QUALITATIVE MONITORING OF SHIREE INTERVENTIONS: CMS5 INTERVENTION TRACKING REFLECTIONS ON THE INTERVENTION (1) FOR HASI Shiree Q2 Research on Extreme Poverty in Bangladesh Author Owasim Akram Institution Oxfam CMS1 Reference Interviewee name 178951320001 Union, Upazilla and Zilla Dates of Interview Well-being Status Livelihoods before and after the intervention Hasi Sex Begum Female Before the Intervention: Age Ethnicity/Religion 43 Muslim End of l ROI (1) 08 June, 2013 Before the intervention April 2012 April 2013 Destitute (1) Moderate Poor (3) 1. Housemaid 2. Vegetable Selling Children Married daughter lives with her Productive Asset or IGA owned working capital Marital status and household composition Keywords 1. Daily wage labourer 2. Domestic help Divorced 1. Stopped working as Housemaid 2. Started her own stall 3. Rearing livestock Children Married daughter lives with her 1. Stored wheat (110 kilograms) 2. Stored corrugated iron sheet for making house 3. One cow worth 15000taka 4. Savings in cooperatives 5. A tea stall Divorced Female headed, market access, female leader, labour exploitation 1 QUALITATIVE MONITORING OF SHIREE INTERVENTIONS: CMS5 INTERVENTION TRACKING INTRODUCTION As a woman, Hasi has developed her social network and leadership within a male dominated culture. From destitution, she has started her journey toward graduation from poverty. Despite being challenged, she never surrendered. While her engagement in the CBO gave her, an identity of leadership, at the same time, her IGAs gave her secured livelihood. This ROI covers detailed analysis of Hasi’s life history events in the last one year since collecting the life history last year. It aims to see the post intervention situation, issues, causes, and consequences that lead to graduation or to further vulnerability. LIFE HISTORY AND RECE NT PAST Hasi was born in 1970 in a village of Patuakhali Sadar Upazila. Her father was did not earn enough to secure even two meals regularly for the family. Hasi was married without dowry to a man who initially pretended to be in love with her. Gradually he refused to provide any support to manage the family and Hasi had to provide for herself. Hasi’s husband was having an extra-marital affair. Despite being pregnant, Hasi left him, and went back to her father’s house. Her husband’s behaviour separated her even from her father’s family, creating a ‘centripetal crack’ where she was asked to eat separately from them. After the birth of her daughter, she attempted to reunite with her husband but failed and he abandoned her. This cycle has been repeated inter-generationally, as her daughter also married a man who treated her cruelly and was thus forced to separate from him. From 2000, natural disasters, in the form of erosion of the riverbank and cyclone SIDR, had serious implications on the sustainability of her livelihood and increased her vulnerability. Cyclone Sidr forced Hasi to rely on relief from a NGO. Hasi’s lack of education has also prevented her from getting a better job. She is an empowered woman who is able to work and provide for herself, but her income is restricted as an uneducated female. Her lack of both sufficient regular income and the support of a male income earner have led her into poverty. Hasi now lives with her daughter (21) in destitution. To know the life history events of Hasi in detail please retrieve her life history from the following link: http://www.shiree.org/wp-content/uploads/2012/02/Hasi-LH.pdf 2 QUALITATIVE MONITORING OF SHIREE INTERVENTIONS: CMS5 INTERVENTION TRACKING NGO graduation design The project is titled, “Resilience through Economic Empowerment, Climate Adaptation, Leadership, and Learning (REE-CALL)”. It intends to build resilient communities in the context of disaster and climate change through economic empowerment and forging sustainable livelihoods for women and men who are living in extreme poverty. They also develop leadership in Southern Coastal communities with three partners in three districts in Bangladesh since 2010. The purpose of the project is to graduate a total 10,500 economically extreme poor (Bottom 10%-BHH) households from the shocks, challenges of extreme poverty by 2014. The project aimed to achieve the following four outputs in terms of achieving the project goal: 1. Formation and Functioning of 400 CBOs, 2. Involve a total 10,500 extreme poor households (in the bottom 10%) with IGA, alternative livelihood and increased income, 3. Enhance communities’ capacity in terms of disaster preparedness, response, and adaptability with the impact of climate change, 4. Capture Local experience from the programme and informs national policy dialogue, and simultaneously enable the extreme poor