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Annual Report 2010 (next part)
8.2 HEALTH, SANITATION AND WATER

IDF started this program with the assistance of Sida in Chittagong Hill Tracts in 1995. The reasons for initiating this program were two. They are: i) ignorance of people on causes of various common diseases and ii) lack of access of poor people to health services and safe water. IDF launched a survey on the sanitation and water in selected villages of Bandarban Sadar in 1996 with the assistance of UNICEF which shows that about 95% households had no sanitary latrine and almost all rural households did not have access to safe water at that time.

IDF selects health agent/secretary from amongst the members in each centre. One health agent/secretary can look after more than one para (sub-village). Health agents are the motivators and contact persons at para levels. Health agents are provided training on causes of common diseases, primary health care, reproductive and child health, safe water and sanitation, HIV/AIDS and eye care. The organizational structure of IDF health program is shown below.

   
Objectives

• To make the poor people aware of health problems and the causes of common diseases.
• To ensure access of the poor people to health services, safe water and sanitation.
• To make the people conscious about the safe motherhood and child health.

Present Status

No. of Health centre : 5
Health Spot : 10


Clinical services

• General Patient : 11325
• STD Patient : 76
• Eye Patient : 102

 Awareness Activities in 2010
Awareness raising on common diseases, safe motherhood, water sanitation:
01.
No. of participants in Health Education Session
: 3120
02.
Staffs/ Health agents training
: 5
03.
No. of participants in staffs/ Health agents Training
: 185
04.
Beneficiaries Training
: 416
05.
No. of participants in Beneficiaries Training
: 9152
06.
Courtyard Meeting
: 536
07.
No. of participants in Courtyard Meeting
: 6432
8.3 Emergency Fund (Micro Insurance)

Intorduction

The target area of IDF is very remote, hilly, difficult and inhabited by 13 different poor tribes with different cultures and languages who lack access to basic economic and social services. Most people and children here suffer from various diseases. Mortality rate here is one of the highest in Bangladesh. It was very difficult to improve income status due to regular expenses for medical treatment. The resources of poor people are so limited that they often experience great financial disruption when unexpected events befall on them. If a poor landless labor or farmer fall in ill, he not only loses his income but also does not get treatment due to lack of money. If he dies, his family not only pays funeral expenses but also requires cash for basic needs and education. A poor has limited property with or without modest shelter, but the loss of any of these brings a greater blow to the family's economy.

It was in this circumstances and requests from the members; IDF explored the possibility of getting micro-insurance services to cover these risks from the insurance companies. But it was very expensive and not affordable by the poor. As a result IDF started micro-insurance for its members in 1997 in Chittagong Hill Tracts which enable to protect themselves from these risks which require only small premium. The premium can also be paid through small installments.

8.3.2 Objectives:

The main objective of the program is to provide insurance services for the poor members of IDF and develop an appropriate micro-insurance model in order to protect them against risks due to sickness, death and damages or losses in income-generating activities.

The activities of the program are

 (1) Provide education on micro-insurance to all IDF members;
(2) Collect premium and payment of claims;
(3) Monitor progress on monthly basis through monthly reports;
(3) Prepare annual report;
(4) Maintaining a data base.
(5) Exchange visits

8.3.3 Methodology

IDF uses its institutional structure to implement its micro-insurance program. IDF reaches its clients through centers, branches and area offices. There is a health worker in each area office that helps the area manager to implement the program and provide health services to the members.

The members can pay the premium in installments. The premium is collected by the loan officers along with loan installments during the centre meeting.

In case of any claim for sickness, death or disaster or activity damage; the client informs respective loan officer who along with branch manager investigate the case. The branch manager is authorized to pay a certain portion of the claim for immediate use in case of sickness and death. The remaining claims for medical treatment or death are settled after the approval of the case by the approving authority. In case of activity damage, the total claims are paid in one installment after the approval of the approving authority.

Diagram: Institutional Structure

 
8.3.4 Components

IDF micro insurance scheme has 4 components.

 These are:
i) Health;
ii) Death;
iii) Damage/loss of activities and
iv) Cattle insurance.

