“Cyclone Aila and It’s Impact on Health Care System:

1. “Cyclone Aila and It’s Impact on Health Care System: A Case Study on Gabura Union, ShyamnagarUpazila, Satkhira” ‘Health Centred Disaster Risk Reduction: a New Agenda for a New Era’. Dealing with Disasters Conference September 2015 Presented by : Sheikh Mohammad AbdurRahman Deputy Director Implementation Monitoring and Evaluation Division (IMED), Ministry of Planning , The People’s Republic of Bangladesh Slide-1

2. Brief introduction of my Job Place • My job place is Implementation Monitoring and Evaluation Division, Ministry of Planning. • I work there as Deputy Director. • The major function of this division and as well as my responsibilities are as follows: • Monitoring and Evaluation of the implementation of development projects included in the Annual Development Programme. • Collection and compilation of project-wise data for preparing quarterly, annual and periodical progress reports for information of the President, Prime Minister, NEC, ECNEC, Ministries and other concerned. • Rendering such advisory or consultancy services to Ministries/Agencies concerned on implementation of projects as and when necessary. • Field inspection of projects for on the spot verification of implementation status and such other Co-ordination works as may be necessary for the removal of implementation problems, if any, with the assistance of related Ministries/Agencies. • Submission of project inspection reports to the President, Prime Minister and Ministers concerned when attention at such levels are considered necessary. Slide-

3. Geographic Location of Bangladesh Slide-

4. Some Historic Events of Cyclone in Bangladesh Slide-

5. About Cyclone Aila Slide-

6. Massive destruction at Satkhira and Khulna districts caused by Aila Slide-3

7. Map of Gabura surrounded by Kholpetua and Kopataska rivers specifying with four mouza, health clinic, drinking water source (PSF), roads, market, canals, settlements and others Slide-5

8. Extent of the impact of Cyclone Aila in Khulna and Sathkira districts Slide-2

9. Schematic Presentation on Different Facets of Impact Caused by Aila Slide-6

10. Primary Health Care run by Directorate General of Health Services at the upazilla level and below Slide-8

11. Types of facility from national to the ward level, with managerial hierarchy Slide-9

12. To make a clear comparison about health care system of Gabura union before and after Aila; • to analyze the situation of the villagers of Gabura in times of disaster and the needs and problems that arose due to the disaster; • to examine the weakness of the health care services provided by both GOs and NGOs agencies working for affected villagers of Gabura and • To push forward some recommendations so that remedial as well as rehabilitative measures in terms of health and education could be initiated to redress the vulnerability of the affected people. Objectives of the study Slide-10

13. Data Collection Collection of secondary data from different issues of the daily, monthly and quarterly newspapers, published and unpublished research reports, articles and various relevant web site. Data analysis, appraisal and assessment Collection of primary data through personal interview with the Aila affected inhabitants, traditional birth attendants, village doctors, community leaders, NGO officials, Shyamnagar upazila statistics and health officer. Supported by : Focus Group Discussion & Case Study Study Output Materials and Methods Study Design: The Schematic Presentation of Different Steps Followed Slide-11

14. A view of FGD session conducted in an indigenous way by the researcher with Aila affected male inhabitants in front of MaddhoKhalishabunia mosque (situated at MaddhoKhalishabunia village) Slide-13

15. Findings of the study . House of a permanent residence Jhupri of the migrants’ family living on the embankment Tiger victims with the researcher Affected hand of the victims by the tiger Slide-17

16. Findings of the study In terms of magnitude diseases placed Gabura in the following ranks: Water-borne diseases - 1st Position (100%) Cardiovascular diseases - 2nd Position (68%) Kidney problem - 3rd Position (54%) High blood pressure/Hypertension - 4th Position (43%) Gynecological problem - 5th Position (36%) Eclampsia - 6th Position (32%) Researcher with Kabiraj Proshanto Researcher at village doctor (VD) chamber Slide-21

17. Non-sanitary toilet of a migrated residence Water sealed toilet of a permanent residence Slide-25

18. PSF water system A harvested rain water tank seen to be functioning Homemade harvested rain water tank Homemade harvested rain water tank Water point of a Piped water system Piped water system Slide-27

19. Findings of the study • In order to ensure remedy of the diseases the facts are as follows: • The doctor is available only once a week only for a couple of hour. • Bad road infrastructure due to Ailait is difficult on the part of the local people to rush for medical services provided by the four Community Clinics (CCs) specially at the rainy season. • The villagers usually take basic health care services from 38 village doctors or paramedics of Gabura. • Village Doctors have their own medicine shop with low quality medicines. • Respondents are taking services from Untrained Traditional Birth Attendants and Kabirajs’ even knowing that they are not qualified enough to prescribe any scientific treatment. • No health and nutrition related education or campaigning found in the study area. Slide-23

20. PSF system installed by OXFAM seen to be non-functioning A harvested rain water tank seen to be non-functioning Front view of Friendship water purification system Front view of Friendship water purification system Partial image of Friendship water purification system Partial image of Friendship water purification system Slide-29

21. Embankment are rebuilt for last five years within this way Damaged portion of the embankment which is still in risk Only pond that was full of pure water even after more than one year of Aila Embankment and river are almost on the same height in this location Slide-31

22. Signboard of some NGO’s which are exists only in the signboard Slide-33

23. Concluding Remarks • This particular study was confined to a union only. • The scope for the study was very much limited. • The findings of this study should, at best, be considered as indicative rather than exhaustive. • This micro study will pave the way to take many macro studies in this particular area. • With this study and future research, a nation-wide programs of action could be commissioned aiming at complete rehabilitation of the people (suffering from natural disaster like Aila on regular interval specially health, nutrition and relevant education) living in coastal regions would be viable and sustainable. Slide-34

24. Researcher with ‘Sheikh AmeerHossain’ who helps a lot to discover Aila affected Gabura union and assist to communicate all through the respondents Slide-35

25. Thanks for your patience hearing Do you have any query? Please………………. Contact: Sheikh Mohammad AbdurRahman Deputy Director Implementation Monitoring and Evaluation Division (IMED), Ministry of Planning , The People’s Republic of Bangladesh Cell No. +8801819260139 E-mail: tinturet@gmail.com Slide-36