UNCORRECTED TRANSCRIPT OF ORAL EVIDENCE To be published as HC 1041-i

House of COMMONS

MINUTES OF EVIDENCE

TAKEN BEFORE

INTERNATIONAL DEVELOPMENT COMMITEE

 

 

DFID's Programme in Bangladesh

 

 

Tuesday 20 October 2009

DR NAOMI HOSSAIN and PROFESSOR DAVID HULME

PROFESSOR ANTHONY COSTELLO, MS SANDRA KABIR and MR BEN HOBBS

Evidence heard in Public Questions 1 - 75

 

 

USE OF THE TRANSCRIPT

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Oral Evidence

Taken before the International Development Committee

on Tuesday 20 October 2009

Members present

Malcolm Bruce, in the Chair

John Battle

Mr Mark Hendrick

Daniel Kawczynski

Mr Mark Lancaster

Mr Virenda Sharma

Mr Marsha Singh

Andrew Stunell

________________

Memorandum submitted by Dr Naomi Hossain

Examination of Witnesses

Witnesses: Dr Naomi Hossain, Research Fellow, Institute of Development Studies, and Professor David Hulme, Professor of Development Studies, University of Manchester, gave evidence.

Q1 Chairman: Good morning. Thank you very much for coming in to help us with this first evidence session on our inquiry into Bangladesh, which we are heading off to next week. I wonder, for the record, if you could introduce yourselves.

Dr Hossain: Good morning, I am Naomi Hossain; I work at the Institute of Development Studies at the University of Sussex. Previously I was working with the Research and Evaluation Division at BRAC in Dhaka as well as doing work for DFID and other donor agencies in Bangladesh on a freelance basis.

Professor Hulme: I am David Hulme, Director of the Brooks World Poverty Institute at the University of Manchester.

Q2 Chairman: We have a series of questions for Dr Hossain and a series of questions for Professor Hulme, but it does not stop you coming in if you think you have something to add - do not feel you are left out. Perhaps if I could start with you, Dr Hossain. Obviously, we have had democratic elections in Bangladesh in the past year, but you have given quite a lot of comments on the governance in Bangladesh. Would you bring us up to date as to where you think the country is following the elections and what are the main challenges that it is facing, and perhaps help us with the kind of thing we should be looking out for?

Dr Hossain: Sure. I am not sure how much background you have on the government situation in Bangladesh. Would it help if I give you a couple of minutes?

Q3 Chairman: Yes, it would.

Dr Hossain: Up until 2006 we were experiencing a 15-year period of multi-party democratic rule in Bangladesh, as you are probably aware. It was not a very liberal mode of democratic rule - there were lots of problems; there was a part-partisan penetration of state institutions and institutions of accountability, and the rule of law was tricky. So there were lots of problems with the kind of democracy that we had, and we had 15 years of it. During these 15 years the main parties alternated in power; so it was not that one party was in power the whole time. We had five years of the BNP followed by five years of the Awami League, followed by five years of the BNP. During that time an institution called the Caretaker Government was established - that was in 1996. That was after a somewhat botched attempt to allegedly rig the election in 1996 by the then incoming incumbent. The Caretaker Government is an innovation that uses the senior judiciary for a three-month position to oversee the transition to government, on the assumption that otherwise this will not happen smoothly in a free and fair way. This was constitutionally established in 1996. So that oversaw the 2001 election which had a major change in government, again. In 2006 it became clear that the incumbent government then was likely to want to stay in power and to be attempting to (allegedly) rig the Caretaker Government so that they would oversee an election which they were likely to win. Ultimately, through a long process which nobody really knows the details of, at the end of 2006 a military-supported Caretaker Government was installed but then stayed for two years in power, and attempted a series of governance institutional reforms. This was a non-party government with, I believe, quite a lot of donor support. The UN, at least, is widely believed to have been in support of this government. So these two years were a period of attempts to reform the governance and the political situation - party politics, internal party democracy - efforts to separate the judiciary from the executive. At the end of the two years, there was an election (so this was in December - the election we are talking about) and the Awami League then came to power with a good strong majority. Since then - so it has been about nine or ten months they have been in power - no formal assessment, no kind of regular data collection that I know of has taken place about what has been going on in governance, so far, so I cannot give you a very full and balanced analysis of what has happened so far. However, I have been back twice since then, so I have spent about six weeks in Bangladesh since this government's tenure, and talking to some of the analysts I know, people who have been involved with some of the governance assessment work that goes on regularly in Bangladesh, a couple of things are noted: one is that it does seem to be business as usual, so politics does appear to have returned to business as usual after this two-year period of attempting to clean up governance and politics; so it is not clear to what extent that has been very effective. It is very clear that the rule of law has deteriorated quite rapidly in the last nine or ten months, and some of the efforts at governance reform do seem to have been stalled or, in some cases, reversed. So this is the situation as people who are on the ground have been telling me.

Chairman: That leads directly to a question that John Battle is going to ask.

Q4 John Battle: In Bangladesh, as part of the government's reforms that DFID here have been involved with I think they put together a paper called Country Governance Analysis, and I just want to know what you think DFID could do to improve the accountability of state institutions. There is an attempt to get projects government support but that implies that we get good governance. How effective could DFID be and what should it be doing? What specific institutional reforms do you think donors should be pushing for? Should it be the rule of law; insisting that the judiciary operate properly, or policing? What are the things that DFID should be engaged in and, perhaps, are not?

Dr Hossain: I think, before we get to the specific institutional reforms, there are a couple of things that you may be interested to explore a bit more closely with respect to DFID's work in Bangladesh. In particular, the best rule of thumb, before you go to do anything on governance intervention, or development intervention, is to do no harm. I am not saying DFID did do harm in this case but I think it is worth exploring the extent to which donor support for the Caretaker Government - from the military ranks - non-democratic Caretaker Government over the two-year period, did, in fact, lead to pro-poor outcomes and good governance outcomes. I think that remains to be seen. Sometimes donors do intervene without necessarily understanding the political history, and so on, and I think that is very dangerous. That would be a general point about when to intervene and when to find out, really, how you should be responding. I am not saying there was an easy answer at that time; there was not an easy answer, at that time.

Q5 John Battle: Can I press you to say: would that view - that people are not being helpful about governance - be the view of the government, or the rulers, or would it be the view of the people? So that, if you like, the donors are seen to be in bed with the governing set and against the people. Would they be seen as on the side of the people and popular with the government?

Dr Hossain: I am an academic so I cannot say it is going to be that clear-cut, obviously. I do not really know the answer to that. I think a question it would be interesting and important to explore is the extent to which DFID's support (I think DFID gave the appearance of being supportive, anyway, of the Caretaker Government during its two years) contributed to a weakening of the democratic process, and so on, or not. Perhaps it was very supportive. I do not know the answer; we do not know. Not much detail is known of what went on behind the scenes at that time; we are fairly certain the UN was supportive of this military-backed Caretaker Government, and with good intentions.

Q6 Mr Sharma: What is the role of the opposition at present?

Dr Hossain: They are very weak and they are very small in numbers; they are very fragmented - the main opposition party, the BNP. A lot of them were in jail and are, again, in jail. The former Prime Minister, Khaleda Zia, is still the leader of the party but they are in quite a lot of disarray. The same could be said to be true of the ruling party, though; they are quite fragmented, at present.

Q7 Mr Sharma: Are they working in the Parliament or the Assembly?

Dr Hossain: Yes. They are very small in numbers this time, so it is not clear to what extent they can have much impact.

Q8 Andrew Stunell: You have obviously got some reservations about whether DFID did it right or not, and in your report you said some quite stringent things about them: "Even committed professional staff" (in DFID this is) "lacked adequate time to engage with the evidence, travel beyond the capital city, or to develop the relationships necessary for a rounded and fully-informed perspective ..." That is, in terms of reports that we get, quite strongly put. Would you like to, perhaps, elaborate that a little bit and say what you think we might be looking for and what assessment we might make?

Dr Hossain: Actually, for some other purpose I was looking at the 2005 internal DFID evaluation, and there they said very similar things; that it was increasingly difficult for Dhaka-based DFID staff to find out what is going on and to spend time on the ground working out what is going on with poor people. There is a strong emphasis on the sort of upstream policy work, which has continued. I would say, primarily, you have very few numbers of, especially, UK-based staff in the Dhaka office, and that those numbers seem to be dealing with ever larger sums of money. I was living in Bangladesh between 2003 and 2008 and I did interact with quite a lot of different staff professionally and, also, to some extent, socially in that time. My sense was that it was increasingly difficult for them to get a good grasp on what was going on - they just did not have the time. They had all these large sums of money to handle. Not having the people was a real problem for them, and DFID did have, earlier on, in the early-2000s, a very positive reputation in Bangladesh among the other donors and among the NGOs with whom they work of really knowing their territory and really knowing their subject - knowing what is going on on the ground. That reputation has, I think, declined somewhat.

Professor Hulme: If I can just answer that, I agree with Naomi there; there is a process that has been put in place. DFID staff are being reduced, its spend is being increased, so the spend per staff creates pressure, and governance projects are extremely messy, extremely time-intensive and you do not spend very much money on them. So the way that DFID is being steered overall, as an institution, makes it quite difficult to have staff who know what is happening in the field. One of the things I would encourage you to look at is the turnover rate of DFID staff. My perception is it has gone very high over the last three or four years; when I called into the office I always knew several people, I find nowadays it is a lot of new people. Some stuff you can be briefed on but the governance stuff, in particular, you need someone in the field.

Q9 John Battle: As well as, in a sense, the autopsy of where we are up to now, we are going to be there soon and I would be interested to know what focus DFID should have now on institutional reform, given that we have to ask for the resources and the funds to do it properly. What would be your priorities now, with the new government, in terms of institutional reform?