Health and death coverage are met from same fund named “Emergency Fund”. Damages or losses of activities are met from another fund named “Risk Fund” while losses of cattle are met from “Cattle Fund”.

Diagram: Components of Insurance Scheme.

 
8.3.5 Emergency Fund

This fund is created with a view to providing the clients with support for risk coverage in case of the death or illness of the member or any one of her family. The members pay 0.95% of the loan money to this fund as premium. The members pay this premium with the weekly installments.

Health Coverage: The whole family of the member is insured under this scheme. A maximum amount of Tk. 2000 is paid for the treatment in each case. In case of hospitalization, the amount of claim is estimated on the basis of expenses of public hospital. The medical officer examines each case before the approval.

Recently A pilot scheme launched to see whether full health support including transport allowance could be provided to the members and their family members under this scheme. The members get doctor’s advice, free medicines, and tests for diabetics and pregnancy and transport cost.

Death Coverage: If the member or any dependent of the member’s family dies, the families get the following benefits under this scheme.

i) Member
 : Tk
11,000.00
ii) Dependent
: Tk
1,500.00
iii) Children
 : Tk
500.00
 
8.3.6. Risk Insurance:

All activities undertaken by loan are covered by Risk Insurance. The member pays 0.95% of the loan money as premium to cover risks of projects under this scheme. If, the insured project suffers a damage or loss, the member gets a maximum 50% of the loan money depending on the extent of damage. For the claims, the member has to apply in prescribed form centre, branch and area office. After a physical verification, the responsible officers recommend the amount. After the physical verification, the Executive Director finally approves the claims. All claims are settled within 30 days after submission of application for claims. The members can collect the claims from the branch office. The coverage will be increased gradually depending on the size of fund.

 8.3.7. Live Stock Insurance

In 1997 IDF introduced Live-stock Insurance. IDF members who take livestock loan must undertake insurance policy so that they might get risk coverage against sickness or death of cattle.

Initially the rate of premium was 1.00% of the disbursed loan and the rate of risk coverage was 20% of the loan money. In 2009 the rate of premium was increased to 1.5% of the loan money and the coverage was enhanced to 50% of the loan money.
Diagram: Coverage

 
8.3.8. Present Status:

The members found micro insurance as an important tool for their protection against diseases, death, damage or losses of activities. The progress of micro insurance program as of March’ 2010 is shown below.

Claims met as of December 2010
Component
No.
Amount (BDT)
Health Insurance
22,716
13.05m
Life Insurance
4,859
12.33m
Risk Insurance/Cattle
26
0.18m
Total
27,601
25.56 m
  1 US$ = Tk73.00
 
8.4. Eye Care
 
Eye problem is very common in Bangladesh. The people of Chittagong Hill Tracts are more vulnerable in eye health. IDF initiated this component through eye camps in collaboration with Lions Club of Chittagong in Southern Bandarban in 2002. The costs of surgery for referral cases were shared jointly by IDF and Lions Club. The component was undertaken as project by IDF in 2004 with the assistance of Helen Keller International (HKI). IDF has been implementing eye care as its regular programme since 2006.
 
Objectives
 
• To raise awareness on eye care and blindness among the common poor people of the remote areas of       CHT, Chittagong and Cox’s Bazaar district;
• To provide primary diagnosis, treatment and referral support;
• To provide medical services at nominal cost to the poor;
• To prevent eye diseases from maiden period and provide services at the grass-root level.
 
The services provided in 2010 are shown below:
Table 13: Progress Upto 2010
Nature of Services
Number
01
Operation
42
02
Treated
835
03
Refractive Error treatment
218
04
Health Education session
8,464
05
Staffs /Health agents training
7
06
Participant on Staffs /Health agents training
150
07
Beneficiaries training
440
08
Participant on Beneficiaries training
9,152
 
8.5. Vitamin-A Capsule: CHT Project
IDF has been implementing this project in partnership with HKI in order to improve Vitamin A capsule distribution coverage in the hard to reach areas of Chittagong Hill tracts since September 2007. This project will continue up to June 2010. IDF supported HKI to conduct a baseline survey in the project areas on the basis of sample at the beginning of the project.
Objectives of the Program
• Make NID program success in the hard to reach areas of CHT;
• Identify and minimize the gaps of VAC distribution in routine EPI.
• To build a strong relationship with District Civil Surgeon Office, Upazilla Health & Family Planning Office   and EPI staff in Thana Health Complex.

