I recently spent some days in Bangladesh with Friendship and the excellent social enterprise’s executive director, Runa Khan. Friendship works with tens of thousands of the world’s most-vulnerable people who live in the northern Chars, remote and shifting sandbar islands that flood in winter and suffer drought in the summer.
Located about seven hours from Dhaka, these must be some of the most inhospitable habitats anywhere and consequently life expectancy for the forgotten people is only late 40s. In the rains, the islands shrink to slips of land with a few banana trees, with inhabitants and their livestock often forced to rooftops to survive the floods. In the heat of summer, the walks to the villages are often as long as three kilometers from the river through unforgiving sand.
An estimated 4 million nomadic people inhabit the 200 islands woven through the Brahmaputra river where land flattens toward the Bay of Bengal. The sand dwellers migrate from one island to another as much as 50 times in a lifetime, carrying with them their tin houses in the floods.
Climate change is clearly felt in Bangladesh’s distant northern and equally distant southern regions, where Friendship is almost alone among NGOs in working. Government reach here is also limited, Khan says. The people used to at least have certainty about the weather patterns but now the rains and droughts are harder to predict and more extreme, she says.
Friendship started its work more than ten years ago providing health care to the communities on a specially outfitted hospital barge, brought from France by Khan’s now husband, French sailor Yves Marre. Now two hospital ships and an ambulance boat ply the Brahmauptra spending a month or two in each location, offering primary care at about US 10 cents for men, 5-7 cents for women and children as well as affordable basic surgery to the region’s weather-beaten inhabitants.
From medical care, Friendship has extended into education, (both for children and adults), livelihood and vocational support, working closely with communities to help them meet all their needs. With a staff of around 350, a complex schedule of foreign doctors and other medical professionals who fly in for specialized care, Friendship works with an estimated 40-50,000 people previously served mostly by microfinance providers, who often prayed on the extreme poverty.
Khan points out that although microfinance can work for people with at least some education and means of support, it is often not appropriate for the poorest, who will use any available funds simply to buy food for their families. Many lenders, she says, show up on the islands with offers of cash, promising interest rates of only 10 percent annually. Without knowledge of basic arithmetic, the people take the money, spend it and then must meet the payments that often add up to rates closer to 50 percent, she says. And these are some of the better microcredit institutions. Money lenders charge as much as 120 percent.
“When we first start working with a char one of the first things we must do is unwind the microfinance loans,” Khan says. “People at that level of poverty need grants and other forms of support not loans.”
Khan says that the char people more than anything need, “hope for tomorrow” and Friendship offers education where there were no schools, healthcare where there were no doctors, livelihoods where people had none, community organization where people were disperse and disaster preparedness where there wasn’t any. A focus is on discussion, trading information, and building savings to prepare for years where the floods or droughts are life-threatening or force a relocation.
Friendship is also working to create a harmonious environment in the stark landscapes, building appropriate and local farming techniques for sand, bringing in solar where they can – with an emphasis on keeping people in their places of birth. Without Friendship, many people from these regions have swelled the slums of Dhaka in search of work.
Schools can be disassembled in three hours and moved to higher ground, girls are taught weaving and dying – skills that help them contribute to the family income and avoid an early marriage (12-14 was the norm before Friendship arrived). Community health workers are trained and sent to the villages, where they teach local people about nutrition, sanitation, about warning signs in a pregnancy and basic child health techniques. They also can dispense basic medicines.
“We listen to the communities, hear their needs and respond in ways that are appropriate,” says Khan of Friendship, which is surely one of the more innovative organizations I have seen.