                                           helping poor people cope with the effects of natural disaster, but after cyclone Sidr struck
                                           Bangladesh in November 2007, we decided to establish our Disaster, Environment and Climate
                                           Change (DECC) programme in December 2008. Our story began in Bhola following the
                                           devastating cyclone of 1970 and ensuing relief efforts. Forty years later our focus remains on
                                           responding rapidly to natural disasters, with emergency relief and following up with rehabilitation
                                           support, to help communities to restore their lives and livelihoods.




                                           Our Approach

                                           We focus on risk reduction, better preparation and development
                                           of disaster management plans. By increasing awareness about                 Achievements 2010
                                           climate change and carrying out essential research we identify
                                           successful coping mechanisms for affected communities. It is              Waste Management Launched as a pilot,
                                           important to help empower and prepare those most affected by              the Solid Waste Treatment Plant in Tongi
                                           climate change so families and communities can be proactive in
                                                                                                                     Pourashava (municipality) aims to significantly
                                           dealing with disaster and recover faster. Our approach to managing
                                           and reducing disaster risks cover three key areas including
                                                                                                                     reduce environmental pollution, surface water
                                           capacity building, developing adaptation strategies and knowledge         contamination and improve the environmental
                                           generation.                                                               health condition of the area. The plant will also
                                                                                                                     produce a significant quantity of organic fertilizer
                                                                                                                     and electricity, which can be used by the local
                                           Programme Components                                                      community.

                                           Our team of experts review the potential risks, calculate probabilities   Weather Stations To help support farmers and
                                           and finally prepare contingency plans that outline specific               provide guidance on the best times to grow
                                           procedures for disaster management. We deliver training on how            seedlings or transplant rice crops, we have
                                           to reduce risks by drawing on local knowledge, supplemented               installed 5 weather stations and plan to install
                                           with our international experience, to prepare staff on how best           3 more, in partnership with the Bangladesh
                                           to respond to emergency situations and save as many lives as              Meteorological Department (BMD) and the
                                           possible. We carry out surveys in disaster prone areas to help us         Ministry of Environment and Forest (MOEF),
                                           allocate resource and levels of preparedness.                             across the country.




                                                                                                                                                    First spread
                                                                                                                                                    After surviving the cyclone Aila,
                                                                                                                                                    a family re-builds their house
                                                                                                                                                    with assistance from BRAC in
                                                                                                                                                    the village of Charbara in
                                                                                                                                                    Shayamnagar.
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BRAC Annual Report 2010

  • 2. BRAC Annual Report 2010 1 A member of our Ultra Poor programme holding her child in Pirgacha, Rangpur.
  • 3. 2 BRAC Annual Report 2010 BRAC Annual Report 2010 3 A Lasting Legacy Chairperson’s Statement Aminul Alam: Field Marshall and Changemaker Bangladesh was fortunate in 2010 not to face the catastrophic natural disasters of the preceding two years. Although cyclone Aila struck in February 2009, all through 2010 we were witness to its devastating impact on people’s lives. Millions continued to be marooned, without safe drinking water, with neither homes nor assets. Relief and rehabilitation have limited meaning for this Aila- affected coastal region which is subject to the vagaries of climate change as saline water intrudes deeper inland. Our efforts have therefore been directed to helping the poor adapt to circumstances not of their making. Innovative microfinancing and development models combined with science and technology helped farmers and fisherfolk build new livelihoods. The global financial crisis had minimal impact on our microfinance programme. But our borrowers were left struggling with larger bills as food prices continued to climb. We noted the decline in loan repayment rates – possibly as borrowers spent more meeting basic needs rather than building up assets or embarking upon an income-generating activity. Sir Fazle enjoying his question-answer “an exceptional person with an exceptional Aminul Alam (1949-2010) joined BRAC in 1975 and worked The Millennium Development Goals (MDGs) continue to guide our session in a reception by BRAC staff on receiving the knighthood. commitment to rural development. BRAC closely with Sir Fazle Hasan Abed for more than thirty-five years work. By most counts, Bangladesh is on the way to reaching the would not be what it is without him” helping turn vision into reality. Amin was at the heart of our very MDGs. We need