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“BASKET-CASE” TO MIRACLE ?
Bangladesh
1971-2021
Disasters make headlines
TOPICS
Setting: Geography, climate, history
Statistical snapshot, 1971: “basket-case”!
1. Agriculture: Feeding more people better
2. Diseases: Conquering cholera
3. Social policy: Empowering women
4. Social marketing: Family planning & health
5. Economic growth: textiles & tragedies
Statistical snapshot, 2012: miracle coming ??
Bangladesh in Asia - today
Historic links: Silk Routes
East Bengal in South Asia, 1947-71
Bangladesh, 1971-today
Typical riverscape
Interstate with 18-wheelers,
Bengali-style
Thatched village house
Bullock-powered plowing
Sargent Shriver explains Peace
Corps at Comilla Academy, 1961
1st
Volunteers fly to mainland Asia,
October 1961
Statistical snapshot, 1971
Population: country ~60 m
density >400/sq km
annual rate 2.6%
Foodgrain production <10 mmt
Births & deaths/1,000 47 & 21
Fertility rate/woman 6.9
GDP: total ~ $9 b
Growth rate 2%
“basket case” - Henry Kissinger, Nat'l Security Adviser
“Basket case”: population
“Basket case”:
rural urban migration→
Monsoon: blessing and curse
1. Agriculture:
Feeding more people better
More water for crops:
- Nature: monsoon 1 harvest/year→
- Irrigation: 2 or 3 harvests/year
Better seeds for higher rice yields
Fertilizers & pesticides for larger harvests
Increasing agricultural inputs
Dry fields awaiting water
Irrigation: traditional
Managing water by building
rural public works – 1962
Villager-built bridge & flood control
Irrigation: by shallow tube-wells
Irrigation: by deep tube-well pumps
High-yield rice
Importing fertilizers & pesticides
2. Diseases: conquering cholera
Bengal the epicenter of several pandemics killed→
millions in Asia, Europe, & Americas.
Cholera (Greek = diarrhea) causes huge fluid loss
with critical electrolytes, kills within hours.
Cholera Research Lab (est'd 1960) scientists →
Oral Re-hydration Saline (ORS) therapy.
NGOs distributed ORS & educated households
nationwide, reducing fatalities dramatically.
Standard therapy worldwide: saved 40M people →
enormous benefits for women and families!
Cholera Research Lab hospital
Cholera Lab field worker
Making oral re-hydration saline
(ORS) solution
3. Empowering women:
A. Comilla Academy, 1962-
Women planning a project
Empowering women:
B. Grameen Bank, 1974-
Famine inspired research: Could poor repay
small loans without collateral & avoid debt trap?
Founder Mohammed Yunus, Ph.D. economist,
trained at Vanderbuilt University, Tennessee
Gram (Hindi & Bengali) = village, rural (English)
Create banks & self-employment for very poor
Peer groups build confidence, ensure repayment
Goal: bypass money-lenders; escape poverty trap;
change “vicious circle” “virtuous circle”→
Traditional banks
Goal: profits for banks
Locations: cities
Borrowers: wealthy men
Security: collateral, individual,
what he already owns
Customers go to bank
Payment terms: strict
Loans for consumption
Traditional banks vs. Grameen Bank
Goal: profits for banks Change for the poor
Locations: cities Rural
Serve wealthy literate men Poor illiterate women
Security: collateral, person, Trust, peer group,
what he already owns what she will produce
Borrowers go to bank Bank borrowers→
Payment terms: strict Flexible
Loans for consumption Only for production
Grameen banker disbursing loans
Dr. Yunus joined Returned Peace
Corps-Bangladesh Volunteers, 1986
Grameen Bank today
Early donors offered cheap capital, research, eval.
Borrowers 98% women! repayment excellent!!
Borrowers are also owners: 94% of Bank shares
Chartered by BD Central Bank, floats own bonds
Grameen enterprises create employment, income
50 M borrowers lifted out of extreme poverty
Spread nation-wide & abroad (40+ countries)
Grameen Phone story
Nobel Peace Prize to Dr. Yunus
and Grameen Bank, 2006
Nobel Peace Prize to Dr. Yunus
and Grameen Bank, 2006
Empowering women:
C. BRAC, 1972-
Building a learning organization
Training and Research Centers:
- Research & evaluate: learn from mistakes
- Develop skilled staff & volunteers
1979: distribute ORS packets to every household
Early donors funded 100% → now only 26%,
due to enterprises: seed, dairy, cold storage, ++
Teachers & volunteers: 127,000, 98% women !!
World's largest NGO development organization
BRAC primary teacher
BRAC's story amazing
Queen Elizabeth knights Abed
4. Social marketing:
promoting family planning & health
US concept: use commercial tools for social good:
public health (smoking), safety (seat-belts)
US AID $$ 1974 test→ project, Ministry of Health
Advertising to establish brands: condoms, pills,
maternal & child health products
Warehouses & sales teams distribute nation-wide
1990 – changed to Social Marketing Company
Research & evaluation now largest co. of its kind→
Advertising “Raja” condoms
Advertising “Maya” pills
Distributing ORSaline (ORS)
packets nation-wide
Village health teacher
Family planning education
5. Economic growth:
textiles & tragedies
Prized muslin killed by English machine looms
British favored Calcutta Bengal agr. hinterland→
Jute key export until replaced by synthetics 1980s
Ready Made Garments: fueled by cheap, rural,
plentiful women, & US-UK-EU mega-buyers
Helped 40 yrs by World Trade & US policies
By 2013, 5,000 factories (sweatshops due severe
competition, weak regulation, corruption)
Garment factory today
Rana Plaza factory collapse
Not the 1st
time:
Triangle Shirtwaist Co. fire
Sweatshop economics & politics
Triangle fire 60 laws, ILGWU, Safety Engineers,→
New Deal labor laws (Frances Perkins & FDR)
Sweatshops exist in garments, transport, toys,
foods, construction, +, due to global competition
Labor unions, gov't regulation: weak/non-existent
Consumers: ignorant, uncaring, unorganized
Some efforts now: ILO, NGOs, industry assocs., a
few firms. Might int'l OSHA standards emerge?
Will Bangladesh business & pol. leaders reform ??
