Most of us have looked after someone who is ill. Even a short illness brings constant questions: Have they had something to drink? Can they wash themselves? Have they slept?
Now imagine asking those questions every day, for years, while caring for a daughter with a disability, a parent with dementia, or a relative with a serious mental health condition.
For unpaid family carers, this is their reality.
They care with love and commitment at enormous personal cost. Their health, livelihoods, education, and social lives can be pushed aside. They hold communities together and sustain health and care systems without pay, recognition, or even a break.
Bangladesh has valued unpaid household and care work at Tk6.7 trillion in 2021, approximately 18.9% of GDP. The calculation includes unpaid domestic work as well as care, but it reveals the scale of a contribution that is too often overlooked.
Bangladesh’s National Healthy Ageing Strategy and Action Plan 2024-2030 acknowledges that family carers can delay or prevent the need for residential care for older people.
Yet recognition in principle is not the same as support in practice. Assistance may go to a person with a disability through the disability allowance or to a household through the Family Card. Too often, nobody looks beneath the surface. Carers are frequently the very people navigating applications and managing payments intended to support someone else.
The evidence from our work in Bangladesh is striking. Through our partnership with the Centre for Disability in Development (CDD), research in a project area in Savar found that 67% of households with a carer and a person with a disability were living in extreme poverty, on less than $1 a day.
Separate research highlighted that 95% of family carers in Savar had a health issue or disability of their own. These findings are local, not national estimates, but they expose the pressures hidden behind the word “care.”
Caring has a profoundly disproportionate impact on women. In our three-year program with CDD in Savar, 93% of the 1,008 unpaid family carers supported were women and girls.
For many, caring means giving up paid work, perpetuating financial dependence, and having little time to look after themselves. When we fail to support carers, we deepen inequality for women and girls too.
Consider Kohinoor, a mother in Dhaka caring for her daughter Farea, who has autism. She once struggled alone. Joining a local carers group connected her with people who understood, and she eventually became its president.
With livelihood training, she started poultry rearing. Within two months, her flock had grown from five birds to 12, and she was earning money by selling eggs.
Kohinoor is not an isolated success. Working with CDD, Carers Worldwide has supported 1,008 carers in Savar, established 50 carers groups and trained 425 carers in income-generating activities. Six community caring centres offered children with disabilities care and learning opportunities while giving their carers precious time for work, rest, and social connection.
An independent evaluation found that 98% of participating carers reported improvements in their physical and/or mental health. These numbers represent people moving from isolation towards friendship, from financial insecurity towards opportunity, and from being overlooked towards being heard.
There are encouraging signs of wider change. Carers ID cards introduced in Dhaka last year acknowledge the contribution carers make and help them access priority services.
Salma, a recipient, said: “Within my family and society, I was without recognition. Now, my value and recognition within my family have increased.” The initiative aims to reach more than a thousand carers.
Bangladesh has a chance to lead. New social protection systems must identify unpaid family carers, not only the people receiving care, and recognize the financial costs they bear.
Health services should offer carers medical care, mental health support, and respite. Flexible livelihoods and carers’ groups should be part of community development, and carers themselves must have a voice in shaping policy.
The community volunteer network proposed in the National Healthy Ageing Strategy offers a promising starting point. It could finally provide an answer to parents who ask: “Who will care for my loved one when I am no longer here?”
This approach deserves a place in the broader National Health Policy, so that support extends beyond older people to families caring for people with disabilities and long-term conditions.
On the International Day of Care and Support, October 29, we should celebrate carers’ extraordinary contribution. But gratitude is not enough.
The real measure of progress is whether someone like Kohinoor can care for her daughter without sacrificing her own health and future. We must make that support a right, not a matter of chance.
Those who care for others deserve care too. It is time for Bangladesh to care for the carers.
Anil Patil is the Founder and Executive Director of Carers Worldwide. Anil has 25 years’ experience in the international development sector as a veterinarian, development worker, grant maker, and trustee.