are able to access services from the government and service providers. Graduation Process The targeted households are living in extreme poverty, which has social, economic, cultural, and political dimensions. The project has been designed to address different requirements at different stages of the project period to sustain those economic changes, which emerge within the targeted household. Aside from the initiative to increase income and creating alternative employment opportunity the project is trying to address a numbers of other issues as follows: 3 QUALITATIVE MONITORING OF SHIREE INTERVENTIONS: CMS5 INTERVENTION TRACKING Timeframe of graduation: The framework of graduation is 5-6 years. During this period, the targeted HH will actively engage with 2-3 different types of income generating activities, and developed ownership of the project through Community Based Organisation (CBO), which is instrumental to reach the targeted HH. The targeted HH will receive necessary skill, knowledge, capital, and linking support directly within two years of inception of the project. In the third year, the targeted HH will receive support to build social and economic leadership, which helps them to generate savings, banking ability, developing community leadership, mobilizing natural resources like khas land, khas pond, and bill and using roadsides for agriculture production. Within three years, the targeted HH emerges as a productive unit and with an increasing per capita income and improved wellbeing. During this next 2-3 years, Oxfam will provide close supervision and follow up support to enhance the on-going IGA also link up the targeted HH with the government social and food security safety-net programme. Oxfam develops this model and ensuring market based livelihood also ensuring accessibility in the entitlements and rights. In the project ‘Asset Protection’, initiatives will be given more emphasis so that poor people can cope with shocks related to health and numbers of family matters. The following chart will provide details: 4 QUALITATIVE MONITORING OF SHIREE INTERVENTIONS: CMS5 INTERVENTION TRACKING Household Requirement and Graduation Process: The targeted household will be identified through a vigorous screening process within set and agreed criteria. After that, each HH will develop their own income generation and alternative livelihood plan under the guidance of NGO field staff. One household may need to be involved with 1-2 IGAs considering the multi-dimensional aspects of poverty the project has identified series of activities link with mid-term and long-term level intervention. The immediate interventions are IGA, alternative employment generation, the mid-term interventions are developing grain banks, savings, disaster preparedness, developing leadership and mobilising natural and local resources. The long-term intervention are strengthening CBOs as well as linking up the micro level voice to national policy interventions. However, each household will have their own income generation and graduation process. The graduation pathway: 5 QUALITATIVE MONITORING OF SHIREE INTERVENTIONS: CMS5 INTERVENTION TRACKING THE INTERVENTION SEQ UENCE Anyone will be impressed with Hasi’s outspoken attitude. She has a boldness and confidence in her voice, which a leader should have. Hasi was not born with this voice, but rather the challenges and struggles of her life helped her to earn this voice. She emerged as a voice raiser not only for her own rather for like-conditioned people of the area. Hasi is a leader of few other community groups organized by different organization but she never received any support that could change her own vulnerable livelihood state. Intergenerational extreme poor marriage When Hasi listed to be as prospective beneficiaries for the project, she was both mentally and financially in a devastated state. Mentally because her daughter who was married could not live with her husband because of the same problem Hasi experienced in her life. Her daughter’s husband was having an extra marital affair making him not serious about the relation with Hasi’s daughter. This happened within the first year of her marriage. Although her daughter is not divorced with her husband but she came back from her in-law’s house and has been living with Hasi since then. To Hasi, this is very shocking as her only daughter is going through the same experience as she did. As a mother, it was intolerable. 