Sample consumer-based action:
Oxfam's food justice campaign
Statistical snapshots, 1971 & 2012
Population: country ~60 m 150 m
density >400/sq km 1,033/sq km
annual rate 2.6% 1.2%
Foodgrain production <10 mmt ~35 mmt
Births & deaths/1,000 47 & 21 21 & 6
Fertility rate/woman 6.9 2.4
GDP: total ~ $9 b $79.6 b
Growth rate 2% 6.7%
“basket case” miracle coming?
Middle-income miracle by 2021 ??
Climbing to middle-income rank possible
(World Bank & other economists) . . .
But not guaranteed:
– Ready Made Garment industry declines ?
– Political paralysis cramps economic growth ?
– Islamist reactionaries re-imprison women?
– Natural disasters ?
– Sea level rise devastating?→
Final thoughts
Reductions in child and maternal mortality
compare to those when Japan modernized
during Meiji transition in late-19th
century
– Economist, Nov. 2012
“ . . . when you create the right conditions,
poor people will do the hard work of
defeating poverty themselves.”
– BRAC's Sir F.H. Abed
Resources for learning & acting
1-page list of book titles and websites available
Robert C. Terry
E-mail: rcterry@post.harvard.edu
Cellphone: 508-237-7574
Website: www.rcterry.com

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Basket Case to Miracle, Bangladesh 1971-2021 - slides & narratives, 2015 Sept 2

Editor's Notes

  1. Good morning! As-salamu Alaykum – that&amp;apos;s the traditional Muslim greeting, in Arabic, meaning “May peace be with you”. Thank you for coming. After a garment factory collapsed in April 2013, pushing Bangladesh once more into headlines worldwide, our Unitarian-Universalist Fellowship asked me to share some context for this tragedy. Bangladesh is indeed prone to disasters ! BUT, it also produces positive stories. From my trashcan of history, I have chosen five. Although my focus here is Bangladesh, this is but one chapter in the larger story – of development to promote prosperity and peace. Here above is Bangladesh&amp;apos;s flag. Its green field symbolizes Bengal&amp;apos;s landscape, especially its lush rice paddies. Its red disc symbolizes both the sun, and the blood of martyrs who died for its independence in 1971. The round logo is its official seal, with an outline map. Source: Wikipedia, “Bangladesh”
  2. Example, The Wall Street Journal, on the day I presented this talk, June 22-23, 2013, Front Page center with a large photo: Factory Paychecks Trump Danger, Long Days for Bangladesh Women Fortunately, this report was responsible – not just one quick paragraph with ghastly numbers, but a long story (full page inside) explaining the tragedy&amp;apos;s social &amp; economic context.
  3. After showing maps &amp; photos of the setting and geography, I shall show a few key statistics in 1971, then sketch five stories (using mainly photos), drawn mostly from my consulting experience, and finish with showing you the same comparable statistics in 2012.
  4. See it lower center, wedged between India &amp; Myanmar (formerly Burma), thus strategically between South Asia and South East Asia. From the USA, Bangladesh is half way &amp;apos;round the globe. Its area is relatively small, about the size of our Wisconsin. Straddling the Tropic of Cancer, Latitude 23 deg. North, makes it near-tropical: monsoon rains arrive every June to break summer&amp;apos;s heat &amp; water the rice crop. BUT natural calamities – floods, cyclones, &amp; tidal bores – occur often; and, making their effects worse, are deforestation and soil erosion – caused by its dense &amp; growing population.
  5. The British ruled all of South Asia first from Bengal and their first capital, Calcutta. They viewed East Bengal as merely a hinterland, rich in jute. It&amp;apos;s blocked on the north by the Himalayas, and on the east by the “Burma Hump”. However, as this map shows, trade routes linked it for centuries with Asia and Europe. Indeed, lucrative trade in fine Chinese silks, starting in the Han Dynasty, named these “Silk Roads” – in red; the sea lanes are in blue. Trade runs two ways. Archaeologists have found beads from Rome, gemstones from Thailand, and bullion from China. Bengal&amp;apos;s white cotton, named Dhaka muslin, was finely-woven &amp; ideal for hot &amp; humid weather, and hence was treasured by kings and merchants far &amp; wide. Impressed by the delta&amp;apos;s wealth, Mughal rulers named Bengal “Paradise of the Nations”. Buddhism spread from India into China, and missionaries from the Middle East brought Islam into Bengal in the 8th century. Trade routes also spread diseases, such as the bubonic plague or “Black Death”. Today, instead of caravans of camels toting silk, trains of flatcars shuttle laptops west to Europe, and auto parts and medical equipment east to China. Source: http://en.wikipedia.org/wiki/Silk_Road (6-11-2013)
  6. Here was the political map between 1947, when British rule ended, and 1971, when Bengalis in East Pakistan liberated themselves from West Pakistan. What happened? About 1500 A.D., the Mughals, who were Turks descended from Genghis Khan, swept from Central Asia through the northwestern Khyber Pass to conquer almost all South Asia. One magnificent legacy, we all know, is their iconic architecture, such as the Taj Mahal. But a lasting political legacy is conflict between Hindus and Muslims. European traders &amp; missionaries arriving later by sea first settled the coasts, then pushed inland up the great rivers. The British united all of South Asia&amp;apos;s vast area and polyglot population into modern India, its &amp;quot;jewel of Empire&amp;quot;. British civil servants spent careers building railroads, schools, and hospitals; battling famines and social evils, such as burning widows on the pyres of dead husbands; collecting taxes; administering laws; and exploiting its riches to benefit Britain&amp;apos;s economy. With Independence in 1947 came also Partition, creating a separate country for Muslims. Pakistan comprised two so-called “wings”: the West, five provinces of ethnically and linguistically diverse peoples; the East, one homogeneous province of Muslim Bengalis. (Next door, Hindu Bengalis form the Indian state of West Bengal.) Linking the two “wings” were mainly Islam and ruling Punjabi generals. In time, inequities became clear: the East had its own language, the larger population (hence, political power via voting), and most foreign exchange earnings (from jute); but the West, by controlling the economy, government, and army, exploited the East. Bengalis rebelled in 1971; Punjabis invaded, but were checked by India&amp;apos;s army, thus allowing the cruel birth of Bangladesh. Note this significant difference: while the West labels itself as the “Islamic Republic of Pakistan”, the East named itself the “People&amp;apos;s Republic of Bangladesh” – geographically farther from Mecca, socially less feudal, and religiously and politically more moderate. Map Source: Wikipedia
  7. Here&amp;apos;s today&amp;apos;s map. Bangla means Bengal and Bengali, and desh means country and land; so, Bangladesh in Bengali is similar in English to England, Scotland, and Poland. Its dominant feature, you see here in blue, is its great RIVERS – Ganges from the west, Brahmaputra from the Himalayas on the north, &amp; Meghna from the northeast. Compare this delta with others – Nile, Amazon, Yangtze, and Mississippi. Monsoons annually deposit silt; rich soil and mild temperatures attract farmers, making this one of world&amp;apos;s most densely populated areas. For our stories today, note DHAKA (center, capital) &amp; Comilla (east, Indian border).
