Brac’s lesser-known gift to Bangladesh: Vaccination push

If one was to list the work Brac, the organisation Sir Fazle Hasan Abed built, has done or how it has contributed to Bangladesh's development, the task would be next to impossible.

What would be easier is if we asked what this organisation has not done -- and Nobel laureate Muhammad Yunus articulated it best.

"It is certainly not an exaggeration to say that there is hardly anyone among the 170 million people of Bangladesh who do not benefit in some way from Abed's programmes or enjoy products and services provided by his organisations," the Grameen Bank founder said.

Sir Fazle and Brac are synonymous -- there is no scope of discussing one without the other.

Even in absentia, he is fuelling Brac's onward journey through his guiding principles.

It is as if there's no end to the half-a-century-old organisation's work extravaganza. Apart from its home country, Brac has reached all over the globe, including conflict-ridden countries like Haiti and Afghanistan.

From providing informal education to establishing a university, from offering micro-credit to operating a full-fledged bank, everywhere he left his extraordinary mark. And women and the poor have always been at the core of all of Brac's endeavours.

A single article can barely give a glimpse of the immense work of this man and his organisation.

Thanks to an opportunity to write a book on the man and trailblazing organisation, I have had the good fortune of enjoying Sir Fazle's company for an extended period. I was blessed to be able to travel with him to many parts of the country, to talk to this legend and have extensive discussions with him.

I had a first-hand account of the work that Brac does and the opportunity of knowing the organisation from its core.

Based on that experience, I will try to shed some light on a comparatively less discussed topic: Brac's vaccination programme.

The year 1979 was termed the International Year of the Child. From that year Brac became the first organisation to highlight the need for vaccinating infants and expectant mothers.

"The child mortality rate is too high in our country. When a country has a high infant mortality rate, it also shows signs of a high birth rate. We have seen that once the infant mortality rate comes down, within a few years, the overall birth rate also starts declining. High infant mortality rate and population explosion are impediments towards our progress and advancement," Sir Fazle told the then president Ziaur Rahman when the latter asked him what can be done for the children.

At that time, tetanus was responsible for the death of 7 percent of newborn children, which could have been saved if the expecting mothers were given tetanus toxoid injection.

Sir Fazle came to know of tetanus injection from his friend Lincoln Chen, who was working at the International Centre for Diarrhoeal Disease Research, Bangladesh.

He also came to know about some other vaccines, which might prevent the death of many infants.

Collecting the vaccines and training the service providers were not all that difficult, but a major challenge came in the form of vaccine preservation.

The vaccines had a requisite storage temperature rating, which demanded some specific refrigerators that were not available in every thana.

It might even take five more years to ensure uninterrupted electric supply in all those thanas to keep the refrigerators running.

Naturally, the vaccination programme went into a hiatus.

But Brac did not stop, nor did Sir Fazle.

He realigned his efforts towards combating diarrhoea. He started reaching out to the doorsteps of 68,000 villages of Bangladesh with oral saline made of salt and molasses.

He also reached Indonesia and Africa with this oral saline. His success spanned across the globe.

At last, 6-7 years after the initiative was first taken, the vaccination programme could be jump-started.

In 1986, the opportunity knocked at the door and a chance to materialise the vaccination initiative became a reality.

Brac would do the entire work, but they would also utilise the public sector infrastructure and human resources.

Sir Fazle always believed in work sustainability. If Brac does something but the public sector representatives are not involved, then how will the initiative continue to function in the long term?

In such a situation, if, for some reason, Brac had to shift its focus to some other endeavour, the vaccination programme would have stumbled and lost its momentum.

At that time, there were only four divisions. The arrangement went like this: Brac would focus on Rajshahi and some parts of Chittagong, while the government would take care of Dhaka and the remaining areas of Chittagong and CARE the Khulna division.

And the initiative to vaccinate against BCG, DPT, polio and measles started.

Although the government and CARE were part of the initiative, it was fully planned by Brac and they also arranged the training.

In 1990, the World Health Organisation surveyed the vaccination status of children and it was learnt that the areas covered by Brac had managed 80 percent vaccination, while CARE registered 65 percent and the government 50-55 percent.

Without a doubt, it was only due to Sir Fazle's efforts that the government was motivated to actively participate in the vaccination programme.

The top leaders were due to attend and participate in the United Nations Convention on the Rights of the Child in 1990. Only the countries that managed to fulfil the requirements of 'Universal Child Immunisation' were supposed to get an invite.

But the then UNICEF chief James P Grant invited President HM Ershad and a Brac representative to join the prestigious summit, where Bangladesh's role was deeply praised.

In 1980, the newborn mortality rate was 135 out of a thousand and the child mortality rate 250 out of a thousand.

After a decade, in 1990, the same rates became 90 and 120 respectively. The death rates fell by half just within four years of starting the vaccination drive. Surveys conducted during those times reveal that the birth rate also went down.

Today, Bangladesh is well ahead of many other countries, in terms of the vaccination of children and mothers.

The vaccination issue again came into focus during the pandemic. The organisation that achieved this exemplary success is none other than Brac. Just like many other fields, this achievement, too, solely belongs to the legendary Sir Fazle Hasan Abed. He was the quintessential champion of Brac, a brother to all Bangladeshis, our very own Abed bhai.

Golam Mortoza is the author of the book 'Fazle Hasan Abed O Brac'

Translated by Mohammed Ishtiaque Khan