A DEEPER PURPOSE

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In a conversation, Nusrat Feroz Aman, Chief Executive Officer at AYAT Education, elaborates on the foundational principles of the organisation, the importance of the health and wellbeing industry and why we need to have a conservation about the right to a dignified life.


 

As an entity of multiple social enterprises, AYAT Education offers revolutionary programs and services to bridge societal gaps. What were its foundational principles?

AYAT Education started its journey with the fundamental notion of improving the quality of life for the people of Bangladesh. Concurrently, we wanted to do capacity development of our young people and equip them with employable skills. And, at the same time, provide them with better access to healthcare through having a skilled workforce in the healthcare sector.

Our primary objective is to improve the quality of life for the people of Bangladesh. We want to achieve that through skilling up our future nurses and caregivers. An essential part of our vision is to facilitate proper caregiving service where we will have trained caregivers. We have established AYAT College of Nursing and Health Sciences to execute and catalyse our vision to facilitate a skilled workforce in the healthcare industry. The institution makes sure that the trainees have access to all the necessary equipment besides receiving excellent learning experiences. Our caregiving training institution is a model institution, accredited by National Skill Development Authority (NSDA) and Bangladesh Technical Education Board (BTEB). It has been providing top-notch training to young individuals aspiring to become skilled caregivers for the local healthcare sector and abroad.

At the same time, we also offer numerous different vocational training programs. For example, AYAT Education provides different training to workers in the RMG and construction industry. There are also training facilities for general electricians who can learn to work on refrigerators and air conditioners. Therefore, AYAT Education is fully invested in enhancing employment opportunities for our growing youth.

Interestingly, many of AYAT’s programs and services are centred around the health and wellbeing industry. What makes the sector so crucial?

Firstly,  a robust healthcare infrastructure is essential to ensure a better quality of life in any country. As a result, AYAT Education focuses on the fundamental reason behind the poor quality of life for most people in the country – our healthcare system. Undoubtedly, it is currently in an abysmal state, and much of it can be attributed to the aberrant distribution of skilled professionals available in the sector. Currently, the health professionals’ hierarchy is shaped like an inverted pyramid which is highly unstable and inefficient. In a stable health system, you have a large number of caregivers, volunteers, psychosocial support workers, and social workers, and then you have fewer nurses. Then you have fewer doctors, followed by the specialists at the top. Surprisingly, we have more doctors than nurses in Bangladesh and even fewer caregivers or social workers who work as their (nurses) aides. Therefore, the hierarchy is unstable and prone to chaos and failure. The system is entirely dependent on doctors and specialists.

Secondly, the quality of care we receive during health checkups, and examinations is not optimum. As a result, a significant number of people who can afford it are seeking medical help abroad. Therefore, we believe it’s high time to address these gaps to ensure a healthier life for everyone. More importantly, it also tackles a fundamental question of our future socio-economic sustainability. We currently have a demographic dividend, with more than 65.15% of the total population (170 million) being under the working age. Failure to convert this population into a skilled workforce will have long-term repercussions. We will eventually reach a point (around 2040) when the birth-rate starts to fall, and the economy will be burdened by an ageing population needing socio-economic protection. Therefore, if we can train our youth to become expert caregivers and nurses, we can address several issues simultaneously. They can become an integral cog in a health care system equipped and competent enough to tackle the challenges an ageing population poses. At the same time, they would be poised to make a decent living in the country and explore lucrative opportunities in places like Japan, Europe, and Canada.

 

 

Over the last few years, the idea of palliative care has been more widely accepted and increasingly demanded in Bangladesh. What factors do you think have catalysed the need for such services? What does the Dignifying Life initiative of AYAT Education aim to achieve in this sphere?

Before discussing palliative care, we must understand how people perceive death in our country. Generally, Bangladeshis do not like to talk about death or address any aspect of it. Unfortunately, this approach is impeding much of the progress that can benefit many people. I would describe life’s journey as taking a flight. So, when you get on a flight, you put on a seatbelt before taking off. But most importantly, you know that you are inevitably going to land. It is improbable to find out when, but it’s always better to prepare for the landing. Likewise, palliative care is what prepares you for the end.

Our initiative is called Dignifying Life. As the name suggests, it aims to make the journey towards the end of life more convenient and peaceful. It is an important step. But this requires awareness, understanding, courage and support. And that’s what we’re trying to bring into the society by starting those conversations. To that end, we have created a programme called Jete Nahi Debo (the name is derived from one of Rabindranath Tagore’s famous poems). We invited people who have either gone through a journey of a terminal illness or have a loved one who has gone through it. It eventually comes down to love, respect, and care. So, when a person is towards the end of the journey, all we can do as a family is ensure the journey is smooth.

Palliative care is about symptom management; it’s pain management. At the same time, it is also taking care of the individual’s emotional needs. So, palliative is divided into a few segments, including physical, emotional, financial, psychological and spiritual needs. These are the five things that need to be addressed. We are training nurses in public hospitals across Bangladesh and have trained 550 nurses so far. It’s a 5 to 6 day course that we are doing in partnership with Massachusetts General Hospital, which is the largest teaching affiliate of Harvard Medical School. We are running a small community program in partnership with World Hospice and Palliative Care Alliances across two Upazilas of Narayanganj, where we train high school students as volunteers who can go from house to house to do simple things for poor, terminally ill patients. Also, we are working with the Prime Minister’s office to create a national action plan. The objective is to incorporate palliative care into primary healthcare services.

At the same time, we are creating awareness in the community by holding dialogues and walkathons where we bring the conversation to non-medical people who go through the journey. Most of us often forget that treatment in terms of spending money is not the same as giving quality of life. Sometimes, doing more is not what the person needs. So, having somebody spending their last days in an ICU or on a ventilator is not for everybody. And this is a conversation we want everyone to talk about. We want people to understand what palliative care is and realise that everybody has the right to a dignified life. It doesn’t matter how painful your journey can be, you have the right to a dignified life, and no one should die in pain.

 

 

How do you expect Bangladesh’s health and wellbeing industry to evolve over the next five years? What role do you envision AYAT Education to play in it?

In the next five years, I hope to see that Bangladesh has truly achieved Sustainable Development Goal 3, which is good health and wellbeing for all, and continuously upskilling our healthcare professionals, doctors, and nurses via short courses. I also hope to see people’s trust in our doctors, nurses, caregivers, pathologists, and diagnostics enhanced to the point that they will not want to go abroad for treatments.

Regarding AYAT, we hope to play a role in bringing this different genre of healthcare professionals together in one platform to collaborate better. We want our doctors to realise that our nurses, caregivers, physiotherapists, diagnostics, and pathologists are essential to the healthcare infrastructure, as if we are weaving a mesh where everybody has a part so that we can create a beautiful piece of rug. That’s how I want us to see it. Therefore, we will continue to skill up and develop more nurses and caregivers and opportunities for them at home and abroad.

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