Episode 10: A More Comprehensive Approach
Dr. Sabina Faiz Rashid is the Dean of the BRAC James P. Grant School of Public Health at BRAC University in Bangladesh. Dr. Rashid specializes in ethnographic and qualitative research with a focus on urban slum communities and marginalized groups. She's particularly interested in examining the impact of structural and intersectional factors on the ability of those populations to realize their health rights and access to services. In 2008, she founded the Center for Gender, Sexual and Reproductive Health and Rights, and in 2013, co-founded the Center for Urban Equity and Health. Both focus on research, capacity building and influencing program designs and policies in Bangladesh. She joins us from Dhaka, Bangladesh.
We speak about:
BRAC’s approach to development
co-thinking and co-creating with communities
unpacking assumptions about the ‘Global South’
solution-based thinking
competency based learning
building a youth friendly research culture
decolonizing global health - and much more!
Transcript
Intro: There are certain kinds of ideas of knowledge bearers and capacities and what development means. But I think we really need to start unpacking some of these assumptions because there are certain kinds of discourses that prevail - then there's also evidence, and what is evidence, and whose evidence is valued. And when agendas are set, I think there needs to be a more critical reflection that is inclusive of actors from Global South. I think it's often been accepted that we learn from the north, and we have our capacity built, right? But that's not the reality.
Safa: Welcome back to the Rethinking Development podcast. My name is Safa, and I'm your host. Thank you for joining me as we speak with and learn from practitioners of all career stages and organizational affiliations around the world. In our conversations, we aim to rethink ethical behavior and best practices through the lived experiences and personal reflections of different guests. Today I'm joined by anthropologist Dr. Sabina Faiz Rashid who is the Dean of the BRAC James P. Grant School of Public Health at BRAC University in Bangladesh. Dr. Rashid specializes in ethnographic and qualitative research with a focus on urban slum communities, adolescents and marginalized groups. She's particularly interested in examining the impact of structural and intersectional factors on the ability of those populations to realize their health and rights and access to services. In 2008, she founded the Center for Gender, Sexual and Reproductive Health and Rights, and in 2013, co-founded the Center for Urban Equity and Health. Both focus on research and capacity building with a focus on influencing program designs and policies in Bangladesh. Dr. Rashid, thank you for joining me today. I really appreciate your time. Could you please share a bit about how you first decided or were interested in studying medical anthropology and public health? What were some of the experiences you had in the earlier years of your life that led you down that path or made you interested in studying those fields?
Sabina: Growing up, I was like a third culture kid, if that makes sense. You know, I lived in different places. I was curious about the study of people, study of cultures. So I was torn between psychology and anthropology. And I heard about these great courses at the Australian National University in Canberra. And I thought, Okay, I'm gonna enrol myself in my first year, and I loved it. I loved studying anthropology. It was social anthropology. And then I decided to go travelling after my undergraduate - many graduates in Australia that I knew, many of my friends after one year, they do a gap year, and they wanted to go backpacking. I wanted to go to Bangladesh and keep traveling around the world. But when I came to Bangladesh, one of my Uncle's convinced me to join BRAC. And I basically thought, Okay, why not? I'm 23, I didn't really have a lot of goals. I was excited joining this development organization. And they sent me to a village for about six months. So I lived and worked and did research in a village, I joined a research sort of division as a junior anthropologist, and it just changed my life. Because the things you study in a book are so different to when you're actually in a village, meeting diverse communities, meeting adolescents, meeting men, meeting women, and trying to understand lives, you know, everyday lives, the resilience of communities. And I quickly also realized that many of these communities are very pragmatic. They're very resilient, as I said earlier, and they also understand their needs and priorities better than us coming in trying to decipher their priorities and needs. And I went on to do a Master's in social anthropology, but looking at health, looking at norplant (a contraceptive), looking at rights, looking at gender, and I spent time again, during my Master's doing a dissertation. And then I went on to a PhD in medical anthropology and public health.
Safa: Wonderful. So as you mentioned, you began to work with BRAC - BRAC is one of the largest NGOs in the world. And you have over the years worked with them in different capacities - in terms of in the NGO setting as a researcher and then later on in the university setting as a Lecturer and Professor and Dean. But to kind of maybe share a bit more about the approach that BRAC takes or their model. Could you share with us about some of the maybe challenges and successes you've seen with their approach to development work in Bangladesh.
