Health Farming

In Bangladesh, the majority of people in the world resides in cities. Urbanization and Urban migration is expansive. Therefore, new and re-emerging communicable and non communicable diseases continue to threaten public health. Inadequate and unplanned health management system exacerbate the problems.

It is emergent to establish a sustainable urban poor health management system.  Health farming project will develop a community for urban poor people which provide:

1. resident in the downtown area.
2. quality health and nutrition services.
3. monitor the disease surveillance, develop community clinic service.
4. education for children.
5. will assess different pollution and health risk.
6. proper training to awareness about healthy living.  
7. employment opportunities like farming, handicrafts, etc.  

By developing a balanced and healthy community to the urban poor through improving lifestyle, reducing environmental hazards, social fragmentation, exposure to crimes, violence and accidents health farming can be powerful tools to improve the global health and decrease the burden of communicable diseases.

Recent studies estimated that 300,000 to 400,000 new migrants leave their rural homesteads annually, heading for Dhaka.  Dhaka is overwhelmed by urban poverty and slums. Moreover, street children, vagabond people live in every big city in Bangladesh. They are deprived off access to quality food, health, and nutrition. Therefore, infectious diseases such as severe acute respiratory syndrome, pneumonia, influenza, swine flu (H1N1), tuberculosis (TB), dengue, hepatitis, malaria, cholera, chikungunya, meningitis, Ebola virus diseases, food-borne gastroenteritis, salmonellosis, 
and campylobacteriosis continues to threaten public health. A study from icddrb found that more than 80 percent households are living with food insecurity which includes malnutrition the rate of stunting in slums is much
higher than the national rate (58 percent versus 36 percent). Again, 
contaminated food consumption causing serious illness like cholera, dysentery, etc. However, the problem remains unsolved. Due to lack of supervision from the authorities, the doctors and nurses are often found to be very inefficient and this further weakens the prospect of poor people being unable to get access to proper health care services from public 
hospitals.  Although community clinic facilities develop in ural areas, unfortunately for the urban poor, especially those living in
slums, these facilities are non-existent.   

Despite the significant reduction of the urban poverty level, the rate is still about 19 percent in Bangladesh. According to the report of Bangladesh Bureau of Statistics conducted a census on the slum-dwelling and floating population in 2014, Dhaka city alone consists of 3,394 slums.  

Equitable access to quality health and nutrition services for the urban poor has emerged as a major and pressing development issue. Hospitals and clinics are not necessarily physically distant, but they are socially and financially distant from poor urban populations. Strengthening and reinforcing the community clinic will assess the health issues and resolve them through trained people including doctors, physicians, social workers.

Health farming project will develop a community for urban poor people which provide:

1. resident in the downtown area.
2. quality health and nutrition services.
3. monitor the disease surveillance, develop community clinic service.
4. education for children.
5. will assess different pollution and health risk.
6. proper training to awareness about healthy living.  
7. employment opportunities like farming, handicrafts, etc.  

According to the UN prediction the world’s urban population will almost double from 3·3 billion in 2007 to 6·3 billion in 2050. The increase will be prominent in developing countries with an exponential rate which has an intense effect not only on public health in developing countries but also on global health. Because of international travel and migration, cities are becoming important hubs for the transmission of infectious diseases, as shown by recent pandemics. This condition is devastating in countries like Bangladesh where very high population densities and deteriorating city infrastructures worsen the already difficult living conditions of poor people living in cities. Moreover, Lack of proper planning to ensure secure health risk due to urbanization remain unsettled. In addition, there is no adequate studies or surveys regarding the risk, disease burden, epidemics in urban poor.

Although some organizations and NGOs are working to ensure the basic health care for rural poor people urban poor still lag behind of these facilities. Health farming will provide a sustainable health management system for urban poor people. Besides, it will assess disease surveillance, health risk due to urbanization. 

This year Dengue fever, a mosquito-borne virus-infection causing severe flu-like illness, outbreaks in every big city very specially in Dhaka in Bangladesh and people dies. In human recovery from infection by one dengue viruses provides lifelong immunity against that particular viruses’ serotype. However, this immunity confers only partial and transient protection against subsequent infection by the other three serotypes of the viruses. As there is no specific medication for dengue fever remedy largely depends on prevention than cure. The severity and latitude of the disease in Bangladesh remain obscure as management, health care can’t reach to the hand of slum people. Again, undefined number of vagabonds, refugees, street people hinders the maintenance system. This scenario is true for any disease outbreaks or epidemics. Therefore, the inadequate health management system for urban slum dwellers and evacuee can deteriorate the public health regarding the communicable as well as non-communicable disease. Furthermore, untreated people can serve as reservoirs for infectious agents which can manifest in new forms in any upset in social or environmental condition.

