In March, this year, I was in Kolkata assisting Oxfam-Bangladesh in the making of a video on the 50-plus years of Oxfam work in Bangladesh. Visiting different places connected with Oxfam in 1971 reminded me of the medical store we had in Kolkata at that time to supply the medical teams catering to the needs of Bangladeshi refugees.
In late 1971, I was informed that a young Bengali doctor had visited Oxfam's medical store demanding medicine to take back to a big bamboo and straw field hospital on the Tripura/Bangladesh border. This young and energetic doctor was put in touch with me and I explained that our store was supplying to the medical teams in the refugee camps, where about 600,000 Bangladeshis were staying.
When we met he said, “I'm Dr Zafrullah from the UK and Oxfam HQ in Oxford said you will help us. I need drugs and supplies now to save the lives of Bangladeshis in our 480 bed hospital and, after all, you can always buy more tomorrow.”
I remember that he put his arm around me and said, “Thank you so much. Just think of the number of lives you are going to save. Like the freedom fighters, you are also a hero. For today at least! And, by the way, your office should be in a refugee camp and not a hotel.” -- with a twinkle in his eye and a mischievous smile, he was gone.
At that time in 1971, Oxfam was supporting work in some of the refugee camps in Tripura and we learnt of the work of Zafrullah's “Bangladesh Field Hospital” on the Tripura border. We learnt that women with no previous training in healthcare were trained in very few days to care for hundreds of freedom fighters and refugees that came to the hospital, and it was this experience that later guided the planning of the work to be undertaken in liberated Bangladesh.
Raymond Cournoyer, my former colleague who was heading Oxfam Bangladesh's program, had made it very clear to Oxfam's head office after the Liberation War, that he did not want to be involved in relief work, however important it might be. “I want to use Oxfam's funds to support young Bangladeshis with vision.” And that is how the early Oxfam grants were made to Dr Zafrullah Chowdhury's Gonoshasthaya Kendra (GK) and Fazle Hasan Abed's BRAC.
Understandably, in early 1972, Zafrullah was in a hurry to get things going and applied to Oxfam for financial assistance to set up a hospital and begin considerable outreach work. Staff from Oxfam-UK, Oxfam-Canada, and Oxfam-America were all interested in supporting GK's ground-breaking work as were a number of other donor agencies.
In fact, one American doctor made the following comments at the time: “The physicians Dr Chowdhury has recruited seem intelligent, enthusiastic, and well-motivated. Their plans for a medical program seem remarkably sound ... They have obviously sought out good advice and incorporated it into their planning ... They have established a relationship with the district cooperative in Savar which will make it possible for their program to be a part of the overall development process. It is unusual to find this combination of enthusiasm with common sense and demonstrated ability.”
A visitor from Oxfam at about that time wrote, “Since April 1972, some of the doctors have been living near the site of the future health centre in tents, and others have been driving out on Sundays in a borrowed van to run a clinic in an abandoned post office and in the surrounding villages. These eight doctors have received no salaries and no outside help, but their devotion is gaining them the acceptance of the villagers who have begun to level the land for the buildings.”
In late 1972 and early 1973, I heard about Gonoshasthaya Kendra's trained village midwives and healthcare workers moving about on bicycles. One Oxfam staff member wrote in March 1975, “There has been considerable enthusiasm amongst our medical advisers on hearing about Dr Zafrullah's use of an illiterate village girl during tubectomies ...” The renowned medical journal, Lancet, also praised GK's work in 1975.
Over the next few years Oxfam supported GK and became particularly interested in the plans for a National Drug Policy where Zafrullah would be a member of the expert committee related to it. Oxfam was glad to support GK's proposal to set up a pharmaceutical production factory for generic drugs.
There was enormous opposition to the National Drug Policy (NDP) which was approved in 1982. Opposition was expected from foreign governments that were supporting drug companies from their respective countries, but there was also very strong opposition from the Bangladesh Medical Association. As one doctor told me, some years later, they received many gifts from the foreign companies including family trips to places like Bangkok or Singapore.
It is important to remember that the NDP was launched at a time when a martial law administration was in place and where not a lot of discussion had taken place. Ten years later with an elected government grappling with consensus democracy a committee was set up to review the NDP. Many, understandably, desired that the NDP be incorporated into a National Health Policy, but there were many who wanted the NDP to be scrapped.
Later on, I was working in Dhaka in 1990 and I remember that mobs attacked offices, stores, and vehicles of GK to express their opposition to the NDP. Those days were extremely dangerous and depressing, to say the least.
In 1985, I came to Bangladesh to work with the Canadian organization, CUSO. I re-established contact with GK and Zafrullah and at the times of the severe floods of 1987 and 1988 CUSO was able to access Canadian government funds for relief and rehabilitation activities.
Travelling out to Savar by boat, in 1988 we found that, by (illegally) tapping into the main gas line which ran alongside the road, GK had set up multiple gas burners making thousands of chapatis day and night, sending out cooked food to flooded areas. It was an amazing production line.
When looking back to see what the inspirational wisdom of Zafrullah has created, it is important to realize the many other aspects of GK's work, such as: Health Insurance, research into medicinal plants, organic food production, agro forestry and, of course, Gonoshasthaya Pharmaceuticals.
However, what has shone through over so many years has been the work of Nari Kendra and the fact that hundreds of women have been trained in activities usually regarded as the domains of men only.
I will always remember the time, in the 1980s, when I saw women carpenters, lathe workers, welders, and drivers. They told me at that time, “Julian bhai, you see that we can now hold up more than half the sky.” More recently, they told me that their children have gone to GK's own university, something they were, and are, very proud of.
It must have been nearly 40 years ago when I was talking to Zafrullah about sustainable development and conservation and we got round to talking about what life was like growing up in London in the years after the Second World War.
I spoke about how we were taught to “switch off the light” to save money and to “shut the door” to keep the cold draughts out. I spoke about how my mother used to “darn” or mend socks which had holes in them and Zafar Bhai spoke of the stupidity of everyone buying lots of new clothes on particular occasions when the existing ones had years of life still in them.
So, on hearing of his passing and in fond memory of Zafar bhai, I decided to wear a Bangladeshi shirt which is still going strong after 37 years! He was so keen in those days about the use of jute and GK experimented quite a bit with “jute plastic” furniture and building materials, and I have always been impressed with the memory of duty free items being packed in jute bags at the Dhaka Airport. Now, of course, “see-through” plastic is apparently necessary ...
In conclusion, I repeat part of a message that the late Andrew Chetley, a colleague of mine when he and I worked for Healthlink Worldwide and a good friend of Zafar Bhai, sent for me to read out when 40 years of GK was being celebrated:
“GK is a pioneer in people's health. You've shown leadership and real courage in the face of determined opposition to the policies and practices that really improve health. You've taken risks that many people choose to avoid. And you've changed the thinking on what is possible in health care and made a real difference to the lives of many Bangladeshis -- and to many, many others around the world.”
Julian Francis has been associated with relief and development activities of Bangladesh since the War of Liberation. In 2012, the Government of Bangladesh awarded him the ‘Friends of Liberation War Honour' in recognition of his work among the refugees in India in 1971 and in 2018 honoured him with full Bangladesh citizenship.