Dr Hossain: I think a lot of work DFID does is on the button, in general. In terms of the sectors they have selected, the public financial management (which is not an area I know a great deal about), that has been a good area and it has had some positive achievements. I think I said in my note to you that I thought human security was an area that desperately needed attention, and I know DFID have been involved with the UNDP police reform programme. Let me just talk to you a little bit about the focus and the kind of approach to that that I think is interesting. DFID's approach to governance is, typically, and for very good reasons, always from the perspective of: "Well, we have these formal institutions of accountability, we have these formal institutions of service delivery, and let's work with those and see how they work." One of the points I tried to make in that note is that when you look at governance you have to take into account that it is an extremely poor country, and there are two reasons why this relationship between governance and poverty are really important. One is - which I think it is always important (I think it really should be the litmus test of good governance in Bangladesh) - how are the poor being affected by governance reforms? The second thing is, actually, you need to think about how governance is affected by poverty. The fact is we are talking about people who are very poor; typically, still 40 per cent, I think, illiterate. People find it very hard to engage with formal procedures of accountability, and so on. So to think of starting your governance reforms at the level of "Well, let's sort out the police" is not necessarily the correct approach. You could approach it very differently, by how are ordinary people already coping? What are poor people already doing to ensure their own human security? I think this would produce an entirely different menu of options for institutional reforms.

Chairman: Just before bringing in Mark, you have both identified the staffing pressures, which is an issue that concerns us, not just for this report but in doing any report. If either of you feel able to give us a slightly more substantial note about the practical implications of those staff shortages in Bangladesh, I think we would appreciate it. If you could give us a fuller note on that, practically about what the effects are, I think we would find it helpful.

Q10 Mr Lancaster: Perhaps we can build on that comment, where, effectively, you are saying that some of the formal accountability processes are quite weak - a weak opposition, for example. However, you also make the point in your note that some of the informal processes are very effective. So could you, perhaps, give us some examples of those informal processes and why they are being so successful?

Dr Hossain: I think the point I was trying to make was not so much that informal accountability pressures are effective but that they are what happens, because formal accountability mechanisms more or less fail. Most of my experience with this is in the area of public service delivery; like David, I work primarily in the kind of poverty governance interface, so I am interested in how poor people access public services. There, all of the formal systems of accountability are, more or less, defunct, and there is almost no question of them working. For example, if your doctor has been rude or is absent, there is almost no way you, as a poor person, can complain about that and get any redress. An example would be that you can, however, get your local patron - your village head-man, or whatever you have - to come along with you and try to exert that level of pressure to get services. We have seen that sort of thing. People use social pressures of all sorts; sometimes the local schoolteacher will be your relative or your neighbour and so you can put pressure on them that way. These sorts of informal pressures are very powerful in a context in which formal mechanisms do not work. It is quite common in Bangladeshi health centres, where patients die, for there to be violent outbreaks of riot or protests, and so on, so that also happens - these sorts of pressures. They are not desirable, but that is not what I am saying; I am saying this is what there is in the absence of effective, formal accountability mechanisms.

Q11 Mr Lancaster: You would not like to see, for example, DFID or other donors supporting these informal processes; you would rather them try and battle their way through in the formal processes?

Dr Hossain: As I said, I think in a context in which the majority of the population are poor and illiterate and probably do not really have much experience of engaging with state institutions, it will be really important for you to understand how they do, in fact, engage - how they do, in fact, attempt to get accountability from public service providers. However, using that, I think, it would be quite a useful way of developing performance accountability measures. You could use them in quite a technical way to help develop more effective monitoring systems for public service providers. I think without understanding how those things go on, however, you would never design an effective governance reform.

Mr Sharma: I do sympathise.

Q12 Mr Singh: You argue, and so do others, that there is a link between good governance and poverty reduction, yet in Bangladesh there has been some success and some gains in social and human development. How do you account for that in the absence of good governance?

Professor Hulme: If I may start off with that. You have to watch out for this myth of good governance; yourselves accepted that good governance is something which most countries are aspiring to, still, and, in a way, good enough government is what one is trying to get to, at this stage. It is extraordinary in Bangladesh how imperfect the processes of governance are but those processes have been sufficient to allow the private sector to invest and improve its productivity and create jobs and to allow the voluntary sector to function, and to allow parts of, certainly, local government and parts of the civil service to function. In a way it is how to move towards this "good-enough" governance.

Q13 Chairman: That rather reinforces the business view that the less government there is the better. So anarchy is fine for business and investment.

Professor Hulme: Not at all. I am not a macroeconomist but the macroeconomic policies that have been in place in Bangladesh for the last 15 years have allowed the economy to grow, far from what many economists would prescribe as the best set of policies. There has been a degree of stability which has worked there. So, in a way, that element of governance has worked reasonably effectively.

Q14 Mr Singh: To what extent, in terms of social development and infant mortality rates, etc, is that down to good or very good NGOs and their service delivery?

Dr Hossain: Part of the explanation is, certainly, the big NGOs are delivering very effective services, but that is definitely, by no means, the full story. Government service delivery is also important for this - there is no doubt about that. You have put your finger on something really important, which is we do not really understand what happened in that period in the 1990s, up until the early/mid-2000s, when Bangladesh had a lot of great achievements in human and social development, while governance was not improving, including at the sectoral level. It is a really interesting question. I think part of the answer lies in these issues that I was talking about with respect to informal accountability. Stuff goes on on the ground that we do not really have a good handle on because our gaze is always at this level of the formal accountability mechanisms, which are just defunct. So if we lower our gaze a little bit and look at what is going on at that sort of frontline level, it does help a bit to understand. The World Bank has some explanation for it; they say - what do they call it, when you have institutional cherry-picking - you have a few pockets of excellence, pockets of success. I do not think that is the full story either. There was also a very strong social demand for, for example, women's education, possibly resulting from, among other things, a demand for garment workers. What that has meant has been that more educated women has, of course, knock-on effects, as we know, for infant mortality and the demand for children's education, and so on. So there have been a number of factors. Nobody knows the full story.

Professor Hulme: If I could just add, it is as Naomi is saying; being academics we say everything is complicated but these informal processes - it is not that they do not work, but they do not work like the rulebook says they should be working - there are norms in that, and resources are pilfered and not used properly, but there are limits on that, and if people start giving old-aged pensions not to old women but to men who are not of sufficient age then the social sanction comes in, and that will not be allowed and the local government will stop that. People may be able to slip 10 per cent of the food aid programme but if it gets to 20 per cent then, again, some informal processes of governance will kick in; the formal system may not be working but there are boundaries. So it is never anarchy; it is not the way it is supposed to be, but it is not anarchy, and there are social norms which, if people go past them, will kick in. The most concrete example I can think of is an old woman getting a pension where the chairman of the local parish was taking a commission on it. Another member found out and she said: "I'll tell everybody that you're stealing from old women", and so he stopped doing it because he did not want people to know that he was stealing from old women, and so she gets a full pension now. These processes are operating in their own way.

Dr Hossain: I think these are the sorts of things that, with some exploration and some careful work, could be supported more effectively than they currently are.

Professor Hulme: Rather than looking at the rulebook and it not working, if DFID staff could spend time trying to work out could more councillors be concerned about pensions.

Chairman: We may explore that a little bit more in a moment.

Q15 John Battle: I think the next question is the extent to which the basic delivery of services (you hint at it there) are undermined by the government, in a way, by accountability. For example, in which sectors would you say the provision of parallel services by NGOs, who are trying to provide services, actually undermine what the government should be doing, so we do not get this balance at all and the government starts to provide properly, but they are always on the margins trying to check what everybody else is doing? Is that what you are saying is happening? You gave the example of the pensions - not to go into that example - but to what extent is that delivery of basic services actually undermined by the efforts of NGOs then?

Dr Hossain: There is, undeniably, that danger. I have not, actually, seen any evidence in Bangladesh that that has happened. I think, especially with the big NGOs and the big programmes of social service delivery - health and education and so on, and microfinance, perhaps, in particular - on the whole, the NGOs appear to me to be supplying services in areas where government is not supplying services, and supplying services that government is not supplying; chiefly, non-formal education in areas that government cannot or will not reach - the groups that government cannot or will not reach - and certain sorts of health services that government cannot. Also, I am thinking, in particular, of BRAC, which is the NGO I know best because I worked for them for five or six years. A lot of the time their health programmes, in particular, were partnerships with government, and so you had quite effective joint working around issues. Also, I think, in some cases, with respect to education, there was some extent to which there was a kind of positive competition which arose around the education of the poor, in particular, where BRAC had reached villages and communities that the government were not reaching. This was something of a spur for government to expand its service delivery, which is primary education, basically. I do not think, in a country like Bangladesh, where there is so much unmet need, that there is much evidence that NGOs have undermined public service delivery.

Q16 John Battle: If I put it another way: I have never been before to Bangladesh but the impression that I have got - not that there is much to go on - is that some of the popular participation in the best sense is some of the best in the world. If people are not getting resources from the centre they have got to survive, so they have built up some form of informal institutions to deliver. I think, as a politician, as it were - and I am going to take the power back off them - they have got the power, they are doing it now, so I would resent them, in a way, doing that. I know that I cannot cut off their livelihood but, at the same time, I find a tension between what was going on on the ground, yet, at the same time, if I was a slightly more progressive politician, I might say that model of doing things might be the right way to do it and it might be a good model to use elsewhere.

Professor Hulme: I do not know about using it elsewhere but the NGOs do work very effectively in Bangladesh, and one needs to work with what works, not look at the models - ideal models - of how government should function. So we need to work with the NGOs and keep them on. I used to worry about them displacing the Bangladeshi state but I do not really do that now because there is so much need. They are an incredible resource; they do create new organisational technologies and new products, like microfinance, like low-cost education. The government is not taking that on now but it could take it on in the future. There are hundreds of thousands - maybe a million - of pretty good staff working for them; that is a resource which the government and the private sector does draw on, at times; it pulls them in. So, theoretically, there is that undermining but, in practice, I see the NGOs as part of Bangladeshi's evolution that will be positive.

