Category: Briefing Paper

    Yamuna Matheswaran                                                                               March 31, 2019/Analysis

Towards the end of 2010, I travelled to Bangladesh with the rest of my graduate school cohort to study various developmental approaches within the country’s healthcare, garment, banking, and agricultural sectors. It was an enlightening trip–one that allowed me to understand not only the intricacies of international development but to also gain a more nuanced perspective of the country as a whole.

 

“To understand Bangladesh, you have to understand the war.”

– Omar Rahman, Professor, Independent University, Bangladesh

 

Scores of Bangladeshis lost their lives in the struggle for independence in 1971 in what was then known as East Pakistan, and nearly 10 million crossed the border into India as the war waged on. They had no army, minimal weaponry and, realistically speaking, not much of a chance for survival against the genocidal tactics employed by the Pakistani Army–actions that its allies, the United States and China, refused to condemn. They fought back, however, and in doing so displayed the same extraordinary resilience that was demonstrated by its students during the Bengali Language Movement of 1952. On 16 December 1971, the new nation of Bangladesh was born.

Taking a bus ride through the cacophonic streets of Dhaka, thoughts raced through my mind: how simultaneously similar and different Bangladesh was from my own home country of India, how accommodating its people were, and how–despite growing up in congested Indian cities–Dhaka’s traffic was the craziest thing I’d ever seen. It still is. After all, Dhaka has a density of 47,400 people per sq. km, and around 37,000 cars are said to be added to its roads every year.

In 2017, Bangladesh’s population stood at approx. 164 million compared to 152 million in 2010. But the population growth rate has been in steady decline since 1986, and the implementation of various developmental approaches have contributed significantly to that decline. (Population Data from World Bank)

An Overview of the Facts

Bangladesh has its share of problems, and then some. For starters, there is the tangible dilemma of overpopulation. But unlike India, which is well on its way to becoming the most populated country on the planet, the total fertility rate in Bangladesh has been successfully lowered from nearly 7 births per woman in the late 60s to 2.104 in 2016. Even so, Dhaka remains one of the world’s most densely populated cities. And with increased longevity, concerns have arisen over the lack of facilities and infrastructure required to care for the country’s growing elderly population.

All around Dhaka, construction sites are aplenty, and dust from these sites worsens the already noxious city air. It’s no surprise then that Bangladesh experiences issues of environmental degradation, while also being susceptible to the devastating impacts of climate change. Scores of people, including millions whose livelihoods depend upon agriculture, have been affected by the frequent cyclones, floods and droughts.

The drainage systems aren’t too different from the ones in Indian cities, and heavy rains even for brief periods can disrupt normal life and cause flooding and waterlogging. Setbacks with the electricity supply, cases of arsenic poisoning in groundwater and ineffective methods of trash disposal are some of the issues that constitute the miscellany of Bangladesh’s woes. Political tensions, attacks on journalists and widespread problems of corruption hinder effective governance of the nation.

In spite of these modern-day problems, Bangladesh is on the right track to eliminating extreme poverty by 2030. According to data from the World Bank, the percentage of the population living in extreme poverty ($1.90, 2011 PPP) fell below 14% in recent years, compared to over 40% in 1991-92. And while it still ranks among the poorest highly populated countries in the world, the GDP growth rate of Bangladesh hit an astounding 7.86% in 2018.

In its less-than-fifty-years of existence, Bangladesh has pioneered breakthroughs in the fields of public health and microfinance, passed noteworthy drug policies, significantly improved aspects of agricultural production, and achieved unprecedented growth in its GDP largely attributed to the development of its garment industry. Notably, it has attained these goals by incorporating its women into the national economy by means of several women-centric initiatives. Institutions such as icddr,b, BRAC, and Proshika are models of the kind of development that is directed by the locals and is, hence, ultimately more sustainable.

The Microfinance Revolution

After Mohammad Yunus founded Grameen Bank in 1982, microfinance became a phenomenon in the developing world, providing small loans free of collateral, lifting thousands of people out of poverty and making businesspersons out of the extremely poor.

