Gonoshasthaya Kendra

Gonoshasthaya Kendra a non government organisation, was established in 1971. Popularly known as GK or People's Health Centre is a registered under Public Charitable Trust in 1972 with two visions: a) poverty alleviation and b) development of women. GK's integrated community health and family planning services earned highest national award The Independence Day Award, 1977. GK also received Magsaysay Award from Philippines (1985), Right Livehood Award from Sweden (1992) and International Health Hero Award from Berkeley University in 2002. GK's innovative programme was accepted as one of the three main background papers for Alma Ata Declaration in 1978.

In March 1971 over 1000 Bangladeshi physicians residing in Britain formed Bangladesh Medical Association in UK with Dr AH Sayedur Rahman as the President and Dr Zafrullah Chowdhury as the General Secretary. In early May 1971, BMA-UK sent Dr MA Mobin and Dr Zafrullah Chowdhury to India to help freedom struggle. They established 480 beds Bangladesh Field Hospital at Melaghar in Tripura State of India with the help of the Provisional (Mujibnagar) Bangladesh Government. Army doctor (Ms) Sitara Begum was the commanding officer of the hospital.

Following independence, Bangladesh Field Hospital was relocated at Eskaton Road, Dhaka. In April 1972 it was moved to Savar with the motto of 'Let us go to village to build villages' and renamed as Gonoshasthaya Kendra and workers chose community living and participation in morning agriculture. Villagers donated land and basic building materials.

GK's health journey has expanded in rural and remote communities of Chittagong Hill Tracts (CHT), riverine chars of Gaibandha and Kurigram and offshore islands of Kutubdia, Moheskhali and Charfashon. GK has established 40 Health Clinics in 25 Upazila and 4 secondary care hospitals at Savar, Dhaka City, Sreepur (Gazipur District) and Kashinathpur (Pabna). Fifth one is being built at Gaibandha.

Foundation of GK Health programme rests on demystification of medical care to health care. Local Traditional Birth Attendants (TBAs) are retrained for 5-7 days to make home delivery safe. Young village women with 6-10 years schooling are trained as Paramedics to work with TBAs and to deliver regular Antenatal and Postnatal care, full preventive care including family planning services, limited curative care and community physiotherapy. GK paramedics startled the medical world by performing Minilaparotomy Tubectomy for female sterilisation.

GK also works in partnership with local government. Verbal autopsy is done for every infant and maternal death and later on audited by villagers to improve accountability of paramedics and families. Elected women members of Union Parishad become chairperson of GK Health Committee and a signatory for GK local bank accounts.

GK is working for achieving MGD 4 and 5 before 2015. It's achievement is ahead of government in achieving maternal and infant mortality. For example by 2005 Maternal Mortality Ratio of 186 per 100,000 live births was achieved, 42% lower than national average. Infant Mortality and neonatal mortality were reduced to 15 and 10 per 1000 live births respectively. Annual unit cost is US$ 1.00 per person while government already spent US$ 4.00 per person with much lower achievement. Such achievement was not a smooth sojourn.

In 1973, GK introduced locally organised Health Insurance (HI)-based on social classes and income. Rich people pay higher premium and poor pay little but receives comprehensive health care almost free. HI income covers over 50% of all recurrent expenses. Deficit is partly covered by GK Social Enterprises and rest by local and international organisations. GK runs a special HI for rickshaw pullers and their families in Dhaka city with annual premium of Tk 100 only. GK is heading towards building cancer hospital with greater emphasis for the poor and marginalised people.