  8. Here are snapshots of rural landscapes . . . and riverscapes. Note the lush green plants, fish weirs, and sail boats. To travel by water is natural &amp; cheap; to build &amp; maintain roads, costly!
  9. Freighters hauling cargoes. In the 1960s, their large sails were colorful &amp; elegant (or so they seemed at a distance). Often not too neat, they seemed stitched together from old sheets. But they were handy as large floating billboards – great for advertising (as we shall see)! Today, they are replaced by engines . . . more efficient, but less scenic. Photo Source: Cholera Research Lab, 1960s
  10. A typical rural house, hand-made from thatch &amp; bamboo mats, hence “kutcha”, meaning soft, temporary, cheap. Fine in dry seasons, but often flooded during monsoons. So, richer owners build their houses on raised platforms of concrete, hence “pucca”, meaning permanent, costly, 1st-class. Note, we see only father and son – no women !! Photo Source: Robert Terry, ca. 1980
  11. A government agricultural farm. Typical style of pucca building: 1-floor, of bricks &amp; concrete, on a raised platform, permanent. The shallow pond, known as a “tank”, is often man-made, &amp; used to farm fish. Photo Source: Robert Terry, ca. 1980
  12. So much for the broad setting. Here start my stories. In 1961, newly-elected President John F. Kennedy and the Congress created a new kind of public program. To design and launch the Peace Corps, he appointed Sargent Shriver. As JFK&amp;apos;s brother-in-law, Shriver radiated “New Frontier” charisma, a valuable asset in Washington and foreign capitals. But he also had faith and missionary zeal. Moreover, he brought practical experience – gained in the 1930s when he led young Americans to Europe with a small, private, pioneer in cross-cultural education – The Experiment in International Living. At Kennedy&amp;apos;s suggestion, Shriver visited African and Asian capitals to sell the new idea and invite their heads of state to invite Peace Corps Volunteers to help fill their needs for modern skills. Here, Shriver addresses Pakistani officials, American diplomats, and the faculty of East Pakistan&amp;apos;s Academy for Rural Development. Funded by Pakistan and The Ford Foundation, this fledgling research institute was just starting, and drawing upon 100 years of US experience with land-grant colleges. Its Bengali faculty had just returned from two years studying at Michigan State University. Peace Corps Volunteers could supplement their skills with “middle-level manpower”. Here we see one of its early classrooms; outside were plots for testing improved varieties of vegetables and rice, a tank for fish, and dormitories for students. Glancing at this scene, do you notice anybody missing? NO women!! During my many visits to Comilla in the early 1960s, the few women I saw stayed always in the shadows, shrouded, and silent. Academy&amp;apos;s Director offered to conduct 3 weeks of in-country instruction to introduce our Volunteers to rural Bengal&amp;apos;s society, economics, public administration, and Gov&amp;apos;t development programs. Photo Source: U.S. Information Service, Dacca, May 6, 1961
  13. Here are the 1st Volunteers to mainland Asia (two weeks earlier, teachers had arrived in The Philippines). Pan American Airways flew us from Idlewild Airport, New York City, to Calcutta, to catch the short hop on to Dacca. We had just spent two months studying Bengali language, society, and cross-cultural skills in Putney, Vermont, at The Experiment in International Living. Shriver started the Peace Corps so rapidly by contracting with universities, such as Harvard and Notre Dame, and private agencies, such as The Experiment and CARE, for training and management. Like Shriver, I was a long-time “Experimenter” and leader; I had also lived in and studied South Asia&amp;apos;s rural development programs; so he and The Experiment charged me with leading the “Pakistan 1” team in East Bengal. Our 30 Volunteers included nurses, engineers, agriculturists, teachers, mechanics, a brick mason, &amp; youth workers. Most were recent college grads, men in their 20s (but in today&amp;apos;s Peace Corps, women predominate). Several were in our 30s, and with military service. One teacher was an intrepid 62-year-old lady (standing behind the banner&amp;apos;s right end, over its letter “N”). Note for our stories: Bob Burns, a civil engineer from St. Louis (left, wearing black fedora, behind the “P”), Roger Hord, a master bricklayer from Portland, Oregon (right, black top coat, right of banner), Florence “Kiki” McCarthy, a California 4-H Club leader (center, tan raincoat, behind the “R”), and Peter von Christierson, an engineer &amp; city planner (behind Kiki&amp;apos;s right shoulder, blond, smiling) &amp; one of the very first to volunteer, in early 1961, to serve with the Peace Corps !! Photo Source: The Experiment in International Living, NYC, October 26, 1961
  14. To suggest to you how these statistics feel in reality, here are three everyday scenes . . . how different from my early and pretty photos ! Villagers gather at a river&amp;apos;s edge to watch a passing boat. Note how many children!
  15. Dacca in the early 1960s was merely a district town turned provincial capital, with pleasant parks, and about 350,000 people. Today, it has about 13 MILLION !!, caused by Bengalis flooding in from villages seeking jobs. (Likewise, cities in other developing economies – China, India, Brazil, Mexico – are mushrooming !)
  16. A Dhaka street during a monsoon flood. Note the main transport: tricycle rickshaws. These scenes suggest how the daily lives of millions, in both villages and cities, can be miserable !!
  17. Let&amp;apos;s glance now at five efforts to improve those 1971 statistics. First, agriculture. In addition to each farmer&amp;apos;s energy and knowledge, bountiful harvests require at least three ingredients or “inputs”: reliable water, disease-resistant seeds, and fertilizers &amp; pesticides.
