cms5 intervention tracking- roi1

QUALITATIVE MONITORING OF SHIREE INTERVENTIONS: CMS5 INTERVENTION
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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
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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
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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:
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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:
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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:
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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.
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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
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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
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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
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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
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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.
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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.
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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
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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.
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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
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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
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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.
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