Given the question of how to further decrease childhood mortality and attain the fourth MDG in Bangladesh, the determinants of childhood mortality and successful health intervention programmes in a rural area of Bangladesh are examined in this paper. The binominal logit regression analysis, on Matlab HDSS data from 2001 to 2005, indicates that the child’s birth order, outcome of mother’s previous pregnancy, mother’s age, mother’s education, economic condition of the household, immunization, and place of delivery are important determining factors of childhood mortality. Interview discussions show that the delivery of health services is a determining factor for successful health intervention programmes. It is worth to note that childhood mortality levels are no longer significantly lower in the treatment area of Matlab. Furthermore, the intervention programmes in the area require continuous reform, especially in the fields of birth assistance and injury prevention.

Elevated levels of arsenic (As) in Bangladesh groundwater has emerged as a massive calamity exposing a large population to the risk of As toxicity from drinking water sources and agricultural products. Holocene alluvial aquifers in the delta- and flood-plains of the Ganges-Brahmaputra- Meghna (GBM) river systems are severely affected by high levels of As in groundwater. Groundwaters abstracted from Holocene alluvial aquifers of shallow depth (<150 m) contain As at concentrations mostly above WHO provisional drinking water guideline value of 10 μg/l whereas groundwater from the Holocene deeper aquifers (usually >150 m) and the Plio- Pleistocene aquifers contain low-As (<10 μg/l) water.The study reveals that the local and regional scale variations in groundwater composition, levels of As concentrations and the redox conditions are governed by the geological attributes of the aquifers. Groundwater in the grey to dark grey argillaceous sediments where organic matter and micas are abundant contain high concentration of dissolved As. Concentrations of As is generally low in the groundwater abstracted from the light grey to yellowish brown arenaceous sediments. A major proportion of As in the dark grey sediments is bound to poorly crystalline and amorphous metal-oxyhydroxides, particularly Fe-oxyhydroxides, that are readily mobile. On the other hand, As concentrations in the light grey to yellowish brown sediments are low and predominantly bound to less mobile stable crystalline phases. Redox reactions linked to the degradation of organic matter are the potential mechanism of As mobilisation through reductive dissolution of Fe-oxyhydroxides in grey to dark grey sediments in the Holocene shallow aquifers. This is reflected in groundwater compostion that is characterised by high concentrations of As, HCO3 -, Fe and dissolved organic carbon (DOC). However, concentration of dissolved Fe is probably controlled by the precipitation of secondary Fe-minerals like siderite (FeCO3), vivianite [Fe3(PO4)2 8H2O] and pyrite (FeS2). Weathering of biotite [K (Fe, Mg)3 AlSi3O10 (F, OH)2] is one of the major sources of Fe-oxyhydroxides in the sediment and thus plays a significant role in the processes of As mobilisation in groundwater.High concentrations of As and salinity are the major constraints for groundwater development in the Holocene alluvial aquifers of the Meghna basin. The Holocene shallow aquifers (<150 m) are high in dissolved As and salinity, while the Holocene deeper aquifers (>150 m) are low in As but contains pockets of saline groundwater. Molar ratios of Cl-/HCO3 - and Na+/Cl- indicate mixing of relict seawater with the freshly recharged water in these aquifers. Groundwater abstracted from the Pliocene Dupi Tila aquifer located at relatively higher elevations along the eastern part of the Meghna basin is not affected by As and salinity. Stable hydrogen (δ2H) and oxygen (δ18O) isotopes indicate relatively fast groundwater recharge rate with insignificant evaporation effect in the Meghna basin. The groundwater samples from shallow aquifers show relatively wider variations in isotopic composition than the deeper ones indicating multiple recharge regimes. Abstraction of groundwater from the Holocene deeper low-As aquifers for drinking purposes should thus be be properly guided to minimise the risk of cross-contamination and installation of high-capacity irrigation wells in the deeper aquifers must be avoided for sustainable drinking water supplies. / QC 20100809