Sabina: What is so important about BRAC is they've always had an integrated approach to development - so its not working on one particular silo. So when I joined, they had a sort of a multi-pronged approach to working with poverty in communities, you know, financial loans, getting women to form groups, right? There's education provided for children who dropped out due to poverty, and there was basic health services through community health workers. And I think the thing about BRAC is that it is always been a very bottom up approach to enable communities to be empowered. And if you look at some of their micro-finance models, you look at their education methods, non-formal primary education methods, and now they work closely with government. If you look at some of their health models, with community health workers as frontline workers, it's very much in line with a community centered approach, even though the communities are diverse. But you have an interaction from communities, with communities, to understand programs - and one of the big successes of BRAC has always been the ability to adapt and scale up, the ability to test and evaluate existing programs and interventions, revisiting that, scaling up, looking at what the challenges are, and then improving on it. And that's what I learned as a researcher when I was quite young at BRAC, as a junior research in the Research Division is the ability to kind of look critically at programs and then looking at scaling up. And BRAC is, you know, now it moved on to BRAC International in I think 11 countries, and it has, you know, innovation. I mean, I think with BRAC, there's a lot of books written about BRAC and the late Fazle Hasan Abed. And now we have Asif Saleh, who's the Executive Director, and you've got, you know, a couple of key leaders in key positions at BRAC. But I think with BRAC, the success is really the grounded approach and the field presence throughout the country. And the fact that they look at core areas, health, education and livelihoods, right. And then the genius of someone like the late Fazle Hasan Abed was he also set up social enterprise models, where poor women, you know, would sow, make handicrafts, earn money sitting at home, because you have to remember BRAC was set up in the 70s, it was still very conservative, and how do you get women to earn money? How do you get adolescence to stay in school? So you have to come up with creative ways that are contextually relevant, but also understand that poverty needs a comprehensive approach.
Safa: Yes, so as you mentioned, this bottoms up approach - often on the podcast, we speak about being reflective of our own positionality, our own social location. Maybe on a more personal note, can you share with us a bit over the years, as you were doing your research work, and then later as you progressed in your career, what have been some of your experiences in terms of how your own multiple identities have impacted the work you do and the relationships you have, and just generally, your worldview or your outlook on this work?
Sabina: So I think one thing that did influence me, as I reflected later on in life, and I said to you that when I went to the village, and I spend time there in communities, you know, we always have preconceived notions, and we box the poor, you know, we look at them as a homogenous entity, and we box them and we label them. And the challenge in development, but also in public health, is it's by virtue of disciplines, by virtue of approaches. Often it's a very top down approach. I mean, we often see ourselves as saviors and communities as beneficiaries, right? But as I spent time, and I was quite young, one of the things that transformed my thinking was, you know, when you spend time in communities, because I was trained in anthropology, and we spent time, and I was very excited, and I was learning - is that public health or development - I mean, what what are our goals? To improve the lives of disadvantaged populations. And what I've realized over time is that if we don't engage and work with communities, versus communities as objects of research, there has to be that paradigm shift to working with communities, because often they know best. Most communities are very pragmatic. They understand needs and priorities, and they're extremely resilient. And whether it's research or program, designing interventions, this has to be fed from the communities, working with them - whether you design tools together, survey tools or research tools, or whether you design policies or recommendations for programs. Secondly, I realized after spending over 25 years working in Bangladesh, and this would apply in many countries, is that are the models, are the policies, are the interventions engaging enough with diverse communities? Because you need to also have different kinds of interventions and models. You need to assess what's working and what's not. And sometimes you also need to look at the larger picture - like if you look at health, and if you look at what happened during COVID, in many countries, we had a very clinician approach to COVID - wear masks, wash your hands. But if you're working in development and health in informal slum settlements, you've got 10 families to a small 46 square foot room. You've got erratic water services, you can't afford masks, and you live in congestion. You have commonly shared latrines, bathing spaces, kitchens and water sources, right? So when we looking at development even, or public health, we can't, in fact, operate in silos. For me, it's very much a couple of key things is that: to be in this in this arena, and work in this arena, whether you are a researcher or practitioner a policymaker, it has to be grounded in the lives of communities, diverse communities, because even within them, there's various vulnerable groups, right? People living with disabilities, you can have sexual minorities, people who are women who are widows, you could have adolescents who are too young to get access to relief materials, because they don't have ID cards, right. So I think one, understanding these sorts of spaces is critical. Two, in developing public health, much more work across sectors is critical, because during COVID, it was the poor who were more worried about hunger, and fears around COVID, but the primary concern for them was dying of hunger because they couldn't work. The country was shut