Over the years, however, the field has been tainted by reports of corruption and mismanagement. Criticism has focused on the fact that loans are frequently issued to the poor with the sole purpose of reaping profits, thus overlooking the necessary supplementary steps. Does the borrower have a plan for increasing income generation with the help of the loan? Do they have the necessary qualities/resources for said business plan? Is the money in actuality utilised in income generating projects or elsewhere? Often borrowers, who are ill-educated about the various facets of microcredit loans, make use of the newly acquired capital to purchase goods, pay school fees, etc. With no increment in revenues, they inevitably enter into a vicious cycle of debt, and are forced to undertake another loan in order to repay the previous one. MFI collection agents and their coercion tactics have also been listed as a reason for an increase in suicides among borrowers.

In contrast, Gonoshasthaya Kendra’s seasonal loans, which require the borrowers to start making repayments after the harvest, seem more logical. Nonetheless, researchers have pointed out that although microfinance might not have a transformative effect on the lives of people, it does have a positive impact. For one, increasing reliability of and access to credit leads to an increased sense of agency and freedom in one’s life.

Pioneering Healthcare Initiatives

From facilitating the local manufacture of drugs to offering affordable health insurance to poorer sections of society, Bangladesh has made extraordinary advancements in the public health sector.

Set up in 1972, Gonoshasthaya Kendra (GK) was the first health centre in newly independent Bangladesh. It was established by Dr Zafrullah Chowdhury with the aim of making basic healthcare accessible to the rural population. Dr Chowdhury was also instrumental in the conceptualisation of the breakthrough National Drug Policy of 1982, which ensured the safety, availability and affordability of essential drugs. GK’s services have since expanded beyond affordable primary healthcare to include work education, nutrition, agricultural cooperatives, disaster management, rehabilitation and women’s empowerment. Hygiene and sanitation in many of GK’s wards has been a persistent issue however, and poses high threats of nosocomial infections.

The International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) originated in 1960 as the Cholera Research Laboratory in the sub-district of Matlab and was officially named icddr,b in 1978. Primarily a research institute, it has been credited with playing a key role in the discovery of oral rehydration therapy (ORS) to combat cholera and diarrhoea, the latter being a leading cause of infant mortality. The institute also focuses on neonatal care, treatments for tuberculosis, malaria and HIV/AIDS, and carries out meticulous demographic surveillance. At the time working on rotavirus vaccine trials, icddr,b’s clinical studies have since contributed to the development of affordable rotavirus vaccines. The institute relies on the funding it receives from several donors, since government expenditure on healthcare (as percentage of total GDP and budget) has reduced to a point where it is the lowest among 21 Asian countries, according to a 2018 United Nations survey.

Cleanliness and technological resources of icddr,b’s hospital in Dhaka appeared to be far better than that of the GK hospital in Savar. However, doctors at icddr,b were quick to commend GK on its effective performance. It’s a matter of concern for GK, though, that a number of its students that graduate from its university, Gono Bishwabidyalay, choose to work for other institutions/hospitals, either for economic reasons or to pursue further specialization or be able to contribute to the research arena, leading to a shortage of doctors.

The Façade of the Fashion Industry

Bangladesh is the world’s second largest exporter of readymade apparel, second only to China. Garments constitute 80% of the nation’s earnings from exports, and in 2015, Bangladesh exported clothing worth over $26 billion, mainly to Europe and the United States.

The garment industry has revolutionised Bangladesh’s economy and significantly impacted its society. A large majority of its workers are female; increased economic freedom has led to women bearing fewer children, thus contributing to declining fertility rates and tackling the dilemma of overpopulation. From the looks of it, it seemed like a win-win situation: the garment industry employed numerous people in developing countries, increased foreign investment and was responsible for an increase in the annual GDP growth rate. International brands now paid a fraction of the production costs that they used to, while oblivious buyers continued shopping at Zara, Forever 21, Russell Europe and Walmart, unaware that they were paying starkly different prices for clothes that had all been manufactured under the roof of the same factory.