Q17 John Battle: If I put the question the other way: which areas of policy or services should the government focus on because the NGOs are delivering in that other area? Do you know what I mean? Is there one area that government should be focusing on because the NGOs are picking up the policy area?

Professor Hulme: Infrastructure. The NGOs cannot do big infrastructure; it is really important that the government does that well. The other sorts of problems remain: health and education. I think we would look at social protection. While the NGOs are moving into social protection, could they take on social protection on the scale that is required? Infrastructure, health, education and social protection.

Q18 Mr Sharma: Crime, violence and insecurity are the major issues in Bangladesh. What forms of insecurity are experienced by ordinary people and why are women more frequently the victims of crime and violence?

Dr Hossain: It was only very recently, in the last few years, that this has really begun to emerge. Bangladesh is not known as a place where there are high levels of crime and violence, apart from political violence. In fact, it is testament to DFID's ability to pinpoint important issues that they did start to do an analysis of human security first, and to support the work of Safer World. Safer World also produced some human security assessments. I was involved with one of those - we did a very large survey of experiences of crime and insecurity and violence, and it is at quite a low level, was what we found; quite low-level but chronic threats of theft and minor forms of violence, and so on. To be honest, domestic violence is, probably, the single greatest human insecurity threat that people in Bangladesh face. The WHO has also done work on this in Bangladesh - women-based violence from their partners is among the highest rates in the world. It seems like such a very simple conclusion to draw but, actually, I think it is probably the greatest source of insecurity. What is interesting about this, and what is important about this (not easy to capture for policy purposes) is the fact that, to some extent, it is not so much the experience of crime and insecurity as the response to the threat of crime and insecurity, or violence, that seems to be quite important; the way people cope, the way women's mobility is curtailed because people are frightened that they will be abused or, you know, beaten or raped; the way people fail to invest in their businesses and their livelihoods - these sorts of things. I think the evidence is only beginning to emerge that that adverse coping is something that is difficult to explore but it seems to be the response that is most troubling.

Q19 Mr Sharma: What are the informal mechanisms and institutions which can help protect people from violence and crime? How should donor programmes aimed at justice sector reform take these into account?

Dr Hossain: Again, as I responded to you, I think it is useful in a country like Bangladesh to approach governance from the bottom up, from how people experience these things. A lot of work has already gone on in Bangladesh over the years on the customary dispute resolution - what they call the "Shalish" - the village-based systems for resolving fights and problems. These are typically around land and marital problems - typically, around 80 per cent of them, or something like that. DFID has done quite a lot of work supporting the NGOs who have been working in this area; NGOs have come in to try and make things a bit fairer - things are very traditional and, in some ways, quite biased against women, against poor people and against minorities and so on. So the NGOs have come in in quite a big way. There is another aspect to it which has not been explored much. Again, this work that I was involved with, in looking at crime and insecurity, uncovered what they call Bahara (?) Committees. This is very well known - anyone you speak to will know what a Bahara Committee is; it is just neighbourhood watch, basically - but these seem to be very, very common. We found something like a third of all the respondents in our survey knew of such a thing in their community. When we asked people how they responded to incidents of crime and violence, and so on (I forgot to get the numbers out for you), they were greatly more likely to approach people in their community for help or their neighbourhood watch or their local patron than they were to approach the police for help. These institutions are there, and this is not only in Bangladesh that we are discovering that informal institutions are very powerful; the evidence is emerging that this is the case, I think, with respect to policing.

Q20 Mr Sharma: Is that at the village level?

Dr Hossain: Yes.

Q21 Mr Sharma: Is it a lower democratic process, tribesman (?), or is it a Godfather in the village?

Dr Hossain: Yes, well, this is where it gets tricky; they are not necessarily very nice institutions.

Q22 Mr Sharma: I thought as much.

Dr Hossain: There is a fine line between a community informal security arrangement and a vigilante group. No, there is not a very fine line, actually - they are almost the same thing. In the urban areas it is what they call the mastang, which is a kind of Godfather - or local gangster - but, actually, local leaders. There is a real ambivalence about whether they are really nasty or really nice.

Q23 Mr Sharma: The local leader as well.

Dr Hossain: Yes. So those are the people who are really in charge there. You know lots about this.

Professor Hulme: Certainly the difficult thing in urban areas is you have the mastangs who are probably providing security and managing things and might even get involved, maybe, in domestic violence if it gets too extreme, but in a way they may also be involved in a number of illegal activities, so it is very hard to see how any donor could actually work with them. In an ideal world one would get the mastangs to behave better - do a little bit less corruption and do a little more justice - but, in practice, a donor's role in that would be pretty difficult to imagine.

Q24 Chairman: You mentioned particular insecurities experienced by women. To what extent are women getting organised? We hear of specific examples of Bangladeshi women who are organising themselves. Is it a significantly growing phenomenon that women are getting organised to stand up for themselves? Are there strong women's movements?

Dr Hossain: Yes, the women's movement is quite strong in Bangladesh. I cannot think of anything specifically organised around violence. Of course, there have been movements in support of a women and children's act in the late 1990s/2000. I do not really work on the women's movement but they are, yes, quite strong. Specifically organising around domestic violence? Possibly not.

Professor Hulme: It is very complicated. Interfering with domestic violence, as in the UK, is seen as something that people should keep their nose out of. We find that women are, in a way, supporting other women against this, but then the mother-in-law is quite likely to be saying: "My son should beat his wife sometimes", and women will have different opinions about it and older women will have different opinions.

Dr Hossain: The big problem is dowry; dowry is very closely related to violence against women. The trend of dowry used to be, in Bangladesh, one, it is specifically "bride price" so the payment goes to the bride's family but in the last 40 or 50 years it has reversed so that you are, essentially, paying for husbands now, and it causes a lot of problems. Dowry is very closely related to the violence. The World Bank did a survey on gender norms - was it last year or the year before? - a very good report on how gender has changed a lot on domestic violence, and I suggest you see that on dowry as well.

Q25 Chairman: Thank you for that. This is more your question, Professor Hulme, but, Dr Hossain, feel free to come in if you have something to add. On the economic issue, one thing that has been impressive, in spite of all this background, is that Bangladesh has sustained quite a long period of economic growth, but poverty is still very significant; there have been some reductions but it is quite significant. How do you explain that combination: the extent to which growth has been sustained but it has not really translated into significant poverty reduction? Are there any changes taking place underneath?

Professor Hulme: I think you have to recognise that Bangladesh came from a very low base; it had incredibly high levels of poverty - much of that was extreme poverty - and there were extraordinary levels of vulnerability and under-nutrition. So, in a way, progress has been quite remarkable over the last 15 to 20 years ----

Q26 Chairman: So you actually say it was a success, it is just that the absolutes are very low.

Professor Hulme: It is a success but it started from a low base, and 5 per cent over 15 years is not enough to eradicate poverty; you need 30 to 40 years at this rate or you need a faster rate of growth, but the achievements have been considerable. Particularly, whilst insecurity and vulnerability may be a bit later, the threat of famine and coping with devastating floods - the capacity to cope with that now - in a way, is great; it is a poverty problem, not a starvation problem, which back in the 1970s and 1980s was the way it was.

Q27 Chairman: Which are the groups that are most vulnerable? Is it geographical or is it sectoral, or what is it?

Professor Hulme: It is really messy and mixed. If you look geographically then the old analysis used to be that the North - and what are called the monga areas - are particularly problematic and the South is doing better. The most recent work suggests, actually, that it is the west of the country - Khulma, Barisal and Rajshahi - where you have got the highest levels of poverty and some of the most extreme poverty. Nowadays people talk about the West-East divide and, again, the sort of detailed work by the World Bank actually started that out, which is available ----

Q28 Chairman: What are the reasons for that?

Professor Hulme: The reasons for that are several, partly because there are two big rivers you have to cross to get to the West, and even though we have got the Jamuna Bridge now that still isolates the West from the sort of dynamo of Dhaka and Chittagong, and from the sort of connections with the global economy. The West is disconnected from that. Historically, because of disconnection, it has just got lower levels of infrastructure - roads, electricity, schools, health centres, are all at lower levels. Private investment is not occurring on that side the way it is on the East. Also, for social and historical reasons the Diaspora from Bangladesh does not come from the West, so remittances tend to flow to Dhaka, Chittagong and do not tend to flow to the West, so the West is disconnected. Added to that (and it is a problem for the whole of the country) is the Indian border that is, economically, relatively non-porous. The amount of trade that could occur with India, because the two countries cannot agree on trade arrangements, are limited. So the west of the country has got a difficult border with India and then there is a sort of semi-border because of the rivers and the history with the east of Bangladesh. Beyond that, you have also got life-cycle factors that are spread around the country; young parents with several children find it hard, particularly if anything goes wrong; older people may be left insecure, and there are high levels of vulnerability to shocks. Sometimes the dramatic natural shocks, the floods, and the cyclones, but, also, particularly, health shocks can often set households back, and if you get a natural shock, a health shock and then something goes wrong with your job, then households can very rapidly fall into poverty, and although the economy might be working well they will be finding it very hard to get out. Most recently there has been a food price spike, which has certainly set back, probably, millions of households in Bangladesh; it is impacting on everybody but food prices have gone up the most at the bottom end of the market, for the coarse grains.

Q29 Chairman: Is that still biting or has that eased off?

Dr Hossain: No, it is come down a lot.

Professor Hulme: It has come down, but it is still 20-30 per cent above what it was 18 months/ two years ago.

Dr Hossain: It is still much higher than it was in 2006, yes.

Professor Hulme: The spike has gone but food prices have risen more than wages.

Dr Hossain: I think it is quite volatile.