Project Areas

Khagrachari District
= All Upazilla
Bandarban District
= 1 Upazilla (Roangchari)
Rangamati District
= 1 Upazilla (Kawkhali)
Total children
= 22864
Total family
= 29757
Total volunteer
= 251
Table 14: The hard-to-reach areas in CHT covered by the project are presented below:
Table 11: District- Khagrachari
Upazila
Union
No. of Child (0-5 year)
No. of Population
EPI Center
1.Khagrachari Sadar
5
1,097
1,597
12
2. Mohalchari
4
707
950
16
3.Dighinala
5
4,759
5,362
30
4. Panchari
4
1,584
2,814
25
5. Matiranga
6
3,131
2,878
30
6. Ramgarh
3
2,952
3,233
28
7. Manikchari
2
4,035
6,395
19
8. Lakhkhichari
1
1,421
1,316
24
 
District- Rangamati
Upazila
Union
No. of Child (0-5 year)
No. of Population
EPI Center
9.Kawkhali
4
2,517
3,018
44
 
District- Bandarban
Upazila
Union
No. of Child (0-5 year)
No. of Population
EPI Center
10.Roangchari
4
661
2,194
23
 
8.6 Child Labour and Non-formal Education

IDF has been implementing this component since 1994. The main objectives of this program are:

Objectives

• Raise awareness on child rights and education;
• Provide basic education (read, write and count) to poor children who
  are dropped-out;
• Reduce illiteracy rate;
• Provide micro-credit support to the parents of poor children;
Supply of Educational material in 2010:

• Books
- 630 sets
• Note book
- 1260 pcs
• Sharpener
- 1260 pcs
• Eraser
- 1260 pcs
• Pencil
- 1260 pcs
• Colour Pencil
- 630 sets
• Vitamin A
- 630 pcs
• Primary health check
- 2 times per year
• Conducting examination
- 3 times per year
 
Table: 12: Non-formal Education Status:
 
Components
In 2010
Upto 2010
No of School
-
21
No of Students
630
3600
No of Teacher
-
21
 
8.7 Agriculture & Livestock
 
8.7.1 Agriculture
• Established Integrated Farm at Matiranga in 15 acres of land where various types of 2,000 seedlings and   or cuttings were planted in 2010.
• Constructed one demonstration shed for beef fattening.
• Prepare one demonstration plot for vegetable production.
• Prepare one demonstration plot for Turmeric Cultivation.
• Establish 1 Central Nursery, 1 Office Nursery, 120 Village Model Farms, 4,100 homestead Gardens.
• Conduct 40 Kendro Workshops on Homestead Gardening covering 1240 beneficiaries.
• Distributed hybrid Maize seeds to farmers in Lama upazilla.
• Distributed 1050 kg of various types of seeds (vegetables, fruits, woods, ornamental etc.) to the farmers.
• 100,000 saplings produced in central and office Nursery in 2010.
 
8.7.2 Livestock
 
Progress in 2010
 
• Total disbursement Tk.10,50,00,000/- to 7,124 members;
• Conducted 24 training on Beef Fattening covering 840 members;
• Provided vaccines to 8,574 cattle, 407 goats and 6,390 poultry birds;
• Provided treatment to 2,493 cattle, 1,014 goats, and 1,201 poultry birds
• Distributed 2,350 de-worming tablets for cattle.
 
8.7.3. IDF Integrated Farm:
 
IDF Integrated Farm is a new concept of development activity. With a view to participating in the national development, making employment opportunity and skill development IDF has established an “Integrated Farm” in 2009 in the village Rasulpur near to Matiranga Upazila. The farm is established on 30 acres of land which is hilly but fertile enough for growing various kinds of plants. Among the activities of the farm the remarkable are – culture of all kinds of fruit trees, all herbal plants, fish culture, paddy cultivation, ginger and turmeric cultivation, vegetable cultivation, beef fattening, goat rearing, poultry and above all an eco-tourism and training vanue of international standard.
 