down for two and a half months. Whereas for us the middle class or well to do, our primary concern was not to get COVID, right? And I think if we can listen with humility and respect, and try to work with these diverse communities across any country or countries, there's a lot of learning we can do. But we can also have better designed programs, and more community centered designed programs, but you will also have better research or solid research, be it surveys or qualitative research, that can contribute to health outcomes. I mean, there's a lot of research that's contributing to health outcomes. I'm not saying it isn't. My own personal opinion, my learning, is that it has to be much more engaged with communities, not just them at a dissemination meeting, or not just having communities to talk to and doing interviews with, but actually part of the research process, to brainstorm together around findings, to get validation, to discuss policies - because I think, then we have a much more sort of a comprehensive approach to what we're trying to do when we live and work in many of these countries, including where I live in Bangladesh. I wanted to add one more point, is that we need to expand the notion of risk. The challenges with public health and development is we operate in silos, right? Vertical programs that don't really work with each other, ARE not necessarily in alignment with each other. Two, if we stick to risk being just disease inside the body, many - I mean, the School of Public Health undertook about, I think about 33 different kinds of research last year, ongoing research continues. And if you talk to many of the deprived communities, and some of the populations affected by it, risk of health is not just about disease, it's about no food, it's about not having a job, worrying about rent, but also worrying about various physical diseases and illnesses. A lot of distress and concerns. And our communication, risk communication did not take in the socio-cultural aspects of COVID. So there was a lot of fears and underreporting because many, many communities were scared of isolation and quarantine. And this is what they were hearing. They were hearing about people being picked up and taken in ambulances to hospitals. And there were worries about, you know, COVID being this disease where you die. And they said we'd rather die at home. So there was a lot of underreporting and low uptake of services. And you see this with the Ebola crisis, where fears around burials and risk communication was not sensitized, and didn't necessarily resonate with communities, if you have a very biomedical approach, right? Wash your, hands wear masks doesn't always resonate when people are worried about all these other issues, like what is isolation? Well, how will we be buried if we die? Will we see our families again? And these are very real concerns that you and I have - so why wouldn't disadvantaged communities and people from poorer areas worry about similar issues, except we have more agency in some ways, and we can demand certain kinds of services, right?
Safa: Yes, yes, absolutely. Thank you for those powerful points in terms of really thinking about a more intersectional approach, not working in silos. You know, nowadays, this word of localization is kind of becoming a buzzword, and I know you have an ongoing project that's entitled: Mitigating Risks and Promoting Gendered Governance and Localization of Humanitarian Response in COVID-19 Era. Could you share with us a bit about how it's been like to work on this specific project in terms of promoting localization and mitigating risks?
Sabina: So for this particular project, we're working with a partner, CPJ - Center for Peace and Justice. They are the implementing partners, we're doing the research, but many of our identification of vulnerable groups are with communities. The plan is, you know, now there was recently a tragedy in the camps with fires. The idea is to work with local youth volunteers from the Rohingya camps who can engage, who can facilitate, who can who can give inputs to training and workshops and capacity building. And for sustainability, our argument was that these are the actors we have to work when we take things forward in their own communities, right. So we're working with youth volunteers, we are not, but CPJ is, which is the implementing organization. And the whole idea of this entire project for three years is how do you empower diverse groups within local communities to be much more active and have a leadership role? They are active, they are extremely capable, but they have to be given the opportunity to do so. And the idea is then to reduce some of the gaps in some of the areas that they feel that they need support in - negotiating conflicts within the communities, along with the host communities. How do you work better with host communities? So a lot of this will take place - it's ongoing- in the Rohingya camps, and in the host communities, where sometimes there's tension, and there's a lack of communication, and there's gaps. And this avoids the model, hopefully, I mean, that's the plan, it's quite ambitious. But I do think we need to start somewhere, where you create sustained effort in sustainability, if you don't work from within the communities. I was involved in another urban project five, six years ago, which was actually mobilizing communities around right space issues, right? Because ultimately, it's the people who live in their own communities who need to continue taking it forward and identifying the issues that are a priority to them. There's no point in me coming in and telling people what the priorities are, because I cannot know it as well as a diverse group of members of any place. You know, there's leaders, there's women, there's minorities, it could be by religion, it could be by ethnicity, it could be adolescence. And I think that's important to remember. If we don't do that initial learning, and then invest in the communities themselves, and give them the space to have agency and empowerment, then I think we just have a cycle that continues, which is very paternalistic.
Safa: Yes, absolutely. Sometimes, you know, we speak about how research can be inherently very extractive. And there's kind of a lack of accountability in terms of sharing results of research with local communities and participants. Could you share a bit with us about that angle?
