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Teknaf is the southern-most corner of Bangladesh enriched with mangroves, mudflats, beaches and sand dunes, canal and lagoons and marine habitat with one of the lowest literacy rates, sharing its border with Myanmar. In comparison to all other government services rendered here, health service is not adequate; the scarcity is attributable mostly due to its geographical location. Except some NGO activities like ‘Surjer Hashi Clinic (Smiling Sun) run by Family Development Services and Research (FDSR) under the programme of NGO Health Services Delivery Project (NHSDP), funded by USAID; no other effective health intervention is available in Teknaf.
NHSDP’s partner NGO, FDSR has been operating through Surjer Hashi Clinic at Teknaf since 1998.It operates in 34 satellite centres covering more than 60 thousand of the population out of 90 thousand inhabitants and near 12 thousand eligible couples. The clinic is providing its services mainly for the underprivileged people out of whom nearly 10% is receiving services including medicines and other facilities without any cost or negligible payment.
Bangladesh has achieved substantial gains in the field of health care especially MDG goal 5&6 dedicated to reduce child and maternal mortality. In Bangladesh, maternal and child health care is provided mostly by government agencies. Besides the public sector, the private for-profit providers and private not for-profit providers or NGOs also play great role in the Bangladesh health sector. NGOs are mostly involved in the provision of primary healthcare in both rural and urban areas.
For maternal health service programme, safe delivery system is very important to save pregnant mothers and infants. But the country-wide overall safe delivery rate is not satisfactory except Taknaf area. Recent study has shown that the rate of safe delivery at Taknaf area is now 74% compared to 30% (or less) elsewhere in the country. Surjer Hashi Clinic, Teknaf deserves acclaim for this achievment. The key to success has been the mobilization of all stakeholders including local community leaders, GO-NGO officials and family members of pregnant mothers towards one goal i.e. ‘save pregnant mother.’ They have a target to achieve more than 90% coverage in this sector.   
Among the many innovations introduced by Smiling Sun Clinic, Teknaf, has been the demarcation of houses occupied by pregnant mothers, with red flags. This enabled neighbors to come together and help that particular family when required. As Mariam Bibi, near 30 with two children said in her own words, “When I was pregnant the second time, my husband, a small trader was unable to take proper care for me. Moreover, our house is so far from upazila health complex, regular check-ups were not possible. In the mean time Surjer Hashi Clinic came forward to help me prevent health problems associated with pregnancy. They hung a red flag atop my house so that everybody could see and understand the need to help pregnant mothers like me.”  Like Mariam Bibi, Shikha Rani Das, Rekha Rani Das, Fatema Begum and many more had the same experience and got the same services provided by Surjer Hashi Clinic.
Champa, mother of a one-year old, received health care in a Surjer Hashi Clinic during her pregnancy, said that now she is motivating other expecting women in her community to go to Surjer Hashi Clinic for healthcare. Babuti Rani, a paramedic working at Surjer Hashi Clinic in Teknaf, said that everyday 40-50 patients come to the clinic for health services.
Health workers of Surjer Hashi Clinic also provide health card (red card) to pregnant mothers to check her progress during this special time.  At Teknaf, Surjer Hashi Clinic has its own ambulance service and a static clinic where 24 hour services are provided including safe delivery.
Surjer Hashi Clinics provides necessary health care services to the poorest women in Bangladesh through a network of 26 NGOs, 360 clinics and more than 6000 community health workers.
Surjer Hashi Network, plans to offer safe delivery services to 0.15 million mothers and 48-hour postpartum care to 0.33 million women, over the five year period of their project duration.
NHSDP, the largest investment by USAID in Bangladesh continues to provide basic health services through Surjer Hashi Clinics in underserved areas of the country and supports the delivery of health services at an affordable cost, strengthen health systems and develop public-private partnerships to improve health outcomes. It continues to complement the Bangladesh government’s health services delivery programmes specially to improve maternal, newborn, child health and family planning status.
The NHSDP interventions lead to 1) increased access and use of effective essential primary health care services 2) improve healthy behaviours and care seeking practices and 3) enhanced ownership of service delivery by partner NGOs.
During our visit, we talked to upazila parishad chairman, two union parishad chairman, members, upazila health and family planning officer, upazila nirbahi officer, local journalists, community leaders, different stakeholders, pregnant mothers and others. They are hopeful that the services of Surjer Hashi Clinic, Teknaf will be a model for the rest of the country soon.

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Editor : M. Shamsur Rahman
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