  18. The Bangladesh Agricultural Development Corporation is a government agency whose task is to import and distribute key “inputs”: equipment such as water pumps, high-yield seeds, and fertilizers &amp; pesticides. The Ford Foundation asked me to help BADC improve its operations by designing a management information system (in that pre-computer era in the late 1970s, it was a simple paper-and-pencil affair, summarized on this status board). I next did the same with the Ministry of Health . . . and then I commuted to Dhaka 3-4 times yearly for two decades, often with teams of my colleagues from Arthur D. Little, to assist many development agencies. Photo Source: Robert Terry, ca. 1980 (The term “Green Revolution” refers to a series of research, development, and technology transfer initiatives, occurring between the 1940s and the late 1970s, that increased agriculture production worldwide, particularly in the developing world, beginning most markedly in the late 1960s. The initiatives, led by Norman Borlaug, the &amp;quot;Father of the Green Revolution&amp;quot; credited with saving over a billion people from starvation, involved the development of high-yielding varieties of cereal grains, expansion of irrigation infrastructure, modernization of management techniques, distribution of hybridized seeds, synthetic fertilizers, and pesticides to farmers. (In 1961, India was on the brink of mass famine. Borlaug was invited to India by the adviser to the Minister of Agriculture . . . India soon adopted IR-8 – a semi-dwarf rice variety developed by the International Rice Research Institute (IRRI) that could produce more grains of rice per plant when grown with certain fertilizers and irrigation. In 1968, Indian agronomist S.K. De Datta published his findings that IR-8 rice yielded about 5 tons per hectare with no fertilizer, and almost 10 tons per hectare under optimal conditions. This was 10 times the yield of traditional rice.[5] IR-8 was a success throughout Asia, and dubbed the &amp;quot;Miracle Rice&amp;quot;.[Wiki article excerpts] )
  19. Here are photos I made of these “inputs” working. First, a winter or dry season scene, with cloudless sky and pleasant temperatures. Note how fields are bounded by ridges – to mark boundaries, to retain water, and for walkways. Photo Source: Robert Terry, Tangail, ca. 1980
  20. The very simplest technique is for two men, standing in a canal (right), to swing a mat of bamboo or a skin to slosh water a few inches higher into the field (left). This image shows a slightly better technique: boys working a bamboo contraption, weighted at its left end to lift water using a hollowed-out log. But, both techniques are tedious and tiring, and require that the canal&amp;apos;s surface lies not too far below the field. Photo Source: Robert Terry, Tangail, ca. 1980
  21. I snapped this photo (hardly elegant) near the Comilla Academy. Because Bengali engineers lived in large towns, they were not reliably available, at reasonable cost, to design small projects in remote rural areas. So Peace Corps Volunteers stepped in. Here, our brick mason, Roger Hord (left), planned with engineer, Bob Burns (right), how to use bricks (dumped behind and below) to make that rutted dirt market road (right, background) passable in all seasons. Photo Source: Robert Terry, Comilla, 1963
  22. When 1962 brought floods, Burns quickly designed small structures – check dams, sluice gates, and bridges. Volunteers supervised villagers to build them. This newspaper photo (pardon its poor quality) shows one example. Their efforts, led by the Academy&amp;apos;s Director, saved that year&amp;apos;s harvest !! This public works program was only part of the Director&amp;apos;s strategy, based on cooperative societies. It created employment and incomes. After evaluating this pilot-scale experiment, the Academy expanded it with Gov&amp;apos;t support throughout East Pakistan, helped later by more Peace Corps Volunteers bringing their engineering and construction skills. (Note: A few years later, Roger Hord returned to Bangladesh, as a staffer with CARE, to help manage its programs; Bob Burns became Deputy Director of the Peace Corps in Micronesia.) This first pilot-scale Rural Public Works Project was evaluated, &amp; then expanded with Gov&amp;apos;t support throughout East Pakistan, with several more teams of PCVs following our team to provide the needed middle-level skills &amp; manpower. Photo Source: Pakistan Observer, Dacca, page 1, September 16, 1962
  23. Here a village boy pumps a hand-powered tube well, with his foot, to suck water up from a shallow aquifer underground. Burns showed villagers how they could sink these small pipes by themselves, rather than wait for engineers to come from the cities. Contrast the green foreground field with the dry brown background field. Photo Source: Robert Terry, Tangail, ca. 1980
  24. Here we scale up to larger, deep tube wells, powered by engines in pump houses (many funded by World Bank loans), drawing from layers deeper in the aquifer. With reliable irrigation, farmers could sow and harvest rice crops two or even three times annually!! Photo Source: Robert Terry, Tangail, ca. 1980
  25. Here we glimpse so-called “miracle rice”. Type IR-8 was evolved through years of research by seed scientists – initially at the International Rice Research Institute (IRRI) in The Philippines (funded by the Rockefeller Foundation), and later by its offshoot, the Bangladesh Rice Research Institute. IR-8 not only produced more rice, but also resisted common diseases. Imagine the thrill of seeing these fields, formerly brown during dry months, becoming so lush and green! Photo Source: Robert Terry, Tangail, ca. 1980
  26. Much or most of these inputs came from the US via our foreign aid $$$. I helped US AID to evaluate and design two such projects. So ends our FIRST story. Photo Source: Robert Terry, Narayanganj, ca. 1980
  27. Our second story started in 1817, when a new and terrible disease spread from Bengal. Its Greek name, “cholera”, means diarrhea. Profuse diarrhea and vomiting leads to profound dehydration, which can kill within a few hours. Several 19th century pandemics killed hundreds of thousands across Asia, Russia, Europe, and the Americas. Since the germ theory of disease was not known yet, doctors did not understand how cholera spread. But during the 1854 epidemic in London, Dr. John Snow mapped how many victims had drunk water from the same public well. No effective vaccine existed. The only way to prevent cholera&amp;apos;s spread was to block the fecal-oral cycle of contagion: by educating people to use pit latrines, dispose of feces, protect household water, wash hands, and use soap. Dr. Snow thus pioneered today&amp;apos;s science of epidemiology. In 1960, the US and SE Asian countries launched in Dacca the Cholera Research Lab. Its scientists developed oral re-hydration therapy: first, replace all lost fluids rapidly; second, replace lost glucose and electrolytes (salt, potassium, etc.). Because patients vomit so profusely that they cannot drink oral re-hydration saline solution (ORS), they must first be re-hydrated through intravenous tubes; this requires skill. But most often, fatalities can be limited to less than 1 per cent! When other countries adopted ORS, it saved about 40M lives, making it the most important medical discovery since penicillin!! Recognize the benefits for women: fewer infant deaths + fewer deaths of family breadwinners lead to better health, chances for better education, and capacity to earn their own incomes through small enterprises !! Sources: Wikipedia &amp; CRL articles
  28. See how the hospital is set up to cope with recurring waves of patients. The hanging sacks of water and electrolytes are replacing lost body fluids. If skilled staff can intervene quickly, cholera&amp;apos;s fatal course can be reversed, often within a few hours!! Note also how family members help patients with their daily needs – typical in South Asia. Photo Source: Cholera Research Lab, 1960s Ten Lessons in Public Health: Inspiration for Tomorrow&amp;apos;s Leaders, Alfred Sommer, MD, MHS, Johns Hopkins Univ Press, 2013, 120 pp. started his overseas career in 1970 at CRL. It tells the tale of how epidemiology grew into global health. The book is organized around ten lessons Sommer learned as his career took him around the world, and within these lessons he explains how the modern era of public health research was born. Three themes emerge: the duty to help your fellow human beings by traveling to places where there are problems; the knowledge that data-driven research is the key to improving public health; and the need to persevere with sensitivity and strength when science and cultural or sociological forces clash. Nothing in this compelling, sometimes controversial, history is glossed over, as the book’s goal is to explain when and why public health efforts triumph or fail. Readers will travel to Bangladesh, Iran, Indonesia, South America, and the Caribbean, where they will learn about spreading epidemics, the aftermath of storms, and vexing epidemiological problems. Sommer reveals the inner politics of world health decisions and how difficult it can be to garner support for new solutions.
