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Reaching out

Alex Haworth's CSR trip illuminated dire need in Bangladesh

Silhouetted figure reaching outIf you work in UK marketing, rural Bangladesh is far from a normal day at the office. But among the makeshift medical wards, searing heat and unforgiving humidity, I found myself volunteering to help those providing vaccines to the front line.

Visit Bangladesh from the UK and as a matter of course, prior to departure, you can get all the vital vaccines required to protect your health from some of the world's most devastating diseases — among them diphtheria, tetanus and polio. But for those who live among the raw beauty, squalor and deprivation of the Bangladeshi islands and capital city Dhaka, any hypothetical entitlement to healthcare in reality guarantees nothing.

While NGOs and pharmaceutical companies donate vaccines and medicines directly to such impoverished countries, sometimes just a small proportion reaches those in greatest need; usually because simple things are unavailable, such as reliable transport to the localities.

However, as part of its ongoing corporate social responsibility (CSR) programme, Crucell has recently formed a partnership with the NGO Friendship, pledging to support the development of a river-based health service delivery system, complete with floating hospitals, satellite clinics and community medics.

Crucell manufactures Quinvaxem — a childhood combination vaccine for diphtheria, tetanus, whooping cough, hepatitis B and haemophilus influenzae B — and is one of the major suppliers of vaccines to UNICEF and communities trampled by disease in the developing world. It is vital that vaccines reach the frontline but the reality is that only some get through because the infrastructure isn't always in place to get them to the local people — and to children in particular. As part of my trip, to see the extent of the problem, I visited the char (river island) vaccination clinics and a floating hospital — essentially a converted oil barge used to provide healthcare for some of Bangladesh's most marginalised people.

A water pump in Bangladesh
Child using a waterpump in Bangladesh

Floating hospital
Even watching the vaccinations being given is a little sad because it highlights not only how strong the need is for these products, but shows up the chronic shortage. Where Crucell and Friendship manage to deliver vaccines locally, just 50 per cent of children get access to them.

This is partly because it's so difficult to control the process. There is little in the way of stock control — the volunteers simply use what they've got and vaccinate the children until they run out. But this is why the work of Friendship is so vital.

In a place where sorting through rubbish is the only employment some Bangladeshi transients can find, an eight-strong international team from Crucell (with me as the UK affiliate) saw people arrive every day at the floating hospital for their treatments.

The floating hospital is impressive, with the attention to hygiene and infection control second to none. However, there is no capability for general anaesthesia and so patients can undergo surgery — even facial procedures, such as for cleft palates — with local anaesthesia only.

On 'ambulance boats', doctors visit the surrounding islands encouraging people to come to the hospital on a certain day and at a particular time. Many arrive supported by friends and family.

I would scream because there were cockroaches in my room, but these people would sleep on the ground near to the hospital in order to cook and care for their relatives as they recover.

Children in Bangladesh
Children in Bangladesh

Crucial outreach
At first the makeshift recovery wards are shocking, with patients lying on wooden benches under tarpaulin among the flies and cockroaches.

The heat is unbelievable. It is really quite shocking, but if these people didn't have their eyesight they wouldn't be able to work.

After starting the trip in Bangladeshi capital Dhaka, a gruelling journey to the river islands and isolated villages in the Northern part of the country unfolded. I saw first-hand the need to strengthen local communities as much through sustainable economic development as the improved provision of healthcare, a broader objective of NGO Friendship's work.

Every day, 10,000 people from the rural areas travel to Dhaka to seek work, but employment is limited and conditions can be horrific. One of the NGO's key objectives is to create the opportunities that allow people instead to work locally in their villages.

Using as a base a 'guest-boat' in Gaibandha, a province in Northern Bangladesh, I visited medical facilities and witnessed educational and development programmes. Although discussion with the locals was frequently via translators, the villagers were extremely welcoming.

Of course they are very keen to show you what they're doing, but they were so intrigued by me that people would try to touch my skin. When they found out that I was 28 but not married and without children, they were shocked. In their culture, that was very unusual. In Bangladesh, women can get married between the ages of 12 and 15, before having children from their mid-20s right through to nearly 60.

Fresh perspective
On returning to the UK, I felt proud to have seen how my employer's vaccines made a real difference to people who need and deserve these products.

It makes you feel incredibly lucky that in the UK there is the infrastructure to ensure we all get the vaccines we need for protection from such devastating infectious diseases, so that we can enjoy our complicated lives. In the Bangladeshi islands, life is simple. It's all about survival.

It was shocking, but was also the most amazing experience.

The honest truth is that I was frightened I would find it very upsetting. But, actually to see these people live a basic life, proud to farm the land and provide for their children, was inspiring as well as humbling.

Alex HowarthThe Author
Alex Haworth, marketing manager, Crucell UK recently took part in a corporate social responsibility trip to Bangladesh to witness first-hand the work of non-governmental organisation (NGO) Friendship. Founded in Bangladesh in 1998, Friendship identifies and reaches the poorest of the poor and the most marginalised communities. Alex took part in a vaccine delivery programme.

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13th December 2010


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