A Brief Discussion on Social Work in Bangladesh.

Abul Hussain
University of East London, UK.
Wednesday, April 28, 1999

For this piece of writing I will discuss what I have learnt about social work in Bangladesh. It will be written in two parts. For the first part, I will give a general overview of social work in respect of its educational base, including some criticisms. For the second part, I will talk about social work intervention through NGO's. This section will aim to explore some of the wider societal issues affecting social work and/or social development.

Although social work in some areas of Bangladesh is gradually becoming recognised as a concept or an organised programme, it is still felt by the masses as an act of 'good will' or charity inspired either by a sense of religious duty or simple piety. A good hearted person with wealth and desire to serve the distressed, the destitute and the abandoned is generally regarded as social work, no professional qualification or experience is a requirement. He or she may practise charity, do reform work and be useful to any person or an institution designed to render social services. However, due to the recent policy developments both nationally and internationally, together with the ground breaking work carried out by some NGO's, there is now pressure on the government to look at ways in effectively organising and delivering human services to the grassroots i.e. the poor. Two significant policies have played a crucial role in this regard. The first is WHO's Declaration of Alma-Ata 1978: achieving health for all by 2000. While stressing the importance of primary health care and reaffirming health as a basic right, its has helped in transforming health care delivery and health services support and management so that health services are accessible to each and every member of the community (WHO, 1998). The second most important piece of policy is Bangladesh's Fifth Five-Year Plan (1997-2002). While poverty alleviation remains the overriding objective, an innovative feature of the Plan is the linking of its national level objectives (human resources development) to those at the local level (health promotion programmes) (Hamid & Stalker, 1997). This linking has been an effective attempt in closing the gap between national level intervention and local level needs, especially as this has often been a neglected area in social policy and cause of inequalities. Social Work in Bangladesh is now recognised at two levels. Although the two are inter-linked, one is based on the more academic level and the other on the 'community development' level. The former can be understood in the pre-qualifying sense (i.e. professional training), and the latter in the post-qualifying and NGO level sense (i.e. fieldwork or non-professional). Apart from this, there is also another form of social work, which is informal. This is provided by the community or family network and stems from the traditional notion of interdependence among family members. Within this system, there is the built-in mechanism of providing services, shelter and security to the needy. Let us now move onto looking at social work in the academic sphere.

The advent of academic social work in Bangladesh has come from the recommendations made by UN experts on welfare for the establishment of a programme of professional welfare practise. The recommendation highlighted the need for scientific knowledge in the solution of acute and large-scale social problems (Watts, 1995). It was felt that, the increasing urbanisation and industrialisation together with landlessnes and impoverishing condition had weaken the joint-family system and had also put serious limits on the role of voluntary and charitable sectors (Moore, 1958) (cited in Watts, 1995). There are now 3 programmes for professional Social Work training in Bangladesh. The Institute of Social Welfare and Research at Dhaka University runs a 2 year MA degree in Social Welfare and a 3 year BA Honís degree in Social Work. The College of Social Work under Rajshahi University also runs a 3 year Hon's degree in Social Work. The training programmes include in their curriculum intellectual training to develop skills and special competence, with application of theoretical knowledge in practical situations through fieldwork. Courses such as 'scientific principles of human behaviour in practical situations' and the 'structure of organisation of social institutions' are taught to equip social workers with the needed knowledge base so that they can work under specific social, economic and emotional conditions (Taher & Rahman, 1993). In the BA courses the traditional social work courses are combined with development orientated courses i.e. social development; population and family planning; policy planning and services; and problem analysis and community development. At the Masters level at the University of Rajshahi there are three compulsory courses: social administration; social research (including an independent research on a particular social issue under the guidance of a research scholar); and social work strategies. FieldWork is also compulsory for both BSS Honours and MSS courses. This remains very much similar to the CCETSW placement model in the UK. But sadly a shortage of qualified agency supervisors is a persistent hindrance in fieldwork training in Bangladesh. This unfavourable situation is however being managed by overburdening the members of teaching staff. Furthermore, where most learners prefer to view social work as a general rather than a professional subject, it creates more obstacles in the way of it becoming a professional entity.