Sabina: For us, because we were set up by BRAC the NGO, the founder, we can't do ivory tower research, right? We live and work in Bangladesh. So most of our research, in fact, I would say all has to have a huge component - I mean, it's all limited resources, but a huge component looking at advocacy to inform policy and programs. Like during COVID, we were sharing a lot of our findings with the citizens watch group, with BRAC's health program, with BRAC's communication program, because it has to inform action, right? You have to translate knowledge into action. Otherwise, there is a challenge with research. I think some of the challenges are also that we really need to unpack what we mean by community engagement, we to unpack what we mean by we're doing research with communities. Is it really with them as partners, as meaningful partners, when we go back and validate findings, is that consistently done? You know, in many, many institutes and organizations, and it's not perfect, but those principles, the ethos of public health or development, has to incorporate some of that - whether you do surveys, as I said, or qualitative, it has to, there has to be certain principles underlying the ethics of research underlying the ethics of program implementation. Luckily, in Bangladesh, we have a history of - I'm not saying it's perfect, there's lots of challenges, but our of history of public health successes has been that many of the programs were designed, working with different groups of community members, if you look at all ORS, if you look at family planning, if you look at immunization, if you look at control of tuberculosis, if you look at trying to get more girls enrolled in schools, it's been done from leaders in slums to women to poor families to men, like whole scale engagement, right? So there is a culture of it. I do think even in research, it needs to be strengthened. I'm extremely critical of some of the work I've done. I sometimes continue to do - we have to critically reflect on this work? And is it making a difference? It doesn't have to be a huge difference. But are you engaging in basic ethics of the reach out, and ensuring that it's not just about going back and giving feedback, but from the start of the research to the end, has there been some efforts to engage with communities in appropriate ways, diverse communities, and get a sense of some of the needs and priorities for the research we're undertaking? And then what happens? What are we doing with that sharing, and you may not be able to change policy overnight, but in Bangladesh, many things have happened without changes in government policy. For example, we don't have an official urban policy, we have a draft policy - that hasn't stopped NGOs and other actors from working in urban slums or research that has been shared and continues to be shared about the about the needs or plights or changes within the slums, right.
Safa: Absolutely. And so you know, in this dynamic, as you mentioned, one of the stakeholders, or one of the partnerships that are made is with government actors, government institutions, their role in this dynamic. Could you speak to us about the kind of relationships or experiences you've had, or you have fostered over the years with government actors and the dynamic of creating those partnerships in terms of doing this work in an intersectional way.
Sabina: So I found it very interesting because I met a British academic who used to live in work in Bangladesh, right. And I met her in Geneva at a meeting. And she said to me something which I took for granted - is that, you know, I forgot when I used to work in Dhaka that there can be challenges, but it's so easy to get a group of very high level stakeholders, including government, for sharing evidence, or to discuss, you know, certain issues of importance in the country. So I sit in London, and you can barely get, I don't know, some MP to come to these meetings, right. It's much more difficult. I think back on a project that we did for five years, and government was one of our partners, their leading research institute, and we were working with two service delivery organizations and funded by the Dutch. And after working with government, we managed to get into their curriculum, concepts around sexual diversity in their formal curriculum, and in the training of their frontline workers. I'm not so sure it'd be so easy to do it elsewhere, as a university Institute to reach out, you know, it's much harder in some ways. On the other hand, sometimes changing policy takes a lot longer, but because Bangladesh has got so many different actors, civil rights, journalists, different groups, sometimes you can create a lot of space for discussion by convening a dialogue or brainstorming with, you could bring in journalists, some key civil society activists, some, you know, senior members of it could be government, private sector, to discuss a key issue. And it may not result in immediate change in policies, but it may change in the way we have development partners approach funding, it may change in the way NGOs take up a certain kind of agenda on service delivery, it may change in terms of the communication information being distributed to disadvantaged populations. It's a very fluid, organic space, it's not that there's a linear model.
Safa: And so in terms of thinking about the power that different actors hold, in terms of the civil society, NGOs, private sector, international partners, international donors, what have been some of your thoughts or reflections, and that work of just the negotiation and relationship building between different actors.
