Its time to stop blaming 2/3 of humans who are Asian for their consciously open minds and love of education. |
5.5 smart global village climate adaptation solutions exchanges between 100000s of people -
updating resilience response to Bangladesh's 6 most typical forms of natura disaster
1.3 deeper context data on dynamics of ultra poor
1.5 latest news from bkash- world's largest cashless bank (population served)
3.2 update on brac primary health care system
2.6 latest news from brac enterprises leading national value chian purposes
1972 being an engineer abed spent his life savings building homes for 100000 villagers 5.1 only to find village mothers first question - what education/livelihoods do we need to end starvation> - dozens of mothers/daughters died weekly in abed's meta vilage until he (and partners) designed microfranchise solutions starting with rice 2.1 and last mile health services oral rehydration 3.1 and doordash (300 homes weekly per micrfranchise) 3.2
updates student year 21-22 sept which nations in asia most desperately need food solutions during covid - eg phillippines community pantry
best news during UNGA 76 Browns Job/Law
PARTNERS IN AFFORDABLE HEALTH what i have learnt from 15 trips to bangladesh and more broadly from 50 to asia is sustainability will most likely depend on celebrating those who empower health networks around love not those who power over health with money -happy to zoom or debate cases on this any time rsvp chris.macrae@yahoo.co.uk
frugal is the terminology brac celebrates in innovating health and well being services in life critical ways but on minimal budgets- brac's doubling of network services every 2.5 years emerged as south/east partnering centre of gravity 10 years ahead of western bottom of pyramid studies -eg gary hamel , and 3.2 the building of the microfranchise of women health suppliers goes back to start of brac early 1970s
we find searches of brac delivery kits first produced 1998 offer a range of reports and academic inputs illustrating brac's longitudinal work and increasing centre of gravity for frugal partnerships
In the developing world, life often runs on jugaad solutions. According to the authors of Jugaad Innovation: Think Frugal, Be Flexible, Generate Breakthrough Growth, western businesses could learn a lot from the jugaad approach of innovation and radical affordability.
Development organizations, too, must create inexpensive and adaptable solutions to alleviate poverty. The BRAC birthing kit is one such example.
BRAC has grappled with the problem of high maternal and infant mortality in a country where the vast majority of women still give birth at home without a skilled attendant. Your response might be to build more or bigger hospitals; BRAC instead brought suitable alternatives to the women themselves, in the form of “birthing huts” in the slums of Dhaka and other Bangladeshi cities, as well as the BRAC birthing kits.
A BRAC birthing kit contains the necessary tools for a safe and sterile delivery: gauze, carbolic soap, a sterile plastic sheet to go over the mattress, a thread to tie the umbilical cord and a surgical blade to cut it. That’s it.
It might not be the most elegant solution, but it transforms any home into a safe and sterile place to have a baby. The cost to the consumer? A mere 40 cents.
By slimming the product down to the bare necessities, the birthing kit is simple to manufacture and distribute. At the Sanitary Napkin and Delivery Kits unit, a BRAC social enterprise, the kit costs 28 cents to make. It is then sold to BRAC’s Health Program for 32 cents, the same price at which it is sold to BRAC community health promoters, or shasthya shebikas in Bengali. These women are trained by BRAC and, as part of a range of products and services they provide, sell the kits for 40 cents to their community.
Since 1999, BRAC has manufactured more than 2.6 million of these.
Of course, it’s not enough to only have a birthing kit. A skilled attendant is still necessary to manage complications. You might think it’s time to send in the doctors, but BRAC learned that with a bit of training – and access to a network of qualified help should complications arise – women from the community can be trained to be skilled birth attendants.
BRAC has made headway in frugal innovation by providing products and services that are affordable, accessible, and – crucially – relevant to those being served. BRAC has already seen measurable results; meanwhile Bangladesh is well on its way to reducing maternal and child mortality by the 2015 deadline of the UN Millennium Development Goals.
upsated examples
The Manoshi Project at BRAC provides community-based maternal, neonatal and child health services for 6.9 million urban slum dwellers in 10 cities in Bangladesh. At the time of the project’s inception in 2007, this population had high maternal and neonatal mortality. The first brac maternal delivery kits started production in 1998 and became incorporated in the enterprise that also manufactures sanitary towels from 2007
2 hours in 3-part dvd series on fazle abed/brac published 2006 by jeff skoll with ashoka
the 2005 pbs television series rx for survival featured sit fazle abed and brac prominently - we have footnoted the group of 15 global health champions the way pbs profiled them
- brac became increasingly celebrated (by gates foundation, soros foundation, jim kim and paul farmers pih) for global health innovations through decade 2002-12 (more recent frugal summaries as brac host annual forums - youtube example)
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pbs global health champions 2005
During production for Rx for Survival, we encountered a great number of individuals making a tremendous difference on the front lines of global health. Some work in remote rural communities; others create national or international public health initiatives. The following profiles of these global health champions are but a small sample of the many fine people, past and present, who have made public health their life's work.
