From the rubble, Radda carries out its mission of community healthcare 

In Bangladesh, where social security is limited, people like Momena Khatun, a mother of two and a brick chipper in Savar's Hemayetpur area, have to look to organisations that provide healthcare free of charge or at a cost they can afford. 

During Momena's pregnancy, she turned to Radda MCH-FPP Centre in Mirpur-1's Shah Ali area, where she could consult a doctor at minimal cost. Both Momena's children later received their immunisation schedules at the same facility. 

Shah Ali area is home to narrow roads, squeezed between street vendors, auto-rickshaws and pedestrians. Shops and markets spill onto the roads and pavements, while vendors display their goods wherever they can find space. Moving through the area is a constant jostle, with people, vehicles and roadside stalls competing for every inch of space.

Infograph: TBS

Amid this chaos, a steep lane leads to Radda MCH, which has been serving women and children like Momena from its centre for more than 50 years. 

But that all changed on 25 September. After midnight, the healthcare centre was attacked by a group of people, who held security guards hostage, looted valuables and medical equipment, and used heavy machinery to demolish the facility.

However, the healthcare facility refused to bow down. 

An organisation committed to serving the poorest sections of the community cannot stop at a time when the country is facing a severe measles vaccination crisis and has already lost more than 1,100 children.

Just a day after the incident, the organisation started its vaccination campaign from the rubble of the facility.

A legacy of serving the underserved

In 1974, Radda Barnen (then Swedish Save the Children), an international non-profit organisation, began operating the centre as a project providing maternal and child healthcare to the underserved and underprivileged population of Mirpur. It was operated, managed and almost fully funded by Radda Barnen during the first two decades of its inception.

Later, in 1994, to sustain the services of the centre, Radda Barnen, with the permission of the Ministry of Health, handed over the complete responsibility for the operation and management of the centre to a local organisation under the name Radda MCH-FP Centre Trust.

For years, Radda MCH-FP Centre has played an active role in improving community health and well-being through its integrated approach to childcare, maternal and child health, adolescent health, nutrition, training and research.

It has worked closely with government agencies, national and international NGOs, and research institutions to deliver reproductive health services and child healthcare to vulnerable populations.

As part of its Mother and Child Health (MCH) services, Radda provides a range of essential healthcare interventions, including the Expanded Programme on Immunisation (EPI), maternal healthcare and family planning services. 

"People visit us from places as far away as Savar, Manikganj, Hemayetpur, Aminbazar and many other distant areas to receive services," said Nasrin Akhter, executive director of Radda MCH-FP Centre.

Over the years, through its services, Radda was able to build people's trust.

"Thinking about our responsibility to these people, we decided to start the vaccination campaign even though we had no proper facilities. We set up tents and used tarpaulins to create a temporary space under the open sky." Nasrin Akhter, executive director, Radda MCH-FP Centre

"We have built a relationship of trust and affection with the community. People have felt that if they come to Radda, they will receive the services they need, as one of our key characteristics is that our services are always available," Nasrin added.

Radda MCH-FP Centre currently operates four static clinics, along with more than nine satellite locations. Three of these static health centres are located in Mirpur — Mirpur-1, Mirpur-10 and Mirpur-12 — and the fourth is located in Uttara.

"We do not work only through our main centres. We also have many small community clinics, and we provide services at subsidised rates through those community clinics. Our field workers and community health workers go door to door to conduct courtyard meetings with community members and raise awareness about health, hygiene, nutrition and related issues," said Nasrin.

Affordable care, rooted in the community

One of the key characteristics of Radda MCH-FP Centre's operation is its systematic approach to service delivery and limited service charges.

"We charge a small fee for services provided to pregnant mothers. For example, we charge only Tk600 for an ultrasound, whether it is an upper or lower abdominal scan. In addition, we have several satellite clinics in different areas, including Baunia Badh, Bhashantek and the Muktijoddha Complex. We also operate satellite centres in several other wards as well as in Shyampur, Jatrabari and Jurain," said Iqbal Zahir Majid, director, Community Health Wing at Radda MCH-FP Centre.

