DSK Activity Report 2010DSK Activity Report 2010

Dushtha Shasthya Kendra (DSK)

DSK Activity Report 2010Executive Committee of DSK 2009-2011

A B M Abdullah, PhD PresidentProf. Mahfuza Khanam, M. Sc Vice PresidentDr. Mahmudur Rahman, MD Vice PresidentA S M Golam Mortuza, PhD Secretary GeneralNazneen Sultana, M. Sc TreasurerHabib Uddin Ahmed, BA Organizing SecretaryMuhammad Emdadul Haque, FCA MemberDr. Jawadur Rahim Wadud, MD, PhD MemberMohammad Abdullah Sadeque, BA MemberQuazi Towfiqul Islam, PhD Member

DSK ACTIVITY REPORT 2010Cover page: Extreme poverty group meeting at Korail

Editor: Dr. Dibalok Singha Executive Director, DSKContributor: Dr. Masudul Quader, CEO (credit)Team: Mushfiqua Mosharref, Training Officer

Mohammad Alamgir Kabir, Sr. MIS Officer

Printed by: Mati ar Manush

House no-741, Road No. 9, Adabar, Mohammadpur, Dhaka-1207, Bangladesh. Tel: +8802-9128520, 8122861, 8159656, 8120965, Fax: +8802-8115764E-mail: dskinfo@dskbangladesh.org, Website: http://www.dskbangladesh.org

Dushtha Shasthya Kendra (DSK)

Table of ContentsAbbreviation and Acronyms 2Foreword 3Introduction 4Vision, Mission and Objectives of DSK 5DSK Development Approaches 5DSK at a Glance 6Health Care Programme 7Micro-Credit Programme 14Water Sanitation Projects 20Non-Formal Education 24Relief, Rehabilitation and DRR 26DSK-Shiree Project 28Other Projects 30Human Resources 34Training Cell- Human Resource Development Programme 35Governance/Management 37Development Partners 38Visitors at DSK 39Annex-1 Audit Report ( 2009-2010) 40Annex-2 Budget 46Annex-3 Geographic coverage of DSK 47Annex 4 Central Management Team 48Annex-5 General Body 48

Abbreviation and AcronymsANC : Ante Natal CareARH : Adolescent Reproductive HealthBURT : Bangladesh Urban Round TableCBDRR : Community Based Disaster Risk ReductionCHP : Community Health PromoterCHW : Community Health Worker CL : Cluster LatrinesCMT : Central management TeamCtC : Child to ChildCUP : Coalition for the Urban Poor CWASA : Chittagong Water and Sewerage AuthorityDCA : Danchurch AidDNFE : Department of Non-Formal EducationDSK : Dushtha Shasthya Kendra DWASA : Dhaka Water and Sewerage AuthorityEC : Executive Committee ECHO : European Commission Humanitarian OrganizationEDBM : Enterpreunership Development and Business ManagementFANSA-BD : Fresh Action Network-BangladeshGoB : Government of Bangladesh GT : Grameen TrustHCP : Hard Core PoorHP : Hand PumpsIFAD : International Fund for Agriculture DevelopmentILO : International Labour OrganizationMDG : Millennium Development GoalMFI : Micro Finance InstitutionMoLGRD& C : Ministry of Local Government Rural Development and Cooperatives NFE : Non Formal EducationNGO : Non-Government Development OrganizationNSCS : National Sanitation Campaign Strategy PBCL : Palli Dushtha Bio-Center LimitedPHC : Primary Health Care PI : Plan InternationalPKSF : Palli Karma-Sahayak FoundationPL : Pit Latrines PNC : Post Natal CareRMC : Rural Micro CreditSACMO : Sub Assistant Community Medical Officer SACOSAN : South Asian Conference on Sanitation SB : Sanitation Block Shiree : Stimulating household improvements resulting in economic empowrementSL : Slab Latrines SP : Submergible Pumps SRC : Swiss Red CrossSSHHE : School Sanitation Household Hygiene EducationSWS : Safe Water SystemsUMC : Urban Micro CreditUN : United NationsUNDP : United Nations Development ProgrammeUNICEF : United Nations International Children’s Emergency FundUS A : United States of AmericaWASH : Water Sanitation and HygieneWatSan : Water and SanitationWAB : Water Aid BangladeshWPI : Water Partners International WSSCC : Water Supply Sanitation and Collaborative Council WP : Water Point

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ForewordWe are extremely delighted to share “The DSK Activity Report 2010” that will update readers about DSK’s activities during the period of 2009 to 2010.

DSK is now passing its twenty one years of operation targeting poverty reduction of the poor and extreme poor people in Bangladesh. DSK started its journey in mid eighties with the initiative of some likeminded professionals, social activists and that was an informal start of DSK. At that time every week medical prescriptions and some essential drugs were distributed under the banner of “Niramoy Free Friday Clinic” at Tejgaon of Dhaka City. In 1989, DSK started its formal mission having registered with Department of Social Welfare.

Later in 1991 DSK got registered with NGO Affair’s Bureau and completed its successful twenty one year’s passage. Last Activity Report was published in 2009 covering the period-July, 2008 to June, 2009. This is the report for the period –July, 2009 to June, 2010.

DSK implements different programmes and projects targeting poor and extreme poor households. Main programmes of DSK are as follows: Health Care (primary health care, hospital and maternity services), Micro Credit, WatSan, Non Formal Education, Disaster Management (Relief, Rehabilitation and Disaster preparedness). DSK also has been implementing projects like- economic empowerment of the extreme urban poor, child rights and protection, project against women trafficking etc. In the reporting year DSK has implemented twenty three (23) projects both in rural and urban areas including hard reaching places like coastal belt and haor (wet land) areas.

Currently, DSK has been implementing its activities in fourteen (14) districts along with three major cities- Dhaka, Chittagong and Khulna. Now it reaches more than one million poor (all projects combined) populations in different parts of Bangladesh through its various development programmes and projects.

Taking the opportunity of this publication we the undersigned would like to express real appreciation to our supporters representing national financing institutions, different international donor agencies and target communities for their continuous support to keep DSK efforts funded and for DSK to stay productive, transparent, effective and efficient.

Taking this opportunity we thank our colleagues and front line staff of DSK for their untiring efforts to make DSK efforts transformed into real action.

A sincere word of appreciation to the respected members of the Executive Committee and the General Members of DSK; it is their knowledge, wisdom, experiences and dependable support that has enabled to lead DSK to targeted directions.

We believe that this report will be conveying a glimpse of DSK’s perception and performance in 2010 to esteemed readers.

Dr. A B M Abdullah, PhD Dr. Dibalok Singha, MDPresident, DSK Executive Director, DSK

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IntroductionDushtha Shasthya Kendra (DSK) is a non-governmental organisation (NGO) working for poverty reduction of the poor Bangladeshi population.

In mid eighties under the banner of “Niramoy Free Friday Clinic” a group of likeminded professionals, doctors, social activists, and volunteers begun to facilitate Primary Health Care (PHC) activities at Tejgaon slums in Dhaka. This was the informal beginning of DSK.

In 1988, a devastating flood engulf two third of Bangladesh including its capital Dhaka, in this situation the DSK was formally started with a Medical Team to provide immediate relief and health care to flood effected people in Dhaka city. The main aim of setting up the organization was to continue and consolidate above mentioned efforts and engage to facilitate and develop a health delivery approach targeting the marginalized that would be self sustainable in the long run.

In 1989, DSK was registered with Department of Social Service (Dha-02273) and in 1991 with NGO Affair’s Bureau (No 577) in Bangladesh.

Depending on the geographic locations DSK’s activities have been generally classified as urban and rural development. The urban program is based in Dhaka, Chittagong and Khulna cities, and the rural development programme is based in Barguna, Bagerhat, Gazipur, Jessore, Khulna, Kishoreganj, Narshingdi, Netrakona, Narayangonj, Sunamganj, and Satkhira districts.

Slum dwellers and low income communities are target project participants from urban and rural areas. DSK targets to cover hard to reach poor and extreme poor households. In addition, DSK is active in Haor region, and Coastal belt which are recognized as extreme poverty pockets in Bangladesh.

DSK has been implementing its programme and projects targeting poor and extreme poor population living in urban and rural areas to reduce their poverty. In urban slums it has been implementing development interventions like- health care, micro credit, water and sanitation, non formal education, economic empowerment of extreme poor. In coastal districts and haor areas it has been providing emergency relief, rehabilitation and livelihood restoration, awareness building and facilitates increase in capacity to face disaster risks and community empowerment. In rural areas DSK also has been providing support through health care, micro credit, non formal education, water and sanitation, women empowerment etc.

In DSK’s development initiatives “Advocacy” is a cross-cutting theme in all its development initiatives. The government and the target communities especially poor are sensitized about their roles and responsibilities. Communities are becoming aware about their rights and entitlements. DSK has played an instrumental role to adopt “National Sanitation Campaign” as GoB’s development priority and also influence change DWASAs and CWASA’s existing policy and accommodate slum dwellers as legitimate clients of WASAs. This initiative has created significant and positive impact on the lives and livelihoods of poor and extreme poor households living in urban slums.

Empowerment and participation of communities’ specially women are the deepest focus of DSK’s development initiatives. DSK has been facilitating to establish strong poor people’s organization that would finally take responsibility for advocacy and development initiatives to create poor people’s access to services in a sustainable manner.

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Vision and MissionVision

DSK seeks a country of social justice, where poverty has been overcome and people live in dignity and security. DSK aims to be a partner of choice within a worldwide movement dedicated to ending poverty.

Mission

DSK aims at building strong community based organizations (CBOs) which will eventually be able to plan, prioritize and implement their own development programs through mobilization of the following combination of resources: -

Objectives

DSK is committed to the following objectives to achieve its vision and mission: 1. Provide health care (primary, secondary and tertiary care) and family welfare services to the rural and urban poor in general and in particular to women and children. 2. To implement illiteracy eradication programme among the children and adults. 3. Implement water supply, environmental sanitation facilities and hygiene education to the rural and urban poor and extreme poor in particular. 4. Exploit all potential options prevailing at the local level to generate gainful employment for the rural and urban poor, with special emphasis on expanding women’s participation in income-generating ventures. 5. Linking various production inputs, particularly disbursement of credit to the rural and urban poor for realizing the available employment-generation opportunities. 6. Contribute to improve the living conditions of the rural and urban poor, campaigning about their right for better livelihood opportunities. 7. Empowerment of community based institutions with visual leadership of women and poor people. 8. Sensitize and strengthen the corporate sector, local government, local private service provider and the community in general about their role in the development process, facilitate and encourage collaborative arrangements. 9. Launching of awareness, relief and rehabilitation program among the victims in the wake of natural calamities and disasters.

DSK Development ApproachesDSK has been facilitating to build a strong community based organizations-CBOs with active and spontaneous women participation in leadership that would eventually be able to plan, prioritize and implement their development programmes. The CBO will be able to develop themselves through mobilization of its own resources, public resources and society upon which they have legitimate claim. DSK did conceive an innovative development approaches such as “Blending Health Care with Microcredit”. Since January 1995, this approach has been followed in the credit project for urban slums. In January 1996, this approach has been extended to the rural areas of Netrakona. In the bygone period DSK did set aside 2.5% of the absolute amount of interest generated by the credit program as health fund and credit clients do not need to pay any extra fee as premium for health insurance. Total fifty six health units were in function pursuing this approach.

Another innovative approach is “community-managed tap water supply” from DWASA / CWASA for the slum dwellers of Dhaka and Chittagong cities. Slum dwellers were not treated as legitimate client by WASAs for water supply and they normally were forced to collect water from public distribution points or from other private households. In order to ensure

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water supply to the slum dwellers under a legal framework, DSK has been advocating for legal piped water supply provision in slums and did implement several Water Points (WPs) with active participation of the slum communities. For overall management of a water point a committee consisting of nine members (all women) was formed for each of the WPs.

