Safety-nets, bed-nets fight malaria in Bangladesh

Mobile clinic
Three-year-old Hridoy, held by his father Joykumar Chakma are among more than a million residents of Bangladesh’s remote south-eastern hills who now have access to healthcare as a result of UNDP’s work in the area. Photo: Mahtab Haider / UNDP Bangladesh

Joykumar Chakma, 28, has never been treated by a doctor.

“My father was the village mendicant. If we got seriously ill, the family sacrificed a pig or a hen and he believed the illness would pass. This was the custom in my community,” said Joykumar. “So many children used to die of malaria in those days.”

Squatting in the queue at a weekly UNDP-funded clinic in one of the remotest parts of Bangladesh’s Chittagong Hill Tracts, Joykumar’s brow was etched with worry. He had walked four hours from his village, down ravines and across stream-beds, carrying his ailing three-year-old son Hridoy in his arms.

Highlights

  • Two-thirds of the CHT population have been served by the CHTDF via health, education, agriculture promotion, capacity development and income generation efforts.
  • 1.2 million patients ensured access to health services through 80 satellite clinics and 1,000 mobile health workers, treating nearly 40% of all malaria cases in the CHT.
  • 300 community-run schools built or renovated, hiring and training 700 teachers, and fostered local ownership of education with community-run School Management Committees.
  • 625,000 people deciding and directly benefited by small-scale development projects worth $17 million.

“Hridoy has had a fever for a week now, and I am scared he has malaria,’ Joykumar confided to the nurse who was examining the sleeping child. Father and son were taken into the doctor’s chambers for a blood test.

Outside a bevy of patients waited in the midday sun. Most had simple complaints that a dose of antibiotics could cure. Some had a fluctuating fever, a possible sign of malaria, some had respiratory infections, and some had angry skin rashes and infected wounds. In these parts, thousands die every year because a simple dose of antibiotics is not easily accessible.

“If my patients miss this Monday clinic, the nearest hospital is eight hours by boat, and the journey costs US$30: more than the monthly income of most families in this area,’ said Dr Jyotirmoy Murong, inspecting Hridoy’s blood sample under his microscope. 

Lagging behind

While much of Bangladesh continues to perform remarkably on the Millennium Development Goals scorecard, the three south-eastern hill districts pose a stark contrast. Ravaged by nearly three decades of ethnic conflict that ended with a historic peace accord in 1997, the hill communities are lagging well behind the national average on almost all counts of development.

According to the World Health Organisation, 80 per cent of Bangladesh’s Malaria cases occur in the three hill districts. And yet roughly half of the medical positions at scanty government healthcare facilities in these districts remain vacant due to a lack of skilled personnel.

UNDP’s Chittagong Hill Tracts Development Facility (CHTDF) started its health interventions in 2006 as part of a peace-building initiative. It has since rolled out 80 weekly satellite clinics like the one Joykumar sought out, and trained more than a thousand community health workers in this remote region.     

“Our vision with CHTDF has been to work with the government in providing basic services for underserved communities, while building local capacity who can take over the role in the long run,” says Robert Juhkam, Deputy Country Director, at UNDP in Bangladesh.

“More than a million people in these districts now have access to health services because of UNDP, and we are already seeing the results in the health indicators,” he adds.        

Since 2006, UNDP’s mobile health clinics and community health workers have treated more than 700,000 cases of Malaria, causing the annual death toll to drop to a tenth of what it used to be six years ago. 

“No one dies of malaria anymore, after we started using rapid detection field tests, advising everyone to use bed nets, and referring the serious cases to the hospitals,” says Kingsemme Rakhine, a community health service worker trained by UNDP.

For Joykumar it’s happy news. He emerged from the doctor’s chambers smiling, with Hridoy in his arms.

“He doesn’t have malaria. My father will be angry that I brought Hridoy to a doctor, but I just couldn’t take that risk with my child,” he said, as he started the trek back to his village.

“People cross ethnic lines to come to this clinic and receive treatment,” said Dr Jyotirmoy Murong. “With ethnic diversity among the medics and patients, we also go a long way in healing the unseen wounds of past conflicts.”

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