to work harder to bring every child to school and, first field programmes and eventually went on to become a once there, ensure that the child stays long enough to complete Sir Fazle Hasan Abed leading figure in the evolution and story of BRAC as we know primary schooling. We also need to do much more to prevent it today. We want to celebrate his achievements and continue mothers from dying in childbirth. to build on his efforts towards helping women and men realise their potential in Bangladesh and in developing countries As the year drew to a close, we received encouraging news that around the world. fewer mothers were dying giving birth to their children. BRAC Key MDG challenges remain in the areas of halving hunger and health professionals and Community Health Promoters, working in attaining gender equality. We must do all that we can to improve “he has left a rich legacy to BRAC: of close partnership with households, communities and functionaries the production and distribution of food, to keep prices low so that programs firmly in place around the world, The story of Aminul Alam and BRAC began in 1975 with a young in public facilities, were able to make a significant dent in reducing the poor are not disproportionately affected, and we must harness of staff and members inspired by his man, recently graduated from Dhaka University, full of radical ideas maternal deaths. Even if Bangladesh achieves the MDG target the energy, strength and will of the State, the private and non- about helping the poor in post liberation Bangladesh. It was at this (maternal mortality rate of 144 per 100,000 live births), the number governmental sector to prevent all forms of gender-based violence. pragmatic vision, and of practical turbulent time, amidst devastating drought and famine, that Amin will still be 50 times higher than it is in Norway! In order to Achieving these goals will mean that there must be concerted and solutions to many of the world’s seemingly recalled he had seen truly poor people for the first time. Abed had address this inequity, we need to create and expand the human sustained action at every level and each partner must play its role intractable problems” offered Amin a job in the Rangpur District as part of an emergency infrastructure where it is most needed – close to the home – where effectively. Men and women must join hands to bring about this relief effort, feeding 15,000 children two meals a day, marking some the vast majority of mothers give birth. By making trained midwives change in our homes and communities. Marty Chen of BRAC’s earliest work in Bangladesh. available and accessible to surrounding communities, we can make births safer for mothers. BRAC University’s School of Public Health Bangladesh continues to make good progress in reducing poverty. Amin moved to Manikgang to continue his work for BRAC and is planning midwifery education to create this category of medical We were greatly heartened by the news that the proportion of ended up staying for eight years, leaving him with an experience professionals. people living in poverty had gone down to 30%, but we were that would change his views forever. More than thirty years later also sobered by the thought that millions more continue to live Amin went on to become a leading figure and much loved member dehumanised lives and that we must work even faster to bring their of the BRAC family, working closely with Abed and introducing condition to an end. On this 40th birthday of Bangladesh, we must pioneering ideas towards their shared mission to fight poverty. renew our promise to eradicate poverty from this land forever. Amin made his first visit to Afghanistan in 2002, leading a team of just four people, to start BRAC operations in post war Afghanistan. Tackling the returning flood of refugees, coupled with a challenging political situation, didn’t make for an easy task. More recently, Amin played a crucial role in leading BRAC’s efforts to help victims of Haiti’s earthquake and the devastating floods in Pakistan that ensued last year. Today, BRAC is the largest NGO in Afghanistan offering education and health services across the country reaching more than 24 million people. Amin’s leadership in expanding BRAC programmes across Bangladesh, and then to 9 countries around the world is undoubtedly one of his most important legacies to BRAC’s work.
  • 4. 4 BRAC Annual Report 2010 MDG BRAC Annual Report 2010 5 Reaching for the Millennium Development Goals: 2010-2015 The Millennium Development Goals (MDGs) are eight international development goals in a range of programmes in a direct effort to help Bangladesh that all 192 United Nations member states have agreed to achieve by the year 2015. achieve the eight goals. Our approach aims to complement The aim of the MDGs is to encourage development by improving social and economic Government efforts and now with five years to go, it’s time to conditions in the world’s poorest countries. From the beginning, we have been investing review and accelerate progress. ERADICATE EXTREME ACHIEVE UNIVERSAL PROTE GENDER EQUALITY REDUCE CHILD IMPROVE MATERNAL COMBAT HIV / AIDS MALARIA ENSURE ENVIRONMENTAL GLOBAL PARTNERSHIP POVERTY AND HUNGER PRIMARY EDUCATION AND EMPOWER WOMEN MORTALITY HEALTH AND OTHER DISEASES SUSTAINABILITY FOR DEVELOPMENT Target: 31 (per 1000 live births) Target: Maternal mortality 144 Target: 29% population below Target: 100% net enrolment in Target: 1% gender parity in infant mortality (per 100,000 births) Target: Use of safe drinking poverty line primary schools secondary schools Target: Detection of TB cases water 89% BRAC Programmes involved: Contraceptive prevalence 75% 90% Progress: On track Current status: 41 (per 1000 International Programmes; 100% primary students reach 50% women in wage employment per couple Use of improved sanitation facility live births) infant mortality Use of treated malaria nets 90% Training Division; Research & Current status: 30% population grade 5 70% hotspots Evaluation Division; Advocacy for below poverty line Current status: 1.2% gender Current Status: Maternal BRAC Programmes involved: Social Change Current status: 92% net parity in secondary schools mortality 348 (per 100,000 births) Current status: Use of safe enrolment in primary schools Health; Water, Sanitation & Current status: Detection of TB BRAC Programmes involved: 29% women in wage employment drinking water 86% [2009] Hygiene Contraceptive prevalence 60% cases 70% [2009] Closing the gap: BRAC Programmes involved: 55% primary students reach per couple Use of improved sanitation facility Negotiations are underway Agriculture & Food Security; grade 5 BRAC Programmes involved: Use of treated malaria nets 81% 54% [2009] between BRAC and key Closing the gap: Community Empowerment; Education; Community BRAC Programmes involved: hotspots [2009] development partners to enter Our Shasthya Shebikas, Microfinance; Targeting the Ultra BRAC Programmes involved: Empowerment; Human Rights Health; Advocacy for Social BRAC Programmes involved: into a Strategic Partnership Shasthya Kormis, newborn Poor; Gender Justice & Diversity; Education & Legal Aid Services; Gender Change BRAC Programmes