DSK also has been facilitating and providing sanitation facilities to achieve national target to cover 100% sanitation in Bangladesh. Hygiene promotion is the integral part of DSK WatSan programme. It implements participatory hygiene promotion activities with special focus on children and adolescent girls to improve sustainable behavior.

DSK believes in participation and ownership of people in development projects, in community institution building and its strengthening. Possibly through such process legitimate space of target poor population shall be established. DSK intends to strengthen its initiative to facilitate building of cooperatives for income increase and building of organization of the poor to be able to impress the state. Possibly that is the process towards empowerment of target poor population. In this reporting period it was possible for DSK to register two CBOs in Bagerhat and Borguna and one in Dhaka city and another one is in process in Chittagong city.

Though started from Dhaka City, DSK expanded its activities in other districts; it covers both urban and rural areas to pursue the same goal and approaches to the extent possible within the given financial as well as organizational capacities. Depending on geographic locations project activities of DSK have been broadly identified as (1) Urban Development Programme and, (2) Rural Development Programme. In the following summary Urban and Rural Development Program activities of DSK along with coverage of specific locations has been presented in a precise form.

DSK at a Glance From inception, DSK has been implementing various development programmes and projects to enhance quality of life and livelihoods of poor people in Bangladesh to reduce their poverty and vulnerability. Following are the major programmes and projects that DSK implemented in the reporting period:- (1) Health Care Programme (Primary health care, Maternity and Hospital services) (2) Micro Credit (3) Water, Sanitation and Hygiene promotion (4) Non Formal Education (5) Disaster Management (relief, rehabilitation and DRR) (6) Economic empowerment of the extreme poor households in urban slums of Dhaka (7) Prevention and protection of victims of human trafficking in Bangladesh (8) Training Cell (human resource development ) (9) Palli Dushtha Bio centre

Geographic coverage

DSK has been implementing its development interventions both in rural and urban areas but focus has been given to hard to reach areas where poverty situation is worst. Currently DSK implements it activities in 66 upazilas of 15 districts through one hundred ten (110) field offices.

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Health Care ProgrammeDSK has started its journey with health care services to the slum- dwellers in Dhaka city and gradually established a hospital for tertiary care service for the poor people. Over the period DSK arrived at a community financed health care model for the poor that has been packaged with micro credit.

DSK health care activities have been materialized through fifty six (56) health units covering 4, 74,225 population in seven districts. Each programme areas cover 1200 to 1500 families.

Aim and Objectives of health care programme

The main aim of the health programme is to provide primary health care services to the households engaged in credit programme; this includes PHC support to credit clients of DSK and their households in fifty six (56) areas; maternity and laboratory support in two areas and tertiary health service through DSK hospital. Aware communities specially women, children and adolescents about different components of primary health care.

Primary health care activity did follow well developed design, covering following components:

DSK’S Health model

1. Providing Health service

adult disease

capacity building trainings (VHP training)

taka consultation fee

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Location of the Project Primary Health Care: Primary health care has been provided through fifty six (56) branches.

Each branch comprises of one static and five satellite clinics.

Maternity Home and Laboratory: Two maternity homes and laboratories were established at Durgapur of Netrokona and Gozaria of Gazipur district. Both the maternities are supported by foreign donations. Durgapur maternity is under the SIMAVI project and Gozaria maternity is funded by Plan International Bangladesh.

Hospital services: DSK is maintaining a twenty four (24) bed general hospital in Dhaka at Mohammadpur area with all facilities (out door and in door patient services, OT facilities, diagnostic facilities and Ambulance service).

Partner supported project(1) DSK has been implementing Plan Bangladesh supported two projects at Gazipur named Community Managed Health Care (CMHC) project and SARH (Support Adolescent Reproductive Health) project.

(2) DSK also obtains opportunity to implement another health care project, which has been funded by SIMAVI. The project is running at Gutura (Netrokona) and Madhanagor (Sunamgonj); in the bygone period another PHC pilot project came to a close that was funded by LIFT/PKSF (Learning and Innovation Fund to Test). This project was to test DSK health model in two areas one near Dhaka (Ashulia) and another in a hard to reach area in Netrakona (Shibgonj).

Target Population Members of the credit programme of the respected branches and their family members are the target population for health care services. Through fifty six health units it was possible to reach 94,845 women members and their families. Considering average five people in a family approximately 4,74,225 people were the target population. Under the approach primary health care (PHC) services for borrowers (women), her/his spouse, selected two children, and two other household mem-bers either parents or father and mother in- laws were under the coverage of the service.

Members of credit programme (health care) in the respected areas were as follows:

Health care service: Total 1,70,577 patients had visited DSK’s fifty six (56) branches including CMHC project (15917) from July ‘09 to June ‘10. Among them 23,476 were children, 12175 were adolescent, 98,273 were female and 20461 were male. Out of total patients 57208 patients had visited Dhaka areas, 17512 patients attended in Chittagong, 33130 in Kishoregonj, 36056 in Netrokona, 9968 in Khulna and 516 in Gazipur areas.

Area wise number of membersDhaka Chittagong Kishoregonj Netrokona Khulna Gazipur Total36,853 7144 14632 22193 6116 7907 94,845

64%

13%

8%

15%ChildrenAdolescentFemaleMale

Patients distribution (age group and sex)

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Health training activities

DSK has been providing different types of need based training to build up the capacity of the project staff (basic on PHC and IMCI) and also target households.

DSK did also provided training to the members to build up awareness such as Health Awareness Training (HAT), Focus Group Discussion (FGD),and Adolescent Health Education (AHE).

To reach the poor people with quality service, DSK has taken an initiative to increase capacity of the Village Health Practitioners (VHP) by providing them training on treatment of common diseases, EPI and ANC.

Total one hundred sixty two (162) Health Awareness Training (HAT) was organized during this one year period and the participants were close to four thousand (3962).

Focus group discussions (FGD)

In these fifty six (56) branches total 3398 Focus Group Discussions (FGD) were organized and participants were more than thirty thousand (33912).

Adolescent health education (AHE)

Total 924 Adolescent health trainings and meetings were held in fifty six branches in last one year. Participants were 14165 adolescent girls and boys.

Community Based Organization (CBO)

In this bygone period seven hundred fifty nine Community Based Organization (CBO) meetings were conducted having participation of 6547 members.

Voucher (Referrals) Scheme

A referral system also is the part of DSK health service model. If required DSK health team is in a position to refer patients to a contracted qualified general practitioner (MBBS). In this by gone period six hundred sixty eight patients referred to contracted general practitioners.

Maternity and Laboratory

Total two thousand one hundred thirty four pregnant mothers made ANC visits to two maternity centers (Durgapur and Gazaria) and our midwives visited more than two thousand (2134) pregnant mothers at their houses during last one year. Two hundred sixty (260) mothers did visit maternity centers for post natal check up. Two hundred twenty seven (227) normal vaginal deliveries were performed at Durgapur and Gazaria maternity centers. Among them one hundred twenty (120) deliveries were performed at Gazaria and the rest at Durgapur.

More than three thousand (3671) tests were done during this one year at Durgapur and Gazaria Laboratory. In this connection BDT 1, 75,379 were earned.

ANC and PNC counseling

Total seven thousand eight hundred sixty (7860) household visits were made by our CHW/CHP to counsel antenatal mothers. Fifty six DSK health units were visited by more than three thousand (3444) mothers in connection with antenatal check up. More than four thousand (4844) families were visited by CHW/CHP to provide counseling to postnatal mothers in the bygone period and one thousand seven hundred eighty seven (1787) mothers had made visit to the static/ satellite clinics for post natal checkup.

In the reporting period maternal mortality was five and child mortality was one hundred seventy four (174) among the target families.

Adolescent health education session

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Verbal Autopsy

It is documentation on deaths that have occurred in the target community. The objective is to expose the possible causes of such deaths as well as possible prevention to such problems. Later a discussion meeting had been organized in the locality on the documented reports to build up awareness in the community.

Total one hundred seventy four (174) children died during this one year (July’09 – June’10) period in fifty six branches of DSK. Among them fifty eight (58) died in Dhaka area, eighteen (18) at Chittagong area, eight (8) in Khulna area, fifty four (54) dead in Netrokona area, thirty four (34) died in Kishoregonj area and two (2) succumbed to their deaths in Gazipur area. The under-5 child mortality rate in our catchment’s area was 41.47 per 1000 live birth (National death rate is 52. per 1000 live birth -BDHS report, 2009). Reported deaths were due to acute respiratory tract infection, birth related complications, severe malnutrition, still birth, diarrhoea, convulsion, injury during deliveries etc.

Maternal deaths

Total five maternal deaths were reported in this one year period. Reported causes were, Hemorrhage, Eclampsia, Obstructed labor and Sepsis.

EPI services: Below table shows the target and achievement in different EPI item. Part of the target children were immunized by other health service providers.

(Note: Pentavalent means by DPT, Hapatitis-B, pneumonia)

Partner supported projects

More than fifteen thousand (15,917) patients visited CMHC project clinics. Out of them two thousand four hundred fifty seven (2457) were children, one thousand fifty one (1051) were adolescent, eleven thousand (11,123) were female and one thousand eighty six (1286) were male. In these period five thousand four hundred twenty one (5421) pregnant women visited CMHC project clinic for antenatal care. CHW and CHP visited six thousand nine hundred sixty five (6965) families for antenatal counseling. Total one thousand six hundred sixty five (1665) mothers received postnatal care from CMHC project clinics. Total one thousand thirty (1030) women gave birth in the catchments population during this one year.

ARH project has been implementing various activities in the project area. In the reporting period one hundred fifty five (155) Life skill training for Adolescent group were facilitated and participants were six thousand three hundred twenty (6320). Thirty five peer education trainings for adolescent group were performed. Total seventeen (17) orientations of Imam, parents and stakeholders on ARH were held. One training on Gender and CCCD and one peer education training was imparted for the staff. Total twenty nine (29) Theaters for Development (TFD) sessions were organized in this period and one teacher’s training on ARH was facilitated.

Child death and Verbal autopsyDhaka Chittagong Khulna Natrokona Kishorgonj Gazipur Total

Child death (includingStill birth)

58 18 8 54 34 2 174

Verbal Autopsy 47 14 6 38 26 2 133

EPI items Target Achieved % achievedBCG 6033 2901 48%BCG with Penta-1st 3166 1742 55%Pentavalen -1st 4222 3038 72%Pentavalen -2nd 4817 3766 79%Pentavalen -3rd 5280 3805 73%Total Pentavalen 22037 14248 65%Measles 5638 3554 64%Total Polio 27675 17802 65%Total EPI 78868 50856 65%

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Sustainability

DSK believed that method of blending health care with micro credit would make the project financially sustainable. The micro credit borrowers pay 15% service charge flat on credit disbursed. 2.5% of which has been earmarked for health care. Health fund shall be also generated from sale of health cards at the rate of Tk 200/ annum per household and generated 2.5% income from ongoing revolving credit programme.

In this bygone period total health premium collected was BDT 2, 23,33,470. There is a system of cross subsidy among the branches. Total amount of health premium deposited first in health fund and disbursed according to the budget of the branch. Hence cross subsidy occurred between low and high health insurance generating branches. Besides, a cross subsidy does occur between borrowers who are borrowing small amounts and those who are borrowing larger amounts including micro enterprise loans.

Targeting extreme poor

To address the health problem of the extreme poor, DSK has adopted a new initiative in those branches which are located in extreme poverty pocket areas. Six branches were selected and these are located in remote areas of Sunamgonj, Kishoregonj and Netrokona districts. The extreme poor are eligible to take loan on ten percent interest (for general member interest rate was 15%). The extreme poor were identified by DSK following indicators that were prescribed by PKSF and also agreed by DSK. DSK is charging on extreme poor 10% flat on borrowed amount and since January, 2009 organization had decided to separate 2% as health premium in extreme poor projects as well.DSK also did decided to plough back 1% service fee as health premium from micro credit activity targeting extreme poor. Previously this principle was applied only where organization did charged 15% flat on borrowed amount annually.