Many indigenous based questions come out from the above. Where the courses of both schools have been originally prepared by UN experts on Social Welfare is overwhelmingly Western in approach and contents, how applicable is it in non-western societies? In other words, is simple transplantation of social work education from one country to another valid especially where values and methods are unique to a particular setting? Where a programme of social work education has value in itself, can it achieve its full value unless there are built into it both local understanding of and responsibility for it? Is there a potential that social work may radically change perceptions towards social welfare, in that, it will play a critical role in shifting the emphasis from 'family' or 'community' development to one of 'individual' development as a basis for change or empowerment? What implication could this have on indigenous values? And so, are sufficient attempts being made to modify or update the curriculum according to the changing need of the society i.e. increasing refugee community and socio-economic constraints, together with emphasis on indigenous materials? The biggest challenge that I feel Social Work in Bangladesh will face is trying to strike a balance between, on the one hand, the indigenisation of course contents and approaches (relevant to local situation), and on the other, maintaining international standards. However, on a more positive note, there now seems to be a growing awareness of this (the shortcomings of Western approaches) and concern among professionals for the need for indigenous teaching and materials. The Institute at Dhaka University has now set up the Bangladesh Social Work Teachers Association for developing indigenous materials. Efforts are also being made to translate the standard foreign textbooks to make learners familiar with basic social work concepts in Bengali language. Together with this, annual magazines, periodicals and research studies published by Government department of Social Services and other organisations and NGO's are also being used as a source of indigenous knowledge. Based on my observations and discussions with certain conscientious members of the Institute, I have to say that, although professional social work in Bangladesh has undoubtedly adopted and adapted a lot from other countries, it is developing a strong cognisance of it having a soul and body of its own. Let us now look at the community development aspect of social work that is delivered through NGO's.

At present there are hundreds of NGO's operating in Bangladesh in the field of health. Through their efforts, it is now accepted as a definite fact that some of the reasons for the country's major diseases such as gastro-intestinal diseases, worms, diarrhoea, scabies, blindness, goitre, tetanus, STD's (sexually transmitted deceases) and general health negligence among the poor are due to illiteracy and poverty. It is thought that these diseases are preventable through education and medication. Health education for health promotion through community participation is the contemporary message in all health sectors. Nearly everyone I spoke to in health based NGO's carried this positive message, which was "education is the only vaccine". Social workers that provide primary care now aim to integrate the community health information services into the process of public health education. Getting information to the grassroots has now become a national responsibility. Access to health and freedom from disease is regarded as basic needs and so a human rights issue, particularly in view of the frequent inaccessibility of medical care to the masses because of its high costs (Mawla, 1996). For instance, VHSS (Voluntary Health Social Services), a research based NGO producing health materials, says that, malnutrition can be diminished by giving information on how to produce, acquire and consume adequate quantities of suitable foods. Another is also the CDD (Centre for Disability Development), a health promotion based NGO, that produces materials on discrimination and disability. Their aim is to enable communities to change their attitudes and to provide assistance to people with disabilities and their families so that they can achieve equal oppurntunity and full participation. This is achieved through distributing posters and leaflets as well as setting up village level self-help groups for the empowerment of women and the disabled. At present women's access to any kind of health care are primarily through either family planning or maternal health programmes. However, a community development approach is slowly starting to shift this trend and so the needs of women are now extending from contraception and safe mothering to freedom from violence, malnutrition, and hazards of domestic and industrial work (Nakajima, 1996). In other words, NGO's are playing a pivotal role in breaking down women's confinement to their reproductive roles. Health services are preparing to address these issues and establishing the connection with women's health needs and providing services that are accessible (Ritchie, 1995). The following are some small examples of community development work.