involved: Disaster, Environment and Climate Arrangement, which will result health workers and skilled Advocacy for Social Change Justice & Diversity; Microfinance; Health; Education; Advocacy for Change; Water, Sanitation & in greater flexibility in resource birth attendants all work Closing the gap: Advocacy for Social Change Closing the gap: Social Change Hygiene allocation for our development together to deliver child Closing the gap: Develop the professional We are working with the work immunization and essential Create self-employment capacity of teachers from Closing the gap: Government and partners Closing the gap: Closing the gap: Collaborative efforts with health care services to the through our microfinance Government primary schools, Empowering adolescent to scale-up our maternal, TB treatment success in Priority is given to the arsenic international organisations in community programme increase community and girls through our specially neonatal and child health 2010 in BRAC covered areas affected areas and saline the areas of research, training Our birthing huts provide Maximise the role of farmers parent participation in designed microfinance programmes to maximise was higher (almost 93%) prone areas to increase and impact monitoring clean and private birthing in the implementation of children’s education scheme and life skills training coverage of regions with the compared to the national access to safe drinking water places for slum women agricultural practices and the A total of 252,040 students clubs worst mortality records average (almost 85%) Awareness raising sessions Developing behaviour change use of new technologies of BRAC primary Schools Emphasising issues such as Our health centres have been Our TB-HIV collaborative regarding water, sanitation communication tools to Provide grants of small assets participated in the grade 5 women’s right to property, upgraded to offer emergency project also offers HIV and hygiene practices for address issues such as to carefully selected ultra-poor completion test of 2009 and gender culture change caesarean sections, newborn screening tests for TB different target audiences health and hygiene practices households 97.4% of them passed the at household levels and care and services like patients Imported two desalination exam against 89% of national strengthening systems that electrocardiograms and ultra- plants from China to help pass rate address gender based sonograms support the availability of violence and abuse Preventive and curative clean drinking water amongst practices are promoted affected people in disaster through targeted household prone areas visits and engaging local communities
  • 5. 6 BRAC Annual Report 2010 BRAC Annual Report 2010 7 BRAC Saving our Mothers LOVELY’S STORY Baby Sumaiya sits wide eyed and smiling in her mother’s arms. She has just been given a As they grew up, Lovely and her sisters were faced with typical adolescent issues. Despite their father being a village doctor check-up by Farida, a BRAC Shasthya Kormi (Community Health Worker), as they sit in the (quack), puberty, sexuality and reproduction were taboo topics. courtyard of their home. Her mother, Lovely Akhtar, gave birth to baby Sumaiya a year ago and The BRAC Kishori Club (club for adolescents) provided a safe space for Lovely and her sisters to learn about being a woman, all signs show that mother and baby are thriving. receive sanitary pads and have regular contact with a Shasthya Kormi. The club also provided a social space to learn, understand and protect their rights, through a process that encouraged independence and leadership. It was at the Kishori Club that Across the rural villages and urban slums of Bangladesh, all too Our story, therefore, begins not with healthy baby Sumaiya Lovely first learnt what ‘eve teasing’ meant. She began to realise often the stories of mothers and babies are unlike that of baby but with the birth of her mother Lovely. that what she had accepted as part of everyday life was verbal Sumaiya and her mother Lovely. On average, for every 100,000 sexual abuse and something that she did not have to put up with. mothers that give live births, 194 of those mothers will die. Whilst A baby girl, who comes into the world underweight, is not Today, Lovely feels confident about asserting her rights and is better every year, 171,000 babies like Sumaiya perish before reaching the exclusively breastfed for the first six months and does not receive informed about gender equality and justice. Our Human Rights age of five. adequate nutrition in her first two years, is likely to grow up to be and Legal Aid programme helped Lovely and other young women anemic and have stunted growth. This means that when she is in her community to equip themselves against discrimination and The good news is that Bangladesh continues to make impressive ready to have her own baby, the likelihood of her dying at childbirth violence. gains in reducing maternal mortality. The last 9 years has seen a will be 40% greater. Whether she dies or lives, she will give birth to 40% drop in maternal mortality putting the nation on track to meet her own underweight baby and the cycle will continue. To break Baby Sumaiya and Lovely, both healthy and BRAC’s Adolescent Development Programme encourages girls happy, in Bakshimul, Mymensingh. Millennium Development Goal (MDG) number 5 by 2015 – but we the cycle and prepare a girl for adulthood, we must intervene at key graduating from BRAC schools to retain their literacy and life skills must try to reach every Lovely and every Sumaiya. points throughout her life starting with her birth. even if they leave school early. The care that is provided to a baby at birth is critical for survival. Over 8,800 Kishori Clubs across the country provide a safe helped deliver the baby safely at home. The IMNCS and Manoshi In the first hour after delivery, BRAC Shasthya Kormis and skilled space for adolescent girls to socialise, learn about health, programmes ensure that rural and urban deliveries are attended by “We must do all we can to stop the unnecessary birth attendants are on hand to teach ‘kangaroo care’ (skin- to-skin develop life skills, receive vocational training and become a skilled birth attendant and that they take place in a safe and clean deaths of mothers and babies. We want to improve contact), distribute a specially designed thermal baby jacket to low involved in their communities. facility.