Sabina: One thing I talked about is how to recognize communities and not reproduce the colonization of global healthcare development, right. So what we have is a language and discourse around development, which is, it's sort of all pervasive, right? And one of the things that we need to do, and COVID is a stark reminder where many countries in the South or Southeast Asia did a much better job of managing COVID, as it continues, compared to many developed countries, if we go by the language of developing and developed, right. But you will find that in the media and even understanding what works and learning from the Global South, there's a lot of reluctance, right? There's certain kinds of ideas of knowledge bearers, and capacities, and what development means. And I think when I look at COVID, and I look at even public health education, we really need to unpack and decolonize Global Health, we need to unpack what is development when we look at what what COVID did, in many of these countries, although many of the poor people in many of the poorer countries suffered much more. But I think we really need to start unpacking some of these assumptions, because there are certain kinds of discourses that prevail, then there's also about evidence, and what is evidence and whose evidence is valued. And when agendas are set, I think there needs to be a more critical reflection that is inclusive of academics, researchers, actors from Global South. I mean, if we're going to polarize in a Global South and Global North, I think it's often been accepted that we learn from the north, and we have our capacity built, right. But that's not the reality, in some ways. Yes, we may have human resource shortages, we may need some technical skills, but there's a lot of very successful models - Vietnam, Taiwan, Bangladesh, and other countries, even Kerala during COVID, that many other countries can learn from as we move forward on responsive preparedness during pandemics, or even in terms of containment or in terms of countries in Africa, because they've managed Ebola and they have managed other kinds of crisis. And I was in a WHO meeting recently and there was a WHO guy presenting and he said, you know, in terms of resilience, it's often these developing countries that tend to be more resilient because we have more crisis and we have to manage. And we have far more sort of systems in place. And then you look at something like Hurricane Katrina that hit America, and the entire state falls apart, which is sad. I'm not saying it's a good thing. I'm just saying, we need to really unpack and try and understand that what can we learn from each other? Why are knowledge bearers seem to be represented from one particular site or country? There's all kinds of power dynamics, who controls the resources, how aid is given, and I don't want to get into that - the politics of aid, the assumptions around knowledge, the kind of sweeping generalizations of what development needs, right, that's one. Two, we also reproduce some of that when we work within communities being Bangladeshi in Bangladesh, right? So there's a paternalistic kind of approach global, local, within local, across and it's not always confined to just someone sitting in North America, it can be someone sitting in Bangladesh who has these approaches, right?
Safa: Yes, absolutely. And so in thinking about those dynamics, and who we kind of look to in terms of examples of who to emulate and stuff, can you speak about in your own journey and thinking about like, decolonizing Global Health, was there like a specific experience in your own journey, in your own experience, where you really became much more engaged in these issues? Is there something that sparked it for you?
Sabina: I'll give you two examples. One is when BRAC went international and started setting up offices and programs and models adapted to Afghanistan, to Sierra Leone, to Uganda. And I thought, hey, you can learn from the South. And I've been living and working in Bangladesh, And there's many models that can be replicated, right? Micro-credit, as you know, from Grameen has been replicated in the Philippines and many other countries, right. So that actually breaks away some of the stereotypes and assumptions of some of this. Secondly, in my own School of Public Health, I brought in a colleague, who was a consultant who does skills development work - we have a one year international MPH program, we've had about 540 graduates from 31 countries from all over the world, Latin America, South Asia, Southeast Asia, different countries in Africa, Europe, North America, even Canada, Japan, etc, right? Because many of the development challenges in developing world contexts, we said, can we kind of take a step back, you know, my consultant colleague and I, and look at and he pushed me to think about what are the skills that are relevant and competencies in these developing world contexts when people graduate and come back to live and work in Bangladesh, or they go to different developing country context, and they have to look at relevant priorities and needs and issues, right. And we reformed a number of our courses to have competency based curriculum - skills that are employable for public health leaders and graduates. And also we brought in, our MPH always had a lot of field based learning. So you have to spend time in the field. But we shifted it to not just going to the field, but how do you engage with communities, co-develop and co-think some of the issues in different modules, right? You've got intro to public health, were they are looking at equity, you got anthropology and public health, were they are looking at cultural social issues to develop - some kind of role simulation of a mini program or a campaign or a message right. Or you know, health systems management. And then we discuss about bringing solutions oriented thinking. So you just don't go to communities and look at all the challenges and lead by just repeating the challenges. What are small things that one can do as a student or think about as groups to improve conditions or at least you know, because we have been influenced in Bangladesh, by the entire BRAC's original, but even Grameen's simple solution - ORS, oral rehydration therapy is one of the most simplest solutions used by communities to tackle diarrheal deaths. Microcredit, which was started by Yunus and BRAC, late Fazle Hasan Abed, is a simple solution of getting women together to serve as collateral to borrow loans to empower them and help them you know, invest in education or little house or in their own businesses. So we come from a country which has very, very successful models along with challenges, so why not inculcate some of that critical thinking in our students, but contextualize public health and development learning, go to the villages, go to urban slums, learn and see what poverty, equity inequality means, trying to understand some of that - develop the critical thinking skills, but also some of the competencies to work with communities. And we have a lot of practitioners who come and take sessions and discussions. We also have teachers who are our alumni graduates from Liberia and Uganda, two women, very dynamic - one is an academic, another one used to work with the government. She was responsible with the team to control Ebola in Liberia. Now she's in Afghanistan, who come and teach our students real world public health. And that's the differences I see that we are trying to do. And we're still trying and some of the research - it's basically the education and some of the research we're trying to do. And some of that drawing on the learning from Bangladesh and from the successes of late Fazle Hasan Abed and BRAC's continued work, and even Grameen Bank, Professor Yunus.
Safa: Very important. So since 2013, you've been serving as the Dean at the School of Public Health. Could you speak to us a bit about what it's been like to kind of be in that position of leadership and the kind of priorities you've had in terms of really changing or making changes in the way that you think is needed? Or what has it been like to be in that role of leadership?
