Friendship works in the chars of Bangladesh, areas that lack any significant physical infrastructure. To support the isolated population that inhabits these areas, Friendship delivers health care from a floating hospital ship and provides complimentary educational and financial programs.
Focus: Health, education, income generation
Geographic Area of Impact: Bangladesh
Model: Leveraged Not-for-Profit
Annual Budget: US$ 2.3 million (2011)
Number of Direct Beneficiaries: 1,500,000 (2011)
Recognition: Social Entrepreneur of the Year 2012
In the Bangladesh chars, areas of silt within rivers, millions of people live without electricity and only minimal access to communication and transportation networks. Without adequate infrastructure, char dwellers are plagued by poor health, limited income opportunities and a low standard of living. Communities, and especially women and children, suffer from the lack of access to health care and other basic services. Due to the unpredictable geographical and socio economic factors, it is a struggle for the government or NGOs to provide services in the region. Outbreaks of communicable diseases are very common in the chars of Bangladesh due to the high population density, a continuous influx of new infectious agents, in-migration of newly susceptible people and low levels of immunization coverage. Literacy rates and opportunities for income are alarmingly low and impair the lives of many. Annual flooding and repeated migrations due to the ever changing geography of the chars traps people in a stagnant economy and allows little chance of breaking out of this cycle.
Innovation and Activities
In order to reach the most isolated populations, Friendship’s first intervention in the chars was to provide health care from a floating hospital ship. There are currently two hospital ships, as well a network of Satellite Clinics and Friendship Community Medics. The hospital ships are fully mobile and relocate every few months to serve a different char. They are staffed by local professionals, but through Friendship’s international partnerships, teams of foreign doctors visit the ships throughout the year to provide additional medical support and expertise. The Satellite Clinics are small boats that carry a team of one paramedic, one health educator and a medical assistant or nurse (all routinely supervised by a medical doctor) to remote islets. The Satellite Clinics provide a range of services including immunizations, family planning, nutrition, health education weekly visits in a designated area in most of the chars. These weekly clinics are communicated to villages in advance by Friendship Community Medics.
Friendship introduced Friendship Community Medics (FCM) in 2006. As static clinics and continuous deliverance of care was not possible on the chars, this revolutionary tier in health delivery promised the care the char populace required. FCM’s are trained female community members, introduced with the purpose of creating a ‘self-sustaining, primary health service’ mechanism in the char areas to address maternal and child health, nutrition and family planning issues. Friendship has established 200 satellite clinics that provide health services and work in coordination with 300 Friendship Community Medics.
Recognizing the vast needs of the local people, Friendship expanded its services beyond healthcare in order to put in place systems for delivering education and financial services. Though its healthcare services remain central, Friendship now provides a broad range of services addressing education, sustainable economic development, and disaster management.
Runa Khan co-founded Friendship in 1998 to provide health care through a mobile floating hospital to the poorest of the poor of the chars of the River Brahmaputra. She graduated from Lady Brabourne College in Calcutta and later completed another Bachelor's degree from Eden College in Dhaka. Before moving into the NGO sector, Runa engaged into a variety of other activities, such as teaching, writing textbooks (for which she was awarded Ashoka Fellowship for innovative teaching methodology in 1994) and story books for children, setting up a fashion house, a security firm, and Contic, a tourism company which renovated old country boats. For her work on traditional boat building in Bangladesh she was awarded a Rolex Award in 2006.
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