Stories from the Field

In August we visited Bangladesh to meet with Dr. Hasib Mahmud, Director of Impact Foundation, Bangladesh.

IFB has been working in Bangladesh since 1993 and their mission is to improve the lives of disadvantaged people and their communities. Specifically, they aim to treat, prevent and reduce causes of disability. They established the first floating hospital on the river ways of Bangladesh. The hospital is equipped with trained health staff, medical equipment and has moved from place to place to provide services to poor and disadvantaged communities. They have also established two health centres in one of the densest regions of Bangladesh and provide health care to the poor communities of Chuadunga and Jibon Mela.

We met with Dr. Mahmud to discuss IFB’s local management of a new project called ‘Proshanti’ (which means enjoying peace and tranquillity). The aim of the project is to provide free surgery for disadvantaged women suffering from prolapse.

The incidence of prolapse in South Asia is huge. Research has been done in Nepal which estimates that there are up to 600,000 women (of a population of 27.8 million) suffering from prolapse in that country. With a population of 166 million in Bangladesh, not much research has been done on estimating prolapse numbers in the country. However a recent research study, one of the first to be done on Pelvic Organ Prolapse (POP) incidence in Bangladesh, estimates about 1 in 6 women in rural Bangladesh suffer from POP (about 15.6%). Increasing age and parity are risk factors for POP and are in line with previous studies. Hence, it is safe to conservatively estimate a huge need for this project.

IFB will be working with local Bangladeshi gynaecologists (12 in 2017), who will provide surgery to poor women who are unable to afford the cost of surgery. In 2016, 8 local Bangladeshi surgeons have been trained in a new technique of surgery that is not taught in Bangladeshi medical schools. In 2017, it is anticipated that three more surgeons will be trained. Each trained surgeon then will perform a maximum of 20 surgeries per month based on set criteria for assessment of the degree of prolapse. These will be monitored by detailed patient forms and follow up calls to a random selection of patients to gather feedback. In addition, post-operative observations will also be recorded by the participating surgeons.

IFB is set up to provide medical and health services to the poorest of the poor, and in such a way, manage disabilities. Living with prolapse is a huge stigma for women and they can often be ostracised from their communities, or be considered cursed. By providing free surgery for women in need, this projects fits in with IFB’s mission.

We are excited by this project because it is like no other in Bangladesh at the moment. With several local Bangladeshi surgeons trained in this new technique, there is scope to train master trainers, who can then train younger gynaecologists who will specialise in the field of birth injury repair. This project will have a cascading effect on the medical community by building the knowledge in Bangladesh.

Impact Foundation, Bangladesh was approved as an International Partner of Partners For Equity in September 2016. The program is set to deliver 8,500 surgeries over the three year period 2017-2019.

We are not the kind of people that generally like to sit still in a conference venue but the Segal Family Foundation’s bi-annual gathering in Africa has become a ‘must attend’ for us.

Segal are based in New Jersey but have ten local staff in East Africa. In their words, they ‘support exemplary organizations finding local and scalable solutions to Sub-Saharan Africa’s most pressing challenges, with a focus on healthy, productive, and empathetic youth’.

In just a few short years they have grown their number of partners to 200 in 20-plus countries. Most are grass roots organisations to which Segal does not just provide funding, but also establishes networks of NGOs working in similar sectors. On a regular basis they convene events for knowledge exchange and training.

We are constantly in touch with other funders in search of knowledge – knowledge about new prospects and updates, as well as opinions on existing partners. The Segal people are generous with their time and their conference, this year taking place in Kampala, was a wonderful opportunity to catch-up with our existing partners (Educate!, Indigenous Education Foundation of Tanzania, Project Muso, The BOMA Project, Beso Foundation and the African SOUP – as well as another fifteen meetings with prospective candidates. As travellers who spend an awful lot of time descending and ascending in all sizes of aircraft across the African continent, you can well believe how grateful we are for the opportunity to meet so many people in just one place!

We love to hear of the successes of our partners but also use these meetings to investigate what challenges our partners are facing, and it was fair to say there were a few that came out of the eighteen meetings. Staffing seems to be a perennial issue, as well as the intransigence of governments and the slow pace at which the wheels of government sometime move. However, one can’t come away from such a gathering of social entrepreneurs and not feel bullish about both the prospects for Africa and the ability of Africans to find those solutions themselves. All they need from us is some financial support to help make it all happen.

Scorecard:

• 66 hours’ travel;
• Seven days and two hours in Kampala and Arusha;
• 25 meetings at the conference and 13 at the School of St. Jude;
• Best beer: Serengeti;
• Cheapest beer: at the Waterhole near St Jude’s;
• Best food: Mushroom Fettucine at Mediterraneo in Kampala;
• Biggest funder met: US Military;
• Mosquito density: High;
• Malaria tablets taken? No, forgot; and
• Latest linguistic fashion in NGO Land: ‘Theory of Change’. Yes…., it’s back!!!

The BOMA Project

Three days in barren rocky Northern Kenya left us in no doubt the project helps some of the worlds’ poorest. Two $50 grants (not loans) to women accompanied by two years of business mentoring seemed an effective way to get them on ‘the first rung’ of the climb out of poverty. Technology is increasingly a feature of so many projects we now visit. A BOMA mentor visits a women’s business in a distant dry village, then feeds the latest results from their businesses into their smartphone and it aggregates real time into Salesforce – providing a wealth of information for management.

The visit gave us insight into how basic many of the businesses are – often nothing more than food supplies displayed in a small hut with $40 of sales a month yielding $15 of profit. However, do the maths and you quickly find that a $180 a year surplus has been generated. That may be enough to send three children to a private school in the nearest town.

We first met the BOMA people two years ago. We kept in touch with them but needed to visit the project on the ground first before we could really feel comfortable with a funding decision. The visit met our expectations and PFE is now a proud funding partner.