Showing posts from category Bangladesh.
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Silent Suffering: Maternal Morbidities in Developing Countries
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Maternal morbidities – illnesses and injuries that do not kill but nevertheless seriously affect a woman’s health – are a critical, yet frequently neglected, dimension of safe motherhood. For every woman who dies, many more are affected acutely or chronically by morbidities, said Karen Hardee, president of Hardee Associates at the Global Health Initiative’s September 27 panel discussion, “Silent Suffering: Maternal Morbidities in Developing Countries.” Hardee was joined by Karen Beattie, project director for fistula care at EngenderHealth, and Marge Koblinsky, senior technical advisor at John Snow, Inc., for a discussion moderated by Ann Blanc, director of EngenderHealth’s Maternal Health Task Force.
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Perfect Storm? Population Pressures, Natural Resource Constraints, and Climate Change in Bangladesh
›Few nations are more at risk from climate change’s destructive effects than Bangladesh, a low-lying, lower-riparian, populous, impoverished, and natural disaster-prone nation. The UN Intergovernmental Panel on Climate Change estimates that by 2050, sea levels in Bangladesh will have risen by two to three feet, obliterating a fifth of the country’s landmass and displacing at least 20 million people. On September 19, the Wilson Center’s Asia Program, with assistance from ECSP and the Comparative Urban Studies Project, hosted a conference that examined Bangladesh’s imperiled environmental security.
Climate Change and PopulationThe first panel focused on manifestations, drivers, and risks. Ali Riaz addressed the threat of climate refugees. Environmental stress, he said, may produce two possible responses: fight (civil conflict or external aggression) or flight (migration). In Bangladesh, the latter is the more likely outcome. Coastal communities, overwhelmed by rising sea levels and flooding, could migrate to Bangladesh’s urban areas or into neighboring India. Both scenarios pose challenges for the state, which already struggles to provide services to its urban masses and has shaky relations with New Delhi.
Mohamed Khalequzzaman examined Bangladesh’s geological vulnerability in the context of climate change. In a deltaic nation like Bangladesh, he explained, sedimentation levels must keep up with rates of sea level rise to prevent the nation from drowning. However, sediment levels now fall below 5 millimeters (mm) per year – short of the 6.5 mm Khalequzzaman calculates are necessary to keep pace with projected sea level rises. He lamented the nation’s tendency to construct large dams and embankments in the Bengal Delta, which “isolate coastal ecosystems from natural sedimentation,” he said, and result in lower land elevations relative to rising sea levels.
Adnan Morshed declared that Bangladesh’s geographic center – not its southern, flood-prone coastal regions – constitutes the nation’s chief climate change threat. Here, Dhaka’s urbanization is “destroying” Bangladesh’s environment, he said. Impelled by immense population growth (2,200 people enter Dhaka each day) and the need for land, people are occupying “vital wetlands” and rivers on the city’s eastern and western peripheries. “Manhattan-style” urban grid patterns now dominate wetlands and several rivers have become converted into land. Exacerbating this urbanization-driven environmental stress are highly polluting wetlands-based brickfields (necessary to satisfy Dhaka’s construction needs) and city vehicular gas emissions.
Adaptation Responses
The second panel considered possible responses to Bangladesh’s environmental security challenges. Roger-Mark De Souza trumpeted the imperative of more gender-inclusive policies. Environmental insecurity affects women and girls disproportionately, he said. When Bangladesh is stricken by floods, females must work harder to secure drinking water and to tend to the ill; they must often take off from school; and they face a heightened risk of sexual exploitation – due, in great part, to the lack of separate facilities for women in cyclone shelters. He reported that such conditions have often led to early forced marriages after cyclones.
Shamarukh Mohiuddin discussed possible U.S. responses. On the whole, American funding for global climate change adaptation programs has lagged and initiatives that are funded often focus more on short-term mitigation (such as emissions reductions) rather than adaptation. She recommended that Washington’s Bangladesh-based adaptation efforts be better coordinated with those of other donors.
Mohiuddin also suggested that to convey a greater sense of urgency, Bangladesh’s climate change threats should be more explicitly linked to national security – and particularly to how America’s strategic ally, India, would be affected by climate refugees fleeing Bangladesh.Philip J. DeCosse highlighted Bangladeshi government success stories in the famed Sundarbans – one of the world’s largest mangrove forests. Officials have banned commercial harvesting in some areas of the forests and shut down a highly polluting paper mill. He also praised civil society and the media for bringing attention to the Sundarban’s environmental vulnerability. As a result of efforts such as these, the Sundarbans are “coming back,” he said, with mangrove species growing anew. Thanks to a range of actors – from the forestry department to civil society – these forests are also now being “governed more than managed,” said DeCosse.
The Sundarbans – click to view larger map.
DeCosse’s fellow panelists identified additional hopeful signs. Morshed shared a photograph of a green, pristine park in Dhaka. De Souza underscored how family planning programs have worked in Bangladesh in the past, with fertility rates declining considerably in recent years, and several speakers spotlighted efforts by civil society and the media to bring greater attention to Bangladesh’s environmental security imperatives.
