Quality care for the poor
Sajida Foundation's leap into the health industry

Imran H. Khan

Sajida Foundation, one of the leading non-government organisations of Bangladesh, started its operations 1987 with a simple plan to educate a few impoverished children. The programme rapidly grew to include programmes in micro-credit and health care. With their motto, 'Family First,' Sajida Foundation is a family-run organisation, which tries to empower the family as a single, inseparable unit, rather than singling out an individual.

Syed Humayun Kabir is the founder and patron of Sajida Foundation. Kabir is also the Managing Director of Pfizer, an international pharmaceutical brand that has been locally named Renata Limited. Sajida's break came when, through the goodwill of the managing director, the foundation acquired 51% share of Renata Limited. It is now funding most of its operation from there. The Chairperson of the foundation is Sajida Humayun Kabir.

The health sector of the foundation is divided into a few segments. Besides the main hospital, there are four sub-centres together with vision centres. There are also two mobile teams who visit the hard to reach places to find out cases. Sajida also sets up eye camps from time to time to do cataract operations for the needy. They send workers door to door to inform the poor people about the necessity for proper health care. After ample requests from its micro-credit members, a hospital was built to better serve its members and subsequently, the population of Keraniganj and its adjacent areas.

Sajida Hospital is a 70-bed fully operational hospital that is currently offering medical services at an incredibly low cost to its members as well as to those who cannot offer regular hospitals. The members or cardholders of Sajida Foundation are usually those who are in the Micro Credit programmes of the foundation. At this hospital, an operation that would normally cost Tk 20,000 to Tk 30,000 is done for about Tk 5,000 to Tk 6,000. There is also a discount on medicines. None of the operations cost above Tk 12,000 for the members. There are now about 123 personnel working in and around the hospital. “There are 22 specialists who take turns to visit Sajida Hospital from Dhaka and they charge fifty percent lesser than they would in Dhaka,” says Zahida Fizza Kabir, the Executive Director of Sajida Foundation.

The hospital also does special eye surgery in partnership with ORBIS International. The most popular case that Sajida Hospital has is that of Momtaz Begum. The 38-year-old is a member of the women's credit group and health insurance scheme. She and her family have a house in the poor area of Keraniganj. Her husband and six of her seven children have congenital bilateral cataracts. The other child is deaf. Though her husband cannot see, he earns a poor wage as a day laborer. The whole family is totally dependent on Momtaz for their daily activities. Soon Sajida Foundation came to know about Momtaz's problem and they rushed to help. The family was taken to the hospital and a well-known ophthalmologist performed a surgery free of charge. The family members now have their vision restored. The outcome for the family has also drastically changed as all of them are now self-reliant and can contribute to the family. Momutaz and her husband now plan to send their children to school. Access to such contemporary eye surgery, and the necessary infrastructure, physical facilities, equipment and trained personnel, has been made possible through a partnership between ORBIS International and the Sajida Foundation. The hospital also has its own spectacles section where eyeglasses are prescribed at a very reasonable cost. The foundation already has a proven track record as a partner with a number of international and national organisations including Neimeth Foundation, ORBIS International, CARE Bangladesh and Brac.

Other than eye surgery, there are also doctors for general medicine, surgery, obstetrics and gynecology, orthopedic surgery and pediatrics. Sajida Hospital also has a comprehensive diagnostic and support services complete with operating theatre, intensive care, pharmacy, ECG, radiology, ultrasound, pathology and physiotherapy. They also have ambulance service to bring in patients from hard to reach places and from other sub-centres. A normal delivery costs Tk 300 with medicines and instruments costing an extra Tk 200. A caesarian operation costs Tk 5,000 for the members. Md. Abu Raihan is the Chief Administrator (Health) at Sajida Hospital. "Maternal morbidity rate is being reduced in this area because of Sajida Hospital," he says. According to him when a woman gives birth at home, there are numerous complications related to the delivery. These can easily be avoided at the hospital but the general people have to be informed. "There are many clients in this hospital who do eye operations for free," says Raihan. Approximately 2,60,783 patients have received treatment at this hospital till September 2006.

One problem such a hospital in rural areas face is the competition with traditional views. There are many people who feel more confident to give birth with dais (traditional birth attendants) rather than at the hospital. Dr. Marufa Rahman is a Residential Medical Officer (RMO) who deals with patients with birth complications that have occurred from deliveries by dais. “She (the patient) or her baby might be fighting for her life at the point they are brought in. Those are some of the worst cases that we have had to handle,” says Rahman.

"There are about 200 to 250 patients coming to the outdoor facility daily," claims Raihan. "This maybe for primary treatment or for eye treatments but almost 50 patients get admitted into the hospital on a daily basis." They are referred to as indoor patients. They maybe here for surgery, for eye treatment or even if they have a bad stomach ache and want to be under observation. There are doctors and paramedics available round the clock.

The hospital currently boasts 22 specialist consultants, who visit from Dhaka on rotation, 17 medical officers, 31 paramedics or nurses and 48 support and administration staff. Of them, 18 are cleaners.

Apparently, the elderly people of the community are the most helpless group. As they start to age, they lose their vision and get dependent on others. Little do they know that cataract is the most common reason for losing one's vision and it can easily be cured completely. "Last month alone we did 120 cataract operations for free" says Raihan.

Momtaz Begum and her family.

One of the main problems that this hospital is facing is of frequent electricity outages. There is a powerful generator that runs for about eight hours each day. This is a major problem at times. There is a need for more cabins. There are currently five cabins, two of which are air-conditioned and three are regular.

Sajida Hospital still needs some more units. A cardiac unit would do well to aid the locals as the hospital currently refers them to other places now. A dental unit would also help the local community, as there is a wide void in this sector.

At the beginning of this month, a new integrated programme the 'Health Education and Life security Programme' (HELP) was introduced to the members of Sajida Foundation. “This is a comprehensive insurance scheme that includes health care till the tertiary level, education, legal service and life insurance,” says Fizza Kabir. “HELP also covers disasters where we give some form of aid to the members who fall under this scheme,” she continues. This helps the members get back to their own feet again. There are too many people in the rural areas who are in need of assistance and NGOs such as Sajida Foundation are constantly on the move to help such underprivileged people.

Copyright (R) thedailystar.net 2006