Anjana (not her real name) had taken the toughest decision of her life – abandoned her three-year-old son and left for Riyad to work as a house maid.
"I thought it was just a matter of time," said a young Anjana. She imagined and hoped that the temporary separation period would be short and fruitful, earning her the money to provide a better life for her son.
When she left Bangladesh, she did not even know what her responsibilities would be as a maid. "My simple mind did not understand how household chores would be different in Riyad than ours because everyone cooks, eats and cleans," she added.
But in Riyad, Anjana found herself in a problematic situation as she was recruited as both a caregiver and a maid. On top of that, people there are dependent on electronic devices, which she barely knew how to operate. The elderly person she was looking after seemed always aggravated by her presence.
"She behaved like I was a piece of rotten meat who always stinks," muttered Anjana, looking down at the floor.
In reality, the old lady did not like the smell of her hair oil and due to language barrier, Anjana did not understand this for a long time. Also, for the same reason, she never could master the household chores.
Subsequently, she had to come back to Bangladesh in six months, wasting Tk3 lac.
This is not a story of Anjana alone. She represents thousands of migrants and their failed attempt to successfully work abroad because they did not receive any skill-based training in Bangladesh.
A report by the Bureau of Manpower, Employment and Training (BMET) last year said the remittance volume in the fiscal year 2019 was around $20 billion, which was 40 percent of the total export earnings of Bangladesh.
However, the number could have been more significant, but the remittance flow is lower due to our higher proportion of less or semi-skilled workers in Bangladesh. Interestingly, around 44 percent of migrant workers are classified as less skilled, low or no skill levels. Another 16 percent are classified as semi-skilled.
"Anjana would not have to come back if she had the minimum knowledge of caregiving or at least an acceptable command of the language. Our workers have a lack of skills, and that is pretty established in the foreign countries.
But training organisations can change this scenario by skilling up our manpower, offering lucrative courses while collaborating with the government. And, there is no alternative way if we want to sustain in the market," said Shakirul Islam, Chairman of Ovibashi Karmi Unnayan Program.
Ayat Education, a social enterprise, has taken this matter seriously. It has four wings – AYAT College of Nursing and Health Sciences (ACNHS), Dignifying Life, Ayat Care and Ayat Skill Development Center (ASDC) – which offer a myriad of skill development courses.ASDC offers courses in health care, general electrician, driving and auto-mechanics, readymade garments (RMG), refrigeration and air-conditioning (RAC), welding and fabrication, plumbing and pipefitting, and solar energy.
ASDC courses are designed to increase the workforce's skill levels to ensure competitiveness and capacity building. Sometimes these courses are provided with a stipend, scholarship and job security. A few of them are paid courses with fees ranging from Tk4,000 to Tk6,000, and some are free.
Filling up the caregiver service void
In our health system, nurses or caregivers are standing at the top of an inverted pyramid. We have three times more doctors than nurses whereas, one country should have six times more nurses than doctors. Sadly, the number of registered caregivers is only 250, but we should have 10 lac of them.
ACNHS started its journey in mid-2019, based on the belief that nearly 20 percent of our population is young; and a decade or two later the scenario will not be the same. Thus, the best efforts should be made to utilise our youth population.
It offers a BSC program in nursing under Dhaka University, a diploma program in midwifery under Bangladesh Nursing and Midwifery Council (BNMC) to skill up young health carers. Till date no one has completed the program yet, and around 350 students are enrolled in this program. The program fees are within Tk1.15 lac to 2.5 lac per student.
In the following year, a masters program in nursing will be offered from ACNHS under BNMC.
Ayat Education promises to ensure good quality training and education to its participants and students. It strives to strike a balance in the teacher to student ratio and also provides top-notch lab facilities. To ensure firsthand and diverse experiences of the participants, it has an agreement with Mugda General Hospital and Institute of Child and Mother health.
"What sets ACNHS apart from other nursing hospitals is that we have an affiliation with Massachusetts general hospital global health and Simmons University. We are working with them in six different areas to develop our nursing sector.
Under this affiliation, our students, participants and faculty can exchange programs visiting their hospitals, participate in research and do online training," said Nusrat Aman, CEO, Ayat Education. What ACNHS is doing is to dignify this nursing profession so that our nurses feel valued.
Lilatul Ferdaus, a senior staff nurse of BSMMU, had joined one of Ayat Education's online programmes where she had exchanged experiences with foreign nurses, she said "70 percent cancer patients are diagnosed in our country at an incurable stage. Where I work, I regularly attend to such patients and provide palliative care under the Palliative Medicine section. Sometimes their pain affects my nerves, but there is no one to listen."
The Dignifying Life programme (one of the four wings of Ayat Education) has started working with the government, general and private hospitals. It is working to bring palliative care to the forefront of healthcare while preparing an army of skilled workers in Ayat Care. It has already trained 430 nurses with good quality palliative care services.
Ayat Care is trying to balance this ecosystem by providing training and courses to the caregivers and care coaches, and these courses are available at Tk18,000 to Tk20,000. Recently, Ayat Care launched a service for elderly citizens providing caregivers and care coachers.
"I felt guilty because when my father died he did not receive the care that he needed. Therefore, I tried to make sure that whoever needed this service could have it in Bangladesh. Our Care Pro Plus Package supports you on a 360-degree level to take care of your loved ones," said CEO Nusrat.
Ayat Care offers three packages providing caregivers under Tk9,000 to Tk30,000. As Ayat's wings are interconnected, it also provides jobs to its participants through the Ayat care and Dignifying Life platform.
Though Ayat's centers are located inside Dhaka, it is not totally Dhaka-centric.
A family of 50 core people is taking care of Ayat's four wings. From all over the country, people are attending their courses, getting in touch with Ayat both in-person and online.
However, Nusrat hopes to open branches of Ayat care in at least two divisional cities, especially in Chittagong and Sylhet. In three years, it intends to be expanded in Khulna.
In the next five years, Ayat Education is planning to introduce campuses in hill track areas where students will receive education through technology and for better learning, will join the main branches in the last couple of years.
Ayat Education's funding has always been from friends, family, funding and investors. Still, it is planning to work in a structured way by working with government and ministry programs.
"Ayat is a very new organisation, but we are proud that we have made it this far in such a short time and hope to continue at this pace in the future too," concluded Nusrat.