Professor Hulme: In rural areas, people who are landless, female-headed households, will generally be much more likely to be poor or extremely poor. In urban areas the labour is female-headed but it is much messier in urban areas. We know a lot less about poverty in urban areas than we do in the rural areas, where things are somewhat easier.

Q30 Mr Singh: Bangladesh has an ambition to become a middle-income country by 2021, but given the global recession and given the impact that that is going to have on remittances and Bangladesh's ability to export, or afford imports, how do you see the economic situation developing in Bangladesh over the next few years?

Professor Hulme: I am not a macroeconomist, I am a self-trained economist who takes a look at Bangladesh, but the difference between economists and fortune tellers over the last 18 months is sometimes not very good. There is actually an American economist who says that economists are an arrogant bunch with very little to be arrogant about. Bangladesh has had a knock because of what has happened to the world. If one makes the assumption that growth will continue in China and will continue in India and that the financial system will somehow be repaired, then I see Bangladesh as steadily growing over the coming years, as long as there is not some sort of governance crisis; as long as it manages to have this "good-enough" governance that allows the private sector and just human agency at the grass roots to operate. I see Goldman Sachs still keep Bangladesh as one of the next 11; they see it as one of the emerging nations of the 2040/2050 period in the future. There are three main issues as to whether it will make it: one will be on the capacity of its businessmen to move beyond garments, beyond shrimps, beyond the fishery sort of products into electronics and other areas, and whether they have got the ability to do that and whether China will be able to, in a way, dominate the world economy on that. Twenty years ago people did not think that Bangladeshi entrepreneurs had the capacity to do what they have done, so I think that is quite possible. The important thing on the poverty front is whether the growth continues to be relatively egalitarian. I differ; the World Bank says that the growth has been spread across the whole population; I think there has been some increasing equality but it has not been as much, probably, as in India and China, but if the growth could remain reasonably broad based then that would mean it impacts on poverty rather than simply creating a middle-class and elite. The real joker in the pack, I think, is climate change. Bangladesh, probably, is going to experience climate change more severely than any other nation. It depends on which sort of scenario you take with it: we have the Tyndall Centre at Manchester who tell us that 2 per cent is guaranteed, which means, certainly, that 20-30 million Bangladeshis will have to move, but as the Tyndall Centre says: "Three or 4 per cent is what we will be moderating to", but other climatologists say: "No, they are being too alarmist". That parameter is the very important one. If climate change does not kick in too badly, if China does not manage to dominate all world manufacturing, then I would see steady rates of growth so a middle income country, perhaps, sometime in the late-2020s.

Q31 Mr Singh: Are there any significant barriers to private sector development in Bangladesh?

Professor Hulme: Yes and no. The businessman will say to you: "The bureaucrats and the politicians are our best friends because they help us make things work and our worst enemies because, at times, what they are doing does not allow us to compete with China and Vietnam." It depends. There are some with trade, but the one that sometimes comes up with me is health and education; in some sense saying, you know, if the Government could just move on to getting health and education to work then that would give us a labour force that will allow us to compete with China and Vietnam.

Dr Hossain: The barriers to doing business in Bangladesh are not that great compared to other places. You know the World Bank does that survey every year, and Bangladesh fares quite well compared to some places. The port has historically been a significant obstacle. That has been improved a lot, actually. That was possibly one of the things that the Caretaker Government helped to sort out and that could, potentially, deteriorate again under a political government. The big thing has always been the power sector. It is not so much a state barrier but it is the inability of successive, political governments to invest in energy infrastructure. It is really, really difficult for most industrial production to operate because of power. Land is also a problem as well - access to land to develop plant is also very difficult. So those things, really.

Professor Hulme: If Chittagong port was allowed to work as it could do then that would really allow the private sector to operate much more effectively than it does.

Q32 Chairman: We are going to be looking at the Charls Livelihood Programme while we are visitors in Bangladesh. What is your understanding of how that programme has helped - or has it helped - to reduce poverty? Does it have scope for further development?

Professor Hulme: I have not looked at a recent evaluation; did look at it when it was being set up - I have got a PhD student working on it at the moment, but it is more on hearsay than detailed knowledge. First of all, I have to say I was really pleased - actually, proud - that the UK and DFID worked in the Chars because if the government keeps away from the Chars, even the most committed NGOs keep away from the Chars, then the private sector keeps away from it. DFID decided to work in extremely difficult, physical circumstances ----

Q33 Chairman: Is it because it is so vulnerable and volatile?

Professor Hulme: It is so vulnerable and volatile. As a rule of thumb, on average, your island will disappear every six years, so your whole asset base has gone. You then have to retreat to the shore and then re-establish. However, that is on average; for some people it is every two or three years, for others they may spend 30 years on an island. It is an extraordinary environment.

Q34 Chairman: Ministers and officials from DFID have quoted this programme to us as an example in a number of different contexts, which is one of the reasons we want to go and see is it really as good as it is cracked up to be. For example, this business of raising houses up on plinths - well, that is all very well but if your island disappears your plinths are not going to be of much use. How practical, how successful, is that in actually securing longer-term stability and what other measures are involved, if you are trying to compensate people for losing their livelihood and re-investing it and for all the other insecurities that go with it?

Professor Hulme: On the plinths, certainly people who have got plinths when it floods and their house does not flood because the plinth has given them enough space, they appreciate it very much! On plinths, you are putting, in a way, an asset there of which probably a high proportion will be destroyed, so you would have to work out whether it is worthwhile. I think that is where probably you will need to look at the detailed evaluations, if they have been done. The livestock development certainly appears to work extremely well. People appreciate it. I was amazed at the way that private traders have come into the Chars and you have got a milk purchasing operation, entirely informal networks, that are coming in and going round the islands purchasing the milk that women have produced. So it has actually increased the resource base like that. Whether it is really worthwhile, I think, one needs to look at the short-term parameters. The key issue will be whether it actually manages to strengthen some of the institutions. It is meaning the areas are getting more, potentially, knowledge and understanding; there is some newspaper coverage now of life in the Chars. So, in a way, it has actually helped the Chars to enter Bangladesh and be recognised more fully, but those changes are obviously much slower than the sorts of promises that aid programmes make.

Q35 Chairman: I do not know whether it is a helpful follow-up question, because we are just about to publish our report on urban poverty and slum development - if you want to call it that. Dhaka is said to be one of the biggest cities in the world; is there anything from this Chars programme, in terms of protection intervention, that is transferable to an urban environment?

Professor Hulme: Not the plinths; in urban areas you do need to get things higher but you have to think across a whole community and ward, not against individual houses. In terms of promoting micro-enterprise and self-enterprise, to be honest, the Chars Livelihood Project took lessons from BRAC's Ultra Poor Programme, in terms of going for these asset transfers. So if one was looking, I would be saying look at BRAC and the other NGOs to be having experiments. The Chars Livelihood Project is managed by a high-cost, international consultancy company with high-cost, expatriate staff. So if you were looking for lessons for urban areas I would be looking at how you could get the NGOs to create those lessons.

Q36 Chairman: Is that its problem, that it is high-cost, or could it be taken over by the local community?

Professor Hulme: Certainly, in a way, introducing the cows and the milk industry is something which is being copied. People who have got resources now will think: "I'll get an extra cow next time and I'll move into that", so, in a way, it is diffusing through the market anyway. The Chars Livelihood Project is a project; the NGOs are institutions, they learn and develop things over time. As soon as the money stops on the Chars Livelihood Project most of the people will be going, so it is the NGOs that you have to look for and/or government agencies (if you can find ones that are functioning well) to come up with these things. I think the urban frontier is really important. I know BRAC are looking at it, but I have been encouraging BRAC to try and learn a bit more because the rural-to-urban transfers are extremely difficult - it is a different world.

Q37 John Battle: I think DFID funds some of BRAC, but it is this notion of the trickle-down theory of how do you get to the poorest of the poor. I get the impression that BRAC has this programme for Targeting the Ultra Poor that cannot be reached by other programmes, but who, though, are the main participants in BRAC's Targeting the Ultra Poor programme?

Professor Hulme: It is not trickle down; BRAC goes straight to ---

Q38 John Battle: No, I meant in an economic, normal system, which might not reach the people it ever needs to - it is the Heineken theory of economics; it never reaches the poor. However, underneath what we might define the poor are the ultra-poor, and you seem to be going there when others do not. Is that programme working, really, is what I am asking.

Professor Hulme: Yes, certainly everything that I see in the field, read about it (and I also had a student studying it) suggests that it really is achieving its goals, quite extraordinarily. It is largely going to female-headed households - often women who have been widowed or divorced - and the processes by which they are selected are extremely intensive, but BRAC seem to be able to operate them at very low cost. You get community assessment and then you get a technical assessment and, usually, there is an agreement. If you visit there you can often see - the women are stunted; physically, you can see that these women have had different lives than average poor people, if one uses that awful term.

Q39 John Battle: What, as it were, are the kind of essential differences with the other social protection programmes that you might see round the world? They seem to be still based on the trickle-down reach them model. What is going on differently, or have I missed ----

Professor Hulme: BRAC is being looked at, and the Ford Foundation and the Consultative Group to Assist the Poor are looking at replicas in other parts of the world. In a way, it has challenged things conceptually because it has put together social protection with enterprise promotion and with this idea of an asset transfer - people need to have social protection to stabilise their lives; you have to give them a resource because they are asset-less to such a high degree, and then they need, in a way, support to develop a micro-enterprise. So conceptually it has done that and then, practically, it has managed to do that. It has trained large numbers of highly motivated staff. I have been to the offices where the staff are and they are often in parts of Bangladesh that are not regarded as good postings and you are not well-paid but you have high-morale staff trying to deliver. Practically, BRAC has had the capacity to look at poultry, look at ducks, look at cows - even look at small-scale trading and work out which enterprises can work.

Q40 John Battle: It is likely it is highly interventionist, then, and personal almost, but is it, in fact (back to Naomi's concept, really), building in the capacity from it to be a base upwards development?