Founder and Chairperson
BRAC (Bangladesh Rural Advancement Committee)
As leader of one of the most effective non-governmental organizations in the world, Abed has fought against poverty, disease, child mortality, and illiteracy by educating and empowering the poor women of rural Bangladesh.
World Health Organization, African Program for Onchocerciasis Control
River blindness, a condition caused by worms that damage the eyes to the point of blindness, affects 12 African nations. With determination and diplomacy, Amazigo has implemented a low-cost, sustainable strategy to distribute a medicine that may eradicate this disease.
Co-Founders
Riders for Health
Their shared love of motorcycles inspired a marriage and the founding of an organization that provides African health care workers with motorcycles to transport patients and deliver medical supplies.
Chairman and Founding Partner, BroadReach
Former Operations Manager, Botswana's Treatment Program for HIV/AIDS
Darkoh is building a nationwide health system from the ground up in Botswana through a public-private collaboration between the government of the small African nation and foundations.
Founding Director
Partners in Health
He has been described as "a man who would cure the world." Trained as a medical anthropologist and physician, the Robin Hood of global health has begged, borrowed, and stolen AIDS drugs to treat the poor in Haiti.
Professor and Health Policy Fellow, Emory University
Former Head, CDC (Centers for Disease Control and Prevention)
In the 1970s he led the smallpox eradication campaign in India and later persuaded governments and drug companies to support polio eradication efforts. Today he is on the front lines of the battle to overcome the public's resistance to the use of vaccines.
Associate Executive Director
The Carter Center
For a long time, Hopkins was alone in his belief that Guinea worm disease could be eradicated. Through worldwide campaigns and community mobilization efforts, he now stands on the brink of its worldwide eradication.
Co-Founder, Partners in Health
Director of HIV/AIDS, World Health Organization
Supported in part by a MacArthur Foundation genius grant he received in 2003, Kim is on his way to achieving an ambitious goal: to get three million AIDS patients worldwide onto antiretroviral drugs by the end of 2005.
Volunteer
BRAC Community Health
A grassroots community health worker, Rohima never finished primary school, but today she monitors the health of 300 households in Bangladesh. She is among 33,000 women who have taken charge of their families' health and started microfinanced businesses.
This physician and nurse team treat 17,000 people in a refugee camp in western Chad. During their six-month mission they will deal with the threat of measles, poor sanitation, armed bandits, and Sudanese militias.
Director General
Mexican National Institutes of Health
Presented with a possible cholera epidemic, Sepulveda launched a massive clean-water program in Mexico, with an aggressive communications campaign to alert people to the ways the disease is transmitted.
Dean Emeritus and Professor
Johns Hopkins Bloomberg School of Public Health
Sommer discovered that children in Indonesia were dying of complications from nightblindness, a condition arising from vitamin A deficiency. His findings and identification of an inexpensive cure have dramatically reduced childhood mortality.
Founder and Board Chairman
The Population & Community Development Association
With humor and determination, Viravaidya has fought for family planning and safe sex in Thailand. Known as "the condom king," his effort to reduce the spread of HIV/AIDS in Thailand has been remarkably successful.
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ck prahalad's classic the fortune at the bottom of the pyramid -eradicating poverty through profits was published in 2005 but must have taken several years to assemble
-its major cases came from india peru brazil mexico venezuela
main health cases were india's aravind eye care and india's prosthetic jaipur footand india's annapurna salt which targets solutions to idd iodine deficiency disorder; india's hindustan lever targeting of soap markets towards mitigation of diarrheal diseases
peru voxiva tech for early detection of infectious diseases
1970-71 Abed's life—and the lives of millions of Bangladeshis—changed as the result of two very dramatic events: a deadly tropical cyclone, which swept across the country, washing away farms, villages, and towns in its path; followed by the nine-month war of independence from Pakistan. The combined death toll from the storm and the war was estimated at well over 3 million people. An additional 10 million were displaced and further impoverished
.Sir Fazle resigned from Shell Oil in 1971, and the next year formed the Bangladesh Rehabilitation Assistance Committee (BRAC’s original name) to address the terrible devastation suffered by the people of his country.
