Friendship Riverbased Health Program
Friendship's 3 tiered health program includes floating hospitals, outreach satellite clinics and community workers designed to cater to the riverine populace.
About Your Organization
Bangladesh, DHA, Dhaka
Country where this project is creating social impact
Bangladesh, XX, Kurigram, Gaibandha
Is your organization a
Non‐profit/NGO/citizen sector organization
How long has your organization been operating?
More than 5 years
Has the organization received awards or honors? Please tell us about them
Runa Khan, Executive Director of Friendship received the Ashoka Fellowship in recognition for her work in developing innovative teaching methodology. She has received the Rolex Awards for Entrepreneurship in 2006 and the IDB Award for contribution to women in development in 2008. Recently she has been accorded the prestigious SCWEC Women Entrepreneur Excellence Award 2010 conferred by the SAARC Chamber Women Entrepreneur Council.
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Select the stage that best applies to your solution
Established (past the previous stages and has demonstrated success)
How long have you been in operation?
Operating for more than 5 years
Which of the following best describes the barrier(s) your innovation addresses? Choose up to two
Access, Cost, Quality.
The Need: What problem are you trying to solve?
The chars and riverbank areas in Bangladesh are highly prone to erosion and flooding. A fragile physical environment, limited assets, reduced income opportunities, remoteness and absence of mainland institutions and services together make char dwellers’ livelihoods particularly vulnerable to extreme poverty and destitution. Char dwellers are plagued by poor health and a low standard of living; and the whole community have been suffering from the lack of access to health services. The char dwellers’ lack of mobility and difficulty to access the mainland results in increased mortality and morbidity from diseases and conditions which may be controlled by the most basic of intervention through access to health care facilities.
The Solution: What is your solution? Be specific!
With a mission to address community needs of the chars, Friendship initiated an innovative 3 tiered health program designed to provide health services to the chars. The program has a holistic approach to health service, providing primary and secondary health care through its floating hospital as well permeating the community with trained community health workers and outreach satellite clinics. However, there also is an acute need for specialized care and surgeries. Friendship's floating hospital cater to this need through health camps held free of cost. These health camps are organized regularly with specialist doctors from home and abroad to provide services such as eye, dental, ENT clinic and surgery, pediatric, orthopedic, plastic-reconstructive surgery, post-operative care, specialist consultation and referral service. By targeting beneficiaries whose lives are most affected, the impact of this project has changed the lives of thousands, ensuring hope where none existed before.
The Model: Walk us through a specific example of how your solution makes a difference; include your primary activities
Specialized Health Camps are organized with the goal of improving the lives of the most desolate char populace by providing specialized secondary care free of cost. These camps, organized throughout the year, provide a platform for both local and foreign doctors to deliver specialized care to the marginalized population through consultations, surgeries and post-operative care. Ranging from simple cataract surgery to multiple surgeries for burn contractures and bone deformities, all are conducted on the floating hospital themselves.
The main activities of the project are
• Awareness and patient search activities where Friendship staff visit different chars to locate relevant patients and inform the populace of the pending camp. Behavioral change communication is also conducted to convince parents, family members and community members that such surgeries will benefit the patients such as convincing a husband that a uterine prolapse operation is a minor surgery with permanent benefits or convincing a parent that a club foot operation will indeed allow their child to walk again.
• The screening and examination of patients where patients are prioritized based on their condition and examination is done to confirm if patient is fit enough for operation.
• The surgeries conducted by the visiting doctors which can vary between 40-50 patients per camp.
• Post operative care which includes medicine, therapy, follow up and even establishing temporary wards to house patients.
The Marketplace: Who are your peers and competitors? Identify others also working to address the needs you are and what differentiates you from them. What challenges could these players pose to your success or growth?
Friendship works extensively in collaboration with the government and other local and international NGOs. Friendship has agreements with the government for referral services. Local organizations help Friendship with technical support for its outreach programs. International organizations such as the Doctor’s Bank of Sweden, HumaniTerra International, Smile Train, Bangladesh Netherland Health Society and Mt. Sinai Hospital has made it possible to bring some of the world’s most renowned doctors to voluntarily serve these communities. Local organizations such as the Eye Care Society, NICVD, Dhaka Medical Burn Unit and SAHIC have also helped conduct camps.
Friendship does not have any direct competitors in the chars as it is the only organization working extensively there on several projects.
This Entry is about (Issues)
Founding Story: We want to hear about your "Aha!" moment. Share the story of where and when the founder(s) saw this solution's potential to change the world.
Over the years that Friendship has worked in the chars, an unusually high number of conditions such as bone deformities, cleft lip/palate, cataracts, uterine prolapse were observed. Each of these required basic and one time intervention but Friendship had neither the funds not the equipments to make this possible. In 2003, Runa Khan, Executive Director of Friendship started approaching local doctors to come in for just a day to conduct surgeries whenever they were able to but the project was not structured enough to be sustainable and the doctors were unable to show sufficient commitment to the project. Then the collaboration Bangladesh Health Society, the Netherlands, was created and very soon HumaniTerra offered their support and the project took off adding supported and volunteers every year until about a dozen camps each with 40-50 surgeries were being conducted each year.