Professor Hulme: I actually joke about conspicuous investment - particularly academics in the USA and people in the USA are worried about welfare dependency, but when these ultra-poor women (and it has gone well for four years, which it often does) you actually find that there are two sort of mud plinths that have been made to put the food on for the cows - they have actually gone from one cow to three cows and they are renting some land in. It is at a micro-level but there is a whole sequence of planned things and it really gets these women planning how they are going to turn a dollar into two dollars and turn two dollars into four dollars. That might take a month or two but they will plug away at it.

Dr Hossain: Can I add to that because I did work on that programme when I was in the BRAC Research and Evaluation Division, and there are two other things I would add to what David has had to say. One is that the programme is designed to enable people to graduate - they call it - into regular microfinance programmes, so that these women who were too poor, initially, to actually be in regular microfinance programmes because they just did not have the capacity to repay loans, after a period of a year/18 months/two years they are expected to be able to graduate into getting regular micro-finance along with moderate poor people or non-poor people as well. That is one aspect of it. Another aspect of it - and this is why the CFPR - BRAC's Ultra Poor Programme - is quite distinct from the old CLP programme. This is that BRAC has this sort of 35-years of experience. It adapts its programmes very fast on the ground very effectively, and one of the things it did, as soon as it established itself for poor programmes it realised that these women needed some extra help, and the staff could not supply it, so they organised these committees of local village elite to support them through this, to become mentors, to be providing them with security and so on, and so forth. These, I think, have had a little bit more of an institutional building effect. They have also been organising the women into women's groups interested in local governance issues; interested in these issues that David is talking about, like when you have government social protection schemes, monitoring who is getting it, and that sort of thing. So they are having a bigger impact; it is not about giving them cows and then going away.

Q41 John Battle: One question I was going to ask is what we are learning from the BRAC programme, but I gather other people are seriously interested in it now, and I wonder if I could trouble you if there were some recent evaluations, if you could reference me the evaluations so that I could read them. My attitude to development is that we probably learn more from what is going on elsewhere than in inner city Leeds and I am looking to see if we can have a kind of BRAC programme in inner city Leeds. That is why I am interested really. There are parallels in what we can learn from a mutual exchange of where things are different, and this scheme strikes me as a very different kind of approach and if there is serious interest by donor institutions we might make a bit of progress.

Professor Hulme: I have just written a report on that which we can send to you.

John Battle: If you could let us have that, we would be grateful, thank you.

Q42 Mr Lancaster: I will move from the particular to the general and ask a couple of questions about expanding the social protection programme. Professor, you have written that while development assistance may be essential in starting up programmes, in the medium and long term it is very important that they are funded domestically. Is that something that can happen in Bangladesh or are there constraints stopping the expansion of such programmes?

Professor Hulme: In Bangladesh finance is always scarce and that sort of thing, but I do not see finance as a binding constraint. It is the delivery systems in getting the institutions that can deliver social protection and other services that is the main constraint.

Q43 Mr Lancaster: So there are not financial constraints! I see that only three out of 140 million people pay tax. There are no revenue constraints?

Professor Hulme: There are revenue constraints, but there are domestic resources and those domestic resources are increasing, and there are donors such as the UK and many other donors who would like to support Bangladesh, so I do not see finance as the critical constraint; it is the delivery systems where we need the breakthroughs and the innovations.

Q44 Mr Lancaster: Can you expand slightly on that? We are nearly out of time.

Professor Hulme: Basically, at the moment in Bangladesh NGOs are being used extensively because they are effective. They often have effective delivery systems, so in a way we need to work more with them and working out how they can scale up, but then it is also looking in a way at whether one can get some of the public sector schemes to work more effectively. Donors particularly have tended to keep clear of what the Government of Bangladesh is doing, but old-age pensions have been introduced. Certainly in my field experience they go to very old women who have very low incomes. Donors in a way seem to keep away from that because "Oh, it is the Government of Bangladesh; it has not been designed outside". I would suggest that one could look at what the government is doing and see if one could, in a way, go with the grain and improve it on those programmes. The politics are not perfect but democracy does mean that there are pressures for the government to take care of its people, and politicians are aware of those. I think focusing more on building on domestic political ideas, which may not appear technically to be as good as the ideas that we might bring from the UK or the World Bank, actually there is a constituency because one of the things with social protection schemes is that you want them to work but you need to build up a political constituency that will keep them working and improve them. You do not want miracles from outside. You need to look at whether there are one or two programmes. The old-age pension programmes in Bangladesh, I think, merits some analysis to work out whether donors could help those be expanded, because at the moment they have got low coverage; they only cover 5-10 per cent of the potential elderly unsupported.

Dr Hossain: That is a perfect example of these informal accountability mechanisms working reasonably well, the old-age pensions.

Q45 Chairman: Thank you both very much. You have certainly given us a flavour of what is obviously a complex but interesting country.

Professor Hulme: Enjoy your trip. Bangladesh is fabulous. There is so much to learn there.

Chairman: Thank you very much. As I say, if you feel you could give us any supplementary information, that would be extremely useful. Thank you very much indeed.

Memoranda submitted by Women and Children First and Christian Aid

Examination of Witnesses

Witnesses: Professor Anthony Costello, Director of University College London Centre for International Health and Development, Ms Sandra Kabir, Executive Director, BRAC, representing Women and Children First and the Diabetic Association of Bangladesh, and Mr Ben Hobbs, Asia and Middle East Policy Officer, Christian Aid, gave evidence.

Q46 Chairman: Good morning and welcome to you. You have obviously been sitting through the last session so you are aware of where we are coming from. Again, I wonder for the record if you could introduce yourselves.

Ms Kabir: I am Sandra Kabir, the Executive Director of BRAC UK. However, today I am representing Women and Children First and the Diabetic Association of Bangladesh.

Professor Costello: I am Anthony Costello. I sit on the Board of Women and Children First but my day job is that I am Director of the Institute for Global Health at UCL, and I run a DFID-funded research programme consortium on maternal and infant health with the London School of Hygiene. I was recently Chair of the UCL Lancet Commission on managing the health effects of climate change.

Mr Hobbs: I am Ben Hobbs. I am the Senior Policy Officer at Christian Aid in the Asia/Middle East division.

Q47 Chairman: Thank you very much and for your written evidence as well, which has obviously helped us. I am looking at the achievements of progress on MDG4 and 5. There clearly has been progress, although there is still some way to go in terms of the overall target. Can you give us a flavour of how you feel things are progressing? Will these targets be met, and, if so, when and how? Do you think Bangladesh is doing better or worse than its neighbours in the region?

Professor Costello: I work on programmes in India, in Mumbai and Jharkand and also in Nepal, Bangladesh and Malawi. One of the things that always strikes me about Bangladesh is how well it is doing when you compare it with Pakistan, with the deprived north-eastern states of India and parts of Nepal. It is doing very well and it is going to achieve probably MDG4, which is the child survival one. It is down to an under-five mortality of 62, although one of our concerns is that the newborn component of that remains high. In other words, as your under-five mortality rate comes down in countries, you tend to find a greater proportion of those deaths are now focused on the newborn period. That is certainly true in Bangladesh where nearly 60 per cent of all under-five deaths are in the first month of life. That is obviously linked to maternal care. The other observation about MDG5 in Bangladesh is that maternal mortality has fallen and probably halved over the past twenty years. This is of great interest and has led me to rethink and challenge some of the accepted wisdom about why maternal mortality rates have fallen, because the WHO line, and to a certain extent the DFID line, has been that this could only be brought about by increasing access to facility care and midwifery services. That is clearly not the case in Bangladesh. If you look at skilled attendants at delivery the figures for Bangladesh overall are about 15 per cent, but if you look at it broken down by wealth quintile - the poorest 40 per cent of households - it is around 5 per cent. Clearly, MMR has come down despite the fact that the great majority of women are not getting access to skilled birth attendants and to a caesarean section in times of need, because almost all the increase in caesarean sections has been in the wealthiest 20 per cent. So why has it come down? I think that the community component of this has been greatly underplayed. I think that first of all community mobilisation through NGOs has been important. I think nutritional change as a result of economic improvement may have contributed. Personally, I think one of the biggest factors is access to life-saving drugs. In the 1930s in this country our maternal mortality rate was 500 and it went over a cliff in 1936, and over six years it almost halved. That was because of the introduction, in my view, of sulfonamide drugs in the mid 1930s. In Bangladesh, unlike, for example, the country I work in, Malawi, where MMR is still sky-high despite half the population getting access to skilled delivery, in Bangladesh we sort of joke that it is almost impossible to walk more than 400 yards without a man trying to sell you an antibiotic. Actually, the private sector distribution of drugs in Bangladesh has been very effective and has increased three-fold over the past 25 years or so. In a sense, we can learn lessons from Bangladesh, but you are right to say that there is still quite a long way to go.

Q48 Chairman: On the evidence we have the regional variations which coincide with the poverty patterns as well still suggest that in the poorest regions the figures are much higher. So the obvious question arises: what could donors do to try and narrow that gap?

Ms Kabir: With regard to the regional variations, there are several inputs required. One is at the political level. If you look at the Chittagong Hill Tracts, for decades there has been this ongoing battle - I use the word "battle" but it is not necessarily actual warfare - about the rights of minority groups. They are treated as minorities and not full citizens of Bangladesh. They are seen as different. They speak a different language and their religion and culture are different. At the political level it is really important that the ethnic minorities in Bangladesh are more accepted and have more say in what happens in their lives, be it by being elected at the local level, at the parliamentary level, or in terms of employment in the civil service or in terms of getting loans from banks, education and everything else. That is at one level. The other level is ethnic minorities anywhere in the world tend to want to clump together and live together, as British Bangladeshis here in the UK live in a very similar way. It is necessary to try and encourage ethnic minorities to come out of the areas where they have traditionally lived over centuries into greater Bangladesh, although Bangladesh is not a very big country, it is quite a small country. I would not use the word "integration" because I do not believe in integration, I believe in cohesion, but somehow to become more involved in the mainstream activities of the country. Also, there is less investment in ethnic minority areas by the governments and NGOs could not work in the Chittagong Hill Tracts because the government did not allow them to work. It was a restricted area for security reasons because there was an uprising of people coming from India into the Chittagong Hill Tracts and there were battles going on and, therefore, NGOs could not work there. That has had a big impact because NGOs normally work with groups that are the most disadvantaged, but they were not allowed to by the government.

