Resources & Articles

Dhaka Faced with Problems of Growth

The Guardian article features the overpopulation problem in Dhaka.

The Guardian article features the overpopulation problem in Dhaka.

In a special series on overstretched cities running in ‘The Guardian’, an article looks at the rapid urbanization and growth of Dhaka, Bangladesh.  Due to this growth, problems such as insufficient monsoon rain drainage in the sewer infrastructure have emerged, partially due to the administrative problems of Dhaka.  Beyond the difficulties faced by the sanitation workers lies the problem of a country of 160 million with no effective political decentralization of authority to regions and urban government.

According to UN Habitat, Dhaka is the world’s most crowded city and the fastest growing in terms of population.  This overpopulation means that Dhaka has grown faster than infrastructure development and that the management of the city is lagging.  In Dhaka, governance of the city systems are the responsibility of, “a chaotic mix of competing bodies”, which leads to a lack of coordination and many hands passing the blame.

The city sewer cleaners, dubbed as having the ‘worst job in the world’ by international media, face stigma and dangerous work conditions.  Many in the profession are Hindu dalits, significant because the majority of Bangladeshis are Muslim, and Hindus were singled out for persecution during Bangladesh’s war for independence from Pakistan.  Furthermore, dalits belong to the lowest caste level, known as ‘untouchables’, and often are given low-paying, lowly jobs in society.

Despite these serious issues of urbanization, there is hope: Bangladesh has won praise for it’s progressive responses in other arenas, such as climate-change, and experts deem that social movements borne from the confines of urban spaces can have the power to change and discipline governments.  According to Population Sciences Professor Nurun Nabi, “Many stories will be written by the people of this nation – forget about the political parties.  Someday they will wake up and be forced to comply with their speech.”

For more information and a fascination depiction of the strain experienced by this megacity, please click here.

 

A ‘Do-It-Yourself’ Approach Published by IUBAT Advisor

CvAlex Berland, Advisor on Health Sciences at IUBAT for the BScN program, has recently published an article about the Bangladesh Health Project entitled, A ‘Do-It-Yourself’ Approach to International Nursing Education.  Featured in the October 2017 edition of the American Journal of Nursing, this article provides a practical framework for social entrepreneurs who wish to develop similar volunteer projects.  His advice is especially pragmatic, relevant and drawn from extensive experience, and amongst his suggestions: conduct research prior to committing to an endeavour and be aware of the possibility of relying heavily on your own resources.  With some hope, the Bangladesh Health Project may inspire similar initiatives elsewhere!

To purchase and read the article, please click here for the online article.

Bangladesh’s Progress Highlighted in Medical Publication

The BMJ, an international medical journal, recently published an article entitled, “Why has Bangladesh done so well?”  In the article, Richard Smith, the chair of the Board of Trustees of icddr,b (formerly known as the International Centre for Diarrhoeal Disease Research in Bangladesh) discusses the elements that may have helped improve the standard of living in Bangladesh.

Bangladesh has had a tumultous past, rife with episodes of civil unrest, war and famine, with each event resulting high mortality rates.  However, it has now become one of the few low income countries to achieve the Millenium Development Goals: life expectancy has increased from 50 to 70+, child deaths under 5 years have dropped from 25% to 4%, and maternal mortality has fallen from 700 per 100 000 to 150.  Almost all children go to school, and the literacy rate of ~67% is equal among both males and females.

The author discusses several relevant cases of health improvements in Bangladesh, exploring why the country has made such major strides in its development. For instance, Richard Smith explains the role of factors such as education, research, cultural sensitivity, social science and female empowerment in the usage of oral rehydration treatment (ORT) to treat roughly 80% of cases of childhood diarrhoea, the highest rate in the world.  Lessons such as these has helped Bangladesh work towards becoming a middle-income country within a decade.  Despite all of the progress, there are still obstacles that Bangladesh has yet to overcome; amongst the issues are a moderately high maternal mortality rate, security, child marriage and loss of land due to climate change.

For more details and an in-depth analysis, please read the blog post on BMJ.com.

