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Avian Flu, AIDS Figure In US Help For Bangladesh

Avian Flu, AIDS Figure In US Help For Bangladesh

Cyclone Sidr's deadly landfall wreaked havoc in southern Bangladesh November 15, killing thousands, displacing hundreds of thousands, and adding pain and desperation to a nation whose population of 133 million already struggles with poverty and disease.

To help with the latest crisis and meet longer-term health challenges, the U.S. Agency for International Development (USAID) has committed $19.5 million since November 15 for cyclone relief, Kent Hill, USAID assistant administrator for global health, told reporters in Dhaka, Bangladesh, December 9. The agency also plans to contribute $115 million for health programs in fiscal year 2008 -- an increase of $39 million over fiscal 2007.

"The United States has a long and very good relationship with Bangladesh," Hill said, adding that USAID has supported the South Asian nation since 1971 with $5 billion over the years in assistance for health care, education, electricity, democracy and elections, economic growth and humanitarian crises.

During his first trip to Bangladesh, which began December 7, Hill visited USAID-funded health programs in Tongi and Bhaluka, and in Dhaka a manufacturing plant for oral rehydration salts -- a mix of salts and sugars that compensates for fluid loss in adults and children with diarrhea -- and an HIV-prevention program for intravenous drug users.


Down one of Dhaka's narrow, noisy, winding streets is a store-front building with a colorful sign. Inside, the counselors and managers of CREA -- the nonprofit society for Community Health Rehabilitation, Education and Awareness -- with HIV/AIDS technical support from Family Health International (FHI) of Dhaka, do something that no one else in Bangladesh will do.

They provide a 90-day residential detoxification and rehabilitation service at no charge to street-dwelling, needle-sharing injected drug users who, on their own, never could afford such treatment.

To give the cleaned-up drug users a better chance to stay drug free after treatment, the program, called Modhumita -- Bengali for "sweet friend" -- has linked up with Jobs Opportunity and Business Support (JOBS), an organization originally funded by USAID, to develop business and expand employment in Bangladesh.

JOBS does "economic rehabilitation" by helping those who have gone through the 90-day program find work, decreasing the number who relapse after treatment. Two employers -- APEX Leather Craft and Bengal Braided Rugs Ltd. -- are working with JOBS on this project.

"What we're finding," said FHI country director Robert Kelly, "is that several of the graduates who are here, they've been on drugs for 20 years -- now they're working."

Hill toured the facility, meeting with the managers and talking with program patients who gathered in a large room for the occasion. The facility houses 35 men and 12 women in separate dormitories. During Hill's visit, the men sat cross-legged on the floor, curious and expectant.

USAID has many programs to help people who are addicted to drugs, he told them through a translator. "I have great sympathy with your situation. I'm impressed that you are willing to do the very hard work of being in a treatment program, because there's great hope if you do."


Hill spoke with reporters about the high risk of avian flu in Bangladesh, which has one of the densest large-country populations on the planet and, according to the U.N. Food and Agriculture Organization, 220 million chickens, 37 million ducks, 5 million people directly employed by the poultry industry and millions of households that rely on poultry production for income and nutrition.

The first officially announced avian flu outbreak in Bangladesh was in February. Since then, the virus has spread to 19 of 64 districts. No human cases have been reported.

In fiscal 2007, USAID committed $3 million for avian flu efforts in Bangladesh, and Hill said the agency would try to increase that amount. USAID is also moving an avian flu expert to Bangladesh in January 2008 to work with the government, the U.S. Embassy and the Centers for Disease Control and Prevention, which also has avian flu staff stationed in Dhaka.

The people of Bangladesh need to be educated about avian flu and what actions to take if they see sick and dying birds, he said. Supplies such as personal protective equipment and test kits need to be prepositioned before an outbreak occurs. Local authorities need an action plan and volunteers should be organized in advance.

"We need to expand our efforts here," Hill said, "but frankly we need to do that in lots of countries. Bangladesh is not completely where it needs to be -- none of us are. Bangladesh has a way to go but I think you're making progress and we're going to be partners with you in making it."


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