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Monday, August 10, 2020

why health grows economies for all but the very richest

all but the very richest can learn from the very poorest- not just ethically but you can define society's most life critical systems such as health and education as ones where the slightly richer often seek to be served separately from the poorest- over time this causes underclasses in a nation- this is where sustainability starts to collapse a nations or the whole of mother earth when globalisation when we are connected  - if you dare explore this viewpoint consider this testimony on why and what health services poorest village women needed to build south asian continent - a region that had become most deeply poverty trap through british emoire colonisation

extract from 1 of 5 core transcripts of 50 years in day of life of fazle abed

09.50  turning to child survival we had  in 1972 very high mortality rates- so we looked at what kills children  -both infant mortality rate and child mortality rate - 53% of children died before the age of 5 and more than half of this was due to diarrhea ...something we all knew children didnt have to die of but in the tropical villages was the biggest killer 
10:34  the lesson of oral dehydration was discovered in east pakistan's cholera lab-  all you have to do is to rehydrate the body with saline and then the child doesn't doesn't have to die, nobody needs to die from diarrhea -the problem was the lab researchers had no idea how to share this solution with illiterate village families-  so we focused on this challenge  in 1979 -the International Year of the child 10:54 we had looked at the statistics in Bangladesh of too many deaths from children and I thought if there's so many deaths, mothers are not going to limit family size because they need to have some children surviving in their old age so there are two things that I wanted to do, I wanted to cut down infant mortality for its own sake and secondly to get mothers to limit size of the of the family -so we started a program in 1979 to try and go to every household in rural Bangladesh and teach mothers how to make oral rehydration fluid at home -that's a network of 18 million families-households  we tested how to do this on samples of 360 families at a time -once we had optimalised the program it ran for 10 years and brac went to every household; we paid our workers on the basis of retention of knowledge by the mothers and whether they could make the ordered rehydration for it correctly and we had to test the efficacy of the solution the mothers made in the house because we didn't want to endanger children if the solution was not right-if there was too much salt it would be dangerous for children 

so this kind of program went very well and the impacts of mothers empowerment and lowering mortality rates throughout the country became famous during last four years of the program. The Chinese barefoot medics program were keen to apply oral rehydration and they knew the epidemiologist Jim Grant who became excited about Oral Rehydration too

James Grant was born in Beijing as a Canadian citizen. He lived in China until the age of 15, where his father, John Black Grant, was the first professor of Public Health at the Rockefeller Foundation funded Peking Union Medical College. Grant attended the University of California, Berkeley, graduating in 1943 in economics.
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http://www.jhsph.edu › about › heroes-of-public-health › john-b-grant John Grant's work has influenced the health care of half of the people of the world. ... Among them is his son, James, who served as director of UNICEF
sir fazle :So it was that Jim Grant then head of UNICEF adopted oral rehydration as one of the great advances of  village education -and then he said to me that can I get can I do something for you? ' i said if you can , please come and talk to our president to try and get every child immunized he said of course I'll come so he came and persuaded the president that we should immunize all children 13:00 so we did that the government did half mainly in the cities and brac as a non-governmental entity immunized the other half of the country -within four years  immunization coverage went up  from 2% to to 76% so that was and then our president was invited to the  UN conference on children because this that's what he wanted to come. Jim had planned all that but apparently he had also told the president of my country : you won't be invited unless you reach 70 percent coverage.That was the incentive anyway and child mortality in bangladesh declined dramatically from more than two hundred per thousand to sixty four per thousand 
this is how we learnt small may be beautiful but in bangladesh large scale efficient and effective village-rising programs are absolutely essential. ... Without microhealth networking of america immunologists, muslim oral rehydration and chinese barefoot female medics there would have been no brac microfinance and no brac university where our james grant school of public health attracts world class collaborations
start of transcsript 1/5
BRAC 00:37 Sir Fazle was born in Bangladesh and was educated at Dhaka and Glasgow universities he worked as a shell oil executive before founding brac in 1972 what began as a limited relief operation called the Bangladesh rural advancement committee 00:54 brac has turned into the largest development organization in the world and the largest ngo coalition- as of 2012 the work of brac reaches an estimated 126 million people in 11 countries throughout Asia Africa and the Caribbean 01:07 sir Fazle has received numerous awards we'd be here all night if I were to begin to read them but he's had many many great honors for his outstanding and really unprecedented achievements with brac these include the David Rockefeller bridging Leadership Award the inaugural Clinton global citizen initiative the Gates award for global health and my personal favorite which is the Ramon Magsaysay Award for community leadership he's currently the age of Foundation's Cheng Lin Tian distinguished visiting fellow the Cheng Lin Tian visiting distinguished visiting fellow program honors dr. Tian who was chair of the Asia Foundation Board and was the Chancellor of the University of California at Berkeley so here tonight to speak about lessons for poverty alleviation in the developing world let me introduce you ladies and gentlemen to Sir Fazle Hasan Abed welcome
02:10 thank you very much ladies and gentlemen good evening I thank the Asha foundation for inviting me to be here today and for you to invite me to speak tonight I thought of talking about Bangladesh's struggle with poverty alleviation over the last 40 years when I started brac in 1972 02:40 Bangladesh was was the second poorest country in the world the poorest country was at that time was Upper Volta now called Burkina Faso so we were the bottom of them of the league the poorest country it became independent after war of liberation for about about a year with Pakistan the country was in ruins in the early 1972 when I started practice coming back from India at the time so the initial task was relief and rehabilitation the first one year we are just trying to get people the relief to survive and then the once the relief phase was over one felt that the country was so poor the people were so poor one couldn't really leave them to their own devices one had to commit oneself to long term development 03:49 situation Bangladesh was in at the time:we had seventy-eight percent of our population below the poverty line and the poverty line was also very low in the sense that it was defined as adult finding 21 calories of food literacy rate was less than 25% then mortality rate of children the infant mortality was one hundred and fifty two per thousand; the child ?(under 5) mortality was two hundred and sixty eight per thousand per capita income was less than $70 so that was the situation 04:44 in Bangladesh we didn't produce enough food to feed our people we needed to import about three million tons of rice and our port system didn't have the ability to you to handle all this food... we needed to help Bangladeshis to feed themselves due to our infrastructure problem: schools were destroyed the bridges were destroyed and the country was in ruins. the government was poor and didn't resources -kissinger apparently jokingly said bangladesh was a basket case but I hope it's not our basket case