  29. Notice her bright sari ( without a black billowing burqua), her ID badge, notebook, and shoulder bag with medicines. Photo Source: Cholera Research Lab, 1960s
  30. A woman dissolves “ORSaline” into boiled water. In time, country-wide campaigns, backed by “ORSaline” packets available cheaply at every village shop, equipped Bengali households to understand and combat cholera successfully at home !! So ends our SECOND story. Photo Source: Cholera Research Lab, 1960s
  31. Our THIRD story is the most exciting: empowering women. It unfolds in three chapters. Chapter A began in 1962 with experiments at Comilla. Here&amp;apos;s one of our Volunteers, Florence “Kiki” McCarthy. Her initial task: listen carefully to village women explaining their needs. Understand this context: Social rules barred the Academy&amp;apos;s faculty, who then were all men, from working with women. So its Director asked Kiki to reach out. Using her long experience as a 4-H Club leader in California, Kiki gained permission from village elders and husbands to talk with their wives and invite them to the Academy. After Kiki learned their priorities – better childcare, maternal health, home economics, self-employment – she designed classes, which women attended regularly. (Although the Academy gave them money to travel by rickshaws, many women instead chose to walk, thus saving for small investments, for example in chickens and goats; this was one origin of micro-finance!) The Academy, like its experiment in public works, evaluated and reported this one. Kiki, with her Academy colleagues, and speaking always Bengali, improved and expanded it. This flier advertised the Peace Corps&amp;apos;s later request for Volunteers for Rural Community Action programs, province-wide. But, several years later, came the still BIGGER story: Kiki returned home to the USA to earn her PhD in rural sociology. After Independence in 1971, her Bengali successor at the Academy, by then a Government officer, urged her to return. Kiki worked in Bangladesh the next six years, supported by The Ford Foundation and other donors, guiding research on the lives of rural women and designing programs to educate them. Government&amp;apos;s pro-women policies set the framework for MANY NGOs to grow and improve their health, education, and economic conditions. So, Kiki helped launch A MAJOR REVOLUTION . . . which is still in progress!! Today, the Academy continues. During a recent visit, I saw its faculty and classes including women – well-educated, confident, smiling, and without burquas. Photo Source: Peace Corps recruiting flier (Black Star photo), 1963
  32. Here&amp;apos;s just one example of countless scenes – village women meet a field worker to plan a project funded by CARE. CARE was one of several NGOs which helped my Peace Corps team greatly as we started working in 1961-62. Photo source: http://devpolicy.org/wp-content/uploads/2013/03/Women-engaged-in-the-CARE-project-in-Bangladesh-.jpg. downloaded 8-11-2013
  33. Chapter B&amp;apos;s name you probably recognize. Grameen&amp;apos;s story began when a young economist started researching whether villagers might learn to handle small loans, without financial collateral, to begin household enterprises. Through many trials and errors, he developed the system we know as “micro-credit” or “group-based lending”. His goal: reverse the age-old vicious circle of &amp;quot;low income, low saving, &amp; low investment&amp;quot; (spiraling downwards, trapped by money-lenders) → into a virtuous circle of &amp;quot;low income, inject credit, invest, earn more, save more, invest more, earn more&amp;quot; – (spiraling upwards)!
  34. Here&amp;apos;s a profile of how traditional banks work. In essence, only those who have money already can borrow more!
  35. Here is the contrasting profile of how micro-credit works. Yunus summarizes his approach this way: &amp;quot;Whatever traditional banks do, I did the opposite.&amp;quot; Many color photos of Grameen bankers at work in villages are available at http://www.grameen-info.org/index.php?option=com_zoom&amp;Itemid=103&amp;page=view&amp;catid=18&amp;key=4&amp;hit=1
  36. Example: in cities, wealthy men drive to their banks; in the countryside, Grameen&amp;apos;s “bicycle bankers” peddle out to meet village women. Notice here: rural setting, but the tin shed is neat and clean, appears new; all women, in mutual-support groups, wearing colorful sarees, but not burquas. Photo Source: http://www.grameen.com/index.php?option=com_zoom&amp;Itemid=103
  37. Every five years, Returned Peace Corps Volunteers and staff members gather for reunions, typically in Washington DC. A regular closing feature is a visit to the grave of Pres. John F. Kennedy, who created the Peace Corps in 1961, followed by speeches and performances in the nearby stadium and then marching back across the Potomac River over Memorial Bridge, with each country-of-service group carrying its host country&amp;apos;s flag. In 1986, we ( dressed shabbily for Washington&amp;apos;s hot summer weather) were joined by Dr. Yunus, shown here on the right wearing his dark green Bengali dress cotton tunic.