 

Project Lauded for Innovative Instruction

Since it’s inception, the Bangladesh Health Project has relied on the generosity of overseas volunteer faculty who have taught students, developed courses and mentored local faculty.  Many of the volunteers originally visited IUBAT as nursing students themselves, through the arrangements that their own school had with the Project.  Some students came solo, others in groups with an instructor.

One such academic partnership was with the University of Vermont (UVM) through Professor Rycki Maltby. The relationship between the two institutions was featured in the book, Innovative Teaching Strategies in Nursing and Related Health Professions by authors Martha Bradshaw and Arlene Lowenstein. The immersion course, offered to senior nursing students, was highlighted as a unique learning experience and noteworthy for instructors as a teaching example. IUBAT and the Bangladesh Health Project welcome future partnerships with academic institutions and any students that may have an interest in getting involved.

The Bangladesh Health Project has accommodated many volunteers in our guest house.  We are grateful for volunteer faculty, as we could not have succeeded without their assistance in building the scholastic foundation of the Project.  For pictures of the guest house, please check out our Flickr page and to read about volunteer opportunities, please visit our website.

Bangladesh Health Project Plans for 2017

As the Bangladesh Health Project (BHP) progresses, we focus on new priorities and needs. With IUBAT alumni now taking more senior roles as nurse educators and managers, our volunteers offer more mentoring and coaching and less student teaching. Looking ahead, these are our objectives:

  1. Provide mentoring support for faculty of IUBAT College of Nursing

BHP has completed mentorship and training of several cohorts of BSN students.  Our next goal is to strengthen nursing faculty capacity.  Through phone contact, e-mail and visiting faculty volunteers, we will assist with program development, classroom teaching, clinical supervision and student evaluation. As feasible, we will continue to supply textbooks and teaching materials. We will provide demonstration lectures for IUBAT nursing students and for staff at our teaching hospital sites.

  1. Support IUBAT graduates in their professional development

In recent years, we have supported IUBAT alumni working in hospitals, colleges and NGOs with mentorship for issues related to advanced education, nursing administration and access to technical information. We will continue supporting our graduates as they advance in their careers and undertake leadership roles.

  1. Develop resources to promote nurse education in Bangladesh

We will continue to offer textbooks to local nursing colleges, ideally establishing a central library for advanced materials, to be used by faculty and senior hospital staff. We will continue developing our Open Education Resource, an open-source collection of BSN curriculum materials for faculty to use in lesson preparation: www.OR4NED.com

  1. Build relationships with colleges and NGOs to improve health services in Bangladesh

We have good relationships with many health care organizations; some are practicum or internship sites for IUBAT, others offer good-quality education or health care services. Most are in Dhaka, while a few are in outlying areas. We will support these agencies as requested, with consultation and educational materials.

  1. Support research projects on quality of health education and health services

We will arrange student internships and projects to link local and global researchers. We have the potential to support some applied research projects on quality of health services, particularly for training and mentorship in research.

We continue to welcome volunteers, either working from home, or at our guest-house in Dhaka. Please contact us about current opportunities.

High Commissioner at International Nurses Day Celebration

In May of this year, Benoît-Pierre Laramée, High Commissioner of Canada to Bangladesh, visited IUBAT for an International Nurses Day celebration.  Mr. Laramée addressed the crowd and in his remarks he stated,

“We must recognize the utmost value of nurses. They are essential to quality healthcare and the closest professionals to the patients. Canada is providing 20 million dollars to improve nursing and other care in Bangladesh, and we are also proud to support institutional partnerships like the nursing training partnerships between Canadian universities and Bangladesh’s IUBAT. Nurses can lead the way in making Bangladesh healthier.”

In his presentation, the High Commissioner spoke of his own familial ties to the profession – his son is also studying to become a nurse, a fact that inspired many of the IUBAT Nursing students.

For pictures and comments, please visit the High Commission of Canada to Bangladesh’s Facebook page here.