Narikendra is GK's women development centre where rural women receive skill development in non-traditional trades such as electrical wiring, printing, book binding, carpentry, metal works, welding, motor driving, boiler and power tiller operation and dyeing and finishing of clothes. Every paramedic learn riding bicycle. On 1 May 1977, 40 women including a lady Dr Laila Parveen Banu covered 40 kilometer on bicycle from Nabinagar to Dhaka to draw media and governments attention. Over 70% GK workers and 4 out of 10 directors are female. GK pays for higher education of female workers. Already two paramedics have qualified as medical doctor, 5 as microbiologists, 4 as pharmacists and 7 as physiotherapists. In 1975, GK started a cafeteria in Dhaka-Jessore road run by young Jhorna Sarker. This cafeteria helped acclimatising villagers and truck drivers with the visibility of women and promotion of soyamilk.

Since 1976, Gono Prakshani publishes important books like Jhagarapur, Jekhane Dactor Nei, Birsrestho (in Bangla) and posters of liberation war heroes, martyr intellectuals, women's empowerment, public health matters and disaster management. Monthly Gonoshasthaya is published since 1980 to expose unethical activities and excessive profits of Transnational Companies (TNCs).

In 1981, Gonoshasthaya Pharmaceuticals Limited (GPL) was established to manufacture high quality essential medicines but at an affordable price. 50% profit has been reinvested in GPL development, 20% for workers (mostly local women) and remaining 30% for financing GK's other social programmes.

Gono Bakery (1975), Gonomudran (1981), Gonoshasthaya Antibiotics Limited (1984), Gonoshasthaya Foods Limited (1991), Gonoshasthaya Basic Chemicals (1997), Gonoshasthaya Grameen Textile Mills Limited (1998) are examples of GK's social enterprises.

GK involves local people in disaster management. GK promoted handmade chapatis instead Khichuri to avoid diarrhoea. Thousand of villagers and school students in non-affected areas produce million chapatis every 24 hours and transported to distant affected areas by boat. High calorie biscuit and food mix promoted as survival food. Cattle feed is distributed free to prevent poor selling their domestic animals to butcher. GK team worked hard in Bangladesh famine in 1974 and Mayanmar refugee in 1978, 1992 to 95, provided full health care and food supplies during floods of 1987, 1988, 1990, 1995, 1998; Cyclone and tidal bores in 1985, 1991, 1994, 2007, 2009; 1990 and to victims ethnic violence in Mahalchari (Khagrachari) in 2005 and Baghaihat (Rangamati) in 2008 also to combat 1995 Malaria epidemics.

non-formal education does not benefit poor unless their children spend 5 years in school. First Gono Patshala in Savar was established in 1975. GK runs 187 Gono Patshala in CHT and chars with locally required all female teachers. GK had built 124 educational institutes to be used as shelter during disaster.

GK Institute of Health Sciences runs Government approved three years diploma courses at Sreepur for Laboratory Medicines, Pharmacy, Physiotherapy, Xray-USG and Midwifery.

In 1995 GK had sponsored Gono Bishwabidyalay. Every student, whether studying medicine, dentistry, pharmacy, physics, Arts or law must study liberation history, gender issue, ethics and society, environment, English and Bangla for 1-3 semesters. Poor and ethnic minority has reserve seats.

GK uses Bangla and Bangla calendar in its office work and local correspondences. GK played a vital role for promulgation of National Drug Policy (NDP) in 1982 based on WHO's essential list. The Policy had improved availability of quality medicines at affordable price and raised hope for other developing countries. GK had promoted National Health Policy, 1991 to ensure health care for all with accountability of health professionals through Local Health Authorities with elected upazila chairperson as head and upazila UHFPO as executive vice-chairperson.

GK's advocacy resulted in employment of 50% female teachers in primary school (1981), free education for girls up to class VIII (1988), a woman Vice-Chair in upazila parishad (2008), six months maternal leave for women and crèche facility in working places.

GK continues lobbying for rational use of medicine and investigations, all intern doctors to work for six months at Union Heath and Family Welfare Centres and to stop smoking in public and recruitment of smokers for public offices and educational institutions. GK hosted for Peoples Health Movement (PHM) in 2000 where representatives from 92 countries participated. [Morshed Chowdhury, Tarun Chakravaty Phizoo and Sandhya Roy]