One health worker told me about the outcome of giving simple and clear messages on how iodine deficiency leads to high degrees of reduced intelligence and physical morbidity, at one of their village level self-help groups for pregnant mothers. According to her, the messages helped to reduced the numbers of pregnancy related anxieties and maternal morbidity counts in that thana at the same time increased the need for understanding about health and illness among village women. The worker also told me that this led to a sudden increase in awareness and market on specific leaves and herbs that boosts functioning for the immune system. Furthermore, that the domino effect of this had resulted in certain women becoming sources of medical reference, as well as generating income, for poor women. Efforts are also being made to correct misconceptions about diseases. For example, although guinea worm enters the body in infected drinking water, there is a widespread belief that water is harmless and there is no risk attached to using the same stream for bathing, laundering, cooking and drinking. Health workers now underlie the dangers and, using materials developed by the support of WHO and UNICEF, they explain proper use of wells and latrines and the need to keep streams and nearby ground free from faecal contamination. For the work being carried out on the urban level, it is considered that if refugees can be made aware of the need for health promotion, preventative medicine and the maintenance of a clean environment, they will make better citizens when they return to their homes. Where there is a strong oral tradition in many rural societies, health workersí messages are now being frequently presented in the forms of songs, which are highly entertaining and holds peoples attention. The clinics attended by women also seem to resound the chanting of these songs. The response in this regard demonstrates a certain degree of susceptibility and acceptance on the grassroots behalf and so success in the community development approach. To this end, let us take a brief glance at some of the criticisms of this approach.

On the positive note, the approach encourages people to take care of their own health and enables one to make informed choices. It also helps to demystify health care services by organising continuous training for women, community and existing health care providers. Community participation may be extended from simple motivation to planning, monitoring and evaluation of projects. This may also improve the inter-sectorial communication among different community development sectors in the community thus strengthen the solidarity among community members. Furthermore, solution for health problems may be organised by introduction of appropriate technologies for health service systems which are acceptable culturally and affordable economically by the community. On the more negative note, the programmes are found not to be sustainable, due to societal pressures women are hesitant to make use of the educational services. The programmes also often do not lead to self-reliance as not all women are able to take on board their learning due to the burdens of childcare and other reproductive related issues. Health issues are also at times very localised. In that, programmes do not look beyond the local causes of health problems, such as inadequate food production of poor knowledge, appropriate foods, to political, social and institutional factors. They tend to address more, a failure on the part of communities to produce adequate amounts of food for themselves. Power is also ultimately not given to the local hands, in that, NGO donors have been known to pull out from projects as rewards at the local level take time to achieve. In this sense, communities are less enabled to solve their problems.

In conclusion, one significant point that has to be raised is that, in spite of Bangladesh's many problems and occasional setbacks, it has always taken its own shortcomings as a challenge and thrives for high standards of achievement. With the country increasingly becoming the NGO junction of the world and with the level of UN interventions, it is clearly, on the public front, a sign of openness and willingness to adopt change for success.

Abul Hussain
BA Honís International Social Work Studies
University of East London, UK.
Email: mazemo@purplenet.co.uk

*Opinions expressed are those of the author and not the institution*

Bibliography:

Hamid S & Stalker P (1997), Bangladesh and United Nations Partnership in Progress, Dhaka Press, Bangladesh.

Mawla F (1999), In Touch: Thoughts on Internationals Womenís Day, VHSS Health Newsletter, Vol.17, No,187, March 1999.

Nakajima h (1996), In Touch: Womenís Perspectives on Health Services and Quality of Care, VHSS Health Newsletter, Vol.14, No.152, April 1996.

Ritchie M (1995), Roles and Approaches of Non-Governmental Organisation in Health Development, World Health Forum, Vol.16, 1995.

Taher M & Rahman A (1993), Social Work in Bangladesh: Problems and Prospects, The Indian Journal of Social Work, Vol.4, Oct 1993.

Watts T (1995), International handbook of Social Work Education, Greenwood Press, London.

WHO (1998), The World Health Report 1998: A Vision for All, WHO, Geneva, Switzerland.