Tag Archives: development

Last Ramblings

It has been a little less than a year and half since I returned from my adventures in Bangladesh. I was compelled to write this post, mostly because memories from that green country flooded my mind in vivid detail as I sat in graduation chairs in December, reviewing the experiences that made my undergraduate years so rich.

Experiences like first rickshaw ride of my life on my 20th birthday. Little did I know I would have hundreds more. Places like Bismillah Fried Chicken, Kamal Ataturk Avenue (this was a sign!) that brought comfort, laughter and adventures and others like the upper floor of BRAC and Dhaka slums that brought me a harsh dose of reality. The serenity of the chars and my very humbling realization that I’d never really experienced real darkness, in a world I saw from the dock of the EFH – no electricity, little connection with the outside world. I remember and miss the effervescent streets – the honks and bickering of the rickshawallas.

The walk to and from work every day and stopping by the mango stand at the corner to pick up breakfast. It only took me a couple of days to realize that I wanted to walk to work, despite parental concerns. It was a very explicit decision not to experience or see Bangladesh from car windows. Worth it 100%, no matter how many stares I got. The monsoon rains and the consequent reaction of the Earth, as if everything had taken a collective sigh of relief. Debates with European businessmen during my few excursions to the foreign clubs of Dhaka – little, protected worlds where many fall numb to the inequities that surround them – about development in Bangladesh. Rocking back and forth for hours on end in boats in transit to chars, or in the buses that introduced me to rural Bangladesh. My patience is one thousand times stronger as a result of these journeys.

A dear Bhai from work telling me stories about the Dhaka of his childhood. A dear grandmother of a colleague who took my hands and kissed them after I kissed her in traditional custom for Ramadan, and the way my eyes welled up in tears because my grandfather used to kiss my hands, too. We are all more alike than we think. Hearing the drums pound during Eid from a rooftop in Dhaka, with the sun setting after a heavy rain. The way everyone, everyone, seemed to smile with their eyes.

When I was in Bangladesh, people asked me all the time why I came. I was never quite sure how to answer. The realities of the health infrastructure in Bangladesh and the obvious societal inequities taught me more about the importance of developing social responses to health issues than I could have ever imagined. It is certain that this realization has now permanently shaped the rest of my career.

Bangladesh was a time for me to truly exercise my love for humans, discovery, and ethnography; it was a time of constant motion, seeing, and doing. It was, and still is, substance and meaning for me as I envision and chart a course for myself in public health.

In his early experiences in Haiti, Paul Farmer was confronted with the ethical question of leaving a place behind, after having seen its problems and met its people. Such awareness inspired him to dedicate his life as well as his passion for public health and anthropology to addressing the roots of the problems he experienced. On a related note, a dear friend, one of my favorite writers, also pondered this question of observation versus “full” participation in a travel blog years ago, asking: “what does one do with a passion, a powerful and motivating interest, in another society? To do nothing but observe it feels futile. Where is the middle way?”

After all, this is the question of the traveler, one who is lucky and unlucky all at once to have had nomadic experiences that have awakened him or her to the implications that there is a world beyond ours – one which, no matter how hard we try, we cannot fully know. And yet, this same world is just as easily impacted, affected and often infected by our actions, even from thousands of miles away.

For me, the opposite is also true – my memories from Bangladesh, fleeting in nature, still very much influence me. And though my personal philosophy around travel binds me to the humble realization that I still have so much to learn and perhaps more importantly, that I will never fully know, my experiences in Bangladesh are anchored deeply into my personal history. These anchors have since created a new depth in my life and career, one that I hope will enlighten and inform my passions and interests moving forward, no matter where I am.

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On brain drain and innovation

Several weeks ago, a colleague and I were sharing a rickshaw ride home. We conversed on the complexities of development in Bangladesh, of Friendship and of what we had seen and experienced since our arrival. Following the flow of the conversation, I asked: “Well, what is next for Bangladesh? What are their choices, what should they do?”

We started talking about how the Bangladeshi government might plan to shape policy around benefiting and preparing for out-migration. We agreed that this idea is realistic only to a certain degree, but also reflected on how out-migration is almost always associated with brain drain (assuming that those who are higher on the socioeconomic spectrum are usually the ones who have the opportunities to move and live abroad). This association is often one of the first points raised in migration debates, and one that is not really backed by any micro-evidence of what it is these migrants might actually be doing. As in, to what extent does “brain circulation” actually happen, if at all? At what levels do remittances occur? Are migrants actively engaged in knowledge transfer about study and work opportunities abroad?