 

Reflections on the State of Bangladeshi Health Care

In this New York Times article, the author quotes WHO (2010) in noting that 50,000 Bangladeshis travel to India for treatment each year.  This phenomenon of travelling to neighbouring countries to recieve healthcare is evident, as billboards that advertise hospitals in Singapore and Hong Kong are numerous in Bangladesh.  Bangladesh nationals justify the expense and trouble of travelling for care because of their mistrust of local hospitals.

Although there are many dedicated individuals working in difficult conditions, nurses are also mistrusted.  As a result of their low status and weak education, nurses’ scope of practice is very limited in Bangladesh – another reason patients get better care elsewhere.

However, there is positive change in the country.  Public health initiatives, many focused on marginalized populations like women, have been very successful in improving health outcomes in Bangladesh, and community-based forms of health care have increased access for much of the population.

IUBAT is also contributing towards better health care through the education of new nurses; IUBAT Nursing students practice in several private hospitals, not-for-profit and for-profit.  They also attend one government hospital, the National Institute for Mental Health.  Through a variety of health settings, the students are exposed to hospitals that have reasonable standards of care.  In post-practice seminars, the students have the chance to discuss any gaps in care that they have observed, and these points serve as learning opportunities and impetus for improvement.  Furthermore, visiting faculty volunteers offer training sessions for the nurses working in our teaching hospital sites.  Slowly, we see that care is improving; our mission is to speed that process for a wider population.

For the full New York Times commentary, please click here.

Furthering Nursing Education with Open Resources

After a decade working in Bangladesh, we have learned that the global shortage of nurses is made worse by an even greater shortage of capable nurse educators.  Therefore, we have just launched the website to access our Open Educational Resources [OER].  This new website will offer our BSN curriculum to support novice nurse educators in less developed countries.

We will post all of our English-medium resources: PowerPoint lectures, student and teacher references, exams and assignments, clinical checklists and policies. Under the Creative Commons license, the OER materials can be adapted and used freely by educational institutions offering nursing degrees, and by association, councils and other groups that provide continuing professional development for nurse educators. We have posted two sample courses and a Teachers’ Guide for beginning educators when using the OER at or4ned.com.

Future phases of the work will include enhancing the OER with multimedia resources, evaluating use of the OER in various settings, and developing a community of practice to update the OER.

We are writing to you now for two reasons:

  1. The OER materials need editing and cataloguing. We would like your advice about potential partners or funders for this task.
  2. Would you be willing to volunteer your time to review and improve the Teachers’ Guide?

The website provides more information, or you can contact us at info@or4ned.com.  We welcome your suggestions and advice.

New Publication from BHP Director

synergies
John Richards of Simon Fraser University is a founding director of the Bangladesh Health Project with strong ties to Bangladesh. He is also a Professor at Simon Fraser University’s School of Public Policy, and a Fellow of the C.D. Howe Institute. In a recent report for the Institute, John argues that Canada’s foreign aid could be more effective if there were strategies in place that addressed the problem of weak host-country governance. In “Diplomacy, Trade and Aid: Searching for Synergies”, John proposes a mix of corporate social responsibility for Canadian firms engaged in low-income countries, diplomatic involvement in aid projects, and aid projects designed to address problems of “weak” host-country governance.

To read the full report, please click here.

Images of Dhaka Captured in Photo Blog

The Guardian recently featured a Dhaka resident in their Blogger of the Week series, a retired government worker who shares photographs of his hometown in his blog, Dhaka Daily Photo.  Ershad Ahmed started his photo blog 8 years ago, and in the article, gives a local’s insight into the evolution of Dhaka and life in the bustling city.

The myriad of images showcases many features of Dhaka living, such as urban growth, marketplace settings and interestingly enough, rickshaw traffic congestion, a mode of transport that the blogger claims is the best way to travel in the city.

Through photos, Ahmed describes Dhaka as, “…uncontrolled and unplanned urban sprawl”, but is also eager to talk about his favourite spots in the city and his optimism for the city’s future.  His vibrant pictures and knowledge of Dhaka’s history illustrate his praise and his hopes for improvement for the nation’s capital.

For the article, please click here.

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