Chakaria Residents Debate Universal Health Care

On 31 December 2011, icddr,b, held a health fair in Chakaria, on the south-eastern coast of Bangladesh, in order to raise general health awareness among local residents and discuss a potential pre-payment scheme that could lead to universal health coverage in the area. The fair was organised by the local Village Health Post committee with technical guidance from the Chakaria Community Health Project, which is being overseen by icddr,b.

A history of awareness and knowledge sharing

Since 1994, the Chakaria Community Health Project has been working towards raising health awareness among residents in the Chakaria upazila, which has little access to national health care facilities. Together with local community leaders, team leader of the Chakaria Community Health Project, and icddr,b’s Deputy Executive Director Dr. Abbas Bhuiya has been building a healthcare model that is financially feasible and can be sustained by Chakaria residents. The model, which could be applied across the country, attempts to address local health problems, and create a medical and financial buffer against natural calamities. The upshot of the efforts may lead to one of the first universal health coverage programmes in Bangladesh. 

Locals get involved

For more than 15 years, icddr,b’s health awareness programme in Chakaria has caught the imagination of the locals. “I love coming to events like these fairs”, remarked Sharifuddin Chowdhury, the local UP chairman.  “I checked my blood group and consulted doctors about some problems, but more importantly, it was a good opportunity to meet other residents and discuss how we can plan for potential future health hazards and problems”.

Community problems, community solutions

“The Fair was an important event to galvanise local interest regarding health problems, but also to get our heads together and think about how to get our universal health coverage plan off the ground”, explained Dr. Bhuiya. “What is vital to the community is a sense of ownership over local resources and ideas that would make any plans about universal health coverage in the area sustainable; a community fair does just that—it makes people realize that we are all part of one community, and addressing the health problem of my neighbour is the same as addressing my own problems”.  

In order to generate interest and an informative discussion about health in the fair, the Village Health Post committee invited several NGOs, private health service providers and other development partners to offer information on a range of health services that are locally available, including blood grouping, on-the-spot medical consultation and MBBS doctors. A large turnout on the day meant that there was a hearty debate about local health issues, including how to take ideas and convert them to sustainable medical practices in the region.

Community theatre takes the message home

To embed the ideas, local theatre groups staged a 30 minute drama called ‘Amader shashthya, amader daye’ (‘We are responsible for our own health’).  The play had child actors vividly present how a simple local health problem can quickly escalate into something bigger and have ramifications not only for individual households but also for the community as a whole.

At the end of the play, visibly moved community members had a chance to interact with medical professionals and community leaders about the future of a universal health plan and address possible health catastrophes.

Questions were addressed to a panel that included Dr. Bhuiya, local government representatives and icddr,b’s Dr. Mohammed Iqbal, who is a long-practicing doctor in the area. The panel discussed the current health scenario in Chakaria, re-launching of Village Health Posts and the current situation of the community health plan as far as generating adequate finances is concerned.

For more information on the fair, please contact Dr. Abbas Bhuiya