* women and children’s health not only to reach the birth-weight babies and encourage early initiation of breast feeding. Millennium Development Goals by 2015 but to Our trained Shasthya Kormis are on hand to provide regular visits, When Lovely was 15 years old, her father pressured her to accept a Baby Sumaiya came along when Lovely was 23, with one vaccinations and micronutrients to babies until they reach the age good offer of marriage from a local boy, but Lovely was determined exceed them” of five. safe birth behind her, Lovely was well prepared to give her to stand up for her rights. She reminded her parents about the ills second baby girl a healthy start in life. BRAC Founder and Chairperson, Sir Fazle Hasan Abed of early marriage. One of her sisters had married young and given With a healthy start in life, a young girl is ready for school. An birth at 17, after which her health had deteriorated. Shasthya Kormi Farida visited Lovely and baby Sumaiya regularly education early in life will not only benefit girls in building their futures for the first 42 days, then weekly and then monthly. Lovely is but will contribute directly to the development of their families and From its earliest days, BRAC chose to focus its attention on the communities. Girls with some level of schooling are more likely “I told my parents that I didn’t want the same now taking the contraceptive pill and does not plan to have more needs of poor, disadvantaged and socially- excluded women. happening to me. I could not stop my sister’s children for at least another five years. When Farida first started to use proper contraception methods, get married later and have Over the next five years, we plan to provide millions of poor work as a BRAC health worker in 2006, young women didn’t want fewer and healthier babies than girls who don’t go to school. The marriage, but I could do it for myself…I told my women in rural and urban areas with effective maternal and child same girls are more likely to seek medical care for themselves and family planning, pre-natal care or vaccinations, but attitudes have health interventions. father, if you do this, I will run away and that will be changed now, she says. Lovely’s husband Tarul agrees, their families, be better informed about nutrition, teach hygiene and humiliating for the whole family. My parents were sanitation to their children and send their children to school. For Throughout the country, 80,000 Shasthya Shebikas (Community 30 years our Education programme has been providing accessible finally convinced.” “Even if we have another girl, we will stick to three Promoters of Health), Shasthya Kormis, skilled birth attendants learning opportunities to girls whose parents are poor, who have children. In this age, girls and boys are equal.” and BRAC doctors combine their efforts to provide mothers special needs and are from ethnic minorities. With nine years of schooling behind her, Lovely was ready for with access to family planning, early detection of pregnancies, marriage at 19. She married a local boy and had their first child When her children are old enough, Lovely hopes to continue pre and post natal checkups, skilled deliveries, hygienic Sumaiya’s mother, Lovely, was a student at a BRAC non-formal within a year. Farida, a BRAC Shasthya Kormi , who Lovely knew her studies and perhaps become a BRAC teacher or health birthing conditions and hospital referrals. Our urban and rural primary school in the village of Baksimul in Mymensingh. Baksimul from her Kishori Club days, identified the pregnancy early on worker like Farida. programmes presently reach 25 million women. relied on vegetable growing and fishing for income and many poor and provided pre natal care offered through BRAC’s IMNCS families could not afford to send their children to school. When programme. Her pregnancy progressed normally and Farida Lovely’s story is important because it tells us that it is possible to We have a holistic approach to poverty alleviation which means BRAC set up the one-room school in the village, Lovely and her two bring about positive changes in the lives of mothers and children if that it is not enough to provide maternal child health services but older sisters were offered their first chance at an education. we can support them at key points in their life cycles. to ensure that poor women and children have access to education, the means to build a livelihood and protect themselves from exploitation. Our support is designed to place *Go to the Health section to learn more about our Improving every young girl in the best possible position to realise her Maternal, Newborn and Child Survival (IMNCS) programme and its potential as a woman and as a mother. urban counterpart Manoshi
  • 6. 8 BRAC Annual Report 2010 Health BRAC Annual Report 2010 9 BRAC Programmes Health Improving health and providing essential healthcare Our Health programme combines promotive, preventive, curative, rehabilitative health care. We focus on improving maternal, neonatal and child health, combating communicable diseases and common health problems. BRAC’s Health programme is the result of an integrated approach, including several interventions, to provide a health service that supports human development and works in partnership with our comprehensive approach to development. The key areas of the programme are: essential health care; tuberculosis and malaria control; maternal, neonatal and child health; health facilities and limb and brace centres. Our Approach An awareness of the changing health needs, adaptation of technology, cost effectiveness, sustainability and delivery through Achievements 2010 partnerships with communities and Government are key features in our approach to providing health care to poor people. Essential Health Care We have adopted an epidemiology-experimentation-expansion 100 million people reached across 64 districts evaluation model in how we develop and deliver the programme. 1,650,673 patients treated by our Shebikas Lessons learned from our experiences in public health, like the 31,174 Ultra Poor patients given health care bare-foot doctors of the 1970s, Oral Therapy Extension and Child subsidies Survival programmes in 1980s, Women’s Health, Reproductive Health and Disease Control programmes in 1990s, have enabled Maternal, Newborn and Child Health us to expand sustainable and accessible health care to more than 100 million people across Bangladesh. We also collaborate on 5.7 million people served in urban areas national projects such as Vitamin-A supplementation and family 8,317 deliveries made in birthing huts planning initiatives. 426 delivery centres in urban areas By choosing health volunteers, or Shasthya Shebikas, from our 11 million population reached in rural parts Village Organisations (VOs), we are making effective use of resource and are able to ensure sustainability unlike other programmes in the Tuberculosis Control health sector. Volunteers receive basic training and provide door-to- 89.5 million people reached door health education, treat basic illnesses, refer patients to health 23,771 cases diagnosed centres and provide essential health items and medicines; which 92% patients cured contribute towards an income for the volunteer. Our Shasthya Shebikas are assessed and monitored by Shasthya Reading Glasses Kormis who are paid a monthly salary to supervise 10-12 Shebikas. 7.9 million people covered Kormis conduct monthly health forums and provide antenatal 36,739 people screened and postnatal care. Around 7,000 Kormis are supervised by 9,573 glasses sold Programme Organisers who are supervised by the Upazila and District Managers. Medical officers provide overall technical Vision Bangladesh supervision whilst Kormis are supported by a team of public health professionals. 612 cataract surgeries completed First spread Parul receives an ante-natal check-up from a BRAC health worker in Gazipur.