The percentage of discount for medicine would be settled by SACMO and Manager of the branch according to the condition of that member.

Health Staff

During the reported period more than three hundred (312) staffs were working in health service delivery programme. Among them six (6) staff have been working at Head Office. In Primary Health Care (PHC) two hundred twenty one (221) staffs were working at field. Forty seven (47) staffs were working at CMHC project and twenty six (26) at SARH project supported by Plan International. Total eleven (11) staffs were working at the Maternity home and Laboratory at Durgapur, Netrakona and seven (7) had been working at Gazaria Maternity and Laboratory. Total thirty five (35) staffs have been working at DSK hospital in Dhaka.

Staff training

To provide quality service, staff of the projects did receive a seven days basic training on PHC. The participants were SACMOs, CHWs and CHPs. They did further receive a refresher.

Area wise Health Insurance fund generated (July '09 - June '10 in BDT)Dhaka Chittagong Kishorgonj Netrokona Khulna Gazipur Total

98,41,676 25,76,691 28,05,139 31,78,309 13,01,501 26,30,154 2,23,33,470

No. of Extreme PoorBranch Name Total member Extreme poor memberDurgapur and Shibgonj 3632 931Birishiri 3611 1028Najirpur 2005 911Kalmakanda 2615 208Madhanagor 1948 652Gutura 2405 538Total 16216 4268

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Budget: In this period total health programme budget was BDT 5,14,94,569 (health insurance TK. 2,22,27,251 and rest donation. During the reporting period total expenditure was Tk.2, 73, 44,453 Number of patient’s increases in this year

The table indicates that sixty percent patient flow increased to DSK health centers. The table also illustrates that the all types of patients were increased in comparison to previous year (July ’08 – June ’09). A considerable (59%) increase occurred in relation to adolescents which is significant; it indicates that adolescent themselves or their parents became aware of the need of adolescent health care and they sought services. Among the total patients the highest numbers of patient were suffering from dyspepsia. The numbers of patient were 33214. Next to this was joint pain 13513 and viral fever 10674. ARI and diarrhea patient were 10761 and 6804 respectively. A fair number of patients were suffering from malnutrition, worm infestation and dysentery.

Maternal care

More than seven thousand (7284) women were identified as pregnant in catchment areas during this year; among them three thousand four hundred forty four (3444) pregnant mother’s made their antenatal visits to DSK’s clinics. DSK’s CHW and CHP visited seven thousand eight hundred sixty (7860) houses in relation to antenatal counseling.

Total one thousand seven hundred eighty seven (1787) mothers sought postnatal care from fifty six (56) clinics and DSK’s CHW/CHP visited four thousand eight hundred forty four (4844) houses to deliver postnatal advice. Total two thousand six hundred twenty four (2624) women gave birth in the catchments area during this period. Out of the above one thousand three hundred twenty two (1322) that is about fifty percent deliveries were performed by TTBAs (Trained Traditional Birth Attendant), six hundred fifty six (25 %) at hospital and remaining six hundred forty six (24.61%) gave birth at home with the help of untrained birth attendants. 55487 eligible couples were visited out of 61192 couples in this bygone period. Total two thousand five hundred ninety (2590) pregnant women took TT (Tetanus Toxoid) during bygone period. Number of women/ girl completed five doses of TT were 1677.

DSK Hospital

Dushtha Shasthya Kendra Hospital (DSK-H), a pilot project, came into existence with a target to facilitate access of low-income group and people from slums to a standard hospital services on an affordable rates.

PHC Training session for staff at DSK HQ

Monthly patient distribution June '09 - July'10July Aug Sep Oct Nov Dec Jan Feb March April May June Total

13035 13808 11835 14854 14762 11789 14221 14866 16421 14839 15420 14727 170577

Children Adolescent Female Male TotalJuly '08 - June'09 16786 7847 63991 13727 102351July '09 - June'10 26206 13229 109394 21748 170577Percentage increase 64 59.3 58.5 63.3 60

Graphical representation of monthly distribution of patients (July’09 – June’10)

Monthly patient distribution July ‘09 - June ’10

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This has became a complementary institution to DSK-managed PHC services to provide tertiary health care to the member of DSK credit programme on a below market rate. Although attempts have been made to provide standard hospital services at affordable rates but target also remains to operate the hospital on its own foot.

This is a twenty four bed general hospital in Dhaka with outpatient, emergency, in-patient, operation, diagnostic facilities. Hospital also provide 24-hr ambulance facilities for the patients.

DSK hospital services were rendered to four thousand three hundred twenty eight (4328) patients in the reporting year. Among them three thousand three hundred thirty (3330) visited DSK hospital outdoor and nine hundred ninety eight (998) were admitted to hospital.

Total seven hundred forty eight (748) patients were operated at DSK hospital during the period of July ’09 to June ’10. Out of the above, numbers of major operation were two hundred sixty three (263); seventy five (75) caesarian sections and eight normal vaginal deliveries were performed.

In the above mentioned period, total four thousand two hundred ninety (4290) patients went through different types of diagnostic tests at DSK hospital. Among them four thousand two hundred ninety (4290) patients have done pathological tests; Five hundred seventy one (571) X-rays, two hundred twelve (212) ECGs, two thousand six hundred sixty two (2662) Lab tests and eight hundred forty five (845) Ultrasonography were performed.

Receipts and payments of Hospital services

Total receipts of DSK hospital was BDT. 1,23,42,776 (including BDT 2.4 million grants from DSK) and payment was 12,003,086.0.

Operation performed at DSK hospital (July ’09 – June’10)

Major Intermediate Minor Caesarian section Normal Vaginal delivery Total

263 238 164 75 8 748

Hospital patient distributionFemale Male Child Total

Outdoor 1494 1473 363 3330Indoor 481 437 80 998Total 1975 1910 443 4328

DSK Hospital

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Revolving Credit Programme (RCP)DSK has a vision that came out of social and economic mission of bringing financial service to the poor and the poorest so that they can come out of poverty. As micro credit service provider DSK at present is providing micro credit to 156,467 families through its 85 branches in 31 Upazilas of fifteen different districts both in urban and rural areas. The Urban areas are in Dhaka, Khulna and Chittagong cities. The rural areas are Nawapara Jessore, Joydebpur and Sreepur of Gazipur, Netrokona, Kishoregonj, Naryangonj, Narshingdi and Sunamgonj districts. DSK has started micro credit through replication of Grameen model in the year 1992 in one of the Dhaka city slums; since then it has served 613,040 families and has disbursed Tk. 8,239,138,625 as loan till June 30, 2011. Present outstanding loan stands at Tk. 1,096,310,188 and total savings Tk. 465,421,387 and have cumulative classified loans of Tk. 62,249,984. DSK has successfully created loan loss provision required for the classified loans as per standard requirements. A successful Microfinance program starts with clear objectives to set up permanent institutions with systems designed to provide standard financial service on a long-term sustainable basis. This objectives implies following key things: good quality financial products or services, delivery by an appropriate institution on a profitable basis to satisfy clients who continue to value and use those services. Quality of financial services means, which would meet the needs of the poor community and not only the needs of financial institution. Loan repayment system and flexibility in savings withdrawalMicrofinance represents an evolving and dynamic system that has shown its capacity to adjust to various socio-cultural settings and respond to the changing and varied needs of the poor. The practice of microfinance has itself evolved, often in unpredictable ways, outpacing the development theory. A proper understanding of this evolution is essential for adopting policies that can better realize the full potential of microfinance. This is in part learning-by-doing, but also in part what can be better termed as a process of “learning-by-seeing done by others”. In spite of the rapid replication of microfinance programme there are many gaps in our understanding of how the microfinance market actually works. What for example, motivate the borrowers to repay loans amidst a culture of widespread loan default by well to-do borrowers of commercial banks? In this regard, by focusing mainly on group liability, the standard theory on microfinance may have missed other institutional features, that may have a bearing on the success of the system; transparent transactions (as opposed to confidentiality maintained in traditional banking), close personal relationship between the lender and borrower, and the emergence of repayment norm through habit formation to name a few of such clicking mechanisms. In mature microfinance systems where loan repayment norms are well established, the design of the programs shall allow more flexibility to meet the varying needs of their members.DSK continues to strive its level best to follow the latest advancement of micro credit. From supply driven to demand base loan disbursement is the present day strategy that capable NGO MFIs are following, but challenge to those who adopt the policy would be to managing them. Large number of variety of products creates massive paper work and strong monitoring of decentralized field units that handle all transactions independently. DSK as a mature organization presently

Mr Fazlul Kader, DMD PKSF and Dr. M Quader, CEO Credit, DSK and others attending a discussion meeting at DSK

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fulfills the needs of the member’s borrowings and savings. Area specific products have been designed to fit with member’s cash flow. DSK experimented flexible financial service named as DPS. Through these project DSK has learned and adopted many features of experimental phase into its present microfinance products. These are different lending and recovery methods such as weekly, monthly and seasonal recovery approaches. Even individual lending for micro enterprise and extreme poor have been customized as products to meet the requirement to fit with the value chain of the members. Service delivery method particularly for the poorest enables them to have an access to the service because it does have reasonable flexibility to fit with the income cycle of the individuals. Special consumption loans are provided to the landless HCP members dependent mainly on irregular wage earning. Insurance of the members life and property (livestock, crop etc.) are essential to come out of abject poverty. Name of loan products according to its nature has been given in table below.

Bangladesh is the country of numerous NGO MFIs in same locations leading to the problem of overlapping. Over debt members create problem for the both organizations and the borrowing families. Often members go to several NGO financing institutions for their borrowing to fulfill actual needs. NGO MFIs often are not equipped to lend to an individual having different needs; that does not fit with normal loan ceiling for the group in each cycle. Initially group members were economically homogeneous so the loan provision practice to group members was equal; experience proved that all members are not equally skilled in utilization of loan in profitable ventures. At present DSK provides loan ranging 5000-300,000 according to the specific need of the members.Table: Product wise loan disbursed during financial year 2010-11

Total loan disbursed were Tk.1, 922,879,400 in the FY 2010-11. DSK has 41% of its loan portfolio in urban and the rest are in rural areas.

Urban and rural Micro Credit

DSK started replication of Grameen model in Dhaka slums with voluntary zeal and intended to target only the poorest. Targeting poorest in Dhaka city slums was not a problem. However, in course of time high pressure to avoid “defaulter” shifted members profile from extreme poor to moderate poor. It has been observed that 95% group members dropped out within 4-5 years cycle through a process of group screening or self-exclusion. The better income earning poor having entrepreneurial skill survived. Most of the city branches has come out of traditional slums and now operating in low income settlements of the city.

Due to product design DSK attempt to reach extreme poor both in city slums as well as in remote poverty pockets was not successful. The economically backward people generally do not have access to land or they lack skill of trading or any other activities of self employment. Extreme poor are mainly dependent on wage labor. Employment opportunities are more in cities, however migration from rural to urban created scarcity of wage employment. Some of DSK working areas in rural are mono crop wet land areas that grows only Rabi crops. During seasonal monsoon flood the scope of self or wage employment greatly reduces. In a location like these where borrowers do not have regular source of wage income or other opportunities of income, very high default loans force them to drop out. Only successful entrepreneurs survive with classical Grameen type of Loan products. At present DSK’s 82,049 borrowers (UMC 33,712+ RMC 48,337) utilize loan mainly for trading; where quick money could be earned to repay regular weekly installments. In current year DSK has disbursed total Tk.1,230,757,000 to these category of clients, which makes 64% of DSK’s loan portfolio.