Please describe the goal of your initiative; outline what you are trying to achieve
The goal of Friendship's healthcare project is to provide highly subsidized essential primary healthcare services to char and riverbank-based population clusters in northern Bangladesh. The secondary camps are held several times a year to contribute to this goal by targeting conditions, which when treated, creates the most significant impact with basic intervention. These surgeries are not only conducted with the goal of treating patients but also for building confidence and making it possible to live with respect within a community and within their own household.
What has been the impact of your solution to date?
The surgeries have changed the lives of thousands. Treatment of uterine prolapse and fistulas has allowed a woman to regain her status in her household. Treatment of clubfoot and other limb deformity has allowed a child to walk to school, play and write in school. Treatment of cleft lip/palate and burn contractures has helped the patients to regain confidence especially for young girls who are considered a burden as their prospects for marriage are limited. Cataract surgeries have allowed many to see again. Over 8000 surgeries have been conducted since the project started. Over 8000 lives have been changed directly and many more indirectly.
What is your projected impact over the next five years?
Friendship expects over the next five years the number of surgeries conducted to triple. Lifebuoy Friendship Hospital has been renovated to improve space and efficiency. Rongdhonu is under construction and once completed will be the 3rd floating hospital along with the Emirates Friendship Hospital. Over a million patients have been treated over the past decade with the second hospital added only 3 years ago. With 3 hospitals, the areas too will be expanded from the north to include the southern coastal and disaster prone regions.
What barriers might hinder the success of your project? How do you plan to overcome them?
Friendship’s major challenge is one of its’ own choosing by opting to work in the remote and inaccessible regions of Bangladesh to focus only on unaddressed communities. Friendship works in areas highly susceptible to environmental hazards with very high rates of migration. This makes planning and service delivery extremely difficult. To overcome this Friendship designs its project based a thorough understanding of the subtleties of the community and its needs. Feasibility of a project is determined from the delivery aspect of the project and not by donor requirements. Friendship projects are designed taking the enviroment into consideration. Funding has also been a challenge which Friendship tries to overcome by proactively seeking out donors who can commit for longer periods of time.
Winning entries present a strong plan for how they will achieve and track growth. Identify your six-month milestone for growing your impact
Within 6 months, 10 different surgery camps with be conducted changing the lives of nearly 400 people.
Identify three major tasks you will have to complete to reach your six-month milestone
Undertake awareness building activities and patient search for the relevant camps
Preliminary examination and screening of patients to short-list those that require the most attention
Conduct surgeries and ensure post operative care including distributing free medication and setting up makeshift wards
Now think bigger! Identify your 12-month impact milestone
Within 12 months, LFH will be able to affect the lives of over 20,000 people for primary and secondary care
Identify three major tasks you will have to complete to reach your 12-month milestone
Reach char based population clusters that are isolated from mainstream habitation and have minimal or no access to healthcare
Provide affordable and accessible primary and secondary care to the poorest of the poor river based population
Conduct regular secondary health camps for specialized care otherwise unavailable to them
Tell us about your partnerships
Unilever (Floating Hospital – Lifebuoy Friendship Hospital)
Emirates Airlines (Floating Hospital – Emirates Floating Hospital)
Crucell (Immunization support program)
Cordaid (Sustainable Income Generation Project)
Humani Terra (Specialized Surgery Camps)
Help Doctors (Training for Disaster Medicine and Technical Support in Health)
Chars Livelihoods Programme, DFID (Education)
Manusher Jonno (Rights and Good Governance)
Are you currently targeting other specific populations, locations, or markets for your innovation? If so, where and why?
With the introduction of Rongdhonu, Friendship's healthcare model will be replicated in the southern coastal regions of Bangladesh. Rongdhonu is the renovated Rainbow Warrior of Green Peace and its size will allow it to service the whole coastal of Bangladesh and beyond. In the south satellite clinics and a land based clinic to be introduced very soon.
What type of operating environment and internal organizational factors make your innovation successful?
Since 2000, Friendship has chosen to work in the most remote and under served communities of Bangladesh. Realising that main stream projects will be unsuccessful in such regions, Friendship takes great care to respond to the communities and utilize them to design projects rather than respond to the needs of the donors. The design of the secondary health camp projects ensures success through its commitment to the communities and from supporting organizations ensuring funds, equipments and technical expertise. The running of highly specialized health camps on the rivers on Bangladesh on floating hospitals is not only innovative but the only sustainable way to deliver quality care to the inaccessible people. Friendship is committed to overcoming all obstacles to deliver care to the chars.
Please elaborate on any needs or offers you have mentioned above and/or suggest categories of support that aren't specified within the list