Q49 Chairman: The implication in that is that is more for the government or the political system of Bangladesh to deliver. Is there a role for DFID in that context, or are they restricted because of those constraints?

Ms Kabir: No, I think DFID should just jump in. It is a matter of human rights. Here in the UK we believe very strongly in people's human rights, so if we do believe in it then we should do what we believe in, and I think DFID should be in discussion with the Bangladesh Government about these issues; it should not be shy about this.

Chairman: That is probably a useful line of inquiry.

Q50 Mr Sharma: When there is an economic downturn, priorities change. What evidence is there to suggest that donor funding for maternal and newborn healthcare has or might decrease? DFID spends approximately seven per cent of its bilateral assistance to Bangladesh on health. How much should it spend? If it is more, then which other areas should be cut down?

Professor Costello: MDG5 and the neonatal component of MDG4 are the two that are most faltering at the moment. If we took it more globally, in sub-Saharan Africa there has been no change in MDG5 since 1990, by and large, from the latest figures we have. In South Asia it has not been that much better if you take out the China effect. So the argument should be you should spend much more. The work done at the London School of Hygiene by Julia Grieg and colleagues on the amount of donor spend that goes to maternal and newborn health programmes currently shows a figure of $1.2 billion worldwide by all rich countries into all maternal and newborn health programmes annually. That is about seven per cent of Goldman Sachs's bonus pool! It is about one per cent more than the Northern Rock bail-out! That is the levels we are talking about. DFID, to its credit, has been one of the major advocates for spending on maternal and newborn health, but when anybody talks about MDGs for health, it all goes to HIV, malaria and TB, or when children are mentioned it is always vaccination even though we reached 80 per cent vaccination levels 25 years ago. Vaccination in Bangladesh is much better than where I live in Brent, much better. We are having measles outbreaks in London because of that. Anyway, back to your question: clearly there needs to be more spend on this if we want to achieve Millennium Development Goals. If you do not invest, then you tend not to get a return. What other priorities should be cut I would leave others to decide because I do not know enough about what is spent elsewhere in Bangladesh. However, I think there is a strong argument for getting a return. What to do, to get back to your first question, there is a whole menu of evidence-based interventions, starting with community mobilisation, perhaps conditional cash transfers. Something that I think should be invested in a lot is regulation of quality of care down at district level and below, all the way up to improving quality of care and investment of hospitals, which is what DFID is spending some money on at the moment.

Q51 Mr Singh: I am going to ask a few questions around the role of the Skilled Birth Attendant Scheme which Professor Costello earlier said in the context of MMR had no effect. Let us focus on how successful this training scheme has been, what the particular success is and what the figures and statistics can point to in terms of addressing this programme?

Ms Kabir: I can tell you about the BRAC experience. BRAC has trained women to be skilled birth attendants, and along with that has set up committees at the local level that are focusing on maternal mortality and maternal morbidity. These committees are made up of local people. Having done that, over the past few years there has definitely been a decrease in maternal mortality, so it does work, but it is not happening enough in Bangladesh. That is one of the areas that both Anthony and I agree on very strongly, that much more investment needs to be made in community organisation, women's groups, so that things do happen at the local level. There is also a degree of accountability for both governments and NGOs because NGOs also need to be accountable.

Q52 Mr Singh: I will just pursue that a little bit. Can I just clarify something? My briefing says this is a government programme. Is it a government programme or a BRAC programme, or a government programme leading on from BRAC?

Ms Kabir: It is a combination. The government is doing it and BRAC is doing it, and I am sure other NGOs are also doing it. Women and Children First are also doing it. When we speak about Bangladesh and services, you think about a conglomeration of government services, NGO services as well as the private sector. Do not forget that the private sector is also there. The private sector can be good as well as bad, because the private sector is your local untrained indigenous provider of medical services or it could be the local person who supposedly has spiritual powers that can heal you of all sorts of diseases. The private sector can be both good and bad.

Q53 Mr Singh: In terms of the issues surrounding skilled birth attendants, are there issues about numbers? Are there enough of them? Is there an issue about women having problems in accessing skilled birth attendants, and where do we go from here in the sense of what DFID needs to do particularly?

Ms Kabir: We certainly need many more skilled birth attendants. We only have in Bangladesh one third of the total number that we really need to make a significant change. But that is only one side of the issue. The other side of the issue is how you get women to use a skilled birth attendant, either for the attendant to come to the home or if the woman goes to a clinic or a hospital. Where the status of women is so low, and women do not make a decision about where they are going to have their baby and who is going to deliver it, most of the time women are delivering their babies at home. Most of the time the babies are delivered by relatives. If she is lucky she may get a skilled birth attendant. It is only a tiny percentage of the total population of women who go to a facility where there are trained providers. We have to change the way people value women's lives, and that has to be done in many different ways, whether education of girls in primary, secondary and vocational schools or it is exposing men and other decision-makers within the family to the value of women. If you have educated girls and women then they can also bring in an income, and that is happening among the middle classes of Bangladesh. You find now that when marriages are being arranged between families, families are looking at whether the woman can bring in an income to the family. That is only happening among a tiny, tiny proportion of people. If people think more about valuing women, that is really important. Unless that happens, you might have the most fantastic services available in the whole world but you will not have any women going there.

Q54 Mr Singh: You are saying that more women would use the service if there were no cultural and perceptual barriers. The service is available but it is under-used, is that what you are saying?

Ms Kabir: The service is not available as much as it should be. As I say, we do not have enough skilled birth attendants, but it is a matter of how the community, the family, perceives the value of the woman, whether it is worth taking a woman to a facility. First and foremost, studies have shown that it takes forever for a family to decide that there is a medical emergency and the woman needs to go to a hospital to have a caesarean, or whatever it may be. Sometimes the decision takes so long and never happens that the woman dies. That is your first problem. The second problem is transportation: how do you get the woman from the home to the facility where she needs to go for the service? Transport is not easily available, or it is expensive, so it is difficult for the most disadvantaged to use that. Then, when they do get to the facility, what are the costs involved? It might seem that the government services are free or whatever, but they are actually not; you have to pay for medicines; you have to pay the doctor for services; there are bribes and all the rest of it. Unless the value of the woman is there, nobody is going to make that investment.

Q55 Mr Singh: In terms of recruits coming forward for this training, are there any problems? Is this a job that women want to go into?

Professor Costello: I do not think there has been a problem. Clearly, getting more skilled birth attendants is a long-term strategy and it seems like a very good idea and should be invested in but there are potential problems though. Firstly, you want to get good-quality people to be trained, but then there is an issue, will they go out to the areas where they are most needed or will they tend to congregate in urban centres? That is a big question mark that remains. There is also the problem that most poor people are very rational. They know they live a long way away and they know it will cost them money, and often when they get to a facility it may be poor quality. There was a very interesting study done recently by Dr Iqbal Anwar, who is associated with our research programme. He reviewed quality of care in 12 districts, and went round and looked at various functions around obstetrics and care for women and newborns. By and large, the district hospitals, which often cater for four to six million, were not too bad, and the NGO facilities were not too bad, they did reasonably well. Once you got below that, to union level, and remember a union still covers 25,000 people, the services were of extremely low quality, and even worse was the private sector at that level. A lot of very bad things were being done. There is an issue around regulation here. Where the skilled birth attendant would fit in is still not clear to me, and how much they would be used, would they be attached to the union complexes or whatever? As an aside, you could say, should I not know that! There is still an observation, which we often raise with DFID and a lot of people in DFID say is an issue. The research programme consortia which are well funded by DFID in many parts of the world, and country programmes, have a very weak relationship. It is often informal and it is often social. I think they are missing a trick - and I think DFID realises this - to link up many skilled people in evaluation from all kinds of backgrounds - economic, health, education - who are in the research programme consortia that could help with the country programmes. Your question is an extremely important one, and it does not just apply to Bangladesh, it applies to India, Nepal and many other countries.

Q56 Mr Singh: Is there any kind of health visitor service as we have here where health visitors or community health workers go out and visit when you are pregnant, and maybe identify to some extent whether they are going to need treatment that the skilled birth attendant could link into? Is that kind of work going on?

Ms Kabir: The government did have a system before where they trained women to be family welfare assistants but a few years ago that was withdrawn because the argument given was that women are becoming dependent on these women going to their doorstep instead of women coming out. I think that was a big mistake and it was withdrawn very, very abruptly. I think the real reason was just money basically. Many, many NGOs in Bangladesh that work in maternal health do have outreach workers who go to the home and visit women and try to do the very basic antenatal care: immunisations like tetanus toxoid for the mother. They talk about the importance of breast-feeding for the first six months, immunisation for children and all the rest of it. It is there, but it is not there enough. One of the other things we need to look at in Bangladesh is there needs to be much greater coordination on who is doing what. I do not think there is duplication per se but there is not enough coordination. For instance, if an organisation is providing certain services but the family needs something in addition to that, does that organisation refer that family to whatever service that may be? I do not think that is happening as effectively as it should.

Q57 Mr Lancaster: You mentioned in passing women's groups and in light of the particular isolation in Bangladesh can you expand on the role of women's groups, their importance and how they contribute to maternal health?

