Interview

Taking the Quieter Journey

FARHANA URMEE

Dr Kanta Jamil

Growing up in a culturally inclined household, Dr Kanta Jamil, daughter of renowned dancer couple Raushan Jamil and Gauhar Jamil (also a well known actress) decided to take a path that was quite different from that of her parents. Despite her natural passion for dance she did not pursue it as a profession. Although Nataraja has a special place in her heart, she moved away from the lure of being an artiste and found another way to contribute to her country's development. She is at present working as a Monitoring and Evaluation Advisor in the Office of Population, Health and Nutrition and Education, USAID. The latest research she has spearheaded is on maternal mortality and health care. In an exclusive interview with The Star on the eve of Safe Motherhood Day (May 28), she talks about why she swayed away from the expected path of performing arts to the quieter arena of research and what implications her work has on the development of the country.

Why did you, coming from such a cultural family, instead of going into the performing arts choose your profession in development research?
I was raised in a cultural environment but my father also placed a lot of value in education. People used to wonder how we would be able to pursue our studies in such an environment of music and dance. I used to be a dancer, dancing was always my passion, yet I wanted to have my degree in a different field other than dance only. So I continued my study, went abroad for higher studies, pursued my PhD in the United States.

Pursuing my Bachelors and Masters in Economics and further pursuing PhD in Health and Population was not actually due to any deliberate planning. It just happened and I only knew I had to do something. Getting scholarships made it easier to study abroad. I had already seen the hardship my parents had to face while bearing the cost of my education while I was studying in English medium school. It was my mother who always used to think that girl children needed more support than the boys. When my parents let me go to English medium school it was real hard for them to pay the fees for their three daughters. My mother, who was always a free thinker and a progressive woman, sent her daughters to an English medium school and sons to a Bangla medium school because they could not afford tuition fees for English medium school for all five of us.

I saw the hardship, probably that led me to study hard. The environment, in which we grew up, obviously was not appropriate for studying as there were music playing on, the rush of students coming for dance classes. Even my siblings and I were involved in dancing, singing, playing Tabla. I used to wake up at 5am and continue studying till 8am as I knew I was not going to get any calm environment to study after 8.

When you went abroad to study did you disassociate yourself from this artistic environment?
Studying abroad never alienated me from practicing my art and culture. Rather it gave me a wider scope to explore more classical arts of the Indian subcontinent living US. I, along with some of my friends who were dancers as well, went to many cultural programmes, danced together, and practiced dancing on weekends. I took dance classes as well while living abroad. I went to the US in 1978 and came back for work in 1991. I came back in an arrangement to work with the ICDDR,B and later started working with the USAID through John Hopkins University in 1994.

What is the most exciting work you have been engaged in which has given you immense satisfaction?
I had obtained degrees in health and population and also worked in this field when I was living abroad; consequently it was easy to contribute here in my country as population is a big concern in Bangladesh. Bangladesh Maternal Mortality and Health Care Survey 2010 was released in February this year which is worthy to mention as an accomplishment in health and population sector. The survey was conducted by the government covering 1,75,000 households with assistance from USAID, Australian Government Aid Programme, UNFPA, Measure Evaluation, ICDDR,B and NIPORT.

Why is it important to do such surveys?
Separate programmes in different regions carried out by the government organisations and non government organisations in the country are able to give an idea of any particular state of health and population to a limited extent. Such data cannot represent the entire country and might vary. Surveys at national level are vital, especially for a country like ours where we need to know where the problem lies to address it. And conducting national survey is a mammoth task as it requires a huge number of samples. Moreover, the methodology needs to be the same for a regular survey, the pattern of questionnaires needs to be the same in every case study, the analysis has to be accurate and the findings must be explainable.

If the government wants to curb maternal mortality, it has to know why the problem is occurring; the cause of the problem will shed light on the way out of it. Thus the findings of such research can advocate a policy direction in solving problems. Further, depending on the findings of such surveys new programmes and projects might be taken. Above all, promoting the survey findings helps to create awareness among people in health and population issue.

Bangladesh Maternal Mortality Survey 2010 (BMMS) shows a 40 percent decline of maternal mortality in the last nine years, what are the factors for this decline?
Bangladesh Demographic Health Survey is not enough to measure the ratio of maternal mortality in the country as it has a limited sample to survey on the particular issue. Again Bangladesh Demographic Health Survey is already covering diverse issues. Hence, to measure accurately the rate of maternal mortality at national level we needed a separate survey having a vast number of samples. The first maternal mortality survey in Bangladesh was conducted in 2001.The maternal mortality rate was 322 per one lakh live births in BMMS 2001 which declined to 194 in 2010.

For decades 90 percent of expectant women were having their deliveries at home, often they wanted to go to a health centre but did not get support from the household level or they did not want to go unless there is a complication; again they did not know where to get the delivery facility. Reduction of child marriage is another factor working behind the decline. I think, women are getting more aware than before and are willing to take health facilities if they are provided. Again, more women are getting educated than ever before and of course maternal health and mortality are becoming a talked about issues.

How can Bangladesh ensure that this decline is constant and be able to meet the United Nations' Millennium Development Goals (MDG)-5 targets?
MDG 5 (improve maternal health) is obtainable as we are seeing a decline of maternal mortality which is one indicator of improvement of maternal health. The 40 percent drop in maternal mortality ratio has taken Bangladesh another step forward. To achieve the MDG-5, the maternal mortality ratio should come down to 143 per one lakh live births by 2015.

Maternity health is not just about preventing the deaths of mothers while giving birth, having a sound health throughout their lives is crucial for mothers. Yet having the decline at an average of about 5.5 percent per year is a great achievement in attaining the MDG targets. But it is important to hold the trend of decline, and there is much more to do in this regard. The government needs to ensure the delivery facilities for the mothers at every nearby hospital and health care centre and ensure that a mother will get the required service whenever she needs.

Awareness must be raised on coping health complications in time. Most often mothers die because of preventable causes, for sheer waste of time. Taking space between two births can be another way to keep maternal health stable. The number of skilled birth attendants should also be increased.

Again, fertility needs to be reduced through effective family planning programmes because if a woman gives birth frequently she becomes vulnerable to maternal mortality risks. If family planning programmes work it will eventually lessen the risk of maternal mortality, improve maternal health and above all improve the entire health, population situation.

How does this kind of work continue to motivate you?
Doing a survey is definitely not enough. Getting the research findings is just the beginning of a whole new endeavour. We have a plan to have another survey next year on the urban slum dwellers and non-slum dwellers. Any research findings should be used at its best. The data must be used from the policy makers to mass people and utilisation of a survey finding makes it easier to adopt new schemes, to discard defective ones and to build public health knowledge. It is a great achievement when surveys like BMMS becomes the most talked about one, people wait for the findings to come out. Such eagerness generates new efforts to do new surveys.