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Activities in the clinic

 

Volunteer doctors from the U.S.

By Rabita Aziz

Persons residing in Western, industrialized nations are often exposed to images of the impoverished in third world countries. Charity organizations like Save the Children and others broadcast commercials on television which showcase the plight of the poor around the world. Images of the underprivileged are also often broadcast on news services and other programs. Western musicians often hold charity concerts for the poor, and other organizations work to raise awareness and funds. From these types of exposures, Westerners often believe that they understand the dire living conditions of the poor. However, one cannot truly comprehend the dismal circumstances of the poor without visiting their slums. Even after visiting their homes and speaking to individuals that survive on less than $3 a day in a major metropolitan area, it is difficult to genuinely understand their plight. However one is still able to gain a small idea about the lives of the urban poor by visiting their dwellings. Therefore, I participated in a project which surveyed residents of a Mohammadpur slum to determine their financial situation as well as observe their environment.

When an individual steps into one of Dhaka’s many slum areas, they immediately experience the harsh living conditions in which millions of Dhaka’s urban underprivileged poor spend their lives. The senses are immediately bombarded with sensations alien to the people residing in neighboring high rise buildings, which instantly raise the question, how do people live here? The first sense that is affected is that of sight, as one’s eyes take in the vast housing complex made up of spare raw materials, which seems to exist upon nothing and yet stretches beyond comprehension at the same time.

As one draws nearer to what seems like a disaster waiting to happen, the stench of raw sewage hits the nasal passages with full force, again inciting the question, how do people survive here? It is easy to see where the putrid odor originates from, as one can see raw human waste bubbling out of the canal water on top of which the slum homes are built. The homes themselves are constructed out of bamboo and other raw materials which surely cannot withstand the many natural disasters Bangladesh is prone to. There are no solid foundations for the homes, as they are held up by bamboo rods over water and mud, both mixed with sewage and trash. The homes are so unstable that one may fear that the floor they’re walking on will break beneath them as they walk through a home. The extremely narrow passageways between homes are built of deteriorating bamboo poles held together by decaying rope. In some passageways there are no bamboo walkways, resulting in the residents having to constantly walk through standing water to reach their homes.

Bathrooms are constructed by cutting a hole into a floor made out of bamboo, through which waste falls. Residents throw other waste products into the canal water as well. This practice has resulted into trash accumulating in piles around the slum. The combination of being constantly exposed to raw sewage and other waste products obviously results in poor health conditions for the slum dwellers. On top of this, residents do not have access to clean and accessible water. Approximately 30 households have access to one water pump, from which unsafe drinking water flows. At times there is no water flow. The residents also have no way to purify the water before usage. Living in such cramped conditions alone will easily result in improper health conditions, but when adding the problems of water access and waste into the mix, the dire situation of the poor is even more exacerbated.

Even if one walks through a slum, they won’t be able to gain a decent understanding of the situation of the impoverished without sitting in a home and holding a conversation with its resident. Upon asking a few questions regarding their family makeup and income, residents opened up further about their lives and the conditions they live in. In fact, many residents spoke quite candidly about the trials and tribulations they go through, as well as their feelings regarding their status in society and how the rest of society perceives them. Although anecdotes are a good way to portray the lives of the impoverished living in Dhaka’s slums, it is necessary to observe hard data to gain a better understanding of their financial situation. This in turn is also necessary to formulate programs and policies intended to improve the lives of the poor.

One hundred and sixty five households in total were surveyed to determine the average socio-economic conditions of Dhaka slums, particularly in the Mohammadpur area. Although one slum was surveyed in total, another slum was partially surveyed, as a few days after the survey began, that slum was destroyed and its residents were displaced as a new building project began on that land. This appears to be a common occurrence as residents of the other slum expressed their concern over possible, similar actions occurring in their slum. While surveying the residents it also became clear that most residents constantly moved around from one slum to another, and that being in constant transit is commonplace among Dhaka’s underprivileged. Consequently, this phenomenon results in constant mental, financial, and personal upheaval for Dhaka’s poor.

Of the 165 families surveyed, 106 lived in one slum, while 59 resided in the other. The average number of persons per household in both slums is approximately 4 persons, with a total of 679 residents. The majority of these residents live in one small room, while joint families usually occupy several rooms in the same vicinity. However, joint families were not counted as one household, as one household was counted as the number of residents residing in a single room. While in some households as little as two people lived in a single room, in others as many as 6-8 individuals lived in the same room.