Professor Costello: We have been doing formal research programmes on women's groups. In Nepal and India, the two studies come to mind, we have done cluster randomised control trials of women's groups focusing specifically on maternal and newborn care. We did this in a very large area of a remote part of Nepal, which we published in the Lancet 2004. To my surprise, it showed a 30 per cent reduction in newborn health even in communities where access to health services was extremely low. There was something about the group mobilisation process, raising awareness about hygiene and care that was having an impact. A lot of people did not believe us and said, "You ought to replicate that". We have got six other trials. One which will be published soon, in the next couple of months, in the Lancet, from India, has shown a bigger effect, a 45 per cent reduction in newborn mortality in poor tribal areas where baseline newborn mortality rates are high, and where there has been absolutely no change in the use of antenatal care delivery and postnatal care services. So, of themselves, that is quite a valuable thing. What the actual impact is on maternal mortality, we did show in Nepal a statistically significant effect but it was small numbers. There are anecdotal reasons why the delays of seeking care may be improved by women having been mobilised in their communities. This is an important thing, but that is the demand side; you have also got to link it up with the supply side.

Q58 Mr Lancaster: On the supply side, how can donors help without moving away from the community-based, bottom-up approach? You have dealt with demand; what are you doing about supply?

Professor Costello: It is a good question. One attempt that has been tried by DFID and is gaining importance is the idea of the conditional cash transfer, which is to encourage the poorest women to go to facilities by paying an incentive. This scheme was introduced four years ago in Nepal, and we helped to evaluate that with the country programme there. I believe there is a maternal voucher scheme in Bangladesh, but I do not know much about that. The problem is that even when you do that it tends to be the better-off quintile groups that access the hospital and get the incentive, so you tend to find yourself investing in something that will tend to benefit the better-off already. That is a problem always with the supply side. I come back to what I think is the most important thing you can do on the supply side. You can probably look at what is already there, because there is a lot going on, and try and regulate it better and look at indicators of quality of care from district level downwards.

Mr Hobbs: I am not really a specialist on health per se, my area of specialism is more climate change, particularly UK funding for climate change in Bangladesh. Coming back to the Chairman's earlier question about some of the barriers to achieving the MDG on gender equality, building on something that was said by Ms Kabir we need to look as well at the value system in the country. There has, of course, been a lot of progress in the development indicators for women over the last couple of decades, but then, as has been pointed out, a lot of the indicators are still stubbornly high, including the maternal mortality rate. That is off-track at the moment for 2015. There are also issues like completion rates in education and low employment rates outside the agricultural sector for women. In regard to value systems, we feel that DFID should focus not only on health, although that is of course an important issue, but looking at the economic and political empowerment of women in Bangladesh, because one of the fundamental problems is that women lack control over income and expenditure decisions at the household level and are also limited in their participation in decision-making, both at the family level and in society. In regard to the issue of quotas in different levels of government and also the national parliament, there has been a quota system in the national parliament, for example, that has basically allocated a number of reserved seats for women as opposed to the general seats, but those 45 reserved seats have not actually been contested seats, the female MPs get indirectly elected by their peers, by the other MPs. Although in the 2008 election there were some female candidates for the general seats, which are the contested ones, 19 got elected in that way, so we have now got 64 female MPs in the parliament, the point is that there you can see a segregation of women in these political power structures, so even when the quota system is introduced it still leads to a form of segregation and a marginalising of women within these decision-making structures. This is an important point. We also made certain recommendations in our submission about how DFID could improve the way it disaggregates data.

Q59 Mr Sharma: You have picked up the question I was going to ask. What are the main factors which account for women's lack of empowerment in Bangladesh? How do you explain the paradox of having strong female political leaders, including the current Prime Minister, and Bangladesh's low score on the UNDP gender empowerment index?

Professor Costello: This is quite complex. Clearly, there are regional variations in Bangladesh. There are traditional conservative areas. We work, for example, in Moulvibazar which is a much more conservative area adjacent to Sylhet. Other parts of the country are more progressive. You could say Bangladesh has done very well on its female education rates and, by contrast, it has got much better indicators on that compared to, say, Pakistan, starting from a lower base of independence. The other thing in my experience is that the idea that all women are lacking in power is simply not true, it depends on your life cycle in many parts of these countries. When you are newly married and you move to your husband's house you have very little power and come under the control of your mother-in-law, but as you produce children and become older, mothers-in-law are quite powerful in households in decision-making. It is a complex business.

Ms Kabir: I think that having a woman prime minister does not have any impact at all on status of women in the country, as you have seen here in the UK also. The gender issue touches everyone's life everywhere in the world, but even more so in Bangladesh. If you look at the laws in Bangladesh, we have not got sufficient laws that are gender-sensitive, and the laws we do have that support women are not implemented. In fact, in Bangladesh we have absolutely fantastic laws, but most of the time they are not implemented in any shape or form. Then if you come to the policy level, policy formulation is not gender sensitive. The same goes for the implementation of policy. At the programme level you have the same issue; the programmes are not designed or implemented in a way that is particularly gender sensitive. As my colleague said, if you look at monitoring and evaluation, you do not have disaggregated figures available to tell us about the impact of the health and family welfare government programme. One of the difficulties we have in Bangladesh is that there is a Directorate of Health and a Directorate of Family Welfare, which is family planning, and they all come under the Ministry of Health and Family Welfare, but the two directorates have their own staff and their own resources, and they do not talk to each other, they do not like each other. Donors for, I would say, twenty years now have tried to convince the Government of Bangladesh to amalgamate the two directorates and just have one, but that has not been possible for political reasons because employees feel they are going to lose their jobs or their seniority and all the rest of it. Resourcing of programmes is also not particularly gender sensitive.

Q60 Chairman: We know what you mean but can you be more specific about "gender sensitive"?

Ms Kabir: I would say that, for instance, if you look at the budget for maternal health it is only one small part of the overall health budget. The overall health budget is looking at many different components, but maternal health, although there are vast numbers of women dying in Bangladesh from pregnancy or at the time of birth, the proportion of the budget that is allocated for that is not the right ratio. It is budget allocation, and it is not just money, it is efficiency. It is no use pouring loads of money into a programme if the efficiency levels are not good, and it is something everyone needs to address, for example the capacity building of the people who work in health. The infrastructure was mentioned in the previous session. If you do not have good roads, if you do not have electricity, you cannot run a hospital without electricity and you cannot get patients to the hospital if there are not decent roads. It is all interconnected. I would like to see DFID playing a much bigger role in supporting the Government of Bangladesh in its vision for changing the status of health in Bangladesh. It is not just looking at hospitals and clinics - in fact, that is the smallest part of it - it is looking at gender issues and a lot more things.

Mr Hobbs: Just back on women in politics again. You were asking about why you have a prime minister who is a woman and yet there is lack of empowerment. Sheikh Hasina and some of the other leading women in politics were elected in the contested seats, so they were not in these reserved seats that I was talking about. That process of competitive election is really important because women are standing face‑to‑face with candidates who are male and there is that sort of equalling of the genders, if you like.

Q61 Chairman: They are immediately second-class MPs if they are in reserved seats as opposed to having one in their own right.

Ms Kabir: Directly elected.

Mr Hobbs: Yes, directly elected. At local level there are some quite encouraging developments because at the Union Parishad level and the Upazila Parishad level you do have competitive elections for women to take positions on those two tiers of local government. It is a third of the seats in the Union Parishads reserved for women, but there is a competitive process for those elections.

Q62 Mr Sharma: Should DFID include specific targets to ensure participation of and benefits for women and girls in its own programmes? What other measures could DFID put in place to help to improve the position of women in Bangladeshi society?

Professor Costello: Coming back to the power of a women's group, because it reaches right down to village level and involves very poor women, one of the findings from a study that we in Women and Children First were involved in, in tribal India, was not only the effect on mortality rates but we measured postnatal depression rates. There was a 60 per cent reduction in postnatal depression in the areas where the women's groups were going on, which is very interesting. It may be a marker of this kind of solidarity effect. In Nepal, where there has been a Maoist civil insurgency going on until very recently, we stopped visiting women's groups for a couple of years because of the difficulties. They all kept going and they all talked about the value of being part of this solidarity movement through the stress of the war. We withdrew funding from that whole programme two years ago, and I was rather of the opinion that rather like all other development interventions everything would collapse, but 80 per cent of all the women's groups set up in a large area of Nepal are carrying on without any financial support. You go out and say, "Gosh, our groups are still running!" and they say, "They are not your groups, they are our groups!" There is a tremendous amount of hidden benefit in regard to gender and empowerment in the broader sense that comes about with this kind of community mobilisation and could be built into all DFID programmes.

Q63 John Battle: On education, one of the things that strikes me is that the enrolment at primary school is good but the drop-out rate is very high. What specifically could DFID do to encourage longer participation in schools so they are not just signing on and leaving? Specifically what measures to ensure that girls stay on at school longer because obviously the drop-out rate for girls is much higher and that goes through the system?

Professor Costello: It is not really my area.

Ms Kabir: That is changing. More and more girls are going into primary school and completing primary school, but it is still not as good as we would like it to be. It is improving. It is the style of education also. Africa has a similar problem. For instance, do the schools have toilets that the girls can use? If you do not have toilets girls are not going to go to school, things like that. It is changing, and we have to continue to keep our eye on the ball with regard to girls' education, not just primary but also higher education, and that could involve vocational training, not necessarily only sitting the classroom but vocational training which would then lead to employment.

Mr Hobbs: You need to look at issues around quality of the schools and quality of teaching, but then also some of the issues such as why it is easier for girls to be pulled out of school than it is for boys. That is linked again to the cultural issue I mentioned earlier. There is the cost of schooling as well, which is, I am sure, another important barrier for poor families.

Q64 John Battle: And the reverse of that which might mean that the young person contributes to the family income when family incomes are falling so goes back home to help.