Loan to extreme poor

DSK provided savings and credit services to 57,253 HCP families through these products since 2001. Many of them graduated to join next stage (i.e RMC or UMC) to receive high ceiling of loans. HCP clients are often victim of high recovery initiatives ofMFIs resulting in dropouts and subsequent exclusion. Over the years DSK’ conceived that the centers (group) serving the poorest clients should be treated separately and subsidy in terms of rate of interest and flexibility in loan repayments

Loan disbursement As on 30.06.2011 % of Total LoanRural Micro credit 440,835,000 22.93%Urban Micro credit 789,922,000 41.08%Livestock Loan 28,723,000 1.49%Micro Enterprise (Urban +Rural) 498,972,000 25.95%Hard core poor Loan 28,934,000 1.50%Disaster management Loan 268,000 0.01%Agriculture Sector Loan 134,033,000 6.97%Dignity Loan 1,192,400 0.06%Total Loan Disbursed 1,922,879,400 100.00%

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should be allowed. MFI serving HCP should have the capacity of achieving over all OSS rather than achieving it at group level. Each MFI should carefully calculate their financial capacity without compromising the financial discipline of a sustainable institution. With present capacity DSK is safely providing loan to extreme poor members in the range of BDT 5,000-9,000 every year. Loan ceiling generally low however high ceilings are allowed to acquire assets. Total 3,937 HCP members received Tk.28, 934,000 as loan during FY 2010-11. Total loan portfolio is only 1.5%, which clearly indicates capacity of using loan by the extreme poor clients; though DSK has capacity of lending more to HCP clients.

Livestock Loan

DSK started livestock credit in the year 1996 and after phasing out of project period established the products that are being marketed sustainably along with livestock insurance. DSK offered such scope to individual group members normally interested to invest in small projects related to birds and milk cow rearing. Loan size and repayment system was designed to fit the needs of the poor borrowers. In this exercise members borrowed on an average Tk.22, 000 with a range of Tk.10, 000 to 200,000. During its 15 years of marketing DSK has served 50,531 clients all having livestock projects. At present there are 1,239 active members and it is running with a loan outstanding of TK. 28,934,000. The products are being marketed in rural branches of DSK. The special feature of this product is that the members and its livestock are covered by insurance for the entire loan repayment cycle. If death occurs among any one of the three i.e. member or her husband or the livestock animal, borrowed loans are waved and all savings including 1% extra charge as insurance contributions are returned.

Micro Enterprise Loan (ME)

NGOs targeting to establish permanent MFI do not encourage dropout of members who has graduated or represents better income poor. Better income poor, who will often take larger loan to expand or maintain the working capital of their business or to finance asset acquisition, enables MFI to increase their surpluses. It is this larger loan on which the MFI will make most profit, since the cost of administering the loan is almost same irrespective of its size. And crucially, it is these clients that allow the MFI to finance the provision of smaller loans and other social service to the poor and poorest clients. At the same time the product would enable entrepreneurs create wage labor, which would lead to creation of employment for the poorest. The services now being offered by DSK has been tailored to meet the needs of the better income and self-confident potential poor entrepreneurs. Since 2002 cumulative loan disbursed for micro enterprises were Tk. 1,276,932,000 to 18,837 micro entrepreneurs. At present DSK has 6,723 members having micro enterprise (ME) and loan disbursed to them in current year alone was Tk.498, 972,000. Loan Outstanding as on 30th June 2011 were Tk.272, 214,929. Majority of the ME loans are recovered on monthly installment basis. 6000-7000 numbers of jobs are created monthly created by the existing entrepreneurs. People belonging to extreme poverty group exploit the opportunity of wage employment in these enterprises.

Agriculture Sector Loan for the Farmers (ASMP)

Farmers particularly the marginal and small farmers were out of the MFI services because of its weekly collection system. Products suitable for the farmers were introduced in the year 2004. Since introduction of ASMP DSK has disbursed Tk 363,753,500 to farmers. At present DSK have 8,844 farmer members (as main stream loan product) supported financially by PKSF. During current financial year DSK has disbursed Tk. 134,033,000 mainly for crop sector. Present outstanding loans as on June, 2011 were Tk.17, 458,217. Demand for these products are gradually increasing; however DSK is now facing

Micro credit center meeting

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growth crisis in meeting the demand; revolving rate is also low with large sum of capital. DSK provide loan for the period of three to nine months. Interest is charged @ 2.08% on a declining monthly basis. Farmers are allowed to repay the loan ata time or in monthly installments after the crop harvest.

Dignity Loan

Purpose of this product was to pull out beggars to come out of that profession. Normally NGO MFI excludes them fromregular lending system or self exclusion occurs in this category. DSK as partner of Grameen Trust started this project in December, 2007. From the day of introduction DSK has provided loan to 1450 beggars’. Total Tk. 1,192,400 was provided as loan to 712 dignity members in the FY 2010-11. These types of members are not included in normal groups but attestedwith local groups and loans are interest free. If they save regularly and repay loan as per schedule they are included in regular groups enabling them to borrow necessary amount as loan to pursue income generation activities and come out of begging.

Service Charges (SC)

There are issues surrounding microfinance that are often subject of intense public debates. For example, how MFIs arrive at certain interest rates in the microfinance market? How can the financial viability of the microfinance program be ensured?Should this program be judged by their financial self reliance and commercial viability, or by their effectiveness in helping the poor, even accessing subsidized funds from the government and foreign donors? A source of confusion may lie in notrecognizing the two separate roles of microfinance: to channel funds to the poor as an innovative banking operation, and tohelp poverty alleviation as part of social security or safety nets for the poor.

Servicing traditional microfinance clients are expensive, because loan sizes are small and the number of staff required to service clients. Though it was carried out with a goal and motivation, but competitions prevent it from charging higher service charges and absorb losses. A key consideration was whether the institution is mission-driven, rather than profit-driven. DSK as non-profit organization charge enough to cover its expenses and build the portfolio. DSK did start some piloting with very high SC, which was gradually reduced; these reductions were the result of the management’sdecision when it was making more than enough to meet its growth needs. In the beginning having some support from donors DSK continued for some time providing loan at rate which were below market rates. While other NGO MFIs (suchas BRAC and ASA) were charging 15% flat DSK continued to charge 12.5% flat and part of its income was spent for health care of members. However later it was decided to charge market rates and plough back 2.5% of interest income as health fund. At present DSK had number of rates of service charges starting from zero to twenty five percent following a decliningmethod; interest rate depends on agreements with financial institutions and it complies with MRA rules.

Funding

To meet incremental demand for lending by the borrowers, smooth fund should be low needs to be maintained. DSK’s fundraising tactics were pursued to generate revenue that it could control itself and that, free from reliance on the whims of grant makers and politicians. DSK has received small amount of grant and soft loans. Though started without any equity of its own its present equity is TK. 166,887,382.

The present equity of Tk. 166.88 million has been achieved through own income (73%) and grant (only 23%). However, inthe revolving fund equity is only 15%, while 38% loan and the rest comes from daily, weekly or monthly installmentcollections, which include savings (45%).

Table- Loan received during the FY 2010-11 from different Landing agencies

Financing Opening Balanceas on 01-07-2010

Loan Receipt Loan Refund Closing Balanceas on 30.06.2011

PKSF-RMC 43,700,000 14,500,000 23,650,000 34,550,000PKSF-UMC 185,800,000 90,000,000 86,400,000 189,400,000PKSF-ME 65,450,000 56,000,000 27,600,000 93,850,000PKSF-UPP 14,166,667 10,000,000 11,166,667 13,000,000PKSF-MFMSF 13,600,000 12,500,000 6,500,000 19,600,000PKSF-AMCP 4,500,000 31,500,000 4,500,000 31,500,000Plan-DPS 10,347,010 - 533,435 9,813,575Grameen Trust 307,402 - 307,402 -ADIP 7,958,915 - - 7,958,915Anukul Foundation 19,787,972 10,000,000 10,673,627 19,114,345

Total 365,617,960 224,500,006 171,331,131 418,786,835

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SavingsThe prospect of borrowing money having a condition to repay loan according to a fixed schedule is a very risky for the poorest clients. These poor people often prefer to avoid increasing their risk through taking loans and normally prefer to build up a lump sum through careful and pain taking savings. Savings play an important role for the very poor. In this way the very poor can, little by little, (as circumstances of their household income and expenditure flow permits), build up some savings reserve without additional risk and cost of taking loan. On the other hand appropriate emphasis on savings are necessary to reduce the overall level of outside capital needed by the MFIs thus allowing precious accumulation of fund permitting institutions more flexibility in its working methods. To meet both the above mentioned objectives few types of savings products has been designed. Many poor households may be actively saving even if their assets at any given moment are low; instead, they are building up lumps of money and spending them within a year. Micro household and individual data reveals much about personal savings rates, the decision-making process at the individual and household levels, and the impact on individuals and households from access to different savings services. The impact of savings program can be difficult to measure, because savings is hard to capture in survey data and to isolate savings from other financial services: few institutions offer only savings service. Three factors particularly complicate measurement: size, timing, and diffusion. Unlike credit inflows, which can be sizable relative to household income, savings flows can be quite small; and balances accumulate slowly. Also, the timing of the change in behavior and outcome is less clear. For households, savings develop slowly through a small reduction in consumption over time, with a large inflow later. At some point the household will have built up enough savings to protect themselves from shocks (like sickness or unemployment), to pay school fees, or to start a business. It may not be a simple question of waiting for savings to accrue household cash flows may vary over time. Researchers need to measure savings balances at multiple points in time, often over several years. Savings deposited by the members of DSK during FY 2010-11 were Tk.293, 325,791 and Tk.184, 453,314 has been withdrawn. In spite of that the cumulative balances of savings as on June, 2011 were Tk.465, 421,387. Even extreme poor members deposited Tk.5, 106,370 during current financial year and withdrawn Tk.3, 565,226.0 Integrated Primary Health Care DSK believes that all poor people and especially extreme poor need to be more than micro credit clients and NGO needs to be more than just MFI, to promote poor out of vicious cycle of poverty. At the beginning DSK started its social development initiatives especially by addressing the health problems of the slum dwellers particularly the women and children. The objectives of the health program are to decrease maternal and child mortality, reduce vulnerability to common disease, and control infectious disease such as acute respiratory infections, and diarrhea through limited curative care and awareness raising. Financing health care service is one of the major problems of Bangladesh. DSK from the beginning tried to develop a primary health care delivery system, which in the long run should be able to sustain with support from community and the government. To achieve the goal DSK has experimented Primary Health Care (PHC) model both in rural and urban context by blending the services with micro credit and by collaborating with other service providers especially GoB. Main features of this system are that DSK charges 15% flat rate for its financial service of which 2.5% goes to form a health fund. Total contribution to primary health care services of DSK from micro credit were Tk. 29,972,342 Government led reduction of service charge and its negative impact on PHC of DSK DSK was trying to evolve an integrated financial service model which would financially sustain with support from micro credit. DSK’s vision is to provide primary health care services to all the poor families that it reaches through micro credit services. DSK covered 97,455 families and their family members through PHC services who are engaged with its 56 branches. DSK initially used to charge 10.2% flat or 20% in declining rate, which was not sufficient to support the cost of health care service and institution building. When DSK increased its service charge to 12.5%, at that time most of the micro credit providers were charging 15% flat. Following others DSK also increased its service charge from 12.5% to 15 %, however it utilized the increased 2.5% income for the PHC service.DSK started running PHC in few branches up to 2001 from grant support and was slowly but steadily trying to achieve its objective by increasing number of branches from own fund. In the year 2003-2004 there were 13 branches under PHC coverage, by the year 2008-09 numbers have been increased to 56, which DSK was financing from 2.5% service charge earned from credit. As per current government order MFIs are not allowed to charge more than 12.5% flat interest rates. This decision brought a strong negative effect on community based health care financing of DSK. DSK fills that until GoB starts financing such micro health insurance services, DSK should be allowed to continue charge 15% to continue its health services.