6 QUALITATIVE MONITORING OF SHIREE INTERVENTIONS: CMS5 INTERVENTION TRACKING Dowry demands after marriage and separation After marriage, her daughter’s husband demanded many things especially gold jewellery (chain, ring, bangles, and earrings) and cash taka for starting a business although before the marriage there was no such condition. Hasi agreed to give those even if she needs to work hard but Hasi was worried about, “to whom will she give those, to a person who is having an extra marital affair? Who knows whether he (her husband) will continue the relation with her daughter or not!” When Hasi discussed it with the UP Chairman, with his help, she sent police to teach him a lesson but he became more ferocious rather than changing himself, saying that police can do nothing to him. Until now, the issue has remained unresolved leaving Hasi mentally agitated. Threatened Eviction - Hasi had to give a large bribe to stay on khas land Hasi is living on khas land. However, the experience of living on khas land was not a good one. They government people tried to evacuate her several times. Later she took the suggestion of the UP Chairman. According to the suggestion of UP Chairman, Hasi paid 18,000 taka as bribe to live there without incident. However, the discussion with Hasi did not make it clear whether she received legal ownership of the land after paying the bribe. The total land size is five decimals. Since then Hasi has not faced any pressure from the government people. Her and her mother’s family managed the money for the bribe jointly. Survived working as housemaid and low paid labour Hasi was working as a house cleaner before and she was paid in-kind. Working for half day, she was paid in half-kilogram rice. Very often, she was working as a helper for a wholesale businessman in the local markets for which she was paid 50-60 taka. Very few women go to the market to work, especially in rural markets unless they are the victim of their situation, which often results in low payment for the labour offered by women. Hasi said, “Most of the period of my life I spent working like this.” Hasi enlisted as project beneficiary and became CBO president When Hasi was listed in the prospective beneficiary, she did not have any idea about the purpose of such listing. After being listed, the project staff visited and talked with her several times. At one point, they brought all the listed people into a group of which Hasi was elected as the President. Since all knew Hasi and she was already member of different 7 QUALITATIVE MONITORING OF SHIREE INTERVENTIONS: CMS5 INTERVENTION TRACKING community groups organized by different organizations, the group wanted her to be the president. Hasi said, “I die for the poor, I raise my voice for them to everyone concerned. During the Mohasen (the last tropical cyclone in the area in May 2013), I warned people through microphones in the whole area. Everyone knows me in this area.” As a CBO President Hasi is expected to take the lead of organizing the group, organizing group meetings, conducting the meetings, mobilizing them about different social issues, about income generating activities, about making them aware of their rights and entitlements and accessing those. After being included in the CBO, Hasi became a public figure in the area. In any kind of village/ward/UP level meetings or arbitration, she is invited. She represents the poor of her area. Many of the poor people take Hasi with them in the arbitration process since Hasi can speak boldly in such forums. Hasi feels proud if she can help a poor to get their rights. She fights for inclusion of the poor in the Social Safety Net programs of the UP. She even argues with UP Body if any eligible poor does not get included or does not get access to those services. Hasi worked under the Cash for Work Scheme Three months after the listing in February 2012, they were told about the Cash for Work (CFW) Scheme. Hasi worked repairing a linking road as an earth cutter. This was for 16 days with payment at the rate of 175 taka irrespective of gender and age. Hasi earned 2800 taka from this scheme. Hasi spent 1800 taka on meeting the basic needs of the family and the rest (1000 taka) she saved with which she bought five chicks to rear. Before the CFW, they were asked to think about two suitable Income Generation Activity (IGA) options for them, which will suit them and can ensure a minimum income round the year to meet the basic needs of the family. The first IGA would be allocated more money than the second IGA. Hasi planned to have a cow as the first IGA and a small stall with multiple items to sell as the second IGA. Hasi got a cow from the project and helped sell them without commission In May 2012, Hasi purchased a young cow from the project, which cost 8200 taka. The current value of the cow will be 15000 taka, Hasi shared. As a CBO president, Hasi took the lead role in purchasing and distributing the IGAs to the beneficiaries. Hasi said, “I was