Bitter Pills:Medicines & The Third World Poor | Page 23

CHAPTER2
UNEQUAL
DISTRIBUTION
"The public health services of the 67 poorest developing
countries, excluding China, spend less in total than the rich
countries spend on tranquilizers." (Dr. Halfdan Mahler,
Director General, World Health Organisation, World
Health Forum, 2(1), 1981.)
CHOR ASHARIDAHA is an island in the middle of the Ganges, just inside
Bangladesh, on the border with India. The island is really no more than a mudflat thrown up by the river, but, because land is desperately short in Bangladesh,
it has become the home of about 12,000 people. They are dynamic and industrious.
Everyone is up before dawn and working: the men labouring in the paddy fields,
the women straining over the monotonous task of husking paddy and the children
tending the animals.
The island is at the mercy of the river. Every year, at the time of the monsoon,
it runs the risk of serious flooding. As the water-level rises dramatically there is
nothing to stop the water breaking across the island, washing away the crops and
mud houses in its path. September 1980 brought a massive flood. Many people
lost their homes and, as the year's main rice crop was destroyed, most lost their
livelihood.
When this happens the poor landless labourers cannot find work, so they have
no means of feeding their families. The powerful in the community who have
their own land, suffer from the loss of their crops. But they have reserves to tide
them over, and by selling their rice at inflated prices they can even amass more
wealth at the expense of the poor. The landowners have little difficulty obtaining
credit to buy seeds for the next crop. But the landless have nothing to fall back
on. They are trapped in the day-to-day struggle to secure food and shelter.
For several days at a time the poorest go without even a bowl of rice. Amongst
the worst off are young 'widows' and their children, abandoned by husbands who
have left because there is no work. The health of the poor is seriously threatened
by both lack of food and the insanitary conditions in the villages. There are no
latrines or basic sanitation on the island and much of the water supply is
contaminated.
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