  38. Here&amp;apos;s one of Grameen&amp;apos;s most dramatic social enterprises. Norwegians provided their cell phone technology to link thousands of Bengali villages, hitherto isolated, with each other and the world. This book&amp;apos;s cover photo shows a village &amp;quot;phone lady&amp;quot; both earning income and helping her neighbors talk with their men working elsewhere, often abroad in the Middle East; farmers obtaining timely market information; and households accessing their new bank accounts. More than 55,000 phones now serve more than 80 million people in 28,000 villages. Grameen Phone&amp;apos;s experience helps to develop cell phone networks in other poor countries. Photo Source: Sullivan&amp;apos;s book cover
  39. These and other achievements were recognized by the Nobel Peace Prize! Photo source: Nobel Prize website, 2006.
  40. These and other achievements were recognized by the Nobel Peace Prize! Photo source: Nobel Prize website, 2006.
  41. Chapter C began also in the early 1970s, sparked also by a disaster – a flood. A young accountant quit his comfortable job with a multi-national oil company in London to return home &amp; start the “Bangladesh Rural Advancement Committee” (note his term “Committee”). F.H. Abed organized college student volunteers to help destitute victims. He focused on very poor, marginal groups, especially women and children; an example was his early request for funds from us at Oxfam America. This photo shows Abed, in the early 1970s, learning from villagers. Photo source: BRAC USA, Scott MacMillan, Communications Manager, 110 William Street, 29th Floor, New York, NY 10038 T: (212) 808 5615, M: 1 (508) 310 3018 http://blog.brac.net/ Appears also in book Freedom from Want. Provided Aug. 6, 2013.
  42. A modern manager, Abed installed business-style organization and accounting, thus attracting many foreign donors. Insisting from the start on researching programs and evaluating their many early missteps, as well as developing a disciplined staff, he created a “learning organization”. BRAC grew into the country&amp;apos;s largest private employer, second in size only to the Government. (His early “Committee” is now simply “BRAC, a development organization”.) Like Grameen, BRAC learned from Comilla&amp;apos;s 1960s experiments, including those with women by Kiki McCarthy and her successor and later Government colleague, Taherunnessa Abdullah (who today still serves on BRAC&amp;apos;s board!). BRAC&amp;apos;s statistics are amazing: 88,000 community health promoters serve more than 92 M rural people; its pre-primary schools graduate 2.3 M youngsters, and its primary schools, 3.8 M; its non-profit enterprises sell seeds, fish, poultry, dairy, retail goods, etc., producing revenues which subsidize its free programs – and supplying now about 75% of BRAC&amp;apos;s budget !!! Its micro-credit program is larger than Grameen&amp;apos;s. Its Training &amp; Research Centers develop staff skills. Its infrastructure institutions include BRAC Bank, BRAC University, BRAC Housing, and BRACNet. (I followed BRAC&amp;apos;s growth during years of consulting assignments in Bangladesh. A “Global Partnership” relationship grew in time between The Experiment in International Living&amp;apos;s School for Int&amp;apos;l Training, in Brattleboro, VT, BRAC&amp;apos;s TARCs, and an institute in East Africa. Abed joined the Board of The Experiment, but only briefly, due to burdens of int&amp;apos;l travel &amp; his other priorities. (Numerous articles and books report BRAC&amp;apos;s growth: e.g. A California political scientist, Catherine H. Lovell, Breaking the Cycle of Poverty: The BRAC Strategy , Kumarian Press, 1992. See Martha Chen&amp;apos;s 1980s research about rural women, A Quiet Revolution: Women in Transition in Rural Bangladesh [Paperback], Schenkman, 1983, 256 pp. She has sparked development of http://wiego.org/ Women in Informal Employment: Globalizing and Organizing, a global action-research-policy network to improve the status of the working poor, especially women. WIEGO Secretariat, Harvard Kennedy School, 79 John F. Kennedy Street, Cambridge, MA 02138.)
  43. Note this clean, well-equipped, and orderly classroom . . . and its teacher not hiding under a burqua! Photo Source: BRAC website, 2013
  44. Of many reports and books, here&amp;apos;s one in 2009. BRAC started working abroad in 2002, in Afghanistan, where it is now the largest NGO. Its programs now serve 126 M people in ten countries! Photo Source: Smillie&amp;apos;s book cover. Citation in 1-page list of resources.
  45. Abed and BRAC have been honored by The World Bank, Gates Foundation, and many others. In 2010, Queen Elizabeth appointed him a Knight, making him now Sir F.H. Abed. This ends our THIRD story. Knight Commander of the Order of St. Michael and St. George (KCMG), For services to tackling poverty and empowering the poor in Bangladesh and more globally. – New Year Honours 2010, announced on 31 December 2009 Photo source: New Years Honours ceremony, from BRAC USA.
  46. This FOURTH story helped facilitate the previous ones, and is an exciting example of innovation. Begun in 1974 as a pilot experiment (about which many were skeptical) within the Ministry of Health, its eventual growth, size, and operating requirements strained the cultural limits of its Ministry host. Around 1990, I and an Arthur D. Little colleague were asked to help transform it from a public project into a private commercial, even though non-profit, company. We taught its staff strategic planning, competitive analysis, and business organization and personnel management, and designed its management and governance. The Social Marketing Company has since grown into the world&amp;apos;s largest such organization in a single country! For general background, see http://en.wikipedia.org/wiki/Social_marketing . Social Marketing: A Success Story in Bangladesh, by Mahbubur Rahman and Toslim Uddin Khan (both SMC senior managers), 6 p. paper, ca. 2009, via SMC&amp;apos;s website – http://www.smc-bd.org/ . SMC in 1990 was funded by US AID $$ and assisted by Washington-based Population Services International (our client). Today, PSI is a global organization dedicated to improving the health of people in the developing world by focusing on serious challenges like a lack of family planning, HIV and AIDS, barriers to maternal health, and the greatest threats to children under five, including malaria, diarrhea, pneumonia and malnutrition. PSI works with local affiliates in 69 countries (but no longer in BGD), with more than 8,000 staff, of which PSI&amp;apos;s expatriate staff is about 1%. Major donors include the governments of the United States, United Kingdom, Germany and the Netherlands; the Global Fund to Fight AIDS, Tuberculosis and Malaria; United Nations agencies; private foundations; corporations and individuals. (Sally Gamble Epstein is a Director.) Source: http://www.psi.org/about-psi/psi-at-a-glance (downloaded 7-2-2013)
  47. The Company aims not only to import or manufacture family planning supplies, donated by the USA and other rich countries, but also to distribute them in ways acceptable in Bangladesh&amp;apos;s context. Here&amp;apos;s one of its several condoms, each brand designed for a socio-economic market segment; as the logo suggests, &amp;quot;Raja&amp;quot; means King. In a rural and relatively illiterate society, advertising campaigns need more channels than magazines and television. To make it familiar, SMC plastered this Raja logo on the huge sails of river boats, on T-shirts worn by thousands of rickshaw peddlers, and on every little corner village shop – to compete for attention with such familiar logos as Coca-Cola. Photo Source: SMC website, 2013