present when we bought 75 cows for the beneficiaries. If the cows were brought taking the help of the UP members or other local elite, you would have to give them commission of 3000-4000 taka for each of the cow but since we did it ourselves we didn’t need to take 8 QUALITATIVE MONITORING OF SHIREE INTERVENTIONS: CMS5 INTERVENTION TRACKING shelter of them, hence they are also very dissatisfied with us.” This kind of engagement made Hasi more popular among the community. Hasi started her tea stall with help from UP chairman However, Hasi’s second IGA was to start a small stall in the nearest market. In July 2012, Hasi received 1800 taka from the project out of allocated 10,000 for each beneficiaries, she already got a cow worth 8200 taka hence received support of 1800 taka for the second IGA). However, 1800 taka was not enough to start a stall. Hasi sold four chickens for 1000 taka, which she bought from the income of the Cash for Work scheme. Thus with a small amount of 2800 taka, Hasi started her stall in the market. Getting rent for a shop in the market was not easy for her as a woman. She took help of the UP Chairman and the front line staff of the project have helped her to rent a shop in the market. She did not need to pay security money for the stall. The rent of the stall is 200 taka per month. Hasi got a good response from customers That was a small entrepreneurial start for Hasi but full of potentials. Since the very beginning, she got a good response. In her stall, she sells tea, biscuits, banana, cigarettes etc. Hasi adopted some business strategies to increase her sale volume. Since tea is the most sold item, she started selling tea at the rate of four taka per cup where the other businessmen of the market sell it at 5 taka per cup. In addition, people say tea of Hasi’s tea stall tastes better than others do. At present Hasi can sell around 300-500 taka each day from which her profit margin varies from 80 – 120 taka. Sale on credit Hasi also has to sell on credit. She says, “If you want to run a shop you have to sell some items on credit. People here are poor, they might not earn today, but they can earn tomorrow.” Hasi estimated that her outstanding amount from the customers is now 3000 taka. Hasi has not faced any problems with this so far, as people are paying back their due amount and buying again on credit. It happens in rural business and she is ok with that. She also said, “Since I am a woman they (customers) do not make any trouble in paying me back. They know I am poor.” Hasi’s business policy Hasi does not need to go to the market to buy goods for the shop; rather the wholesalers come to her shop and supply them. At the end of the day, they take the payment. Hasi has to look after her cow as well and she has to take it to graze. However, Hasi never closes her shop from morning until the night. When she cannot remain present in her shop, she requests 9 QUALITATIVE MONITORING OF SHIREE INTERVENTIONS: CMS5 INTERVENTION TRACKING someone to replace her for the time gone. Most of the time she requests her sister to replace her. In return, Hasi does not need to pay to them. Hasi does not allow her daughter to be in the stall nor does she asks her daughter to take the cow to graze outside. Hasi fears people might spread rumours about her if she is more engaged outside the home as she is still married and not divorced with her husband. Since Hasi’s shop remains open throughout the day, people like it, because most of the shop owners close their shops during the off time but Hasi is present there even alone at that time. Some customers come to the market at that time. Thus, Hasi has gained goodwill. Hasi planned to add to her business Making bread Since the stall proved to be gradually profitable, Hasi’s thoughts revolve around the stall regarding how she can increase the business portfolio. She has thought about starting to sell handmade bread as another food item, for which there is a demand, and that is profitable. Hasi purchased three maund (37.5 kilograms =1 maund) wheat given in VGD program by UP to the poor. She purchased the wheat from the poor, who later sold it. Building rather than renting a stall Hasi also thought to make her own stall rather than running the stall on rent. For this Hasi has also kept tin sheets given as relief to the poor during the last cyclone. When a poor person of the area sold those relief tins, Hasi thought to buy it. She bought them for 1800 taka when the market value of the tin is 3200 taka. She invested it from the income of the shop but paid in three instalments. Hasi still has to purchase wooden logs for at least 6000 taka to build the shop. There is enough space in the market and if she requests the