Toilet for differently able

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Water, Sanitation and Hygiene ProgrammeDSK has developed a community based water supply and sanitation approach targeting slum dwellers to facilitate access to water supply and environmental sanitation facilities along with hygiene education. This approach has been successful and became known as “DSK Model". Many other organisations are now replicating this modal as the base for their work. DSK’s WatSan model is an integration of software and hardware i.e. hygiene promotion and community participation having combined with water and sanitation facilities. DSK has been working in WatSan sector with the support of Water Aid Bangladesh, Plan Bangladesh, Water.Org, Water First International and ICDDR, B. The aim of the programme is to improve the health status of the poor through ensuring access to safe water, sanitation and health hygiene improvement and community empowerment. DSK had been implementing six WatSan projects in bygone year. Projects were: Water Aid supported two projects in Dhaka and Chittagong city corporations, Plan Bangladesh supported one project in Dhaka city. Water 1st and Water.Org supported two projects in Dhaka and Chittagong cities. DSK has also been implementing one research project with support from ICDDR, B.

Key components of DSK’s Water and sanitation programme are as follows:

WatSan model and approach

communities can access formal utility services. Thus the key principle of the project is to respond to the demand for water and sanitation indicated by the communities who are willing to pay. According to this model people from the slum community that form groups are provided

management and maintenance of water point and sanitation

Cluster Latrine at Chittagong

Piped water supply to slums

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facility, health hygiene habits and in that way promote behavioural change.

Through community participation, DSK facilitates to identify existing situation, WatSan problem, priority issues, community plan for actions, formation of CBOs, selection of options and design for WatSan infrastructures, select location, and formulate guidelines on water usage and cost sharing.

DSK mediates with the formal utilities, lends capital costs; whereas WASA provides technical input, gives permission for the construction and connection of the WP. The users have been paying/ sharing the capital cost, managing the WP and sanitation facilities, and paying the maintenance cost along with the WASA bills on a regular basis.

Apart from the standard water supply and sanitation technology, DSK has been piloting few other WASH innovative technologies like – rain water harvesting, public toilet, mobile toilet, Eco-Toilet in urban settings.

WatSan programme coverage areas

The DSK’s WatSan programme has been implemented in both rural and urban slums; but major focus is in urban slums of Dhaka and Chittagong cities. WatSan facilities also have been provided to disaster prone coastal districts such as Satkhira, Khulna, Bagerhat, Borgurna, as well as in Sunamgonj and Netrakona.

DSK has targeted to provide 100% access to safe drinking water and sanitation facilities to 85,000 families living in 230 urban slums of Dhaka and Chittagong cities. A number of slums already have been fully enjoying water supply, sanitation and hygiene promotion facilities.

WatSan programme status

Water supply in community: DSK has been providing safe drinking water supply to the un-served poor communities both in urban and rural areas. During the reporting period it has facilitated provision of eighty one (81) urban water points, thirty seven (37) submergible pumps, and one hundred fifty seven (157) deep tube wells.

Water supply to School: In the reporting period DSK has provided and improved water supply in eighteen (18) urban schools of Dhaka and Chittagong cities. The school students are mostly from low income communities. More than eleven thousand (11,520) school children have been enjoying access to safe water supply in the reporting period. DSK has been currently providing WASH facilities in forty two (42) schools.

Water supply through mobile van: DSK has been running mobile water supply to the pavement dwellers and street food vendors through engagement of community members. Seven mobile water vans (Dhaka -6 and Chittagong-1) have been providing water supply. On an average one van provides drinking water to 200 populations daily. Gradually seven mobile water van operators shall become small water supply entrepreneurs seizing this as an opportunity for alternate livelihood.

Rain water harvesting system: DSK has been piloting rain water harvesting system in urban areas. Six rain water harvesting tank has been installed in six schools in Dhaka city to harvest water and to provide drinking water to three thousand seven hundred fifty (3750) students. Capacity of each tank is 25000 litters. It stores water two to three times in a year. Water treatment has been done to make water drinkable. In the reporting period following categories of population got access to safe drinking water under this component (table below).

Environmental Sanitation

DSK intended to achieve 100% sanitation coverage in target areas through WatSan interventions. DSK did install three hundred eighty (380) community toilets, twenty five (25) twin pit latrines and seventy two (72) single pit toilets.

During the reporting period, 2520 ft drainage and 1250 rft lane, bi-lane, footpath in urban slums has been renovated. Twenty five (25) Bio-gas systems have been running to cover seven thousand (7000) families in Bauniabadh slum in Dhaka city. However such systems are now overstretched of its capacity and needs and require radical overhauling.

Category Total beneficiary Male Female Children Poor Extreme poor Differently ableWater to urbancommunity and schools

43,733 21,970 21,763 15,638 31085 12648 46

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Mobile toilet: DSK has introduced two mobile toilets in Dhaka city to provide toilet facilities to mass population who moves around the city daily. On an average hundred people a day use each mobile toilet on pay and use basis.

Public toilet: DSK has piloted one public toilet in a market place at Kamrangir Char of Dhaka city. The toilet has been run and maintained by the community. DSK has provided loan for the construction to the community and they are paying back on the basis of monthly installment. About two hundred people use the toilet daily and monthly average income is BDT 10,000.

Eco-Toilet: Five Eco-Toilets have been constructed in Dhaka city as pilot. The eco-toilets have been constructed at Demra, Vasantek and Amin Bazar in Dhaka city. Cost of one toilet construction was in the range of BDT 35,000 to 40,000. Eco-toilet is a new technology in urban and peri urban areas of Bangladesh.

Bio-gas Plant: DSK has been engaged in managing twenty five (25) biogas plants at Bauniabadh slum of Dhaka city. Total 35,000 low income population representing seven thousand (7000) families are benefitted from the biogas plants.

Vacutug: DSK has been managing a Vacutug service (a suction device to empty septic tank/pit of toilets) in Dhaka city the Vacutug is running on a pay and use basis. On

an average it earns BDT 50,000 per month. In the reporting period it has cleaned eighty five (85) septic tanks and three hundred fifty (350) pit latrines.

In the reporting period DSK has provided new toilet facilities to more than forty thousand (42,034) populations living in urban slums. Out of them over twelve thousand (12 062) were extreme poor and thirty seven (37) differently able.

Sanitation Coverage (reporting year)

Rikshaw driven Mobile Toilet

Vacutug Mark II with 2000 Liter capacity

Category Totalbeneficiary

Male Female Children Poor Extremepoor

Differently able

Sanitation to urbancommunity (new toilet)

42034 21105 20929 16028 19872 12162 37

Sanitation to School 5510 - - 5,510 - - -Public toilet 200/day - - - - - -Mobile toilet 200/day - - - - - -Vaccutug system 200/day

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Solid waste management: DSK has been implementing solid waste management component in urban slums along with water and sanitation facilities. It has approached the issues in two ways: (1) Community managed solid waste collection from household and disposal in city dumping points (2) Solid waste composting (organic fertilizer production). In the reported period community managed solid waste collection and disposal system has been in-place in seven (07) slums in Dhaka and Chittagong cities. Each family pays BDT 10-20/ month to run the system inclusive of payment of salaries paid to van drivers. DSK has provided thirteen (13) waste collection van trolleys to the community to manage solid waste.

DSK has been running a solid waste composting plant in one of the slums in Dhaka city. Four hundred seven (407) barrels were provided to two thousand six hundred (2600) families. Average 500 Kg compost had been produced in a month and sold in market at BDT 10-12 /Kg.

School WASH: Since 2006 DSK has been implementing WASH component in schools to improve access to safe drinking water, safe sanitation facilities and personal hygiene for school children through an innovative approach – ''School Sanitation and Household Hygiene Education (SSHHE)'' in slum areas of Dhaka city. During the reporting period DSK has implemented SchoolWASH in forty two (42) urban schools and more than fifteen thousand (15,500) school children (boys and girls) were covered under DSK- WatSan project. Through joint initiative of student forum and the resource teachers’ hygiene promotion have been continuing in schools as well as in the community. Significant improvements on personal hygiene knowledge and practices have been observed among the school children. More significantly a partnership has been established among School (GO education department, SMC, teacher and student), Community (CDF, LGI and family) and NGOs in the project areas.

Revolving loan fund for WatSan: DSK has build up a revolving loan fund (RLF) with a view to support construction of water and sanitation facilities for the un-served poor communities. This fund is generated from repayment of WASH hardware loan taken and repaid by the community. DSK has been implementing two projects in Dhaka and Chittagong slums at 100% cost recovery basis inclusive of ten percent service charge. Slum dwellers took loan to install water points or toilets and repaid back in 12-24 months on monthly instalments. Till December 2010, total recovery was BDT

1, 33, 60,758.

All these activities were based on the followings: strengthening “Community Based Organisations (CBOs)”, women engagement and leadership, and Behavioural Change Communication (BCC) along with social and financial sustainability. Hygiene promotion activities have been carried out among the beneficiary groups. All the CBOs had been trained on organizational development and management, O & M of infrastructure, advocacy, lobbying etc. one hundred fifty one (151) CBOs have been functioning and six hundred fifty five (655) CMCs (community Management committees) were formed to operate and maintain the infrastructure.

Newly installed ninety four (94) Tube wells has been tested for arsenic (As) and all were found safe. Samples from one hundred seventy five (175) water points (WP) were tested to understand depth of bacteriological contamination and twenty eight (28) WP were found contaminated. These were disinfected using chlorine (Cl). Three thousand five hundred seventy (3570) hygiene promotion sessions including menstrual hygiene sessions for adolescent girls and women were conducted this year. One low cost sanitary napkin production centre has been open at community which is managed by the community members.

Hand washing demo at School

Hygiene education

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Non-formal Education (NFE)In 1992 DSK did start to implement non formal education project with support from BRAC. DSK did start with ten (10) learning centers at Durgapur and Kalmakanda Upazila in Netrakona district. Over the period, it did expanded NFE programme in Dhaka, Chittagong, Khulna and Rajshahi cities; DSK also had implemented “Basic Literacy for Adult project” with DNFE support. Under the project six hundred seventy five (675) learning centers’ were established and more than twenty thousand (20250) adult learners have been graduated. The project was implemented in 08 Upazilas of Gazipur, Narsingdi, Netrakona, Mymensingh, Kishorganj districts.

During the reporting period DSK had implemented three projects in Netrakona (Durgapur, Kalmakanda), Dhaka and Chittagong cities having support from BRAC, CARE, and GoB- Unicef. DSK has been continuing NFE project in Durgapur and Kalmakanda of Netrakona district. Thirty eight (38) learning centers’ have been continuing with one thousand one hundred forty (1140) learners. DSK has been implementing NFE programme in Chittagong city under BEHTRUWC project with the support of GoB-Unicef since 2006. At the beginning DSK did managed five hundred fourteen (514) learning centers’ in the project areas. Till date out of five hundred fourteen (514) learning centers one hundred eighty (180) have been completed and three hundred thirty four (334) are continuing in Chittagong city corporation areas. Under the project (in previous phase) five thousand four hundred (5400) working children were graduated and eight thousand three hundred fifty (8350) children are continuing their education in three hundred thirty four (334) centers. 8-14 and 10-14 years urban working children were the target learners and sixty percent were girls and forty percent were boys. The total graduation period as per initial design was twenty four months (24) months; however design was revised and currently it shall be closing at 40 months.