Following initial relief efforts 5.1 building metavillage for 100000 refugees, the organization soon became involved in more long-term community development, with primary objectives of alleviation of poverty and empowerment of the poor—and was renamed the Bangladesh Rural Advancement Committee.
With his strong focus on growing its operations across a broad spectrum of agricultural, economic, and social enterprises, Sir Fazle set BRAC on a course that was different from other non-governmental organizations. He had concluded that economic development was one of the keys to helping the rural poor—and thus launched a microfinance program to provide very small loans to women borrowers as part of village support groups that participated in skills and organizational training.
BRAC’s multi-dimensional and dynamic methods of fighting hunger and poverty include the creation and support of a range of integrated enterprises, such as: seed production and dissemination; feed mills, poultry and fish hatcheries; milk collection centers and milk processing factories; tea plantations; and packaging factories. The income generated from these social enterprises is used to subsidize primary schools and essential health care. Under Sir Fazle’s leadership of more than 40 years, BRAC’s agricultural and development innovations have improved food security for millions and contributed to a significant decline in poverty levels through direct impacts to farmers and small communities across the globe.
2.6 Profiling the fourteen
national agri-related markets abed chose ;
this supports appreciation of the particular nature of
agriculture and sustainability in Bangladesh – a nation still 70% rural with
very small farmholdings and built over 50 years by womens rural Keynesianism.
If you purpose is sustaining another rural developing nation – which agricultural
products are common, which unique selections for local human development?
Example – profiling agricultual value chains/channels Bangladesh most needed poorest entrepeneurs to lead
core documents : download 14 pages on why Brac received Gates Global Health Award 2004
FAZLE ABED WAS DESPERATELY DISAPPOINTED IN 1972- he had built 15000 village homes with his life savings and a matching grant from oxfam rated as best they'd seen when he observed 5 or more young women dying a week typically of famine and 10 or more infants dying from dehydration
so instead of building any more metavillages he searched for community solutions- where possible sustainable village business he could microfranchise to village mothers
fortunately rice practice alumni of borlaug explained how up to 5 times more local rice production making 2.1 rice business microfranchising an obvious business
3.2 para-health franchise Shasthya Shebika (in 2008 forbes reported 68000 brac para health workers reached 80 million villagers - in effect brac is the lowest cost wholesaler and through its Shebika retailer of the health products it offers)
abed was introduced to barefoot chinese doctors who in turn wanted to know about 3,1 oral rehydration- bangladesh didn't have china's history of medical studies so instead abed invented a doordash of non prescription medicines - the para-health franchise owner was assigned 30 village homes to visit weekly- the merchandise brac chose for her
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best abed health-alumni interventions since abed's death 20 dec 2019
g irene khan chair brac international UN Special Rapporteur for freedom of expression and opinion, bio
recalls sir fazle abed- what if every country in asia (or indeed everywhere) had enjoyed through the last half century an inspiring connector of women's productivity lifts up half the sky
"BRAC's approach has been to put power in the hands of the poor, especially poor women and girls," said Sir Fazle Hasan Abed.
We were sitting in his office on the 19th floor of the BRAC Headquarters in Dhaka. Abed Bhai was describing BRAC's pioneering work with women and girls. Although I had heard him recount these anecdotes many times and had also seen some of the programmes on the ground, it was always inspiring to listen to him.
As dusk fell over the slums and rooftops of Dhaka that evening, Abed Bhai turned from talking about what BRAC had achieved for women and girls in Bangladesh to what still remains to be done elsewhere, about where and how it must scale up, innovate, break barriers and set new records. His plans were as audacious as ever, his energy seemingly abundant. But we both knew time was running out for him and the baton must pass on to others. When we next met a few months later, it was to say goodbye as he lay in bed, his eyes closed. Weeks later, on December 20, 2019, Sir Fazle Hasan Abed passed away.
Of all the remarkable contributions for which Abed Bhai is remembered today, I believe none has been more ambitious in scale, nor more impactful in consequence, than his work to empower women and girls. His ground-breaking approaches to development turned perceived wisdom on its head and transformed the lives of millions of women and girls in Bangladesh and beyond.