Progress:
 
IDF has been implemented its plans on the farm for the last 2 years. 80% of the fruit trees and herbal plants have already been planted. At a total 5600 trees are planted. In 2010, turmeric and vegetable are cultivated in 3 acres of land. Sheds and other structures are made for cattle rearing. For fish culture, embankment is being made around the low land of the farm. Within a year the construction of training center is expected to start.

At present 1 manager, 2 permanent workers are and 10 part time workers engaged in the farm. In 2010 in average 10 part time workers worked in the farm. IDF agriculture department provides support to the farm.
 
8.8 Improved Cook Stoves Programme
 
IDF undertook this program in May 2008 with the assistance of German Technical Cooperation (GTZ). Improved Cook Stove (ICS) is a wood-stove that produces more heat but less smoke in comparison to the traditional stoves. ICS has been proved to be cost effective, safer and environmentally friendly. IDF provides financial and technical support to the clients for its installation and use.

The main objectives of this program are:

• Decrease the use of fire-wood and save environment;
• Reduce fuel crisis and cooking cost in the families which use traditional wood-stoves;
• Mitigate health hazards of wood-stove users.
• Save cooking time and Improve cooking efficiency.
 
Table 13: The progress of this program is given below.
 
Sl. No.
District
Up to 2009
In 2010
As of Dec. 2010
01.
Bandarban
127
5
132
02.
Rangamati
136
1
137
03.
Khagrachari
84
0
84
04.
Chittagong
600
275
875
05.
Cox's Bazar
92
1
93
06.
Dhaka
10
0
10
Total
1049
282
1331
 
8.9 Renewable Energy
 
IDF started this program in collaboration with Infrastructure Development Company Limited (IDCOL), a government owned company in 2003. The main purpose of this program was to provide electricity through small scale solar home system to the rural and remote people who do not have access to national grid. People will have access to medium and long-term credit facility through this program to procure these systems. The program has planned to set up mini solar plants in future.
 
Table 14: Progress of Renewable Energy Program:
 
Particulars
2010
Cumulative
System Installed.
3,184
7,689
Loan disbursed (m)
67.46
163.48
Loan repaid (m)
30.99
79.16
Loan outstanding (m) 33.47 84.32
(m=million taka)
 
8.10 Skill Development
 
IDF provides various types of training to its members for enhancing their functional skills through which they can earn additional income. These are mainly group management, nursery, home-gardening, vegetable and fruits gardening, cutting & tailoring, cattle fattening, milk cow rearing, Enterprise Development and Business Management, product designing and mushroom production.
 
Objectives

• Assess needs and organize skills training for its group members;
• Train members on group management, nurseries, home-gardening,
cattle fattening etc. as per needs;
• Increase income of poor rural women and
• Raise awareness of woman on rights.

In addition to training on agriculture and livestock, IDF provided EDBM training to the members as shown below.
 
• EDBM Training
: 154 Persons
• No. EDBM workshops
: 4
8.11 Housing
 
IDF undertook this program in 2004 with the assistance of Grihayan Tahabil, Government of Bangladesh. The main objective of this program is to provide support to the poor people who are not capable of making safe with sanitation and water facilities. The progress of this program is described below.

Progress
Sl. No.
Particulars
2009
As on Dec. 2010
01.
No. of houses
300
02.
Total amount disbursed
60,00,000
03.
Total amount repaid
8,73,800
60,00,000
04.
Total amount outstanding
-
Source of Fund Grihayan Tahabil, Bangladesh Govt.
01
 Total Amount received from Grihayan Tahabil
60,00,000
02
 Total amount repaid
8,73,800
55,31,400
03
 Total amount repaid
8,87,060
4,26,829
04
 Interest paid to Grihayan Tahabil
19,601
2,61,894