DSK did start a non formal education project in Dhaka city with support from CARE Bangladesh in 2008.One thousand (1000) working children were enrolled to attend classes in forty (40) learning centers’. One thousand (1000) students have been graduated during the reported period. After graduation DSK did organize skill development trainings for them. Total six hundred ninety eight girls and boys (boy 316 and girl 382) learners were enrolled in six skill development trainings and the trades were- Embroidery and Kartchupi, Block, Boutique, Screen Print, Tailoring and Dress Making, Beautician Course, Leather Craft and course for electrician. DAM was contracted to provide training. DSK, DAM and CARE took initiatives to search jobs for these trained adolescent groups, who completed the training and intend to do jobs independently or on wage arrangements.

Skill Training Session Skill training for school children

Successful rice harvest at Barguna late 2009

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Relief, Rehabilitation and DRR ProjectsDisaster management states the activity that will make people prepared to face the emergency at local level and to be able to respond and mitigate disaster related risks as far as possible. DSK has been implementing emergency projects since 1991. After SIDR in 2007 DSK had implemented several emergency relief, rehabilitation, livelihood and DRR project supported by ECHO/DCA both in SIDR, AILA and flood affected districts of Barguna, Baherhat, Khulna, Satkhira, Jessore, Sunamgonj and Netrakona. During emergency DSK had provided food, medical and water and sanitation support to the affected poor families.

Under rehabilitation and livelihood support DSK has provided shelter construction, boat and fishing nets, agriculture inputs, livestock support, water and sanitation facilities, empowerment of CBOs and community through training, awareness building and savings. Apart from the emergency and rehabilitation support DSK has been implementing DRR project in three upazilas of Netrakona,

Barguna and Bagerhat districts. DSK had provided community development training facilitating CBO formations and capacity building, awareness raising on disaster, disaster preparedness, linkage with local govt and community to minimize disaster related future risk among the vulnerable communities.

Relief and rehabilitation: Last year DSK provided significant support to the cyclone affected people through implementing projects in disaster effected Sidr and AILA areas. These projects were supported by DCA/ECHO. During that period DSK provided emergency medical support, food and material support, drinking water supply, livelihoods restoration, shelter construction, water and sanitation facilities and building community organization and capacity of the affected community at Borguna (Patharghata, Bamna) and Dakop of Khulna. People used to collect

contaminated water from their neighbourhood villages (Dakop, Kailashgonj and Kamnibasia). They were suffering from different types of waterborne diseases; in that situation DSK installed Pond Sand Filter (PSF) and water desalination treatment plants where people find it most difficult to access safe sweet drinking water. Now the affected families are getting access to safe drinking water and use safe water that protects them against water borne diseases and facilitates alternative livelihoods generation.

In the bygone period DSK has given much focus in following areas targeting the AILA affected poor people’s lives and livelihoods in Khulna and Satkhira : 1. Emergency medical and water supply support 2. Food and material support 3. Livelihood restoration support 4. Shelter construction

Water desalination plant at Dakop

CBDRR training at Borguna

DRR through livelihood: distribution of Goats to Aila cyclone victims

27

5. Water and sanitation facilities 6. Building Community organizations and its capacity

Support to the AILA victims (Till December, 2010)

This project was able to reach twelve thousand HHs through food ration two times and various livelihoods, WASH, PHC and other activities were implemented. Below mentioned table provides a concrete view of above matters.

DSK did also implemented project in AILA effected area with support from Christian Aid. Project was successful in building good linkage with local administration and was started having a joint meeting of all stakeholders. Main target was to build up community based disaster risk reduction (CBDRR 600 trained members) and rehabilitation of community lives through provision of support for livelihood and access to vitally important water supply (six PSF) and sanitation services of target communities living in Kamarkhola and Sutarkhali of Dakop thana in Khulna district. It was possible to develop local physical plan having participation of local villagers in consultation with local union parishad. It was also possible to facilitate formation of 25 CBOs and through cash for work (400 people’s 37work days) repair local village roads and polders to revive life to normalcy in river water inundated areas. It was possible to supply cash capital following revolving fund approach to support income generating activities (390 members). Savings generation were encouraged. Limited number of one room shelter (58) and shelter repair (66) support were also provided. Through this project one thousand two hundred forty five target participants were benefited.

Re-excavaed sweet water pond

Sl # Activities Target Families TargetBeneficiaries

Reached(Families) Reached

(Beneficiaries)1 Food distribution 12000 (6000

families twice)66000 6000 66000

2 Shelter repair 392 2156 - -

3 Cash for work 1500 43726person days

1500 46626person days

4 Small fishing Boat & Net 200 1100 200 1100

5 Engine Boat (4 x 40) = 160 880 160 880

6 Single pit latrine 200 1100 - -

7 Community latrine 200 (2x100) 1100 200 1100

08 Tube wells 10X2=20 110 20 110

09 Plastic drum 6000 33000 6000 33000

10 Water treatment plant 1000 5500 1000 5500

11 Sheep distribution 500 2750 500 2750

12 Clotech distribution 6000 33000 6000 33000

13 Primary health care 1000 individuals 1000 individuals 1600 individuals 1600 individuals

14 Paddy seedsdistribution

1000 5500 Dropped Dropped

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DSK-Shiree Project: Economic empowerment of urban extreme poor household’s DSK has been implementing a three year project “Moving from Extreme Poverty through Enhancing Economic Empowerment of Extreme Poor Households” in Dhaka city slums to address the multiple causes of extreme poverty in Dhaka city by enhancing the capabilities of the extreme urban poor to cope with urban life, through their household’s economic strategy. The project is funded by Shiree/EEP- a GoB and DFID partnership to address the multiple causes of extreme poverty in Dhaka city. During the project implementation period (2009-2012) a total of 10,000 extreme poor households of Korail and Kamrangirchar slums has been targeted to be graduated from extreme poverty by this project. This project will contribute to Government’s initiative to achieve MDG-1. Eighty percent (80%) of the total budget is for improvement of the livelihoods of the 10,000 extreme poor families. Unit cost per household is about BDT 28,222 (direct input) which includes capacity building, assets transfer, startup capital, cash stipend, apprenticeship and support to the pregnant mothers, health and water-sanitation facilities.

This project was started in April, 2009 and will close at March, 2012 (negotiation for an extension is going on). DSK targeted the bottom 10% of extreme poor living in two urban slums in Dhaka city who are mainly day labors, housemaids, beggars, rickshaw pullers, push cart drivers, vegetable vendors, no regular job, disabled etc. Usually they cannot afford two meals a day and remain beyond the scope of any safety net support available in the country. The extreme poor families have been selected using PRA tools such as: transect walk, rapport building, social mapping, wealth ranking, physical verification, cross checking and final verification by Shiree.

When the households had been selected, DSK started to organize the households as groups, facilitate courtyard sessions, collect savings and provide Primary Health Care (PHC) services. Simultaneously DSK provided basic organization building training, entrepreneurship development and business management (EDBM) trainings. DSK also started to complete household profiles with photographs; facilitate process to prepare target HHs for asset transfer, provide asset and start-up capital, provide stipend targeting pregnant and breast feeding mothers, old age and disable persons.

Targeted HHs will be covered by the project as per following time schedule:

During the reported period total one thousand five hundred thirty nine (1539) extreme poor (bottom 10%) families have been selected for assets transfer and other project benefit. Out of which fifty seven percent (57%) are female headed families. In this reported period one thousand three hundred ten (1310) households received assets to enhance their income activities.

Extreme poor and poor people’s health is most potential human assets for their livelihoods. Health service is one of the integral components of DSK-Shiree project; families obtain PHC service along with referral and hospital support. Lack of access to safe water and sanitation is another big problem. DSK-shiree project is also providing WASH support through combination of hardware and software. Many extreme poor households are unable to work due to old age, sickness,

Participatory Training session

Period Y-2009 Y-2010 Y-2011Households 2000 5000 3000

29

pregnancy and lactating period. This project does provide cash allowances at Tk 600 per person, per month for initial six months; this is identified as transitional support. In between time target participants will find out an earning source or re-engage themselves with previous employment. Flexible savings is a notable activity in this project. Extreme poor people are encouraged to save to mitigate disaster or

e c o n o m i c shocks.

B e s i d e s these, through direct asset or cash transfer support these project beneficiaries are linked with market and able to purchase raw materials to produce and market their own grocery items, clothes, shoes, dusters, food items and mini garments.

DSK- Shiree project went through some learning’s such as, some households had less interest to be engaged in actions linked to business development; vulnerable women headed families can also run a small business efficiently if they are backed by financial and technical resources etc.

Key achievements: Following achievement so far achieved during the reporting period (June, 2010)

Type of physical assets so far transferred to the households

Small Gorcery Shop at Kamrangirchar

Hand embroidery

Sl Activities Achievement Population / HH1 Beneficiary HH selection 1539 1539 HH2 Asset transfer 1310 1310 HH3 Old age/disable stipend 447 447 HH4 Pregnant/lactating mother stipend 100 100 mother5 Disbursement of startup capital 4 4 HH7 HH EDBM training 63 1603 person ( male-283, Female 1320)8 Skill based training (apprenticeship) 31 31 person ( male-9, Female 22)9 Basic training 82 1806 ( male-317, female-1489)10 CBO management training 10 158 ( male-28, Female 130)11 Savings by the HH BDT 3,23,011 4277 HH12 CBO formation 18 979 members ( male-217, female-762)13 Community Water Point 1 19 HH14 Community Toilet 1 19 HH15 Health Care ( Static and Satellite clinic) 1296 Children- 132, Male – 254, Female-91016 Hospital care and referral 56 Male 17, Female 3917 Child Immunization 206 206 (Boy- 95, Girl-111)18 Health Awareness ( courtyard session) 365

Name of Assets Total Kamrangirchar KarailRickshaw, Van, Boat, Cart 318 179 139Tailoring (Sewing machine) 123 71 52Clothes trading ( hawker) 199 129 70Vegetable, silver, fruit, scrap 253 141 112Tea, grocery shop 345 100 245Duster, shoe brush making 27 27Shoe factory, Cake, Juice, Saloon 36 29 7Food (Ghugni) Business 2 2 0“Biyer Dala” making 1 1 0Vibrator machine (construction work) 1 1 0Flexi Load, Watches, Pharmacy, Water 5 0 5

30

Other ProjectsPrevention and Protection of Victims of Human Trafficking In Bangladesh Dushtha Shasthya Kendra (DSK) implemented the project “Prevention and protection of victims of human trafficking in Bangladesh” with financial assistance of International Organization for Migration (IOM). The Ministry of Women and Children Affairs (MoWCA) was the lead ministry, and other nine ministries, Department of Women Affairs (DWA), Bangladesh Shishu Academy, Bangladesh Counter Trafficking Thematic Group, NGOs and Networks were involved in the project implementation. The project also worked with the judicial and law enforcement agencies (LEA) officials to foster prosecution of human trafficking. The project was implemented in Netrakona and Sunamgonj districts bordering with India.

The project was started on 01 August, 2007 and closed on 31 October, 2010 inclusive of extension period. The overall objective of the project was to address trafficking among children, adolescent girls and women in Bangladesh through raising awareness of the general public as well as specific targeted groups and facilitating income generation opportunities for the vulnerable people; the project aimed at preventing trafficking of persons. Under protection component, the project promoted activities on economic empowerment of the vulnerable women and underprivileged children. The project also aimed at building capacity of NGOs (through NGO Network) and government officials on the issue of counter-trafficking (supporting government to implement their interventions). Through various planned activities, DSK was able to achieve the project targets (98.69%) during the project period despite various constraints and challenges. DSK was able to reach a total of 151,770 people by organizing different events, of which 48% were male (72378), 26% female (39665) and 26% children (39727). Project details including activities performed and results obtained at the end of the project period are presented in the below mentioned sections of the report.