"At these satellite centres, many services are provided free of charge. Overall, approximately 30% of the total services we provide are offered free of cost to beneficiaries," he added.

So far, community people have taken stewardship of the satellite centres, helping ensure that they remain safe, functional and rooted in the neighbourhoods they serve.

"There are also some places where we contribute a little financially, but they support us in other ways. For example, this place in Bhashantek is provided free of charge. However, the local community supports us — we don't have any security guards or anything like that. We have all our supplies inside: there is a blood pressure machine, a stethoscope, medicines and so on. Yet nothing has ever been stolen," said Iqbal.

At the heart of its work is a commitment to childcare and early childhood development. Radda MCH provides childcare facilities where mothers are actively involved in teaching, nurturing and caring for their children.

This approach helps children receive appropriate care and attention and also encourages mothers to take an active role in their children's development.

"Whenever a child comes to our centre, we measure the child's weight and height and assess their nutritional condition. If the child needs nutrition counselling, we have a nutritionist at each of our centres," said Nasrin.

The nutritionists provide nutrition counselling to children and their families. If a child is found to be malnourished and requires further care, they are referred to a tertiary hospital.

Our nutrition service for maternal, infant and young child nutrition is also quite unique.

"To explain the background, we previously worked with FHI 360 on a programme related to Maternal, Infant and Young Child Nutrition (MIYCN). Through that programme, we established a system where nutrition was formally established as a service. We established nutrition counselling as a specific healthcare service, rather than treating nutrition as something separate or secondary."

When a woman comes during the antenatal period, she needs nutrition counselling. Similarly, when young children reach the age of six months and begin complementary feeding, they need proper nutrition counselling.

Radda MCH provides these services through its nutrition centres or nutrition units.

"And this service is not only for children. We provide nutrition counselling and related services for mothers as well as people of different age groups," Nasrin added.

Vaccination from the rubble

So, how did Radda operate after 25 September, when almost all the instruments and equipment were looted and taken away?

"At that time, we were supposed to begin the measles-rubella catch-up vaccination campaign. We felt a strong responsibility towards the people in this community, particularly those who are disadvantaged and have limited access to healthcare," said Nasrin Akhter.

"Thinking about our responsibility to these people, we decided to start the vaccination campaign even though we had no proper facilities. We set up tents and used tarpaulins to create a temporary space under the open sky," she added.

Many parents and children came to receive vaccinations early the next morning.

Reconstruction of the health facility continues as Radda MCH refuses to bow down after vandalism. Photo: Syed Zakir Hossain

Mohammad Afzal Hossain, who runs a shop at Mustafa Market, near the Radda MCH Centre, came to vaccinate his two-year-old daughter at the facility.

"The main reason I come here for vaccinations is that it is close to my home. All of us received our vaccinations here while growing up. Now I am bringing my daughter here as well. Our entire family lives nearby, so this place is not only convenient to us, it is close to our heart as well."

But the demolition of the centre brought a sense of loss. For Afzal, it meant the disappearance of a place that had served generations of his family.

"We protested against the demolition, but since they have already demolished it, there is nothing more to do. The vaccination campaign is running despite all this, and that's what matters," he added.

But it was far from business as usual. The building still lacked electricity and other basic amenities, and they could provide only essential services — EPI vaccinations and measles-rubella catch-up vaccinations.

For a time, the vaccination services had to operate outside the facility. A makeshift shelter was put together, with a few chairs and tables arranged to accommodate patients and healthcare workers. Despite the difficult conditions, the doctors and nurses continued serving the community, particularly women and children, who make up the majority of those seeking care.

Amid these difficulties, service provision continues.

"We have been able to resume working inside the facility, so we are in a slightly better position now. Electricity is gradually being ensured, and hopefully, the water supply will also be restored today," Nasrin added.