Perhaps the most interesting part of this is that those countries which keep their best and brightest inside their borders do not necessarily show impressive rates of growth and innovation (North Korea, for example).

Which brings me to my next point – my colleague said that she believes the reason that Bangladesh is and will remain resource-poor is because “there is no innovation here.” My initial visceral reaction to this was pretty intense, to say the least, but I wanted to write just so I could organize my thoughts on why I disagree with this statement.

i) We need to stop defining innovation from our Western point of view. Bangladesh is its own country (and one that is just 40 years old) and will undoubtedly create and shape its own story. We cannot expect our own European and American models for growth to apply to all other countries.

ii) Bangladesh is often referred to as the Silicon Valley of Social Innovation. Think about it – revolutionary organizations like BRAC and Grameen Bank came into the world from this country. The loudest critiques of Grameen’s micro-finance techniques, and thus strongest alternatives, also come from this country. Again leads me to beg the question, by whose terms are we defining innovation? From a public health standpoint, Bangladesh has achieved in just 20 years with its population growth rate what the US and Europe barely achieved in 200 years. This is a result of health marketing campaigns, BCC, IEC, which all requires a certain amount of innovation.

iii) If anything, Bangladesh just doesn’t have the infrastructure necessary to support the mass scale-up of innovations we might envision happening elsewhere. There’s a certain amount of time and energy lost in cultivating the innovation that’s already there, because the fundamentals of statistics, monitoring and reporting are missing. This doesn’t mean say anything about the Bangladeshi people’s ability to innovate, just that the country is in the middle of the taxing and continuous process of building a system to make innovations operational.

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Allies on the Field

*July 5, 2011

I talk a lot about geographical barriers in the chars. My trip today to the Gaibandha field office is a perfect case in point of how arduous it can be to travel from Point A to Point B. Sareeta Apa and I left EFH early in the morning for a half-hour boat ride to the mainland. From there, another 20 minutes with a motorized rickshaw took us to the stop where we got on absolutely the most full public bus (a fun and funny experience all at the same time). We spent about an hour on the bus, and afterwards, took a motorcycle to the Gaibandha Field Office. Friendship was recently voted as the best-performing NGO in Gaibandha for 2011 (more information here).

We followed the same structure of the health meeting we had in Chilmari, with the main purpose of trying to identify the strengths and gaps in our current monitoring and supervision tools. Three paramedics, a health manager and the district supervisor attended the meeting – an impressive showing considering that today was the first day of a 48-hour hartal or national strike in Bangladesh. The strike is a result of recent political developments, namely a recent constitutional amendment which scrapped the provision for a pre-election caretaker government, making it so that elections will be held under an interim party government from now on.

Some of the best parts of these conversations is not only that we get valuable feedback from the level of the organization that deals directly with the community beneficiaries, but we also establish partnerships with the true program implementers. The significance of this cannot be understated. We leave these conversations with an overwhelming consensus that program monitoring and evaluation will help Friendship identify the problems in its programs and find ways to rectify them. The Friendship field staff are the most valuable allies we can have.

In addition to visiting the Gaibandha office, we also visited two NGOs to gain information about some of their own monitoring and progress-tracking tools. Namely, we visited GUK, which works in five districts in the North to strengthen coping capacity as climate change occurs. I was also impressed with the work of Akota, an NGO operating in Gaibandha that aims to establish sustainable livelihood with various interventions ranging from gender, justice and human rights to health, sanitation and environment.

Because of these various encounters and exchanges, I think a lot about the words that comprise my generally accepted epistome of development. It’s a constant tug-of-war in my head as I aim to answer my own questions of the macro vs. micro, quality vs. quality, collective vs. personal, what is actually possible with NGOs and what is not. I came to Bangladesh to seek clarity in some of these questions, but the obstacle of reconciling all of the parts of my experience will prove to be harder than I thought. One thing is for sure – for years, Friendship has prioritized the quantity over the quality to follow its philosophy of ensuring health access for all. My internship project is part of a strategic move on part of Friendship to review and fortify, to ensure quality access. This a daunting task given Friendship’s many arms and mere coverage, one that is made more onerous by some of the same barriers our beneficiaries face – geographic, economic, and even social obstacles that separate the Head Office from the field work.

On a simpler note, as we were leaving the mainland, we spotted a huge gathering of folks, singing in a narrow path next to a house. It’s impossible to observe anything here without attracting attention, so Sareeta Apa and I were ushered to the front to see a tradition that is a part of a Hindu wedding. It’s sights like this that make me feel like one of the luckiest people on Earth.

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