The aim of this thesis is to investigate how some Proshika-teachers describe their mathematic teaching. Proshika is a non government organisation in Bangladesh. One of Proshika’s areas is to provide school attendance for children of poor households on the countryside. We chose to do a qualitative study, and interviewed teachers at six different Proshika-schools. We also made five observations in order to formulate relevant interview questions. The result from the interviews shows that the teaching looks similar in the schools. The mathematic book has a dominating position in the teaching. The students calculate the same task at the same time and they calculate every task in the book. Group work exists and concrete materials are used as equipment in the teaching. To get better conditions in the teaching, the respondents want further education and cooperate with other teachers to improve their knowledge about different work methods and to develop their teaching. They also want more materials and breaks during the school day. Some of the teachers can think of having longer school days. Later in the thesis we reflect on how it is to collect data in another culture, how the researcher affects the result and how our theoretical framework can be relevant in this study.

Syftet med den kvalitativa studien har varit att undersöka vad som kännetecknar en god pedagog. Vid litteraturgenomgången har författaren sökt finna gemensamma kännetecken på en god pedagog från en mängd författare som arbetar som pedagoger eller med forskning inom pedagogik. Kvalitativa intervjuer har gjorts med fem pedagoger från Sverige och Bangladesh. Analysen av intervjusvaren har resulterat i sex rubriker: Relationen mellan lärare och elev, utbildning och fortbildning, ett kall, motivation och engagemang, att tycka om sitt arbete samt erfarenhet. Vid diskussionen betonas betydelsen av relationen mellan pedagogen och eleverna.

The “miracle” success of transplant technology, alongside the commercialization of health care, and the increasing polarization between rich and poor have created the conditions for an illegal but thriving trade in human body parts. Based on 15 months of challenging fieldwork, my research examines the ethics of the organ bazaar, particularly the experiences of 33 kidney sellers living in Bangladesh. On the underground bazaar, not only human kidneys but also livers and corneas are advertised for sale. Recipients, sellers, and brokers regularly post newspaper advertisements to buy and sell organs. The average price for a kidney is US $1,500 in Bangladesh, a country where 78% of people live on less than $2 a day. My research examines serious ethical questions, such as these: Is it right to purchase an organ, even if the organ sought provides longevity? Is the sale of one’s organ a justifiable means of fighting poverty? These questions allow me to examine the ethics of harvesting organs, particularly from the bodies of impoverished people. Narrating the victims’ deeply moving testimonies, my ethnography reveals how organ buyers (both recipients and brokers) tricked and pressured Bangladeshi poor into selling their kidneys. In the end, these sellers were brutally deprived and deceived, and their suffering was extreme. In the post-vending period, sellers’ health, economic, and social conditions significantly deteriorated, yet none of them received the promised post-operative care—not even one appointment. My research therefore concludes that organ commodification is serious structural violence against the poor, at the terrible cost of harm and suffering to them. Examining the organ market proposition, I argue that the resulting violence and injustice against the poor provide a hefty reason to rebut this trade. Bangladeshi kidney sellers also stood up against organ commodification, speaking out about their suffering, and about various detrimental and unethical outcomes incurred in this deal. My research aims to offer insights to bioethics and to broaden the debate on human rights by exposing how technological advancement, structural violence, and grinding poverty intersect in the violation of justice to the poor, turning them into “living cadavers.”