Watching women toil in the villages and small towns of Bangladesh, he saw in their thrift, ingenuity and resilience the promising talent of would-be entrepreneurs. Women became the key resource as well as the subject of BRAC's poverty eradication strategies.
With astute business sense, Abed Bhai invested heavily in women and girls through education, health, legal services and microfinance programmes, income generation opportunities, community development and social mobilisation. BRAC's approach of working directly with communities to develop solutions and of testing, monitoring and modifying programmes constantly to make them more responsive gave new meaning to women's empowerment.
3.1 Women's agency was explicit in what is one of BRAC's—and Bangladesh's—great success stories: the Oral Rehydration Therapy (ORT) programme. Over a decade, starting from 1979, BRAC visited around 11.8 million homes, covering 98 percent of the total rural households, to teach at least one woman in each household to make oral rehydration therapy with a three-finger pinch of salt, a handful of gur (molasses) and half a litre of boiled water. With no particular skills needed, ingredients available in every home and a simple technique for measuring, mothers produced oral rehydration solutions to treat diarrhea and reduce infant mortality. Today, Bangladesh has one of the lowest death rates from diarrhea and one of the highest user rates for ORT in Asia.
In the early 1980s, BRAC created income generation opportunities for women in poultry rearing and trained women to vaccinate chickens for a fee. The government provided free vaccines but there was no cold chain to carry the vaccines from the office of the sub-district livestock officer to the villages. So, BRAC devised a simple system by which the vaccines were packed inside ripe bananas to preserve the temperature and provide protection against damage during transport.
These are just a few examples of Abed Bhai's down-to-earth approach to development and his relentless drive for scaling up. He was thrifty, creative and persevering, just like the poor women he admired so much. Today, frugal innovation on scale is a badge that BRAC wears with great pride.
With his characteristic audacity, Abed Bhai carried BRAC's development models to other geographies. From adolescent girls in BRAC's schools in Helmand, Afghanistan to the BRAC community health micro-entrepreneurs in small towns in Uganda, thousands of woman and girls broke barriers to take control of their own destiny.
1.3 One of BRAC's most transformative programmes is the Ultra Poor Graduation initiative, which focuses on the poorest and most marginalised families, usually women-headed households, who are unable to afford even one full meal a day, live on the fringes of society and are caught in the inter-generational trap of extreme poverty. For two years, the women are given an income generating "asset" (such as a cow or chickens), a stipend, healthcare, and education for their children, alongside training and counselling to build their financial capabilities, a sense of self-worth and become integrated into the community. Results show that over 95 percent of the almost 1.5 million women and their families benefitting from this programme have "graduated" out of ultra-poverty, and even more remarkably, have continued to improve their lives. Many have become successful microfinance savers and borrowers.
As always, Abed Bhai was keen to scale up and readily shared BRAC's experiences with others. Today, the Ultra Poor Graduation Initiative is being replicated in 45 countries with impressive results.
Abed Bhai knew that development cannot be sustained if it does not change the social and cultural norms that hold back the progress of women and girls, but to be successful, the change itself must take into account the cultural context of the community. So, to make girls' education culturally acceptable to tradition-bound families and communities in Afghanistan, BRAC trained thousands of female teachers and engaged hundreds of older women to chaperone the girls from home to school and back. In Bangladesh, where the social context is different, popular theatre and public campaigns are used to transmit messages on gender equality, women's groups are mobilised at the village level to advocate for social change and thousands of paralegals are trained to resolve family disputes in ways that respect women's human rights.
Whether in Afghanistan, Bangladesh or many other countries, the major barrier to women's empowerment and gender equality remains patriarchal values. "Patriarchy is an enemy to both men and women," Abed Bhai declared on International Women's Day in 2018, acknowledging that gender equality was his "unfinished agenda".
Ultimately, the poor woman's struggle is not only a struggle to increase material assets but a struggle for equality, justice and dignity. Much remains to be done to make the world a safer, more equal place for women and girls. The pandemic has made that task harder, and also more urgent and vital. But when I think back to that evening in Abed Bhai's office and how he not only made the impossible possible but also sustainable and scalable, I feel optimistic. The arc of development is long but it bends towards gender equality.
Irene Khan is an international thought leader and advocate on human rights, gender and social justice issues. She is a member of BRAC International governing body.
