Barguna, on the coast of the Gulf of Bengal, is situated in one of the poorest regions of Bangladesh. At the mercy of typhoons, frequent flooding, it lacks a suitable healthcare structure, and its population faces endemic malnutrition. The women and children are, as always, the most vulnerable. Forty-three per cent of the children are under-weight, most of them since birth. The project run by Terre des hommes aims at preventing malnutrition in children in the area of Patharghata, basing its work on the triple approach of promoting proper infant and young child feeding practices, protecting access to safe water and garden vegetables during natural disasters, and setting up community clinics. Bangladesh is one of the countries in the world that is most susceptible to being hit by climatic change in the future. When combining this risk to the fact that its population will reach 220 million people in 2050, the fight against malnutrition there becomes more and more urgent.
When poverty and natural disasters go hand in hand
Besides the harsh climatic conditions and the poverty that prevails in this region, two other factors led Tdh to give priority to Barguna District. The first element comes from the fact that when times are economically difficult, families tend to save on food, whether in quantity or quality, in particular causing premature termination of breastfeeding, the premise of a vicious circle of malnutrition for the child. The second fundamental element to make the extent of the phenomenon clear is the absence of systems for specialized healthcare. There are few functioning maternity services in Patharghata. Furthermore, the unqualified staff at many private clinics endanger the life of the mother and her child.
Prevention is better than cure
The project that started in April 2012 and will continue until December 2014, is co-financed by Swiss Solidarity and implemented in direct collaboration with the local NGO “Multi-Task’. The project is comprised of three complementary components.
In the first place, prevention is angled not only towards the women, but just as much to the family in its entirety. Tdh wants the members of the community, once they are made aware of the situation, to share their experiences of motherhood. So as to fight against malnutrition from the very beginning, Tdh recommends instructing families on the risks taken if breastfeeding is stopped too early. It is a proven fact that exclusive breastfeeding for the first six months is the best way to ensure the child’s good health.
As regards the second component of the work, Tdh with the assistance of its partner, Greendots, helps mothers to build homestead vegetable gardens, that are specially designed to cope with the consequences of floods. The poorest families will thus have easy access to nutritional vegetables. Similarly, Tdh raises embankments to protect ponds—the only viable drinking water source for most of the year—from tidal surges and also reinforces the sand filters that purify the pond water. This second element emphasizes the importance of promoting alternative food resources in cases of natural disasters, as well as reducing the risk of environmental disease, which in particular supports the efforts of the mothers to keep their children healthy and well nourished.
And finally, Tdh stresses supporting the government healthcare systems in the region, most especially the clinics specializing in maternity care. In areas without access to government clinics, Tdh helps communities to establish maternal and child care clinics. These clinics operate on one or two days a week, and will eventually be run by local women trained as maternal practitioners who diagnose, treat and refer the most serious cases to the main hospitals of the region. If required, help with transport is available, and Tdh ensures follow-up during the entire treatment and afterwards as well.
Preventing malnutrition demands constant effort and the establishment of interdependent activities such as promotion of breastfeeding, safe water and hygiene; natural assets for homestead food production; and supporting clinics to ensure follow-up care of the mother and child. This holistic approach is based on nearly 40 years of Tdh’s work in Bangladesh in in the fields of healthcare and nutrition and shows that simple measures can prove extremely effective.
Towards collective awareness
Whilst Tdh continues its lobbying with local and government authorities, it entrusts local women to improve the everybody’s knowledge, as well as to run the established clinics. The project currently supports over 1’000 women and 3’000 young children. However, above and beyond the statistics, Tdh wants to help develop practical answers to the fight against malnutrition and also to implant a collective awareness of the validity of practices such as family planning, registration of births and a suitable diet for mothers and children.
After service in the British SAS Regiment the author became a physician and then an orthopaedic surgeon.
He has held professorial positions in Canada, Vietnam and the United States, practiced and taught orthopaedic surgery in three continents and in several wars.
He has extensive experience as an expert witness in court. Somewhere along the way, time was found to operate a four hundred acre mixed farm, a one hundred seat restaurant and to obtain a licence as a flying instructor.
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