Providing an adequate health management system:

·         will ensure the equitable access to quality health and nutrition services for the urban poor.

·         Assess ill health as a chronic condition emerging from adverse living and working conditions and ensure greater resources to manage over the medium- to long term health promotion facilities.

·         additionally, will change lifestyles, adequate nutrition, persistent social equality, economic security, proper education and training for stable social life to reduce new health challenges, non-communicable diseases, substance misuse, and mental health problems.

According to recent UN data 25% of Bangladesh’s current population lives in urban areas. Out of this 25% almost half resides in the four largest cities Dhaka, Chittagong, Rajshahi, and Khulna. Due to lack of decentralizing of opportunities and services, Dhaka city is carrying a population of approximately 12 million. This includes a significant number of low-income people who are residing in slums in Dhaka. The annual population growth rate recorded in the 2014 Census of Slum Areas and Floating Population was 2.70%. In the year 2014, the census recorded a rise in the number of slums in Bangladesh from just 2,991 in 1997 to 13,935 slums in 2014 which comprises the 6.33% of the urban population of the country. The latest census report says 1.06 million people live in slums in Dhaka division, followed by the Chittagong, Khulna, and Rajshahi divisions with 635,916, 172,219 and 120,036 slum dwellers respectively.

In the first year, as the number of evacuee and slum dwellers is undefined the target is to identify and define the number of evacuees resides in Dhaka and settle them. Gradually the project will deal with Slum dwellers in every big city including Dhaka, Chittagong, Rajshahi, Khulna, Sylhet. 

Establishment healthy resident in the downtown area for the evacuee and slum dwellers.

• Providing quality health and nutrition services to promote life style.
• Monitoring the disease surveillance, develop community clinic service.
• Assessment different pollution and health risk.
• Making database according to the health assessment and risk factors.
• Education for children.
• Organizing proper training for awareness about healthy living. 
• Developing employment opportunities like farming, handicrafts, etc. 

Most people living under the poverty line are illiterate and ignorant. Like other third world countries, Bangladesh faces problems with social taboos. Additionally, there are still several issues that Bangladesh health care system is yet to tackle, governance, accessibility, and affordability are key issues that are preventing the implementation of solutions to the public health issues in Bangladesh. Lack of adequate information, research regarding the health risk in urban poor people and insufficient infrastructure, equipment and resources. 

·         Involving trained social workers, health workers to literate and develop awareness for the healthy living.

·         Developing adequate information through proper research regarding the health risk due to urbanization, climate change, environmental pollution.

·         Providing proper infrastructure, equipment, and resources to develop the community clinic for proper treatment and management. 

• Social workers
• Health workers
• Physicians
• Researchers
• Policy makers
• Statisticians 

Health farming will develop a balanced and healthy community for the urban poor through improving lifestyle, reducing environmental hazards, social fragmentation, exposure to crimes, violence and accidents. The primary focus is to assure equitable access to quality health and nutrition services for the urban poor which will ensure the sustainable health management system for urban poor. It in turn reduce mortality, morbidity and societal disruption resulting from epidemics, natural disasters, conflicts, environmental, and foodrelated emergencies, through prevention, preparedness, response and recovery activities that build resilience and use a multi sectoral approach.

Health farming can be powerful tools to improve the global health and decrease the burden of communicable diseases.

Improving health care-seeking behavior such as education, awareness-raising and skills building in recognizing and treating communicable diseases and obstetric emergencies will promote universal health coverage with strengthened health systems based on primary health. In broad spectrum health farming will provide employment through green farming, handicrafts, etc. which will establish a social enterprise of nonprofit organization to achieve larger scale social impact while also diversifying their funding has been credited as a major factor in the appearance of the nonprofit hybrid part for profit and part nonprofit.  

Tiger challenge will provide the platform to raise questions regarding the health management system for urban poor people which will facilitate the remedy. In addition to prize funding, the Tiger IT Foundation will also provide strategic and operational support from a network of seasoned professionals and entrepreneurs in Bangladesh, including mentorship, office space, support with IP efforts which will assist concept to be debuted with successful outcomes. 

Local-level involvement by urban governments to be responsible for their health services, with support from the two relevant central ministries Ministry of Local Government, Rural Development and Cooperatives, and the Ministry of Health and Family Welfare and research organizations.