Sabina: I've been with the school since 2004, when I joined, and I became Associate Dean, I think, a couple of years prior to me becoming Dean. I was quite overwhelmed. I was 44 years old. I'm 51 now, so it's my eighth year. When I joined the school, it was four of us. When the last Dean wrapped up, you know, Dr. Timothy Evans, who's in Canada with McGill, I took over, I was the Associate Dean under him. And now the school is about 220 staff. I have an Associate Dean, Professor Malabika Sarkar, we work very well together. And when I inherited the school, I have to say we have a really good, good team at the school - really committed. We have more women than men, I would say 60% are women, 40% are men. One of the things I realized when I became Dean is that I'm very vocal and I'm really blunt. I think initially, when I would go to meetings - I was 44, and people expected a Dean to be this, I don't know, older male. So I think people don't know what to expect. But I mean, I have very, very strong support. Like my father who passed away a year, almost a year and three months ago, he always pushed me and my husband, and it's kind of like, well, I can do this. So I would kind of you know - in many places you work, it can be quite hierarchical, and it can be quite male centered. So when I became Dean, and I was working with Professor Malabika,we set up an organogram and we also set up an HR policy system to create spaces for younger academics or researchers to write - first authorship papers, because, you know, often you have always the seniors leading papers, right? You don't often have younger academics or junior academics. We also created a space for policy changes where you cannot - I mean sexual harassment anyways, because BRAC has very strong policies around gender sexual harassment, so does the university, but we created additional policies around - I mean, there doesn't have to be a dress code, you can not comment whether a young woman is wearing you know, jeans and a T shirt, or if she's wearing a traditional shalwar kameez, or if she's wearing a hijab, that's up to her. And we created a policy around religious tolerance and sexual diversity, because I do a lot of work around sexual minorities. And I think it's very important to create a safe space, but also a space to build capacity and leadership within the school. My colleague Malabika, she was the Research Director, she recently stepped down for the last many, many years, set up a systems of journal clubs, seminars, reading discussions around papers, presenting to each other. Because you know, sometimes you lack that space for mentoring, for feedback - because we're entirely soft funded. So the School of Public Health, the Jamest P Grant School of Public Health, we self finance, we don't get any money from the university, we raise our own salaries. So we're very much a research academic institute. So we wanted to inculcate a research culture, but a culture that allows people to think critically and write and encourage that. But also, we need to submit proposals and write research grants, you know, it's sort of a continuous cycle. We also wanted to create a safe space, if someone is gay, if someone is a trans woman, or, you know, as self label identification, we want to create a space if you're a minority, if you're a Hindu, or if you are from a community that is not always accepted or recognized due to discrimination and bias. You need a couple of things in any institution - like it shouldn't be too hierarchical, because we are an academic research Institute, but the nature of many Institute's are it tends to be very top down, right. And because I started at 23, and moved up, I saw the challenges I faced but I also saw the opportunities other bosses gave me to create the space for me to thrive, to write, to write mini-grants. We've also introduced performance benefit bonuses, where if you're a young person, and you brought in a $5,000 grant or a 10,000 or $20,000 grant - you published, you can get a reward and an added bonus on your salary. So creating that research culture but also creating a safe space. We also changed policies for young mothers if they had to come in late because they have to drop off their child to school. Maternity leave that was always there, but paternity leave, for young men are men who need to take some time off after the child is born. So those are the things in terms of policies. But also organizationally, we are trying to create a research culture. I shared with you about the education, we piloted the competency based community centered solutions thinking in 2017. It was evaluated by a public health colleague who was a consultant working in public health for a long time. And he was coming in and out of Harvard, and then we got an educator and a public health person to come in and evaluate it, got very good feedback and we've continued to do this sort of solutions based oriented thinking in some of the other modules. So I would say sort of creating that research culture where we've gone from 60 to about 220 staff, creating a space for a lot of mid level - we changed designations, so people could be coordinators, they could be focal leads, they could actually have an opportunity to have some leadership roles, and write papers and teach. Everyone is required to teach even if it's a teaching assistantship so they can learn, they can build confidence and skills, and also the education - we're trying to make it more contextualized. And that's going to take a couple of years, but we started in 2017. And my colleague, and I would say she's a very, she's become a very dear friend to me, we've worked closely together for many years, my Associate Dean, Professor Malabika, but also many of the senior management, but especially her, we kind of think that we can either do something about it, or you can sit and complain, right? And you have to figure out solutions, things are not going to change overnight. And yes, there's a certain lens of patriarchy or a certain lens of is she as capable as a male leader? Women have that, men have that, you know, gender is cross cutting in terms of some of the biases, but I got to focus on the work I do and what are the kinds of ethos we want to create in our school? Good research, quality work, good quality, international standard MPH education, published in peer reviewed journals, go to conferences and seminars, get young people to go out there, get exposure, and this is pre-COVID. But create that space and create as much as possible quality standards - I mean, there's the fair share of challenges Safa, but a nice community of us working together as much as possible.