Mr Hobbs: Yes, in times of crisis. On the question of what DFID could do, we have suggested they should aim for 50 per cent of their programmes having disaggregated data on gender in, say, the next five years. That is one specific proposal. In terms of other interventions, for example, specialised training for women, for female decision-makers, would be one idea. Sponsorship schemes for women becoming managers of NGOs or in the private sector in management positions is another idea. The other thing that should be mentioned is the way that DFID is set up in Bangladesh is not really conducive to giving a lot of support to the smaller NGOs. Often the money goes through these big management consortia and large NGOs. I would say they should make sure there is sufficient funding for grass roots initiatives and work by Bangladeshi grass roots NGOs. It is interesting because in south Asia, actually in India, DFID has quite a strong policy on social exclusion and is funding various initiatives, including one that Christian Aid is managing which is on caste-based discrimination. In Bangladesh they have not been so vocal in developing a policy on social exclusion, and that could be something they could develop in coming years. We should look not just at the issue of women's roles and women's rights but also at the position of Dalits in Bangladesh. Up to five per cent of the population are Dalits, so from both the Hindu and Muslim sections of the population; and look at indigenous peoples, the hill tract peoples that were mentioned earlier, and the Bihari communities. Having that social exclusion focus is another thing that they could develop more strongly and we are noticing that is quite absent at the moment.

Q65 Chairman: Professor Costello, you have made a number of references to Nepal. You should be aware that the Committee is also visiting Nepal on this visit, so if you were able to give us some evidence on your experiences in Nepal relevant to the terms of reference we have, it would be helpful.

Professor Costello: Now?

Q66 Chairman: You have made a number of references which suggest you could give us a little bit more useful information. In writing, I mean, not now. Can you give us a written response?

Professor Costello: Yes, with Nepal actually I could do that rather better because I lived and worked there for a long time.

Q67 Chairman: I do not want you to talk us through lunch, but it would be very helpful.

Ms Kabir: If I could say two things. I think that DFID could do a lot more with the British Bangladeshi diaspora here in the UK. BRAC UK is working with them a lot. For instance, we have a diaspora volunteering programme where we support British Bangladeshi professionals to volunteer in Bangladesh, and that is working out extremely well. They are coming back and doing development awareness in the UK and becoming involved in international development issues.

Q68 Chairman: Can you also help on that because the Committee has decided it would like to have a meeting with representatives of the diaspora, probably in Birmingham we thought. You can probably give us some help.

Ms Kabir: No problem at all. The other thing I wanted to say, and I do not want to promote BRAC UK but it is just an idea I want to plant in your minds, is the lessons that BRAC has learnt in Bangladesh and other countries in Asia and Africa over the decades we are adapting to the diaspora communities here in the UK. So far we have been concentrating in Tower Hamlets. This is a reference to your comment, by the way. We made a visit to Burnley with the Prince's Trust. It does work. It is in terms of women health volunteers, money management, voluntary work and things like that. There is a huge potential which DFID and other parts of the British Government are not taking advantage of in the diaspora communities.

Q69 John Battle: We could follow that up after the visit perhaps by visiting Tower Hamlets.

Ms Kabir: Yes. I hope that you will be visiting BRAC in Bangladesh! I can send you information before you go.

Q70 Chairman: Yes, we are. That is extremely helpful. We were discussing Birmingham and/or London and I am beginning to think we need to do both. That would be extremely helpful. It sounds as if we are on the right track.

Ms Kabir: One last comment. I am sorry, I did say two but it is actually three. DFID in Bangladesh is in a way doing itself a disservice; it does not talk about itself enough. DFID has been investing in Bangladesh for many years now and huge amounts, it is the biggest bilateral donor to Bangladesh, but I do not think DFID and the British Government are talking themselves up enough about what they are doing with the Government of Bangladesh and NGOs and other things, because there are lots of wonderful things happening. I think we should shout it out a bit more.

Q71 Chairman: It is always DFID's style, of course, but we take note of that. There are a couple more other things we wanted to explore with you. One we have already talked about with the previous witnesses, the Chars Programme and the Committee has already looked at this. I wonder whether you have anything to add to what we have already heard about its benefits and shortcomings, and, more to the point, what happens when the programme ends, in other words its continuity?

Mr Hobbs: I would like to have the chance like you do to visit the Chars Livelihoods Programme, but I have not unfortunately visited it. From my analysis of some of the programme documents what I can say is that overall I think what they are doing is pretty good. There are a lot of signs that asset transfer is raising income levels of the poorest households by as much as 100 per cent, so the targeting of the very poor, and raising the plinth will clearly help some of them with flooding. The veterinary extension schemes and some of the other things are good. What I would say though, and again I have not visited the programme so you might be in a better position than me to make a strong judgment on some of these things, is I do not really notice the kind of longevity or sustainability of the programme being there because it does strike me as essentially a welfare programme, and what you do not see a lot of is the attempt to understand why these people are in poverty and on these Chars in the first place, and what improvements need to be made to their lives, what actions the government needs to take to address some of the classic issues such as lack of agricultural land, lack of access to health and education services and lack of access to employment, because there are huge employment shortages too amongst these communities. What I would like to see more of is a focus on advocacy towards the government in those areas so that some of these structural causes of poverty get addressed so that when this programme ends some of this good work that has happened does not just peter out. I do not feel that, even saying some NGOs can be in there and helping out - I still think there is still an important task to hold the government to account on some of these issues. The other issue is around the impact that climate change will have on the Chars, and actually the more basic point of whether you can invest in the Chars, is it worth investing in the Chars if they are getting washed away so frequently and then recreated somewhere else? For me there is an important that I hope the programme has looked at, whether it is worth making those investments on the Chars in view of the temporary nature of the phenomenon, their existence. What are the other strategies on resettlement elsewhere, on the mainland or on stable land? What are those options? Coming back to the climate change issue, we know that river flows will increase with climate change, so in the monsoon season there will be more flooding and heavier rainfall, so that is another thing that would need to be thought about carefully.

Mr Singh: In your submission you were saying - not critical - there was a concern that DFID's approach to disaster risk reduction is focused on physical infrastructure projects, and you think it should be more about raising awareness. It occurred to me when I read that, that surely DFID is doing the right thing in terms of doing infrastructure projects to try and lessen the risk when disasters occur.

Q72 Chairman: They would describe this as adaptation as opposed to mitigation.

Mr Hobbs: Yes. There is obviously an issue around climate change funding and the fact that it should be additional funding to existing ODA, and I would have a problem with DFID labelling the Chars Livelihoods Programme as a climate change programme because of that issue. There are international conventions and the UK has entered commitments at the international level that the climate change finance should be in addition to ODA because it should not be taken away from these other important sectors to do the climate change work. On the point you made, I think it is more a question of us wanting DFID not to continue some of the good approach that it has had in the past where it has recognised that it is not just structures that count. For example, in the Comprehensive Disaster Management Programme there is that recognition that it is about getting government policies to be improved and getting communities to be working on the issues. We had seen mention of infrastructure featuring heavily in the Country Assistance Plan, and we were looking at that a little bit warily and wanting to make clearly this point that just building infrastructure is not the sole answer, you need to focus on maintenance of existing infrastructure first but then also community ownership of these assets and the way the disaster restructuring policies work at a local level.

Professor Costello: On the evaluation point, I reiterate again that there are tremendous links that DFID and others have supported with indigenous universities, BRAC University in Sussex, Manchester, UCL with BADAS and various things, which do not get brought to bear on the evaluation of relevant DFID programmes. They tend to use short-term consultants to do that and we do our research, and I think they should be linked up much more. On climate change, I met with Atik Rahman when I was in Dhaka about two months ago, who is one of the top climate people, and he showed me a lovely slide - I had it on my computer - showing the one-metre sea level rise effect on Bangladesh. At the moment sea level rise in Bangladesh is about double the global rate because it is warmer and so water expands. That means that they will hit one metre probably, on current projections - but it could accelerate - between 2040 and 2050, so that is only 30 or 40 years away. A one-metre sea level rise brings the coastline up to Dhaka. It is really terrifying. I think Bangladesh has done fantastically well. There were 300,000 people who died in 1971 from a cyclone, it was 130,000 in 1991, and in the 2007 cyclone it was only 3,000. That reflects their tremendous resilience to climate change, but this is going to challenge them in ways that ----

Q73 Chairman: Is the result the Dutch solution or is it abandonment?

Professor Costello: I would not know about that. I do not think it is abandonment, but it may obviously be abandonment in certain parts. The grave concern is salinisation of drinking water at the moment in the southern states and what effect that might have on things like blood pressure and pregnancy.

Q74 Chairman: The implication is that there should be a lot of dykes, which are quite expensive to build and operate?

Professor Costello: Yes, actually Atik Rahman said that the problem is that when you find the Dutch and the British experts they are used to very static scenarios, and he said the whole point is that they do not understand that Bangladesh is this phenomenal hydrological moving target, that water comes down one way and then it all goes back the other way, so you have to apply different principles. I am right out of my field here!

Q75 Chairman: It is a big challenge.

Mr Hobbs: There is of course the debate on what is the appropriate solution and are coastal defences a way or other less interventionist approaches. The one thing I did notice in the Chittagong area last year when I was there last year was that there were sea walls that had been breached by cyclone Sidr and I spoke yesterday to one of our local partners in that area about the situation because the sea water was getting right in onto the agricultural land and completely stopping farming there and causing real havoc, and the director of that parliament said the sea wall had still not been repaired, and this is nearly two years on from Sidr. That is an example of one of the problems. It is about making existing infrastructure work well rather than suddenly dreaming up these big new schemes that we know in the past, because there have been some schemes that have been quite controversial around infrastructure like the flood action plan. That was just an additional point.

Chairman: Thank you very much indeed, and thank you for your offers of additional assistance, for example on Nepal and communication with the diaspora, we certainly do feel that will be valuable. It has been really helpful from our point of view, and seeing these things on the ground will give us a better idea. Thank you very much.