Achievements: Two (2) district level orientation workshops were organized (Netrakona and Sunamgonj). Seventy participants from relevant ministries, district administration, police officials, District C o m m i s s i o n e r s , Superintendent of Police and NGOrepresentatives were present in these workshops. Two (2) district level workshops for Counter-Trafficking Committee (CTC) members were held with the participation of 70 participants.

Twenty (20) monthly upazila CTC meetings were organized, where a total of 412 CTC members (21/meeting) attended. Sixteen (16) monthly union/pourasava CTC meetings were organized. A total of 391 CTC members (65/meeting) attended these meetings.

There were twenty six (26) Focus Group Discussions (FGDs) with Local Elected Bodies (LEBs) in Netrakona and Sunamgonj districts. A total of 392 participants (15/FGD) attended these FGDs, There were forty eight (48) FGDs with Community Based Organizations (CBOs) and seventy (70) FGDs with local elites (religious leaders, members of the civil society, school teachers and parents). More than one thousand five hundred (1,556) participants (32/FGD) attended CBO

Govt. Officials Training

31

FGDs; Fifty four (54) courtyard meetings were held with women groups in the project area. A total of one thousand seven hundred thirty eight (1738) women (32/meeting) attended these meetings. They were sensitized through relevant information against human trafficking for their proactive role in their own community.

One hundred fourteen (114) group meetings with livelihood beneficiary groups were held in the project area. A total of one hundred seventy five (175) women beneficiaries attended these meetings. They were trained IGA activities at village level. The purposes of these meetings were to provide them with capacity building supports.

One hundred fifty one (151) bazar meetings were held in local bazar premises with the help of bazar (market) committees. More than eighty thousand (84,404) persons (559/meeting) attended these meetings; one hundred fifty one (151) bazar committee meetings were held to convince them about the importance of human trafficking and their specific roles in their respective capacities. More than one thousand (1,661) members (11/meeting) were present in these meetings.

Seventy (70) community based cultural events were held in engagement with specialized cultural groups working in the project area. Almost sixty thousand (59,500) persons (850/event) were present in these events; out of the above 32% were male (19,250), 42% female (25,175) and 26% children (15,075).

One hundred seventy five (175) vulnerable women were provided with IGA Training followed by livelihood support amount-ing BDT.20, 000.00 per beneficiary.

Two (2) batches of training for one hundred ten (110) primary school teachers were arranged at the district level to discuss human trafficking issues and their vital role to protect the children from being trafficked. Thirty eight (38) meeting with NFPE (Non-Formal Primary Education) students were held to aware them about the different aspects of human trafficking and their vulnerability. Students and teachers were provided with colourful posters with anti-trafficking messages. A total of thirty eight (38) female teachers and 1,140 students attended these meetings.

Two (2) district level events on “Observation of International Migration Day” were organized in two project district head quarters (Netrakona and Sunamgonj) with the assistance of DEMO, Government, NGOs and community people. In the meeting, one successful migrated labour and one worker who failed to migrate shared their experiences. A total of four hundred ninety three (493) people attended these events.

ETV broadcasted the International Migration Day observation events in addition to the coverage by some local and national news papers.

Barrister Shafiq Ahmed, Honorable Minister, Ministry of Law, Justice and Parlimantary Affair’s, Dr. Mihir K. Majumder, Secretary, Ministry of Environment and Forest, Ms. Nina Llona Ellinger, Regional Representative of DCA, Dr. ABM Abdullah, President DSK and others at publication ceremony of DSK position paper on Climate Change, October 19, 2010

32

WSSCC-B and grassroots sanitation campaign The Water Supply and Sanitation Collaborative Council (WSSCC) is a leading international advocacy organization that advocates about access of poor people’s right to and access to WASH across the globe. Its mission is “to accelerate the achievement of sustainable water, sanitation and waste management services to all people, with special attention to the un-served poor, by enhancing collaboration among developing countries and external support agencies and through concerted action programmers”WSSCC-B platform is composed of national NGOs, international NGOs, Academia, UN organizations, bilateral donors and GoB. The platform meets on a regular basis. WSSCC-B did play an instrumental role in organizing SACOSAN in Bangladesh. WSSCC-B is the member of National Sanitation task force and organization was founder member secretary of National Task Force on Sanitation. WSSCC-B continues to play an important role in WatSan sector of Bangladesh. Besides this, in 2007 WSSCC-B did act as a regional networking forum for End Water Poverty Campaign. DSK’s Executive Director is the National Coordinator of WSSCC-B and has been implementing various activities through it member organizations. DSK is also involved with WSSCC-B activities in Bangladesh. Grassroots Conventioon-2009-10 updatesIn line with the above, MDGs and GO campaign to achieve hundred percent sanitation by 2013, WSSCC-B undertook two projects to facilitate participation of grassroots in Sanitation campaign of Bangladesh. WSSCC-B believes that active participation of grassroots in sanitation campaign will bring strong coverage and influence sustainability of the process. In view of the above WSSCC-B chapter developed two project proposals and submitted to WSSCC global office for necessary to WSSCC for possible support. Main target activities in these projects were as follows:

National Grassroots Convention took place on March 24, 2010 and was jointly organized by WSSCC-B, FANSA-BD & EWP. The Convention was divided into three segments. 1. Sanitation Rally, 2. Panel discussion session and 3. Plenary. Grassroots convention covered grassroots observations and it was reflected through six divisional reports. WSSCC-B grassroots convention news were well disseminated through print (in different news papers across divisions and national dailies) and electronic media and a special 30 minutes TV program was screened by popular private TV channel RTV. It is to be mentioned that RTV was the media partner.

Ms. Juena Aziz (fourth from left), Joint Secretary, Ministry of LGRD & C and other dignitaries at plenary session of grassroots convention-2010

33

Following grassroots statement a plenary session was organized. Ms Juena Aziz, Joint Secretary, Ministry of Local Government Rural Development and Cooperatives, Engineer Taksim Ahmed Khan, Managing Director, Dhaka WASA, Mr. Shamsuddin Ahmed, Deputy Secretary, Ministry of Local Government Rural Development and Cooperatives, Mr. Khairul Islam, Country Representative Water Aid, Prof. Mujibur Rahamn, BUET, Ms Rokeya Ahmed, Water and Sanitation Specialist WSP, Ms Mahmuda Begum Elected Ward Councilor (4,15,16), Dhaka City Corporation, Engineer Dewan Nakib Ahsan, Additional Engineer (planning), Department of Public Health Engineering Department, GoB participated. It was presided by Mr. Hamid Fakir, President NDBUS a CBO. Vote of thanks was given by Mr. Milan Bikash Paul, Executive Director, PSTC.Grassroots National Declaration came up with the followings

effective participation of the grassroots people at village, ward, union and Upa-zilla levels.

allocation for the hardcore poor and its proper use, and urges the government to ensure the effective participation of the extreme poor in the processes that decides the distribution of such allocations.

have been heavily inadequate and hence, this issue must be taken into special consideration.

rehabilitation; ensuring sanitation services for the slum dwellers will not require installing latrines at the slums only, but will also require collective actions to ensure their proper usage by the dwellers.

demands that both the government and non-government financial allocations for sanitation must be increased.

demands to ensuring technologies that would explore possibilities to provide sustainable sanitation services.

participation in processes.

Parishads to share in public, the steps through which they ensure sanitation services are reaching to the hardcore poor.

rather it should be considered as a continuous process.Apart from the national convention, WSSCC-B chapter did organize campaign activities throughout the year. During last year following activities were achieved.WSSCC-B along with FANSA-BD organized a common strategy building workshop having twenty nine participants representing several organizations (DSK, PSTC, VERC, UST, Plan BD, ISDE, NABOLOK, SDS, JHASIS, NISHKRITI, CBOs: NDBUS, CAC, Bostibashi Union, CBO of Chittagong city. Twelve grassroots consultations took place in Bagerhat, Barisal, Chittagong, Dhaka, Narayangonj, Netrakona. Shariatpur, Sylhet, Sunamgonj and Tangail districts.Six divisional conferences took place in Dhaka (March 01, 2010) Chittagong (March 17, 2010), Barisal (11 February 2010) Rajshahi (February, 07 2010) Sylhet (March 04, 2010) and Khulna divisions (March 16, 2010).

nineteen upazillas (19) and one hundred sixty two unions (162). More than eleven thousand (11,120) people were participant in such consultations. In the consultation following issues have been highlighted

needs to be increased.

of hygiene sessions should be more focused and numbers increased.

34

Radio Programme

Human resources

Program Male Female Total

8 58 5 8

55 9

8 98O 8Sub Total 271 387 658

88 8 6Sub Total 389 285 672

5 99

Total 36 111 147Grand Total 696 783 1477

35

Training Cell-Human Resource Development ProgrammeDSK did establish a separate training cell in 1999 to enhance capacity building of staff and target community leaders. The initial aim of the Training Cell was to equip staffs of DSK with necessary communication and management skills to help them to do their best. This was done by both the internal trainers as well as getting outside experts to share their learning.Over the period the training cell has been equipped with skilled and experienced training personnel along with physical facilities. The training facilities at Dhaka are equipped with modern aids including audio visual support having accommodation capacity of 25-30 participants.

DSK training cell is running with few full time trainers and resource persons having particular experience in micro finance, entrepreneurship development, livelihood promotion, water and sanitation, health care, gender, participation, management of community institutions, project management, monitoring etc. DSK’s training team has well-established track record of providing training support to the development institutions, program and project both nationally and internationally.

The focused training areas are: Micro finance and entrepreneurship development, Primary Health Care, Water, Sanitation and participatory hygiene promotion, Community hospital management, Non formal education programme, Visualization Techniques, Management and development of community institution, Disaster management, Advocacy and Communication, Gender and Development.

DSK Training cell follows some procedures to conduct training, such as follow the project proposal, conduct training need assessment (TNA), develop training calendar, develop training modules, develop lesson plans, schedule and training materials etc. and finally the training conduction (staff and beneficiaries). After training conduction training impact have been monitored through field visits, individual interviews and need based FGDs.Major Trainings Conducted during the reporting period are shown in boxes:

More than one thousand (1390) staff were trained in numerous types of skills. Among participants total two hundred seventy eight (278) people were male participants and three hundred ninety (390) were female. At community level, there were more than thirteen thousand (131217) trainees; among them more than twelve thousand (12414) were female and they were trained in different types of skills during the reported period.

SLNo. Project

Staff TotalParticipant

(Staff)

Community TotalParticipant

(Community)TargetBatch

AchievedBatch

TargetBatch

AchievedBatch

1 Micro Credit 28 28

1390

No Plan No Plan

131217

2 Primary Health Care Project 6 6 224 2243 EECHO Project 1 1 53 534 Shiree Project 9 9 155 1555 Plan Project 3 3 131 1546 Water.Org Project 2 2 30 307 Water 1st Project 12 10 78 728 ARSP Project 7 7 69 729 CMHC Project 3 3 7 6

10 DRR Project 3 3 29 2911 AILA Rehabilitation Project (CA & DCA) 2 2 20 1712 ICDDRB-Pilot Project 1 1 0 013 Human Trafficking Project 1 1 2 2Total 78 76 798 814

36

CBO Management Training

Training imparted by DSK training cell is as follows:

Male – Female Ratio

Training on Finance and ManagementTraining on waste managementTraining on CBDRR

Training on parenting

Level ParticipantsMale Female

Staff 278 392Comm nity 7113 12414

Governance and ManagementExecutive CommitteeThe eleven-member (11) Executive Committee of DSK meets at least once in a month and participated in all policy level and strategic decision makings. Meeting and AttendanceIn this reported period a total of ten (10) Executive Meetings were held. Apart from this one “Special Meeting” also took place. As per constitution Annual General Meeting took place in due time, besides the AGM two special AGMs were also held. The average attendance of EC members in meetings was 71%.Discussions Topics of the meetingsConfirmation of meeting minutes, implementation progress of decisions made, Governance of DSK a comparative analysis, Micro Credit program, Health Program, report on relief and rehabilitation program and WASH activities, DSK hospital, new membership, Auditors appointment, staff promotions, DSK budget and annual plan, purchase of DSK vehicle, increase of staff salaries, internal audit report, sale of fixed properties, AGM date and meeting preparations, executive directors reports, Palli Bio centre, charity fund its status and mode of implementation etc. Delegation of AuthorityThe Executive Committee of DSK has delegated chief executive functions to the appointed Executive Director and CEO (credit) of DSK. The Executive Director and CEO with support from other Directors and Coordinators implements day to day activities of the organization on the basis of written accounting, employment and other procedures practiced in the organization.ManagementDSK has developed a Central Management Team (CMT) participated by the Directors and Coordinators of different programs. The CMT sits together monthly and takes into account all the programs and administrative matters of the organization.