Safa: Yes, it sounds like a very wonderful work culture. And I appreciate you sharing those dynamics and reflections with us in terms of your experiences and being in that role as a woman leader, especially. One thing I'd like to also bring up is, you know, in the context of Bangladesh, there's so many really vital issues in terms of the Rohingya crisis, COVID-19 pandemic, garment workers and the issues around that, could you tell us how it is to work in a context that has so many competing needs, and so many issues - in that environment, what has it been like for you and your colleagues?
Sabina: I can speak for myself, we're quite decentralized the school. It's not top down, where everyone reports to the dean. There are senior professors who have their niche areas, it could be health systems, could be reproductive rights, it could be non communicable diseases, it could be humanitarian hub. So it's quite decentralized, which allows - hopefully allows people to thrive in those who areas they are interested. I love living and working in Bangladesh. Despite the challenges, the most I've learned and I keep learning is the communities, the successful models, even failure, some of the challenges teach you something. I've never lived and worked in - I mean, I worked with Aboriginal issues when I was a research assistant during my PhD. So I can't really compare myself to other places. But yes, there's lots of kinds of crisis, at the same time, you see the ingenuity of many of these organizations as they step in and work together. You see the kinds of different kinds of interventions - if you take an intersectionality for different groups, right? Safe spaces, if you look at the humanitarian hub, there's a whole psychosocial working group, there's a gender based violence group, there's a food, working for nutrition group, right. And the commitment and the passion and the dedication, I find it very, very inspiring. And I think it's really a space for learning. If anyone wants to really learn about development, I think this is the country to come to. Come and spend some time at BRAC, come and spend some time in many of these organizations, come and spend time in communities - because even you realize communities themselves come up with their own solutions to figure out some of their basic needs. I love living and working here. Yes, sometimes it's challenging. Yes, it's frustrating. But I think that there's so much to learn. There's so much to learn, that the world can learn from coming to Bangladesh. I learn all the time, you know, I mean, go to a meeting and I sit next to a journalist and they'll start talking about something that's occurring somewhere. I mean, I remember being 26 or 28, being in a boat during the floods, handing out food relief in packets throughout the country, we were in boats. And we quickly discovered that they couldn't take tablets because we didn't have water and they had to figure out another way of providing medicines, right? But you're constantly learning and there's constantly innovations and there are constant spaces, and there's failures. But you don't stop at the failures. That's what I like, you just don't give up - people persist and persist. And they try, including communities themselves. I think if you ever want to do a degree, it's like, live and come and work and do a degree here. I really believe that - I say it with a lot of sincerity. In terms of the possibilities, the creative ways of reaching out, you know, when we were working with young people, and we had to discuss LGBT issues, because there's a law against homosexuality, because we inherited it from the British, we came up with cartoons and animated videos, and we had a conference with 700 students and gave them the hard drives of these little mini-pen drives with videos and fact sheets and information. And we brought teachers in to give them an orientation. I mean, where else can you do that?
Safa: Yeah, the passion that you have in terms of the words that you're sharing, it's heard across your voice, I think it will resonate with the listeners a lot - the power of working in such a dynamic country. Over the years, how would you say your motivations have changed in terms of your commitment to this work, what you want to focus on?
Sabina: I'm older, sometimes I'm more tired. But the challenges and wanting to learn, and trying to hear about different innovations or meeting communities, I get kind of revived if I go to the field or to communities, because I'm always learning something. Or if there's sort of a very interesting group of stakeholders coming together to brainstorm, it's always you know, you have lawyers sitting with public health, with people in governance, and people working in the front lines. And you get very interesting, diverse opinions. I think for me now, sometimes I wish - I mean, I do a lot of research, and I teach, and the teaching reform is going to continue, we have a colleague who's a consultant, but he's sort of like, I always tell him, you're not a consultant, because you work with us all the time. And you have been work with us for six years. And we have mid-level now colleagues who are being trained in this reform, and that's going to continue. That's my dream, I hope to have contextualized public health learning that matches the competencies required in developing world context, that people can learn. Even if people go on to the UN and World Bank, and they visit Bangladesh, and they get training from our school, it's a much more grounded real world training, right? Second, I would like to write more Safa. But I don't get the time, I'd like to write more about the stories of the people and the research that I do. Not that I'm some fantastic writer, but I would just like to write more, if I could. I would like to have more leadership in public health from the Global South, represented everywhere. I'd like to see a world where there's more leadership from the Global South, who have spent time here, who have a lot of considerable sort of expertise and experience immersing themselves in these countries and contexts, to have a voice at the table, and be able to share and lead agendas, lead research - not just when we come to our age, because I'm Dean and PI projects, but a lot of mid-level young women and men. And I, my ultimate dream is I think we really need to unpack public health and look at social justice as a part of our model of public health and development interventions. We need to really look at human rights and change the way we do interventions. Because I think some of the solutions become temporary. And if it's not comprehensive, and we don't recognize human beings needs more holistically, we will continue with this cycle of poverty and inequalities and inequities. I don't know if that answers your question, but that are some of the things I think about.