The “miracle” success of transplant technology, alongside the commercialization of health care, and the increasing polarization between rich and poor have created the conditions for an illegal but thriving trade in human body parts. Based on 15 months of challenging fieldwork, my research examines the ethics of the organ bazaar, particularly the experiences of 33 kidney sellers living in Bangladesh. On the underground bazaar, not only human kidneys but also livers and corneas are advertised for sale. Recipients, sellers, and brokers regularly post newspaper advertisements to buy and sell organs. The average price for a kidney is US $1,500 in Bangladesh, a country where 78% of people live on less than $2 a day. My research examines serious ethical questions, such as these: Is it right to purchase an organ, even if the organ sought provides longevity? Is the sale of one’s organ a justifiable means of fighting poverty? These questions allow me to examine the ethics of harvesting organs, particularly from the bodies of impoverished people. Narrating the victims’ deeply moving testimonies, my ethnography reveals how organ buyers (both recipients and brokers) tricked and pressured Bangladeshi poor into selling their kidneys. In the end, these sellers were brutally deprived and deceived, and their suffering was extreme. In the post-vending period, sellers’ health, economic, and social conditions significantly deteriorated, yet none of them received the promised post-operative care—not even one appointment. My research therefore concludes that organ commodification is serious structural violence against the poor, at the terrible cost of harm and suffering to them. Examining the organ market proposition, I argue that the resulting violence and injustice against the poor provide a hefty reason to rebut this trade. Bangladeshi kidney sellers also stood up against organ commodification, speaking out about their suffering, and about various detrimental and unethical outcomes incurred in this deal. My research aims to offer insights to bioethics and to broaden the debate on human rights by exposing how technological advancement, structural violence, and grinding poverty intersect in the violation of justice to the poor, turning them into “living cadavers.”

Early childhood malnutrition is a global public health problem with serious short- and long-term consequences. The aim of this thesis is to evaluate the effects of psychosocial stimulation (PS) with or without food supplementation (FS) on growth and development of severely malnourished children, quality of home environment, mother’s child-rearing practices and depressive symptoms. The study setting was Dhaka, Bangladesh, and the participants were severely malnourished children, aged 6-24 months, admitted at Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B). A hospital-based study was conducted in Nutrition Rehabilitation Unit of ICDDR,B hospital, where a control group (n=43) was studied initially, followed by an intervention group (n=54). All received standard nutrition rehabilitation care. The intervention group received daily group meetings and play sessions in the hospital, and was thereafter visited at home for 6 months. A community-based randomised trial was conducted including children (n=507) admitted at hospital for initial treatment of an acute infection, and thereafter assigned to PS, FS, PS+FS, clinic control or hospital control groups. PS was delivered at follow-up visits, fortnightly for 6 months at community clinics. FS included distribution of cereal-based food packets (150–300 kcal/day depending on age) for 3 months. All groups received standard medical care and micronutrient supplementation. In the hospital-based study, the intervention group had significantly higher scores in mental (p<0.001, effect size 0.52 SD) and motor development (p=0.047, effect size 0.37 SD), and weight (p=0.03, effect size 0.39 SD), after 6- months intervention. In the community-based trial, there was a significant effect of stimulation after six months of intervention on children’s mental development (group*session interaction p=0.037, effect size=0.37 SD) and weight (group*session interaction p=0.02, effect size=0.26 SD) but no effect on motor development or linear growth. The PS+FS and PS groups differed in total HOME score, two HOME subscales (maternal involvement and play materials), and in mother’s child- rearing practices scores but not in depressive symptoms. PS with or without FS had small improvement on children’s growth and development, quality of home environment and mother’s rearing-practices of severely malnourished children. More intensive interventions with longer duration are therefore recommended.