  • 7. 10 BRAC Annual Report 2010 Health BRAC Annual Report 2010 11 Programme Components Manoshi: Maternal, Newborn and Child Health Initiative (Urban) launched in 2007 in Dhaka and provides community Essential Health Care (EHC) forms the core of our health based maternal and child health care services in urban slums, with programme, combining preventive, promotive, basic curative the support of slum volunteers, skilled community workers and and referral care, aimed at improving the health of poor people, Programme Organisers based in nearby hospitals for emergency especially women and children. EHC has seven components: cases. Birthing huts provide clean and private birthing places for health and nutrition education; water and sanitation; family slum women who usually live in small shacks, with large numbers of planning; immunisation; prenatal care; basic curative services and family members, which offer unhygienic conditions for giving birth. tuberculosis control. In 2002, EHC was adapted to fit the needs Each of our huts have two birth attendants, covering around 2,000 of the Ultra-Poor, our poorest members, by offering basic health households (approx 10,000 people), whilst community midwives care and health awareness services as well as financial assistance are on hand to provide skilled care during deliveries. towards clinical care. Shushasthya (Health Centres) provide accessible and quality outpatient and inpatient services, general laboratory investigations Malaria Control Programme operates in 13 districts across and essential life-saving drugs to the local community. We have Bangladesh including the Chittagong Hill Tracts (CHT). Our also upgraded nine centres to offer emergency caesarean Shasthya Shebikas receive a 3-day training course on malaria section or newborn care and advanced diagnostics such as treatment and prevention to help achieve early diagnosis and electrocardiograms and ultra sonograms. prompt treatment of cases. Limb and Brace Fitting Centres provide low cost, accessible, Tuberculosis Control Programme using a community based quality artificial limbs and braces. We provide physiotherapy approach, our Shasthya Shebikas are trained to provide DOTS services and education and counselling to patients and their family treatment (Directly Observed Treatment Short-Course), diagnose members. Our work aims to improve the livelihood capabilities of cases, distribute information on TB and refer suspected cases the physically challenged and help their integration into mainstream to nearby outreach smearing centres. Medical Officers initiate society. We currently have centres in Dhaka and Mymensingh. treatment, whilst the Shebikas conduct the DOTS treatment of TB patients, either at their own home or during home visits. Our TB-HIV collaborative project also offers HIV screening tests for TB patients. Reading Glasses for Improved Livelihoods working with Vision Spring, covering 15 districts, specially trained Shasthya Shebikas Improving Maternal, Newborn and Child Survival Project use simple charts to identify near-vision deficiency. They sell ready-to-use spectacles at a nominal price, educate people on eye Shomola Khatun, a Shasthya Shebika from the village of Chankanda in (Rural) has been successfully scaled up to ten rural districts across Jamalpur explains how to use contraceptives to the women in her community. Bangladesh since its launch in 2005; working with the Government problems and are trained to refer complicated cases to medical and UNICEF. This project aims to provide quality maternal, newborn professionals. and child health care using a community based approach to reach the rural poor. Major interventions include capacity development Vision Bangladesh is a partnership programme between BRAC Challenges of community health resources, empowerment of women and Sightsavers aiming to eliminate preventable blindness in Sylhet New Initiatives through support groups, provision of maternity and child health by 2014. To date, 1,300 poor people have undergone cataract There is an emerging need to tackle the increase in non- related services and referrals to nearby health facilities. Shasthya operations and 7,000 people have been successfully screened. communicable diseases, alongside the ongoing burden of We have developed a Mobile Health Project, in partnership with Shebikas, Shasthya Kormis, newborn health workers and skilled communicable diseases, coupled with a lack of accessible and Click Diagnostics Inc, where Shasthya Kormis can use mobile birth attendants all work together to deliver these services to the Alive and Thrive is an initiative to reduce malnutrition in children quality health care and medical facilities in Bangladesh. Lack of phones to share real-time information about their patients, mainly community. Preventive and curative practices are promoted through under the age of two by promoting exclusive breastfeeding coverage, skilled workers and accessibility to remote parts of pregnant women and newborns, helping to improve the process targeted household visits. Our approach has significantly improved and healthy feeding practices. This includes community level the country continue to present major challenges in how we can of diagnosis and treatment. pregnancy identification and antenatal care as well as ensuring safe counselling, coaching and demonstrations. Following a successful provide health care to poor people. Developing effective referral and clean deliveries in rural communities. year long pilot this initiative has been expanded to 50 rural Upazilas. facilities with adequate human resources and logistics will prove Working in partnership with GE Healthcare, we plan to introduce essential in reducing maternal and newborn mortality. a portable oxygen support device, at community level, in an Micro-Health Insurance is a sustainable community health effort to fight birth asphyxia in newborns. The pilot will launch in financing model, to empower and improve the well being of poor January 2011. Future Plans women and their families, giving poor people access to affordable and quality health care. Our approach in developing community based interventions recognises that workplaces and urban slums are becoming new settings for delivering effective health interventions. Our approach with EHC, continuing as our core health programme, will be adapted to accommodate the emerging needs of non- communicable diseases, elderly health care, climate change and nutritional initiatives. In our shared effort to build a more ‘Digital Bangladesh’ we have identified the mobile phone as a key medium for exchanging information. Using ICT will enhance our ability to provide efficient and effective health care, whilst opening up new channels of communication for a lower cost higher reach service.