Nonetheless, major challenges remain, and panelists offered a panoply of recommendations. Khalequzzaman called for a major geological study of soil loss and siltation. De Souza implored Bangladesh to ensure that women’s roles and family planning considerations are featured in climate change negotiations and adaptation policies. Morshed advocated for imposing urban growth boundaries and enhancing public transport in cities. And several speakers spoke of the need to pursue more effective natural-resource-sharing arrangements with India. Ultimately, in the words of De Souza, it may not be possible to eliminate Bangladesh’s “perfect storm” – but much can be done to calm it.
Event ResourcesMichael Kugelman is a program associate with the Wilson Center’s Asia Program.
Sources: UN.
Photo/Image Credit: “Precarious Living, Dhaka,” courtesy of flickr user Michael Foley Photography; “Impact of Sea Level Rise in Bangladesh,” courtesy of UNEP; and the Sundarbans courtesy of Google Maps. -
Sajeda Amin on Population Growth, Urbanization, and Gender Rights in Bangladesh
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“One of the reasons why population grows very rapidly in Bangladesh is women get married very early and have children very early,” the Population Council’s Sajeda Amin told ECSP in a recent interview. “So even though they are only having two children, they are having them at an average age of around 20. As demographers would say, women ‘replace’ themselves very rapidly.”
Largely through the promotion of contraceptive use, family planning programs implemented over the past 35 years by the Bangladeshi government and a variety of NGOs have helped lower the country’s total fertility rate to 2.7 from 6.5 in the mid-1970s. To build on this progress, the Population Council has joined a consortium of other organizations – including the Bangladesh Legal Aid and Services Trust, Marie Stopes International, and We Can End All Violence Against Women – to launch the Growing Up Safe and Healthy (SAFE) project in Amin’s native Dhaka and other Bangladeshi cities.
Currently nearing the completion of its first year, the four-year initiative has several aims, among them increasing access to reproductive healthcare services for adolescent girls and young women and bolstering social services to protect those populations from (and offer treatment for) gender-based violence. The project also looks to strengthen laws designed to reduce the prevalence of child marriage – a long-standing Bangladeshi institution that keeps population growth rates high while denying many young women the opportunity to pursue economic and educational advancement.
A Focus on Gender and Climate
Amin says the SAFE project boasts several qualities that collectively set the initiative apart from similar-minded programs in Bangladesh dealing with gender and poverty. These include a strong research component incorporating quantitative and qualitative analysis; the holistic nature of the program, which incorporates educational outreach, livelihood development, and legal empowerment; a commitment to working with both male and female populations; and an emphasis on interventions targeting young people, with the hope that such efforts will allow adolescents to make better-informed decisions about future relationships and reproductive health, thus reducing the likelihood of gender-based violence.
Finally, while many existing gender-based programs focus exclusively on rural communities, Amin points out that the SAFE project also stands apart because of its focus on the country’s rapidly expanding urban areas. To date, the initiative is focusing many of its early interventions in a Dhaka slum that has seen an influx of rural migrants in recent years due to climate-change impacts in the country’s low-lying coastal areas.
“A lot of the big problems in Bangladesh now are climate-driven in the sense of creating mass movements out of areas that are particularly vulnerable or have been hit by a major storm,” Amin said. “Usually these are people who, once they lose their homes and their livelihoods, will have no choice but to move to urban areas, and that’s a process that is kind of a big outstanding issue in Bangladesh now.”
By building programming around girls and young women in such communities, the SAFE project is looking to spark change from the bottom up, prioritizing the unmet health and social needs of some of Bangladesh’s most vulnerable populations.
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Sources: Global Post, Ministry of Health and Family Welfare (Bangladesh), Shaikh and Becker (1985). -
USAID: Maternal Deaths in Bangladesh Decline by 40 Percent in Less Than 10 Years
›The original version of this article, by the USAID Global Health Bureau, appeared on the USAID Impact blog.
Bangladesh is on track to meet the 2015 deadline for UN Millennium Development Goal 5 (50 percent reduction in maternal deaths). The Bangladesh Maternal Mortality and Health Service Survey, jointly funded by the Government of Bangladesh, USAID, Australian Aid (AusAID) and the United Nations Population Fund (UNFPA), found that maternal deaths in Bangladesh fell from 322 per 100,000 in 2001 to 194 in 2010, a 40 percent decline in 9 years.
The decline in direct obstetric deaths is most likely the consequence of better care seeking practices and improved access to and use of higher-level referral care. The decline in total fertility rate due to the successful family planning program has reduced exposure to high risk pregnancies and has thus prevented a large number of maternal deaths.
Continue reading on USAID’s Impact blog.
Sources: Directorate General of Health Services – Bangladesh, UN.
Photo Credit: Adapted from “Mother & Son,” courtesy of flickr user Anduze traveller.