05:26 so that was the situation so...Bangladesh is last forty years has done remarkably well..Goldman Sachs recently said that Bangla is the next country after the BRICS 05:47 so Bangladesh has made progress and it's growing very fast it's about six percent annually right now and for the last ten years it has been growing more than five percent annually in last six 06:08 obviously if we keep up the growth in this present rate then we will be doing quite well and Goldman Sachs prediction might come true but then what do we did 06:19 so what did we do?that'ss the question that I'm going to try and answer and draw some lessons for other countries which are still poor and are confronting similar kind of problems have we faced5 now if you look at agriculture 06:40 Bangladesh we used to produce 15 million tons of rice paddy rice paddy in nine million hectares of land but over the last 30 years we have lost a million hectares of land in through other things eg infrastructure housing because our population has grown from 70 million we in had 1972 when we started to now 154 million so it's more than doubled but then food production has more than trebled so now producing 50 million tons of food rice production has grown up by more than the population growth rate so we are now --food self-sufficient

 so what did we do and why did Africa not do the same thing 07:30 and that's the question that I've been asking to myself the Green Revolution happened in Asia India of Bangladesh Vietnam China everybody took advantage of Green Revolution and idea many of you know who which which institutions were responsible for Green Revolution it was it was all kinds of institutions which were built by Rockefeller/ford Foundation and so on to own Agricultural Research which provided-this spearheaded the Green Revolution in Asia but in Africa it didn't have so when we when thirty years later I copy go to Africa brac goes to Africa it finds that there's no extension service going on there's no high-quality seats going on,there's no irrigation possibilities the government is not investing enough in infrastructure and so on so Africa is completely missed the Green Revolution 08:31 and then of course when I was on the board of IRRI International Rice Research Institute and I happen to be the chairman of the finance in our finance and Audit Committee and elevated five billion dollars to Erie to go to Africa 08:48 just before Agra which was started by Gates Foundation and Rockefeller Foundation on to produce enough research for crop in Africa was created about six years ago six years ago so there's so much so that's one lesson about food production and agriculture where Africa needs to learn from 09:22 extension work in high quality seeds,multiple seed multiplication exchange a extension of good practices that farmers need to learn and proper dosage a fertilizer usage of biomass for so all kinds of things that needs to be done 09:41 one had to learn those and and we are trying to as I'm now working more in more countries in Africa now we are working to implement some of the things that we have learned in our own work in Bangladesh

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