  48. Similarly for women&amp;apos;s contraceptive pills, here&amp;apos;s the Maya brand. Photo Source: SMC website, 2013
  49. SMC&amp;apos;s network of warehouses made it ideal also for supplying millions of packets of salt, potassium, and trace minerals needed in every village and household to combat cholera. Helped also of course by BRAC&amp;apos;s national rural network and 1979 ORS campaign. Photo Source: SMC website, 2013
  50. Note how this young lady does not cover her head, but wears a brightly-colored sari, while the two village women shroud themselves in dark burqas. Photo Source: Robert Terry, Tangail, ca. 1980
  51. A village woman teaching proper child care. All of these institutions – Comilla Academy, Grameen, BRAC, and Social Marketing Company – invested heavily in designing pictorial teaching materials, and in training teachers how to focus on the interests and learning abilities of Bengalis with limited education and literacy. This ends our FOURTH story. Photo Source: Robert Terry, Tangail, ca. 1980
  52. Tragedies forced the FIFTH story into our headlines. For 40 years, international treaties governed the textiles and garments trade, and encouraged massive expansion in Bangladesh, where wages are “cheaper than anywhere else in the world” – in 2012, only $37 a month! Its Ready-Made Garment industry, worth $19 B-a-year, ships 60% of its products to Europe, 40% to USA. By 2013, about 5,000 factories housed about 4 M workers, 90% women; garment jobs attract rural migrant women, in an economy where rural job options are increasingly limited, and where women are largely barred from formal work in cities. (Multi Fibre Arrangement (MFA) governed world&amp;apos;s textiles and garments trade, 1974-2004, imposing quotas on the amount developing countries could export to developed countries. Introduced as a short-term measure to allow developed countries to adjust to imports from the developing world. However, it was not negative for all LDCs: EU imposed no duties on imports from the very poorest countries, such as Bangladesh, leading to a massive expansion of the industry there. Bangladesh was expected to suffer the most when MFA ended, due to competition, particularly from China. This was not the case: Bangladesh’s labor is “cheaper than anywhere else in the world.” (Next came US Tariff Relief Assistance for Developing Economies Act of 2009 designating BGD as one of the 14 LDCs eligible for &amp;quot;duty-free access for apparel assembled in LDCs and exported to the U.S.&amp;quot; from 2009 through 2019. (November 2012 fire in the Tazreen Fashion factory in Dhaka killed 117 people and injuring 200; deadliest factory fire in the history of Bangladesh.)
  53. This stock photo is no doubt meant to suggest clean and orderly, albeit crowded, assembly floors in a building which appears metal-framed, hence presumably sturdy. BUT five deadly accidents within six months caught world attention, and pressured big brands, such as Gap and Nike, to enact change. (But Walmart helped block reforms.) The Bangladesh Labour Act of 2006 contains fine language; but low standards, lax regulation, and corruption allow overcrowded factories, accidents, and fires. Two dozen factory owners are also Members of the Bangladesh Parliament (which Sir Abed describes as an “unholy alliance”); none have been charged or prosecuted.Garment workers&amp;apos; minimum wage set at about $37 a month in 2012; but since 2010, Bangladesh&amp;apos;s double-digit inflation with no corresponding rise in minimum wage and labor rights. Major source of employment for rural migrant women in an economy that has increasingly limited rural job options, and where women migrants have been largely excluded from formal work in the cities. [WIEGO, Martha Chen &amp; colleagues, Harvard.] Predictions by McKinsey &amp; Co of the industry tripling in size by 2020 !! . . . 1,363 workers died &amp; 830 workers injured in work accidents during 2012 in various industries. Weak enforcement of existing provisions under the Bangladesh Labour Act-2006, lack of effective labour inspection system at enterprises, inadequate occupational health services, lack of basic training and awareness programs for workers and unsafe working conditions. Photo Source: Wikipedia, “Garment industry”, 2013
  54. This building was reportedly sited on a &amp;quot;pond filled with sand&amp;quot;. Its top three floors were illegal, with probably sub-standard engineering and construction. A rooftop generator caused vibrations, and probably cracks in weak walls and floors. “Workers knew the building was dangerous. On Tuesday, April 23, huge cracks had opened in the walls and a local inspector ordered it evacuated. But on Wednesday, April 24, workers were told they would not be paid for the month unless they returned to work to meet delivery quotas.” When it collapsed that morning, 1,129 workers, mostly young women, were crushed. Sources: Reports from the press and my friend, Dr. Richard J. Murphy, a seasoned ISO auditor from England who works regularly in the US, UK, Bangladesh, and other countries. Photo Source: BRAC website, 2013
  55. Study the horrors displayed on The New York Herald&amp;apos;s front page on March 26, 1911 . . . . . . and the eerie parallels with the Rana Plaza disaster: in the Triangle company, fire started in a pile of fabric waste &amp; swept through the top three floors of a ten-story building; workers fleeing down the only stairs were crushed to death against its exit door, locked by managers; fire ladders were too short to reach top floors; many workers jumped to their deaths. Most of the 146 victims were Jewish and Italian immigrant women. The Triangle tragedy, the 4th highest loss of life in a U.S. industrial accident, spurred outrage, growth of the International Ladies Garment Workers Union (ILGWU), and The Committee on Public Safety. The Committee&amp;apos;s head, social worker Frances Perkins, researched workplace problems and lobbied for new laws. Source: Wiki article, downloaded June 15, 2013. (Committee on Public Safety, headed by Frances Perkins, a noted social worker, formed to identify specific problems and lobby for new legislation, such as the bill to grant workers shorter hours in a work week, known as the &amp;quot;54-hour Bill&amp;quot;. New York State Legislature created Factory Investigating Commission. In NYC, 200 other factories w similar conditions. Commission led to 60 new labor laws – mandated better access and exits, fireproofing, availability of extinguishers, installing alarms &amp; automatic sprinklers, better eating and toilet facilities for workers, and limited the number of hours that women and children could work. (American Society of Safety Engineers was founded in New York City on October 14, 1911. (Large literature, e.g. von Drehle, David, Triangle: The Fire That Changed America , New York: Atlantic Monthly Press, 2003; PBS documentary, American Experience: Triangle Fire , in 2011 as part of the 100-year commemoration ceremonies; recent biography of Perkins.)