  • 8. 12 BRAC Annual Report 2010 Education BRAC Annual Report 2010 13 BRAC Programmes Education Education as empowerment Our carefully developed pre-primary and primary schools provide free education to children who are left out of the formal school system and, in particular, reach children who are from extremely poor families or ethnic minorities, living in remote areas or have special needs. Working with partner organisations we offer our guidance and technical support, to help schools replicate our successful primary education model in hard to reach areas, like the Chittagong Hill Tracts, haors, baors, chars and coastal areas, and work with non-government rural secondary schools to improve their techniques and curriculum. Our Approach Our non-formal schools offer flexible timings and make room for students of varied age whilst operating on a low cost but effective Achievements 2010 model. The classes are small, with around 33 children per class, and are taught by a female teacher selected and trained from the 4.66 million boys and girls have graduated from local community. Free educational materials are given to students our schools with a more hands-on approach to teaching, focusing on student participation, whilst less homework and longer holidays aim to help 21 children received essential eye operations, accommodate children who may never have enrolled in school or 40 children given cleft lip and plate surgery had previously dropped out of the formal schooling system owing to family or work commitments. 1,298,516 students have enrolled to date in both Preparing for a successful education A pre-primary education our pre-primary and primary schools has proven to be a significant factor in promoting the success of primary education. Our pre-primary schools aim to familiarise 8,715 clubs for adolescents operate across the children, under the age of 6, with the alphabet, numbers and a country reaching 225,631 young girls curriculum that focuses on Bangla, Maths and Science over the course of one year. This year 11,765 pre-primary schools were Special needs students participated in the opened with 329,184 students, 61% of them girls, including 13,654 Special Olympics trials and Afsana Akter, from children with special needs. a BRAC school, was awarded first place in ball throwing qualifying for the official Bangladesh team Programme Components Supporting the Government Our efforts are to complement the work of the Government and help improve the quality of mainstream formal schools in Bangladesh. In 1998, the Government in fact handed over 44 community schools to us to help improve the quality of education being provided – there are currently 7,940 students, around 54% of them girls, and 231 teachers, around 97% of them female across these schools. Previous spread Ahki Khatun, in Grade 3 at a BRAC Primary School in Jamalpur.
  • 9. 14 BRAC Annual Report 2010 Education BRAC Annual Report 2010 15 BRAC Schools Our first primary schools opened in 1985 and women on the path towards financial independence – activities Shah Alam’s story have since expanded and been developed to cover a 5 year include poultry and livestock rearing as well as vegetable farming curriculum across 4 years of teaching. A total of 31,670 schools, or beauty therapy skills. Financial literacy courses give girls some including 2,308 urban and 1,950 ethnic schools, are currently in insight into managing a small business, along with access to credit operation across Bangladesh. We also support 3,089 secondary and savings facilities which provide seed capital to help start small schools across the country to help Government efforts in improving businesses. the quality of secondary education. Education for Ethnic Children The use of Bangla as the main 12,000 girls, between the ages of 11 language, when teaching children across primary schools in and 21 years are reached through SoFEA Bangladesh, was standing in the way of a proper education for in 360 clubs across Bangladesh children from ethnic minority, or indigenous, backgrounds. So that these children could feel free to speak their native languages and receive effective schooling, we established schools for ethnic children in 2001. Supporting Higher Education Chittagong Hill Tracts Our Multi Lingual Education (MLE) model, Medhabikash Uddyog (‘Promoting Talent’) is a scholarship adapted from our primary schools model, has been specially programme that targets bright students from disadvantaged developed to suit the learning needs of children from indigenous backgrounds and offers them financial support to help pay for communities. The students’ native languages are adopted as the tuition fees. Young people from poor rural communities, who main teaching medium; the aim being to help children become want to study, often find themselves struggling to cover living proficient in Bangla on their own terms. We have been piloting expenses, despite working part-time jobs or even taking loans ‘mother tongue’ based primary education for Chakma children at from family members, let alone pay for tuition fees. Earlier this year, ten schools in the districts of Rangamati and Khagrachari since we celebrated the success of graduates with a two day event that 2008. recognised their achievements and role in helping build a stronger nation. An Inclusive Education We are committed to increasing the enrolment of children with special needs and through the Chhatrabandhu is a Volunteer Tutor programme initiated to offer programme we provide essential support to families and children tuition support to poor students who cannot afford private tuition. including corrective surgeries, wheelchairs, crutches, hearing aids, We believe that promoting volunteer activities like this, in poor rural glasses and ramps to make schools more accessible to physically communities, can contribute to better student access, higher challenged children. We adopt classroom policies like sitting in success rates and better teaching; which in turn can improve the front or studying in pairs, coloured border boards whilst highlighting quality of schools and the teaching-learning process. special needs issues in textbooks to help raise awareness amongst classmates and teachers. Community Learning Centres These are multi-purpose Shah Alam has learnt to write with his community learning facilities, known as Gonokendros, which wrists and take part in all his exams. Empowering Girls we have set up in non-government secondary