chairman, she will get a tiny piece of land in the market to install her own shop since the market is situated on the two sides of a road and there is some khas land there owned by the government. Saving in cooperative Hasi started saving 100 taka each month in a cooperative, which is an initiative of all the shop owners of the market. The maturity period of the savings is three years. The cooperative also lends money at 8% interest per month and this profit will be shared among the depositors according to the size of the deposit. Attempts to evict Hasi from the marketplace Hasi started high profits compared to the meagre investment in her stall but that attracted the jealousy of the other shop-owners. Many times, they have tried to evict her. She is the only 10 QUALITATIVE MONITORING OF SHIREE INTERVENTIONS: CMS5 INTERVENTION TRACKING female shop owner in the market. A few months back she saw her shop had been sealed and locked, the day before there was a clash in the market among some of the shop-owners with which Hasi has no link. It was locked for two days and she could not sit in her shop. Hasi could not easily open the shop because it was locked by the shop owners, if she did she would be further chased. Hence, Hasi, with the help of the Chairman, immediately took action. He asked the shop owners to open immediately Hasi’s shop and warned them saying, “next time when you will do such things, before that look at the person who she is”. Before starting the shop, Hasi did not know if she would have meals the next day. Soon after starting the stall, she has secured an income year round, which ensures two if not three meals a day. Hasi runs the risk of river erosion/flood Hasi’s home is threatened in two ways: 1. She lives on khas land and 2. It is situated just near the bank of a river. Hasi shares that most of the people are poor in the area because of the river. The mighty river has eclipsed them, their properties, and their confidence leaving them in extremely vulnerable state from where they cannot graduate. When we visited the Hasi, the river was almost overflowing. A month back, the water flow was so high that the whole area was over flooded causing an outcry among the inhabitants there. Health costs During that flood, Hasi also suffered from severe diarrhoea. She suffered for two weeks. It was so severe that she had to go to doctor in the nearest city, which cost her 4000 taka to treat. She obtained that amount of money by taking loan from the cooperative of the shop owners, for which she is paying interest of 320 taka. She would have to keep paying 320 taka each month until she can return the 4000 taka. People want Hasi as UP Member because she represents the poor well Hasi became so popular in the area that poor people now encourage her to compete as a candidate as a UP member in the next local level election. They use to say, “We are behind you, we will campaign for you without any reward, you do not need money”. Since she has a good term with the other UP Members and the UP Chairman, they are also positive about this. They encourage them to elect her for the UP member, which is reserved only for women. The Chairman said, “I will bear the cost of poster and campaign for you.” The UP Member of the ward said, “I will bear some of the cost of the election campaign for you.” Hasi wished she could take part in the election but she is not sure, whether it is a good time now to take part in the election or if she should wait until the next term. 11 QUALITATIVE MONITORING OF SHIREE INTERVENTIONS: CMS5 INTERVENTION TRACKING Hasi’s success as a leader Just the day before the interview, the Hasi and other local labour have won a case in court. Three years back there was a road-repairing project of Water Development Board. The total budget for the poor labourers was 874,000 taka. However, the contractor was corrupt. He paid far less than the labourers were entitled to, even the rate of payment varied from labour to labour for the same volume of work. They took signature of the labourers on a blank sheet. Thus, the contractor deprived the labourers. When the labourers came to know about it, Hasi emerged as the voice on behalf of them with the help of other labourers who were involved. When they did not see justice even after complaining, they filed a case. Hasi and the other poor labourers struggled a lot. They have even gone to the minister of the area for justice. Thus, it continued for three years. In the meantime, Hasi was even offered bribe by the contractor but she refused. She said, “I would rather die but would not surrender”. After three years of continuous struggle, they have won the case. They will get back 362,000 taka. They have spent a lot of money in running the case which they managed by borrowing from different sources. When they get back, the money they will return the borrowed money and the rest of the money will be distributed among the day labourers involved in work at that time. Age and religious belief makes her nostalgic After sharing all those things, Hasi shared, “My situation has brought me to this stage. I am becoming old. I want to enter into the house; after all, I am a woman. What will I say to the almighty on the day of resurrection?” However, this religious belief has impact on the movement of women, which can be investigated further why and how religious belief affects the lives of women. 