In Bangladesh, community health workers (CHWs) play an indispensable role in delivering health services to every corner of the country, often under extremely challenging conditions. Their commitment is unwavering, but the path they walk is quite literally filled with obstacles.
The most common mode of travel for CHWs is by foot. While they also rely on local transports like rickshaws, vans, boats, motorbikes, and auto-rickshaws, using these vehicles often costs them valuable time and money or resources they can scarcely afford. Many of the roads they must navigate are poorly maintained, becoming muddy and nearly impassable during the rainy season. In some areas, rivers that serve as main transport routes dry out during the dry season, forcing CHWs to switch between multiple modes of transportation just to reach a single destination.
Beyond these physical and logistical barriers lies a deeper, gendered challenge. In districts where fishing is a major livelihood, a local superstition claims that carrying women on boats will reduce the day’s fish catch. Consequently, boatmen often refuse to transport female CHWs. Even when women are allowed aboard, they frequently face harassment: unfairly inflated fares, verbal intimidation, and, at times, even threats of harm.
For many CHWs, walking long distances remains the only viable option. In numerous upazilas, local transportation is either scarce or nonexistent. Carrying heavy equipment across rough terrains under the scorching sun or pouring rain is part of their daily reality. And as the day stretches on, many CHWs find themselves still providing services as night falls. Getting back home becomes a risky business, with dark, poorly maintained roads posing serious safety threats, especially for female workers traveling alone.
To cope with these persistent challenges, CHWs often take precautionary measures. They avoid certain routes known to be unsafe, even if it means walking longer distances. Sometimes, they wait for long hours just to find a safer or more convenient mode of transport. Many also request their husbands or other family members to accompany them during field visits to ensure their safety. However, all these coping mechanisms come at a personal cost: CHWs frequently have to pay for their commute out of their own pockets, adding financial strain to their already heavy burdens.
Despite these exhausting and often dangerous journeys, transportation allowances, if provided at all are minimal, leaving CHWs to shoulder the physical, emotional, and financial burdens alone.
The struggles of Bangladesh’s CHWs to reach their communities highlight the urgent need for better support systems, fair compensation, and safer transportation options. Their tireless dedication deserves not just recognition, but concrete action to ease their burden and honor their service.
Semonty Jahan, Senior Research Associate,
BRAC James P Grant School of Public Health, BRAC University