Dr. ABM Abdullah (extreme right) presiding at EC Meeting

38

Besides that, considering the large volume of the Micro Credit Program, the organization has divided its programs into thirteen areas (Dhaka-5, Chittagong-1, Gazipur-3, Khulna-1 Kishorgonj-2, and Netrakona-3). In each and every area an “Area Manager” has been assigned the responsibility to supervise and administer the micro credit units located in that area (5-10). Apart from that regional management teams participated by different program focal points are also in practice for better communication and understandings across the programs. Apart from micro credit, there are project offices in different project locations Project Coordinator/Area Managers or Unit managers look after the project activities. All the Program Coordinators located at the head office also supervise the specific programs as per program needs. Internal Control, Accountability and TransparencyAll the projects and programs of DSK are monitored monthly, bi monthly and quarterly-basis by the “Monitoring Cell” of DSK. Moreover, the half yearly Internal Audit is accomplished for reviewing the Micro Credit Program. Apart from this, the Coordinators and the Directors review the programs and projects at the filed on a regular basis. Both the Annual audit and the project audit are conducted regularly in accordance with the financial procedures of DSK.

Development PartnersThe major donors and supporters in this period were BRAC, CARE Bangladesh, Christian Aid, DanChurchAid (DCA), DNFE (GoB), ECHO/DCA, IOM, ICDDR,B, LIFT/PKSF, SIMAVI, Shiree/Dfid, Plan Bangladesh, Water Aid Bangladesh, Water.Org, Water 1st International, Water Supply and Sanitation Collaborative Council (WSSCC), and financing institutions Palli Karma-Sahayak Foundation (PKSF), BASIC Bank, and certainly the target communities themselves.

Annual Audit

Last financial year’s audit was done by ACNABIN chartered accountant farm. Auditors comment, Balance sheet, Income Expenditure statement and Receipt and Payments have been inserted as an annex.

Development Partners

In this bygone period DSK projects received support from following donors and financial institutions: BRAC, CARE, Christian Aid, ECHO/DCA, DCA, GoB-Unicef, LIFT/PKSF, Plan International, Shiree /Dfid, SIMAVI, Water Aid, Water .Org, Water First International, Water Supply Sanitation Collaborative Council (WSSCC)

Financial Institutions: PKSF and Anukul Foundation

DSK publications

DSK has published a number of reports, policy document, IEC/ BCC material, video documentation to strengthen its capacity and care awareness among the target communities. Following are the major publication published so far – 1. Current Climate Change Vulnerability: Position of DSK in the climate change discourses in Bangladesh 2. Bangladesh Cyclone SIDR, 2007: DSK experiences 3. WASH in Schools : Schools with Water, Sanitation and Hygiene 4. Towards a complementary health financing model : blending health care with micro credit 5. Creating Livelihood options for the urban extreme poor : exploring the challenges 6. Eradication of extreme poverty among the slum dwellers in Dhaka city 7. Bangladesh Citizens’ Report on Sanitation, 2011 (preliminary) 8. Training Profile of DSK 9. Moving from extreme poverty through economic empowerment of extreme poor household 10. Innovative Financial Ventures and its impact on Microcredit Program of DSK

During this period IEC and BCC material were developed to rais[[[e awareness among the slum dwellers. The materials are

on WASH implemented in Korail slum.

39

Visitors at DSKIn the bygone period representatives of following organizations made a visit to different project of DSK, they are as follows: ABC News, BMGF, Dfid, FAN-SA, Harvard University, Harewell, Liberia WASH activists, London School of Hygiene and Tropical Medicine (LSHTM), Nick News, Unicef, Water Aid, Water First, Water Advocates, WSP, UN Special rapporteur on Right to Water and Sanitation,

Mr. Nick Low honorable British Deputy High Commissioner and his wife did visit DSK-Shiree project on November 03, 2010 at Korail project sites.

Mr. Nick Low, Deputy British High Commissioner visiting extreme poverty project at Korail Slum

WSSCC Liberia activists visiting WASH project Prof. Frank Rijsberman of BMGF visiting Kollyanpur slum

40

41

42

43

44

45

Abridged Summer

46

BudgetThe General Body of DSK has approved a surplus budget of Taka 2743.30 million for the financial year 2010-2011. Grant budget is Tk. 413,838,946.00

WatSan, 100, 963,624

DSK-Shiree169,738,854

Health Care61,293,257

DSK-IOM, 777, 222DSK-ICDDR,B 629, 750

Disaster Management67,461,067

Education 12,900,172

Micro credit2,329,451,758

DSK Budget 2010-2011

WatSan100963624/-

24.4%

DSK Shiree169738854/-

41%

Health care61293257/-

15%

DisasterManagement67461067/-

16%

DSK-IOM777222/-

.36%

DSK-ICDDR,B629750/-

.24%

Education12900172/-

3%

Donor’s Contribution: 2010-2011 (July-June)

47

Geographical coverageAt birth, DSK started its activities in slums of Dhaka city and gradually expanded its work over other districts to address the problems of both urban and rural poor. Presently it is operating in following areas:

# Districts 14 No. of Thanas 66 Name of union/ wardBagerhat Sharankhola Southkhali, RayendaBarguna Barguna sadar Burirchar, Badarkhali

ChittagongHalishahor 11, 23, 24, 26, 38Dampara 8, 13, 14, 15Khulshi, Kotualy 9, 11, 12

Chittagong District Shitakundu, Chandgaon Sonaichari, Barab kunduKumira Kumira union

Dhaka city

Cantonment, Kafrul 15, 16Tejgaon, Ramna, Dhanmondi, Mohammadpur, Adabar 20, 36, 37, 38, 39, 46Lalbagh, Kamrangirchar Sultanganj 58, 59Gabtali, Mirpur, Pallabi 2, 4, 5, 6, 15, 17Uttara, Uttarkhan, Dhakhinkhan 1, 2, 3, 4Gulshan, Baddah, Shaterkul, Khilkhet 15, 17, 18Khilgaon, Motijheel, Sabuzbagh 57, 58Demra, Shampur, Sutrapur 79, 80, 81, 82, 83, 84, 85, 86

Dhaka District Shavar, Ashulia, Shaver sadar, Ashulia

GazipurSreepur, Kapashiya Razabari, ProhladpurTongi, Turag Ward no. 1, 2, 3, 5, 6, 7, 9 of Tongi powrasavaGazipur sadar Ward no. 1, 2, 3 of Gazipur powrasava

Jessore Avainagar sadar Noapara (Madhapur, Bibaghdi, Akhtarpur)

Khulna

Dawlatpur, Dumuriya, Dighalia 3, 4, 5 wards, dighalia & zabdipur union porishadKhalishpur 14Sonadanga 16, 17, 18, 24, 25, 27RupshaNoa paraShahpurDakop Sutarkhali, Tildanga, Kamarkhola

Kishorganj Kishorganj sadar Kadirjangal, Mohinanda, ward no. 1-9 of Kishoreganj powrasavaKarimganj Karimganj sadar, Guzadia, Nowabad, NeamatpurItna Itna sadar, BaraibaryMithamoin Mithamoin sadar, Gubdhigy

Narayangonj Fatulla, Rupganj Kotobpur, AnayatpurVulta, Shiddirgonj Vulta, Golakandail, Vatiary

Narsingdi Narsingdi sadar, Noralapur, Mohishasur, Madobdhi powrasava

Netrakona

Durgapur Durgapur, Birishiri, Gaokandia, Bakaljura, Kullagara,Kakairgara, Chandigar

Netrakona sadar Netrakona powrasava, ward no. 1, 2, 5, 6, 7, 8, 9, Maugati,Rawha, Challisha union

Kalmakanda Nazirpur, Lengura, Kharnai, Kailaty, Rongchati, Kalmakandasadar

Sunamgonj Dharmapasha, Madhanagor Dharmapasha sadar, 1,2,3,4,5,6 , Selboras 7,8,9

48

Central Management Team of DSK 2009-2010

General Body of DSK

SL. NO. Name Designation Mobile No.01 Dr. Dibalok Singha, MD Executive Director 01713-14732902 Masudul Quader, PhD Chief Executive Officer (Credit) 01713-00580703 Tushar Kona Khondker, BA (Hon’s ) Managing Director (PBCL) 01716-29175804 Sirajuddin Ahmed Bhuiyan, B.Com Director (Finance) 01819-25010805 Ranajit Das, B.Sc (AG) Senior Project Coordinator (WATSAN) 01711-68682606 Tofail Md. Alamgir Azad, PhD Project Director (Shiree Project) 01711-15134207 Shamsul Alam, M.A Senior Coordinator (Credit) 01713-14739208 Afroza Daliya , M.A Coordinator (Admin ) 01711-83040309 Subas Chandra Joydhar, M.Com, (CC) Coordinator (Finance) 01716-06115710 Suresh Chandra Datta , M.Sc Coordinator (Relief and Rehabilitation) 01552-446312

SL. NO. NAME SL. NO. NAME

1 A B M Abdullah, PhD 17 A S M Golam Mortuza, PhD2 Anjan Datta, PhD 18 Debopriya Bhattacharya, PhD3 Tushar Kona Khandaker, BA (Hon’s) 19 Prof. (Dr.) Nazmun Nahar, MBBS, FCPS4 Dr. Mahmudur Rahman, MD 20 Prof. Mahfuza Khanam, M. Sc5 Habib Uddin Ahmed, BA 21 Dr. Jawadur Rahim Wadud MD, PhD6 Shagufta Yasmin, M. Sc 22 Mohammed Jasim Uddin, M. Sc7 Habibur Rahman (Tuku), MA, MBA 23 Md. Khairul Alam, M.Com8 Quazi Towfiqul Islam, PhD 24 Dr. Anisur Rahman Siddque, MBBS, MPH9 Mustafizur Rahman, PhD 25 Mohammad Abdullah Sadeque, BA10 Jahangir Hossain Siddiqui 26 Prof. M. M. Akash, MA (Econ)11 Laila Arjumand Banu, PhD 27 Mahbub Zaman, MA12 Dr. Saqi Khandoker, MD 28 Prof. Dr.Taibul Hasan Khan, PhD13 Binaek Sen, PhD 29 Dr. Shahidul Islam, PhD14 Syed Amir Hossain 30 Partho Sarathy Chakrabarty, B.Com15 Nazneen Sultana, M. Sc 31 Dr. Mahfuzul Haque, PhD16 Muhammad Emdadul Haque, FCA

Micro credit group meeting

AusAID and Water Aid visitors in discussion with CBO at Kollyanpur Learning session at NFE School

Repair of polder at Amirgonj, Modhanagar, Sunamgonj

House no-741, Road no- 9, Adabar, Mohammadpur, Dhaka-1207, Bangladesh. Tel: +8802-9128520, 8122861, 8159656, 8120965, Fax: +8802-8115764E-mail: dskinfo@dskbangladesh.org, Website: http://www.dskbangladesh.org

Dushtha Shasthya Kendra (DSK)