In January 2016, an Emmaus International delegation set off to visit the Emmaus Thanapara Swallows association in Bangladesh in order to take stock of the progress made in providing access to healthcare in this isolated region where the local population lacks access to its fundamental rights. Through its numerous activities and strong roots in the village, Emmaüs Thanapara works to remedy this as far as possible, ensuring people’s fundamental rights are upheld.
The Thanapara Swallows Development Society is an association born in the 1970s following the massacres perpetrated in the region by the Pakistani army. Today it has some 70 members of staff, including teachers, coordinators and administrators. Handcrafted fairtrade production remains the association’s main economic activity, yet this is accompanied by many other missions: health (formal and informal schooling), teaching environmentally friendly farming techniques, prevention work on domestic violence, eco-tourism, micro-credits and access to health. This last field is one of Emmaus International's priority areas of work.
In fact, for five years now the group has been running a mutual health programme which is one of Emmaus International's pilot projects in the Asia region. It now has some 450 members who are mostly handicraft producers (people who work in the workshops), but also members of the association and pupils of the school. Bangladesh’s public health system is nascent and barely reaches rural areas and so it’s difficult for people living in the region of Thanapara to access healthcare and medical services. Even those who could potentially make the long journey to health centres cannot afford to pay for the services provided by private clinics – not to mention the general lack of awareness about prevention or general health education in the area.
Each member pays a minimum membership fee: 10 takas per month per person, which equates to 0.2% of the average salary in Bangladesh. Once they've joined, members can access the medical centre or consult Shelim, the pharmacist (photo). He sells medicine for 30% of the price it is bought at, carries out basic medical tests (for diabetes, blood pressure, etc.) and refers patients on if necessary. It becomes clear just what an essential service this centre, open six days a week, provides when you learn that the nearest public hospital is over half an hour away by car. Indeed, the centre receives between 15 and 20 people a day. If a more serious case arises, the cost of hospitalising the patient as well as part of the cost of medicine can be covered.
Prevention work is carried out in parallel to these activities, for example discussion groups and regular health groups are run or a specialist (e.g. an ophthalmologist or gynaecologist) comes and spends a day holding free consultations for the health scheme members. Each of these camps provides around 40 people with access to specialised care.
Although the mutual health fund is still far from being economically independent (it is currently 25% independent), the members’ involvement in the programme is quite remarkable. In the wake of the global economic crisis, Thanapara lost important clients which endangered the salaries of the producers employed by the association. Despite this, the health scheme members decided to contribute a day’s wage every year to the fund so that they could benefit from an additional health service – an extremely brave economic commitment in this poverty-stricken region. The members are involved in the scheme – they have nine elected representatives, half of whom are women. They work in a spirit of trust to maintain this vital system of solidarity in the local community.