Safa: Yes, it does, it does in terms of, you know, this dynamic we have sometimes in the sector of bandaid solutions versus more long term meaningful, as you say, holistic analysis and intervention. Maybe you can go further into that.
Sabina: I think it's a paradigm of how development and health you know, health is primarily bio-medical, social science research stays in the periphery. If you look at COVID in many countries, it is a very biomedical approach about controlling disease. But you know, there's all these other economic social factors that impact on people's lives. Development often can also be very, very operating in silos. So I think there's sort of a lot of paradigms that need to be critically looked at - the way to development aid is thought through and the areas of concern - because I think, you know, something like COVID, we need to really look at what are the fault lines in public health and development. What are the critical gaps and sometimes it's basic, in slums it is basic infrastructure, water, a proper drainage and sewage. You get a vaccine but when you are sleeping every night and there's holes in your tin and there's no ventilation - you can have other forms of diseases, right? And health challenges. It's about the way these aid/ trade -now that we've gone into the trade mode, but aid and the way these are structured has a certain kind of paradigm of thinking of health bounded into disease, development operating, you know, in parallel, how do we have a more sustainable long term approach if you want to improve the lives of the poorest, right? But to translate that into an arena where there's diverse actors, diverse stakeholders, politics, of where money goes, allocation of budgets, are certain kinds of framing of what health means, what development means, results in some of these challenges. I think it can be done, I think we need more critical discussions, because this is not the first pandemic or the last global pandemic. I think there are going to be many more, there's been epidemics in the past, but this has kind of affected the world right, in different ways. And I think it's not just short sightedness, you generally, you may have organizations that have money for three years. And that's it - wraps up, then a new project, new kind of issues. So I really think this needs much more sort of much more critical discussions at many levels - global, local, glocal, whatever you want to call it, but we need to critically look at what are the results we want? What are the outcomes we want? What are the priorities, there's structural stuff, there is social stuff, education and health and livelihoods, right. As I said at the beginning, BRACs original approach was a comprehensive, multi-pronged approach when it was set up : health, education, and economic support, right, whichever way the different models are - because we have to recognize they're all interrelated to your improved life and well being and health and your own aspirations and actual sort of good health and development outcomes. Right?
Safa: Yes, yes. Very well said. Absolutely. I think those are really important points. And I think it's a good place to wrap up the conversation. Are there any final thoughts you'd like to add?
Sabina: My final key messages is there's a lot of learning one can do from the Global South. There's a lot of models of successful interventions, but also you can learn from failures and what didn't work and what was the adaptation of programs, right. I think communities need to be at the center - as heterogeneous and diverse as they are, and populations at the center of the research and the program design and interventions. I think there always needs to be a constant checking in of how the programs or interventions working and that means working with communities and populations and not about them, or on them. And ultimately, the ethos of health and development work should be learning, listening, humility, respectful listening, from the very groups and populations that are the most affected by different kinds of humanitarian crisis, and they are most capable of sharing, and we we can learn a lot.
Safa: Definitely, yes, thank you so much for speaking with me today and sharing your really rich and wonderful insights. It's been a pleasure to speak with you. Thank you. Thank you so much.
Sabina: Thanks, Safa. Keep up your good work, and if there's more young people like you doing interesting, very useful products like these podcasts, I think the world definitely has hope.
Safa: Thank you so much. It's been a pleasure to speak with you.
Sabina: Take care, bye bye.
Safa: Thank you. Thank you so much. Thank you also to our listeners for tuning in and supporting the podcast. I invite you to join in on the conversation by going to our website, hitting the send us a voice message button and sharing some of your thoughts with us. Don't forget to subscribe to the podcast on your preferred podcast player, rate and review past episodes and share our conversations with your friends. You can also keep up to date with our latest episodes and offerings by signing up for our newsletter on our website and following us on social media. On our website, you can also find a donation link where you can choose either a one time donation or reoccurring monthly donation option to help us cover our production costs. Thank you again for tuning in. I look forward to continuing this conversation with you all next time. Until then, take care.
