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Water-Based Health Care Delivery in Bangladesh
Presenter: Ms. Rupa Patel, Volunteer, Friendship Health Care

Bangladesh is located in the Ganges Delta of the Indian subcontinent where the population is subject to continuous flooding and cyclones. Friendship, a non-profit, non-governmental organization, has overcome geographic barriers to provide a consistent health care delivery system for the poor of north and south Bangladesh using boats. The organization consists of 2 floating hospitals, water ambulances for emergency relief, satellite clinics, and a community medic program. Over a hundred satellite clinics operate each month, where staff paramedics travel to isolated communities situated on riverbanks or river “char islands” (sand islands created by floods) to provide health services and hygiene/nutrition education to men, women, and children. Services include antenatal examinations, child immunization, family planning and medication distribution. The hospitals provide urgent care, eye and dental evaluations, surgeries, and laboratory and radiographic testing. This model, which aims to provide health care access to the poorest of the poor (income<$14/month), charges 2 taka ($0.03) per person which includes one week of medicines, examination by a paramedic or doctor, and all necessary diagnostic tests. Friendship provided care for over 300,000 people in 2008 in 8 districts at an annual budget of $363,192 from donors such as Emirates and Lifebuoy. Sustainability is achieved through “training up” selected locals to paramedics and community medics; uniquely, this community medic model is integrated with an income generation program to ensure broader geographic coverage of health care. This model displays replicability with a land-based health care model implemented in Azad Jammu and Kashmir.

Contact: rappupatel@hotmail.com

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