  56. Outrage led to 60 new laws, including the &amp;quot;54-hour Bill&amp;quot;, which limit how long women and children could work weekly, and the American Society of Safety Engineers. (In the 1930s, Frances Perkins, then Secretary of Labor under President Roosevelt, initiated the New Deal&amp;apos;s major occupational safety and health laws.) Today, degrading and dangerous sweatshops exist not just in Bangladesh, but also in China, Cambodia, and elsewhere. Reform efforts are underway: International labor organizations, NGOs, and some garment firms signed in May 2013 the “Accord on Factory and Building Safety”, a five-year legally-binding agreement. In June, the Obama administration suspended Bangladesh&amp;apos;s trade privileges, to signal that it must clean up its garment industry. A long-term question is whether an international system of enforceable standards might gradually emerge. It could draw both on the history of OSHA (our Occupational Safety and Health Act of 1970) in the US, European Union, and elsewhere, and on the 60-year experience of the International Organization for Standardization (known as ISO), composed of 163 organizations worldwide. The immediate question is whether Bangladesh&amp;apos;s business and political leaders will reform.
  57. We all know of course that part of the problem is cost-conscious consumers, many of whom are ill-informed, perhaps uncaring, and unorganized. Here&amp;apos;s one example of a consumer-based strategy: Oxfam&amp;apos;s “Behind the Brands” campaign features a scorecard displaying each company&amp;apos;s policies; see it on the internet at http://www.behindthebrands.org/ . Might this work also in the garment industry? A European effort is the Clean Clothes Campaign. Over the past century, powerful food and beverage companies have enjoyed unprecedented success. But they have grown prosperous while the millions who supply the land, labor and water needed for their products face increased hardship. Now, a rapidly changing environment, affected communities and an increasingly savvy consumer base are pushing the industry to rethink ‘business as usual’. In this 52-p report, Oxfam assesses the social and environmental policies of the world’s ten largest food and beverage companies and calls on them to take the critical next steps to create a just food system. The “Big 10” – Associated British Foods (ABF), Coca-Cola, Danone, General Mills, Kellogg, Mars, Mondelez International (previously Kraft Foods), Nestlé, PepsiCo and Unilever – generate revenues of more than $1.1bn a day and employ millions of people directly and indirectly in the growing, processing, distributing and selling of their products. Today, these companies are part of an industry valued at $7 trillion, larger than even the energy sector, and representing roughly ten percent of the global economy. Important policy gaps include: • Companies are overly secretive about their agricultural supply chains, making claims of ‘sustainability’ and ‘social responsibility’ difficult to verify; • Only a minority of the Big 10 are doing anything at all to address the exploitation of women small-scale farmers and workers in their supply chains. Photo Source: Oxfam America, Behind the Brands, 2013. http://www.behindthebrands.org/ 226 Causeway Street, 5th Floor, Boston, MA 02114. President Raymond Offenheiser.
  58. Look how these indicators have changed over 41 years!! Especially in the last two decades, Bangladesh has: more than trebled its food-grain production, becoming self-sufficient; dramatically reduced its birth, death, &amp; fertility rates; and more than trebled its economic growth rate. Helping these changes are improved education &amp; literacy, health care, communications (helped by Grameen Phone), and opportunities for educated women. In the last two decades, Bangladesh has made marked progress: become agriculturally self-sufficient; dramatically reduced its birth rate; highly improved literacy rates; delivered basic social services to its people; and empowered women. Bangladesh’s voice of moderation in regional and international fora is widely respected and appreciated. Bill Clinton paid the first-ever visit by a sitting U.S. President in March 2000; Secretary of State Colin Powell in June 2003; Secretary of Defense Donald Rumsfeld in June 2004; Secretary of State Hillary Clinton in July 2012. U.S. Ambassador in Bangladesh Dan Mozena has been consistently upbeat in his remarks about Bangladesh: &amp;quot;Indeed, we have moved a long way ahead since Henry Kissinger&amp;apos;s labeling of Bangladesh as a basket case in the early 70&amp;apos;s, in resonance with the political and economic situation of the time.”
  59. Economists forecast Bangladesh&amp;apos;s growth to continue, &amp; perhaps reach middle-income status by 2021 – compared with 1971, 50 years before, a possible miracle! However, questions remain: Garment industry: It&amp;apos;s difficult to predict whether and how its business and political leaders can reform sweatshop conditions. Vicious politics: E.g., Government ousted Yunus, &amp; now seeks 51% ownership of Grameen Bank. Islamist reactionaries: Threats exist from Saudi Arabia&amp;apos;s Wahabi sect, but seem unlikely to succeed, thanks to the moderate character of the People&amp;apos;s Republic of Bangladesh. Natural disasters: floods and typhoons will of course continue; but some effects can be mitigated. Climate change: a more serious threat . . . the Ganges delta is one of the most vulnerable areas. Most of Bangladesh is less than 12 meters (39.4 ft) above sea level; if water were to rise by 1 meter (3.28 ft), about 10% of the land would be flooded. See papers issued by World Bank economists. A.T.Rafiqur Rahman, Can Bangladesh be a Middle Income Country within a Decade?, Dhaka: University Press Limited, 2012, 82 pp.
  60. I have probably loaded you with more than you wanted or needed to know. But I hope that you now realize that Bangladesh is a “basket-case” no longer. It has become an incubator of concepts and experience inspiring development leaders elsewhere, including in the USA. Moreover, Bangladesh is happily not the only success story. During the past two decades, the number of the world&amp;apos;s people mired in extreme poverty (with incomes less than $1.25 per day!) fell from 43% to 21%, or almost 1 B ! The major contributor was of course China; but Bangladesh helped! Finally, two encouraging thoughts: First, The Economist noted: “The most dramatic period of improvement in human health in history is often taken to be that of late-19th-century Japan, during the remarkable . . . Meiji transition. Bangladesh’s record on child and maternal mortality has been comparable in scale.” (And it exceeds that of its richer neighbor, India!) Second, BRAC&amp;apos;s Founder reflected: “After independence, I began working to try to help the poor of Bangladesh. My early colleagues and I initially thought that BRAC would be a short-term relief effort. But the realities of entrenched poverty soon changed our minds. I have learned much . . . Perhaps most important – when you create the right conditions, poor people will do the hard work of defeating poverty themselves.”