schools across rural areas of the country. The centres reach out to everyone, Adolescent Development Programme (ADP) The ADP works by from children to adults, to promote a learning society in poor rural providing clubs, life skills based education, community participation communities. The centres are essentially community libraries, as well as giving internet and computer access, offering a range of Shah Alam is in grade 7 at Parulia High School in Hatibandha. He dexterity and recently received an A+ in his grade 5 completion test. and livelihood training to young girls. Adolescent boys can also reading material that students and members of the local community goes to school like many other children his age but, for Shah Alam, Shah Alam now dreams of going for higher education. His parents attend the clubs, which not only hold reading materials, but also can borrow. To make them self-sustaining, centres are usually his journey there was not an easy one. Shah Alam lost both his have overcome their past fears. They are very proud of their son. offer a safe place for young people to socialise, play indoor games, transformed into trusts and managed by a Board. In collaboration hands when he was twelve months old after unknowingly putting Shah Alam says, sing, dance and exchange views and experiences – all of which with the Ministry of Youth and Sports, centres organise skills them into the stove. Severe burns took away both his hands. His may prove difficult or impossible in their family homes. development training for the youth. parents were in despair. As Shah Alam grew up his parents were “I want to pursue higher studies at university and unable to get him admitted to a school because of his disability. His Social and Financial Empowerment of Adolescents (SoFEA) become a successful professional, BRAC has helped parents did not know how to offer their son a normal life or a basic The SoFEA initiative is about empowering adolescent girls through Currently 80% of Gonokendros are self sustaining education. me lay the building blocks”. financial and social support. By giving young girls life skills and 40% are equipped with computer and training facilities livelihood training, coupled with an understanding about saving and Shah Alam’s parents came to know about the primary schools financial services, we can help them become self-reliant and build run by BRAC in the local area. They were reassured that he would a better future for themselves and their families. Training sessions receive special care and attention for his individual needs from held at clubs aim to raise awareness on social issues, to help girls the teachers. Shah Alam soon started his education at the BRAC understand and protect their rights and make informed decisions, primary school in Hatibandha. His parents were very happy with the whilst income generating activities are promoted to put these young care he was given. Today, Shah Alam smiles. He can write with his wrists and loves drawing geometrical shapes. He can finish exams with amazing
  • 10. 16 BRAC Annual Report 2010 Water, Sanitation and Hygiene BRAC Annual Report 2010 17 BRAC Programmes Water, Sanitation and Hygiene priority to arsenic affected and saline prone areas. We raise awareness Nur’s Story in villages on how to keep water clean until drinking it, by keeping glasses clean and keeping water covered or sealed. Supporting the Ultra-Poor The VWC are responsible for identifying ultra-poor households in the village that may be eligible for Annual Development Programme grants from BRAC and the Government. They will also select poorer households that qualify for microloan support, which can go towards installing sanitary latrines and constructing tube well platforms. Promoting Hygiene We realise that simply providing access to safe water and sanitation facilties isn’t enough – we need to educate people on good hygiene practices too. In our practical approach, to understand how best we can promote good hygiene in communities, we look at everything from socioeconomic factors to any traditional practices, and use innovative communication tools that target women, men, adolescents and children . We work with Imams and the Masjid Council for Community Advancement (MACCA) to help us develop khutbas, Nur shows off the sanitary latrine installed based on verses from the Quran and Hadith, which refer to cleanliness at his home – one of the few and earliest and hygiene, and work as effective communication channels when in his remote village of Alokdia Char. working with Muslim communities. School teachers are engaged about teaching children the importance of health and hygiene and are given BRAC provide and help install sanitary latrines and water filters in remote special flip charts and posters developed by BRAC to use in schools. areas of the country. Children can play a crucial role in helping to spread the knowledge of Nur Muhammad is a teacher at Manikganj Sadar Hafizia good and safe hygiene practices to their families and within the local Madrasa. He lives with his wife in Alokdia Char in Manikganj – Providing access to clean, safe water for everyone community. an extremely hard to reach area in Bangladesh. Char Alokdia Building on years of experience working with communities, providing water and sanitation facilities, we cannot be reached by public transport and, after crossing started our Water, Sanitation and Hygiene (WASH) programme in 2006 in partnership with the Government. A Girl Problem the river, the only way to reach Nur’s home is a five kilometre journey by foot. Our aim is to provide sustainable integrated WASH services to rural areas and break the cycle of Research tells us that schools in rural areas lacking separate contamination caused by the use of unsanitary latrines, contaminated water and unsafe hygiene practices. washroom facilities will experience significantly higher drop-out Char Alokdia is home to many families and households that rates and absenteeism of female students. This issue is primarily don’t have access to sanitary latrines. The private sector associated with the discomfort many young girls feel, when faced does not provide sanitary latrines there, as it is not profitable with inadequate washroom facilities during their periods. By whilst transportation to and from the area is challenging. As Achievements 2010 Our Approach improving sanitation facilities, providing separate washrooms and a result many people like Nur suffer from diseases