12 QUALITATIVE MONITORING OF SHIREE INTERVENTIONS: CMS5 INTERVENTION TRACKING INTERVENTION M AP FOR HASI (43 YE ARS OLD) FROM DATE OF INTERVENTION TO M AY 2013 2012 (Jan) Enlisted by Oxfam-Shiree project Wealthy elite Middle elite Affected with cyclone, fewer earning opportunities, daughter dropped out from school Lower earning 4 non-poor Moderate 3 poor 5 Got married into an extreme poor family and husband didn’t provide her, started working as housemaid as she went hungry. Developed an eye problem which she got treated selling mother’s jewelry Got a cow as the first IGA Daughter got married but Husband got an extra martial separated within affair and she moved to short time father’s house, but ate separately, there gave birth to first child. Worked under cash for work scheme, earned 2800tk Bought and stored wheat and iron sheet Got support from project to start tea stall Reunited with husband Daily income increased from tea stall while she keeps increasing the business Working Extreme poor Destitute Dropped out from school and started working with father Born in a poor family where her father was the sole income earner 1970 1980 1987 Continued day Migrated to Dhaka and both laboring she and her husband Husband had affair and afforded three meals divorced 1991 1994 2000 Suffered from strong diarrhea during the cyclone of May, borrowed 4000tk on high interest from a cooperative 2007 2010 2012 2012(Jan) Hasi was enlisted in shiree project. Joined the CBO S2012 (Jan) March’12 13 May’12 Sep’12 Jan’13 May’13 QUALITATIVE MONITORING OF SHIREE INTERVENTIONS: CMS5 INTERVENTION TRACKING- ROI1 DISAGGREGATED ANALYS IS MATERIAL EMPOWERMENT : CHANGES IN ABILITY TO COMMAND MATERIAL WELLBEING Diet Now Hasi has the ability to manage three meals. She is concerned about future savings necessary to increase her business size which she is consuming three meals a day. Meal quality has not improved that much, which might have a nutritional impact. Cheap vegetables accompany most of their meals. House and homestead: ownership, condition of tenure, condition of house. Hasi is living on khas land. Although Hasi said she has paid 18000 taka to the government people to ensure uninterrupted access over the land, her response did not make it clear whether she has legal access to the land. The house is built with tin sheets. The position of the household is vulnerable because it is located by the bank of a big river and the land around it is vulnerable to river erosion and repeated flooding. Assets Since Hasi is more concerned about her stall, she wants to increase the business size. For which she has kept four tin sheets, three maund of wheat to invest in her stall. She has some chickens and she is fattening the cow she received from the project. However, the most important asset is her leadership skills and her social network, which she grew as a CBO President. Income Although Hasi received a cow as her first IGA, her wellbeing level increased because of the daily income of her tea stall. She started with only 2800-taka capital from which she earns 80-120 taka a day. Soon her income will increase further when she adds some other items to her selling list. Savings Hasi did not open a bank account for saving but she kept saving in different forms, first she saves regularly in the co-operatives of the ship-owner. She also kept some assets purchased. WIDER CONTEXT – CHANGES SINCE THE IN TERVENTION Threats Hasi’s threats are manifold. Gender, climate, and health remain some of the more pressing issues she faces. 