Mini-GA Report

25February 2014

Bangladesh

Field Associative Debate (FAD)

24 - 25 February 2014

Dhaka, Bangladesh

Organised by MSF OCA Bangladesh

Background

In the two-day meeting, the first day was for Field Associative Debate (FAD). The second day was allocated for pre-discussion (Mini-GA) relating to MSFSARA’s General Assembly (GA). This report focuses more on the activities conducted on the second day.

On both the days, national staff presentedinformation from their projects.On the second day, there was a discussion on ‘MSF Working in Urban Settings’, a topic that was alsoon agenda of SARA’s GA. Half a day was allocated for a presentation and question and answer session regarding the status, membership and activities of SARA, and for feedback on last year’s FAD.

In total, there were 32 people, including facilitators in the programme.

Discussion on Urban Interventions

What we did

Urban intervention would also be a topic for the upcoming GA in Delhi, thus this topic intends to link Bangladesh’s operational experience.

Three presentations were made: Manaf (Project Coordinator & SARA Board member), shared experiences from the Kamrangirchar (KAM) project; Lorraine Rebello (SARA board member, via Skype) shared her experience of working in Mumbai’s slums, and Ram Krishna (Christian Aid) gave a presentation on the impact of climate change on health.

After these, the group was divided into four teams. Each of them briefly presented the outcomes of their team discussions, followed by a plenary debate and conclusion.

A documentary ‘Urban Survivors,’ which relates to humanitarian crises in the slums of Johannesburg, Karachi and Dhaka, was also screened during the session.

General Overview

Manaf spoke of the Kamrangirchar project and the adverse living conditions in the slum, the dilemmas in positioning MSF and the challenges of the 21st century.

Lorraine explained how MSF is assisting patients in Mumbai’s slums, where 65% of the city’s population lives (mostly migrant labourers working in small factories). In the slum, they support active case finding of tuberculosis and follow-up of MDR-TB and HIV cases via outreach activities.

Ram Krishna, a guest speaker and a member of the Climate Action Network South Asia, gave a global outlook on climate change, and presented some recent observations specific for Bangladesh.

Due to its large coastline and dense population, Bangladesh is known to be one of the countries which aremost vulnerable to climate change.MSF could prepare for climate change via disease prevention and emergency preparation.

Conclusion

The challenges are:

  • A migrant population creates a challenge in tracing patients and treatment adherence.
  • MSF’s scope for intervention is based on emergencies, and would need to be adapted to a more developmental approach for slums.
  • Addressing unmet needs in slums can be controversial due to local power play, illegal workers, drug use, and acceptance by government and factory owners needs to be negotiated.
  • There is alack of awareness among slum dwellers with regards to hygiene and working time.

The participants suggested starting an MSF intersectional platform to share information on working in urban settings. Particularly, they have suggested that occupational health and Sexual and Gender Based Violence (SGBV), including mental health,should be another area that MSF needs to address. Regarding sexual violence, various examples were discussed of countries trying to overcome this by empowering female groups and organising support groups for victims.

The challenge of ensuring drug-resistant tuberculosis adherence was further discussed.Early diagnosis, ambulatory treatment, use of mobile phones for patient tracing, and providing migrating patients with information on TB clinics in other slums were mentioned as opportunities.

MSF SARA

SARA board member Anant Kumar presented the current status of the Association, the activities and the opportunities for membership. He encouraged MSF staff to be a member of the Association, and contribute as much as possible. He mentioned that the Association is inits growing phase and requires support from all.

Sarathi added that the FAD discussions should not stop here, and he suggested debates and activities at the project level throughout the year (for which time and resources can be made available).

Anant Nepal

Board Member, MSF SARA