Welcome to Kam: Community health in Dhaka’s biggest slum

Around one million people live in Kamrangichar, the largest slum in Dakha. Kelly DeVore, a health promoter from the US, is at the beginning of assignment that will see her working with the local people to improve the health of this crowded community.

Some 400 kilometres from the sprawling makeshift settlements of Cox’s Bazar, where hundreds of thousands of Rohingya refugees are located, is Kamrangirchar: the biggest slum in Dhaka.

Here, you’ll find another story of what MSF is doing in Bangladesh.

In this densely populated slum, where small-scale factories and poor living conditions impact people’s daily health, MSF runs projects that are uniquely focused on occupational health, along with sexual violence and reproductive health.

Currently, two MSF clinics provide medical care to the women and factory workers in this area.

Welcome to Kam

To get to Kamrangirchar you need to pass through the busiest roads of Dhaka, where facing head-on traffic is inevitable and crossing paths with an elephant begging for money is somewhat probable.

Then, you will cross a bridge which was seemingly measured to be the exact width of one car and one rickshaw. Beneath the bridge is a waterless river, now filled with garbage, plastic-burning fires, and women gathering greenery.

Once across, you have entered Kamrangirchar, more commonly referred to in the MSF world as ‘Kam’.

One of the bridges into Kamrangirchar. Photo: Kelly DeVore

One of the bridges into Kamrangirchar. Photo: Kelly DeVore/MSF

Around one million people are thought to live in this 3.7 square kilometre area. A majority are here only temporarily, moving on every few months along with the ever-changing availability of work.

Every day, you can see how driven they are because people in Kamrangirchar never seem to stop moving - unless they are waiting for rickshaw-customers, taking a short break at the many tea stalls or going for prayer. 

With less space than people, what space there is can be highly prized. In response, buildings are built upwards, alternating factories on top of residences and residences on top of factories. Consequentially, the roads become thinner and traffic jams denser, but the lack of space does not seem to discourage people’s determination to move about.

Going door-to-door

I am the Health Promotion / Outreach Manager, and my team and I bridge the gap between the clinic and the community. This is accomplished through door-to-door and factory visits.

I have very warm and positive experiences from our outreach activities. During these visits, we gather small groups of women together and discuss the services MSF provides and the health issues they may encounter – focusing on violence and reproductive health.

An MSF team visits a house in Kam. Photo: Kelly DeVore

An MSF team visits a house in Kam. Photo: Kelly DeVore/MSF

On my first visit, the moment I entered a home with my team, smiles sprung upon the faces of two women who excitedly started ushering me into the small, dim, cluttered room, which they offered for our session. They kindly urged me to drink tea and eat with them. They gestured at one another and said in broken English, “We are your family, you are welcome”.

This act of kindness and generosity to a stranger, when they owned nothing, has been something that I’ve routinely experienced here.

Factory conditions

Beyond house-to-house visits, our outreach team also passes on health messages and promotes MSF services in the factories.

When entering the factories, people are still welcoming but the story becomes a bit dimmer and heavier. So too does the light and air.

Conditions inside a small factory. Photo: Kelly Devore

Conditions inside a small factory. Photo: Kelly Devore/MSF

As the outreach workers walk around the raw plastic materials, used to make everyday items such as flip-flops or metal bowls, the air is full of nearly-invisible particles that make it difficult to breathe. This is most profound when you enter the factory rooms where metal is being shined. It’s hard to breathe, and, when you leave, your eyes become agitated and red.

It’s painful enough as a visitor; how must the people who regularly work here feel, without gloves or eye protection?

In a future post, I plan to write more about the factories and the stories encountered shared by factory workers.