But the entire world got a reality check with the tragic Rana Plaza building collapse in 2013, which claimed 1,134 lives and was termed a “mass industrial homicide”. But long before that horrifying incident, workers had already been calling for liveable wages and safer work environments, and other deadly incidents had led to periodic loss of lives.

On 12 December 2010, on our way to the airport, we drove past one of Bangladesh’s export processing zones and caught a glimpse of what appeared to be a peaceful protest against delays in the implementation of a wage hike. We later came to learn that the protest had turned violent, claiming at least three lives and leaving dozens of people injured.

The factory we visited at the time, Knit Asia Ltd., boasted good working conditions and facilities including a free childcare centre and regular fire drills. It was one of Bangladesh’s leading garment manufacturers, and also owned the largest biological effluent treatment plant in the country.  However, that is more the exception than the norm.

In 2010, Bangladesh’s garment workers received the lowest wages in the world – as little as $45 per month. That amounted to a measly $0.25 an hour, when compared to the hourly wages of $0.48 and $0.57 earned by workers in China and India at the time, respectively. From what I garnered, it cost Russell Europe $3 to manufacture a polo shirt in 2010, which was then sold for approximately $7.

The profit made from the sale of a single piece of the polo shirt exceeded the factory worker’s daily wage.

In 2019, minimum wage for garment workers in Bangladesh is approximately $95 (or 8,000Tk) a month. It was not enough to make a decent living then, and it still isn’t today, and workers are still fighting to be paid a living wage. Since consumer demand dictates how the garment industry functions, we as buyers have a responsibility to utilise this power to generate awareness and take a stand against inhumane practices by choosing ethical brands over fast fashion.

The Role of Women in Development

“Bangladesh shows what happens if you take women seriously as agents of development. It not only halved the rate of fertility within a generation, but also increased women’s influence within their own households. For the first time, wives controlled the size of families.” – Out of the Basket, The Economist (3 Nov 2012)

The role of women in mainstream Bangladeshi society is a contradiction of sorts. Women are the principal participants in the microfinance sector, a majority of the paramedics that work in villages are female, and they constitute 80% of the workers in garment factories. Nearly every institution that we came into contact with – BRAC, GK, icddr,b, Proshika – had a project that focussed on empowering rural women. However, like in other countries rooted in patriarchy, sexual harassment is rampant, female enrolment rate in universities is low, and women do not enjoy the same freedom and social stature as men.

Regardless, the empowerment of women is crucial to development. It has been demonstrated that women are more likely than men to spend their incomes/loans on the welfare of the entire family as opposed to squandering it on nonessential goods. Increasing women’s access to education and economic security also results in reduced birth rates, which ultimately alleviates myriad issues associated with overpopulation.

To Harbour a Dream

Upon the conclusion of our study tour, what stood out to me most was the hospitality of the people who went out of their way to ensure that we were comfortable and well-fed at all times, with plenty of tea and biscuits between meals. To this day, I remember my experience of travelling around Bangladesh fondly. The lessons that it has taught me in the field of development – about what works as well as what doesn’t – remain invaluable. Considering the number of NGOs that are at work in Bangladesh – reportedly over 2,500 – I wonder if collaboration might render them more effective.

Nevertheless, this land that has been twice occupied and weathered innumerable floods and famines is a prime example of what locally pioneered methods of just and sustainable development can achieve.

Working with iDE during the last few days of our tour provided the most tangible example of how something as simple and affordable as a treadle pump can truly empower families. How I’d love to hear that the bottle gourd-growing couple eventually realized their dream of travelling abroad! But the essential part is the fact that one is prepared to harbour a dream.

Yamuna Matheswaran is a freelance writer, artist, and technical editor at TPF. She has a Master’s degree in International Studies from the University of Denver and is currently based in New Delhi.