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Business & Profession Health Economics and Policy, Professional Development, Education and Training, Practice Management

Securing the Right to Sight

My career of advocacy and program development began around 18 years ago. After completing degrees in education and special education at the University of Dhaka, with a focus on people with disabilities, I began to work within the Centre of Services and Information on Disability (CSID). It was at this local level where I first saw how people can be isolated by their situations and left without any sense of community. In Bangladesh, this is particularly applicable to women with disabilities who are often left without a voice. It is this reality that has driven me throughout my career of advocating for equal rights within national and international organizations.

As a country, and thanks in part to an increase in funding by the government, Bangladesh has developed considerably. Despite this, the benefits of such developments have not been reaped equally by men and women. Although Bangladeshi women are more likely to be visually impaired or blind than men, they have reduced access to treatment and services. Within all aspects of life, including the healthcare sector, it is expected that any decisions pertaining to a woman will usually be made on her behalf by the head of her family – a male relative.

This convention persists because women are not often given the opportunity to generate their own income and so feel as though they have no claim to their family’s earnings and, most significantly, no say in how it is used. This lack of autonomy places their health, education, and livelihood in the hands of somebody else who may not understand or prioritize their needs. These problems are then exacerbated for women with disabilities. I now focus on devising policy that combats prejudice and ensures that reforms are implemented in society to benefit the lives of marginalized groups.

Equality efforts
 

In Bangladesh, health policy – and its implementation – are overseen by the Director General of Health Services (DGHS) who works under the Ministry of Health and Family Welfare. Under the DGHS, Bangladesh has introduced several initiatives that have both boosted development and ensured the inclusivity of health policies. As part of this approach, the government has cultivated close working relationships with a number of eye-focused, non-governmental organizations, including Sightsavers, who are able to give insight on issues relating to disability, inclusivity, and eyecare as well as provide guidance and support as to how budgets and government resources can be allocated and expanded to meet the needs of the population. It is through such relationships that we have seen our health and education policies amended to include people with disabilities, marginalized groups, and those in hard-to-reach areas. Although these positive changes take time, it is promising to see steps being made in the right direction.

One source of information that has directed our efforts is the Bangladesh National Blindness Survey, which is led by the government with support from organizations including Sightsavers. The most recent survey found that approximately one percent of all Bangladeshi adults over 40 years of age are blind. Cataracts, the primary cause of preventable vision loss, make up 80 percent of these cases (1). Although the numbers show there is definitely scope for improvement, they also highlight the fact that we have the opportunity to prevent more people from experiencing blindness. At Sightsavers, we’ve been looking to address this problem by focusing on inclusivity and making sure that everybody has access to good quality, affordable and inclusive eye care health – irrespective of gender, age, disability, economic circumstances, or ethnicity. For all women, we have been raising awareness about the barriers that prevent access to existing healthcare services, including those brought about by the traditional patriarchal structure. We also ensure they are in the forefront of our minds when assessing policy implementation and developing programs to address their specific needs.

The right to health
 

Now concluded, the Right to Health Project remains close to my heart. Funded by the UK government through UK Aid Match, the project was implemented in the Rangpur, Rajshahi, and Dhaka districts of Bangladesh as well as in Pakistan from July 2018 to December 2021. It focused on people with low income and marginalized groups within society, specifically people with disabilities, women, older people, and transgender populations, aiming to increase access to healthcare facilities but specifically ensuring that these people received equal treatment to the rest of the population. Looking back, it was a tremendous feat that required a number of innovative approaches – not least because it was both technically and socially challenging. We worked closely with the government throughout the whole project, from design to implementation, which helped to inform our steps.

As part of the project, we had mass eye health awareness and inclusivity campaigns and targeted outreach camps. We also considered the accessibility of our hospitals (something that had not been done before in Bangladesh) to ensure that people with disabilities could go and enjoy the healthcare facilities independently. Finally, when it came to the care that those who attended our hospitals received, we supported our hospital partners and ensured that all staff received diversity and equality training. In Bangladesh, the Right to Health Project supported around 877,000 people from marginalized communities and provided over 47,000 cataract surgeries and approximately 508,000 non-surgical treatments.

Though the project has concluded, its success is just the beginning. We want to extend its reach by drafting a national guideline that makes facilities accessible to all, and encouraging the government to endorse it and document how to support the needs of those people who are marginalized or discriminated against.

The Right to Health Project was, in some ways, the perfect execution of what I have strived to achieve throughout my career. I want us all to live in a society without discrimination and, as such, it is important to me that people know their rights and that their voices are heard. I’ve used my passion for advocating and campaigning for justice and equality to fuel my career – and, though I will continue to work towards reducing gender discrimination and other forms of prejudice, I don’t believe that the full responsibility of this reform lies upon me. Everyone has a part to play in advocating for the voiceless among us. Working to remove the discrimination befalling others should be a global and universal effort.

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  1. SA Shakoor et al., “Prevalence of blindness and its determinants in Bangladeshi adult population: results from a national cross-sectional survey,” BMJ Open, 12, e052247 (2022). PMID: 35365514.
About the Author
Syeda Asma Rashida

Project Manager at Sightsavers and is based in Dhaka, Bangladesh.

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