Of the 679 residents, 362 are adults, making up 53% of the population. There are 169 male adults, and 193 female adults. The remaining 317 residents are children, making up 47% of the population. Of this amount, 16 children are under the age of one, 47 children are between the ages of one and three and 75 children are between the ages of three and five. There are 57 male children between the ages of six and ten, and 46 female children in the same age bracket. There are 43 male children between the ages of eleven and eighteen, and 33 female children in the same age range. From these figures it is clear that children’s health and educational development are key in Dhaka slum areas, as children under the age of 18 comprise such a large portion of the population.

Although many of the children between the ages of five and eleven attend school, at a certain age many of these children stop attending school and are put to work to support the family. These children are conditioned from a young age to internalize their impoverished status in society, and are thus prevented from even considering a potential uplift from their impoverished state. There is also a large distinction among female and male children when it comes to aspirations of breaking the chain of poverty. For example, when a ten year old boy was asked what he wants to do for a living when he grows up, he replied that he’d like to be a teacher. When a ten year old girl was asked, she replied that she’ll either work in a home or work in the garments sector.

Another 13 year old girl expressed that she’d like to pass high school and possibly go on to higher education, and that her parents would like to see the same happen. However, the school she currently attends does not offer education past grade five, the current grade she’s in. She expressed that she does not know where she can continue her education, as her family cannot afford to send her to a better school, and because there are no other free schools in the vicinity where she can continue her education. From this we can see that young girls are not provided with the proper opportunity for education, and furthermore, that young girls are not given much value in society. From anecdotes like these, one can ascertain that young males enjoy a higher status in society and more privileges than young females, and this in turn will result in greater socio-economic disparities between the sexes in the future.
Families surveyed were placed in one of three financial categories: those in group A earned more than 8,000 taka per month, those in group B earned between 5,000 and 8,000 taka per month, and those in group C earned less than 5,000 taka per month. The majority of slum residents fell into group C, with 91 families earning less than 5,000 per month. While 55% of those surveyed fell in group C, 23% of families, or 38 families, earned between 5,000 and 8,000 taka, and the remaining 22% earned more than 8,000. The most prominent profession among breadwinners for families that fell in group C is that of rickshaw driver. Other prominent professions were that of house servant, construction workers, and cooks. From this we can ascertain that those individuals that provide the greatest amount of services to the middle and upper classes are those that are at the bottom of the economic system. In addition, these professions require a high amount of physical and mental strain, and provide little job safety, or satisfaction. The people working in such industries receive the least amount of respect and the most amount of abuse. Because individuals who work in such jobs receive salaries that barely allow them to meet the subsistence level, their children do not have the opportunity to attend school long enough to reach higher education, and are put to work at a young age to earn for the family. Subsequently, this results in the continuation of the cycle of poverty.

From analyzing the economic situation and resulting living conditions of the underprivileged living in Mohammadpur’s slums, it is clear that much work needs to be done to improve the lives of residents. Although making tangible changes to their community, such as establishing a cleaner sewage system, will make an impact in the lives of residents, such changes will not make a lasting impression. In contrast, taking steps that will make permanent changes will result in not only a reduction in poverty levels but will improve the economic status of the nation, which in turn will prevent any future occurrences of poverty.

For this to happen, youth education and personal development must be a prime concern and goal. Without educating the youth and providing them with the opportunity to be competitive in future job markets, the cycle of poverty in Bangladesh will never be broken. In particular, educating young girls will create even more meaningful impacts, as the education of girls will ensure economic competitiveness and success for a developing country. When observing the factors that make Western, developed nations so financially sound, one can see that female education and consequently empowerment is prevalent in all developed nations. Therefore it is pertinent that young girls are given the opportunity to uplift themselves and their families out of poverty, through education.

When first stepping foot in a slum, the situation of the poor seemed beyond hope. However that viewpoint was changed thanks to slum residents who demonstrated resilience and expressed that they are hopeful about the future. One young girl in particular was quite interested in the fact that I live outside of Bangladesh. Her mother in turn told her that if she studied hard, one day she’d be able to visit other nations as well. Witnessing such scenarios extinguished any doubts I held about working to end poverty in Bangladesh, which at first seemed futile. Such occurrences instead instill a sense of determination and hope that the poor themselves will work to improve their conditions and rupture the cycle of poverty in Bangladesh.