14 QUALITATIVE MONITORING OF SHIREE INTERVENTIONS: CMS5 INTERVENTION TRACKING- ROI1 Gender Hasi as a woman leads the poor in a society where such leadership and engagement are not often welcome by the patriarchal society. The closure of Hasi’s stall by her male competitors in the market is a symbolic one, which defines Hasi’s vulnerability in such a context as Hasi moves toward challenging the established old norms and social reality. Although Hasi has developed, a strong tie with UP members and other people who hold power and these people often act for Hasi not because she is welcomed in that structure but rather than for their own benefits which is vested mostly on earning the votes of the poor by giving Hasi certain responsibility. Climate and Seasonality Hasi is living on the bank of a river, which makes her geographically vulnerable because the khas land she is living on is prone to river erosion as well as flooding. However, during the rainy season the sale volume in her stall falls significantly which affects her income and wellbeing. Health Hasi’s expenditure on health makes her further vulnerable as she has to pay the interest from the loan taken every month from her daily income. The liability of health often affects the wellbeing of the poor people and deters the efforts they make to graduate from poverty. Cultural The daughter who now lives with Hasi after separating from him has had a significant impact on Hasi’s life, wellbeing, and mental condition. Hasi shared that she has to face many questions from her neighbours and from the community, as if it is their fault that Hasi’s daughter has to separate from her husband who both was having an affair and was asking for heavy extra dowry demands post marriage from Hasi. Sometimes it is difficult for Hasi to answer the neighbours and rumour mongers, leaving her in a mentally distraught state. SUBJECTIVE UNDERSTANDING OF WHAT CONSTITUTES GRADUATION “If I only live in happiness in a village and the rest of the others live in poverty, how long can I remain happy?” This quote from Hasi symbolizes that real graduation occurs when everyone of the society can enjoy the minimum needs equally. community graduation. 15 Not Individual graduation but QUALITATIVE MONITORING OF SHIREE INTERVENTIONS: CMS5 INTERVENTION TRACKING- ROI1 SUMMARY AND CONCLUSIONS SUMMARY Hasi’s long days of struggles and challenges, taught her to be strong. Her engagement in the project as a CBO President further boosted her leadership skills and she is emerging as a voice for the poor. She received support from the project to start her own business and she got a cow which she is rearing with the aim to have multiplied benefits from this. Hasi was seriously challenged as a female shop owner in the market, they tried to evict her as she was not only a woman, but she was doing quite well. She was only helped by her strong social network with UP members. Hasi’s case has some important policy and program dimensions. Lack of homestead land and/or security of residence is a key definer of extreme poverty in Bangladesh. Divorced/abandoned/widowed extreme poor women are particularly vulnerable and it is clear from this tracking study and others that they should have access to khas land on a priority basis. Hasi had to pay a high bribe just to continue living on the khas riverbank land. However, it is also important for the program implementers to assist EPs like Hasi to link her to the respective departments, as there are some formal procedures, which they are unaware of and/ or which make them victims of bribery and fraud. Millions of poor like Hasi spend significantly on health, which makes them more vulnerable. Out of pocket, expenditure for health is the single most important cause for the downward mobility of the poor to extreme poor. Drug and diagnosis related health expenditures represented the lion share. Often the unethical practice of the health care providers led them to prescribe unnecessary tests and/or medicine creating overburden for the EPs. There should be some policies and practice for promoting the rational use of drugs. Bangladesh is committed to reaching the Millennium Development Goals and to ensuring access of its population to adequate healthcare services with commitment through the development of an extensive infrastructure of government healthcare facilities. Treatment is intended to be available to patients mostly free of charge. Both the service centres and the health care providers should be EP friendly with additional support from the government along with monitoring that the EPs are receiving both medicine and services fairly. INDIVIDUAL SUSTAINAB ILITY Hasi’s leadership skill and her social network seem to be a great capital for her, which will always contribute to her sustainability although she might be challenged off and on by the traditional patriarchal norms and values of the society. However, Hasi is mentally strong 16 QUALITATIVE MONITORING OF SHIREE INTERVENTIONS: CMS5 INTERVENTION TRACKING- ROI1 enough to cope with those challenges having a strong social network. This suggests that a strong social linkage helps the extreme poor to survive in adverse situations. 17
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