such waste management facilities in schools, we can help improve the as diarrhea. People were not aware of personal hygiene The core of the WASH programme lies in the Village WASH enrolment rate of adolescent girls in secondary education. practices such as using soap. Our staff approached Nur and 174,487 monthly meetings were held where at least 80% Committee (VWC). This committee, made up of people from the offered him a subsidised latrine. We also gave him advice of members attended village, helps us to identify and assess the needs of individuals and on hygiene awareness. Like Nur, other residents in the 6.62 million people were given access to sanitary latrines families living in the community. Working with the VWC, along with Char Alokdia area, realising the importance of hygiene and other local committees, agencies or local NGOs, in the planning Sanitation in Schools We work with rural schools to help set up sanitation, also decided to install latrines and BRAC agreed through WASH Student Brigade made up of 24 students who are each selected from and implementation of projects, we ensure the entire village is to cover transport costs. 694 deep tube wells were installed represented. classes 6 to 9. Along with ensuring the overall cleanliness of the school, the brigade is responsible for the proper use and maintenance of 7 pond sand filter installed Today, issues like diarrhea have been greatly reduced in The VWC is made up of 11 members, 6 females and 5 males, washrooms for their classmates. The school Headmaster and a female the area and people are better informed of safe hygiene Celebrated Global Hand Washing Day across 39,870 who meet twice every month to assess the water and sanitation teacher, also trained as a part of the Student Brigade and along with its practices. Nur feels, as a teacher and Imam, he understands Village WASH Committees and in 7,808 secondary situation of the entire village and identify any issues that need urgent student members will meet monthly to review and discuss the school’s the importance of good hygiene and is grateful for BRAC’s action. We choose two key members from each committee, one sanitation needs. schools work to help improve sanitation conditions in Char Alokdia. female and one male, and provide them with leadership training Nur says, 5,348,194 meetings held to promote hygiene awareness helping to build the capacity of the committee. They select sites Building Partnerships To help Bangladesh realise the MDGs, the in segmented sessions targeting 59,294,509 men, for community water sources, collect money from borrowers and Government has formed WATSAN (Water and Sanitation) committees women and children from ages 9 to 11 monitor usage and maintenance of latrines. across the country. As a member of the National Sanitation Taskforce “I am a religious teacher and hope to teach my we actively participate in these discussions to support the Government’s students how to be good human beings and 38.8 million people were given hygiene education work. We are working with UNICEF, collaborating with UNJI (United follow the path of goodness. BRAC is helping Programme Components Nations Joint Initiative), to improve water and sanitation in Ukhiya, Cox’s improve sanitation and hygiene. I hope they keep Bazar. Free sanitary latrines will be provided to 2,500 ultra-poor families and 40 schools in the area. on working.” Safe Drinking Water After installing deep tube wells we regularly run water quality tests to ensure drinking water stays safe, giving
  • 11. 18 BRAC Annual Report 2010 Disaster, Environment and Climate Change BRAC Annual Report 2010 19 BRAC Programmes Disaster, Environment and Climate Change Helping communities cope with disaster Frequent natural disasters induced by climatic change adversely affect the lives of tens of millions of Bangladeshis each year. The effects of climate change are threatening to slow down, perhaps even reverse, the progress made in alleviating poverty. We were already helping poor people cope with the effects of natural disaster, but after cyclone Sidr struck Bangladesh in November 2007, we decided to establish our Disaster, Environment and Climate Change (DECC) programme in December 2008. Our story began in Bhola following the devastating cyclone of 1970 and ensuing relief efforts. Forty years later our focus remains on responding rapidly to natural disasters, with emergency relief and following up with rehabilitation support, to help communities to restore their lives and livelihoods. Our Approach We focus on risk reduction, better preparation and development of disaster management plans. By increasing awareness about Achievements 2010 climate change and carrying out essential research we identify successful coping mechanisms for affected communities. It is Waste Management Launched as a pilot, important to help empower and prepare those most affected by the Solid Waste Treatment Plant in Tongi climate change so families and communities can be proactive in Pourashava (municipality) aims to significantly dealing with disaster and recover faster. Our approach to managing and reducing disaster risks cover three key areas including reduce environmental pollution, surface water capacity building, developing adaptation strategies and knowledge contamination and improve the environmental generation. health condition of the area. The plant will also produce a significant quantity of organic fertilizer and electricity, which can be used by the local Programme Components community. Our team of experts review the potential risks, calculate probabilities Weather Stations To help support farmers and and finally prepare contingency plans that outline specific provide guidance on the best times to grow procedures for disaster management. We deliver training on how seedlings or transplant rice crops, we have to reduce risks by drawing on local knowledge, supplemented installed 5 weather stations and plan to install with our international experience, to prepare staff on how best 3 more, in partnership with the Bangladesh to respond to emergency situations and save as many lives as Meteorological Department (BMD) and the possible. We carry out surveys in disaster prone areas to help us Ministry of Environment and Forest (MOEF), allocate resource and levels of preparedness. across the country. First spread After surviving the cyclone Aila, a family re-builds their house with assistance from BRAC in the village of Charbara in Shayamnagar.