The dissemination of members of the Enterobacteriaceae family with extended spectrum beta-lactamases (ESBLs) and metallo-beta-lactamases (MBLs) has become a global concern. ESBLs and MBLs have been reported in humans, domestic animals, wildlife and the environment, and their isolation frequencies are increasing rapidly worldwide.  Most studies have been performed in developed countries and quite few in developing countries, where the antibiotic consumption is often poorly controlled. To explore the environmental contamination of antibiotic resistance in Bangladesh, and of ESBLs and MBLs in particular, fecal samples from poultry and wild birds were studied in this thesis. Samples were collected from both sick birds (poultry having Escherichia coli infections) and healthy birds (free-range poultry, seagulls and crows) residing in different environmental niches. Samples from patients and fresh/sea water were included, to follow the chain of antibiotic resistance in bacteria from humans to the environment. Information regarding the antibiotic usage in poultry production was also collected. The susceptibility of avian E. coli isolates cultured with and without selective pressure was tested against antibiotics commonly used in human and veterinary medicine in Bangladesh. Special attention was paid to ESBL-producing isolates, which were further characterized genetically. The results of the studies showed that E. coli isolates from commercial poultry, free-range poultry, gulls and crows were resistant to several classes of antibiotics, and that the level and spectrum of antibiotic resistance varied between different bird populations. There was no NDM-producer found among the birds, but ESBL-producing Enterobacteriaceae could be found in up to 59% of the crows, the birds with the highest carriage rate of multiresistant  Enterobacteriaceae of all bird species studied. The most common ESBL-type was CTX-M-15, which also is the most common in the human population in Bangladesh. Birds also shared clinically important sequence types with humans, including E. coli clone O25b-ST131. In conclusion, ESBL-producing bacteria with multiresistance are easily spread to wild birds. Their opportunistic feeding behavior at poorly managed hospital waste dumps and nearby water bodies makes them into both reservoirs and active spreaders. The high level of antibiotic resistant and ESBL-producing bacteria in the bird population of Bangladesh is worrying, and there is no easy solution in sight. Nationwide programs are necessary to both improve the management of hospital waste and sewage and the control of the antibiotic usage to prevent further environmental contamination. / <p>Time of defence has been changed to 09:00 am on 2013-05-27</p>

Le microcrédit est aujourd'hui un terme qui revient souvent quand on entend parler de développement. Les bailleurs de fond se dirigent de plus en plus vers cette « nouvelle » forme de financement du développement qui semble prometteuse à bien des égards. Cet outil peut, selon certains, avoir des effets positifs à plusieurs niveaux: économique, social et politique. Ce mémoire tente d'explorer ces aspects en portant une attention particulière à l'empowerment des femmes au Bangladesh. Il est question d'étudier la Grameen Bank, première banque spécialisée pour les pauvres qui émet des microcrédits à des femmes (97%) pour que celles-ci l'investissent dans une activité rémunératrice et qu'elles se hissent au-dessus du seuil de la pauvreté. Cette recherche dresse un portrait socio-économique et culturel du Bangladesh; présente l'institution étudiée, la Grameen Bank; et aborde les enjeux reliés à l'empowerment des femmes et à l'élimination de la pauvreté à travers des entrevues effectuées durant le printemps 2007, dans trois régions du pays: Rajshahi, Chittagong et Netrokona. Ce mémoire s'appuie aussi sur diverses études et recherches traitant de la question. L'hypothèse de départ est que grâce à ces prêts, les femmes acquièrent un pouvoir économique qui leur permet de sortir leur famille de la pauvreté et les mène sur le chemin de l'empowerment. Les principaux résultats obtenus suite aux entretiens semblent indiquer que les femmes ont encore un chemin à parcourir avant d'atteindre ce qui pourrait ressembler à l'égalité entre les hommes et les femmes. Toutefois, des transformations ont déjà pris formes et ces dernières ont vu leur position au sein du foyer s'élever. Elles ont gagné beaucoup en respect et en confiance, sans compter que plusieurs ont vu leur liberté de mouvement grandir et souhaitent une meilleure éducation pour leurs enfants. Par conséquent, cette étude semble montrer que lorsque les prêts sont bien investis, les femmes réussissent à augmenter leur niveau de vie et les changements au niveau social apparaissent peu à peu.

Ce mémoire a pour objectif général d'essayer de comprendre pourquoi, malgré toutes les mesures et actions entreprises au fil des ans pour lutter contre la traite des personnes, en particulier des femmes et des filles, ce problème persiste sinon s'accroît de nos jours, notamment dans certaines régions du monde telles que l'Asie du Sud. Pour atteindre cet objectif général, nous avons effectué une recherche sur le terrain dans l'État indien du Bengale occidental. Nous avons procédé à une recherche qualitative et avons interviewé divers intervenants à l'aide d'un questionnaire comprenant des questions ouvertes, semi-ouvertes et fermées. Au total, nous avons réalisé trente-cinq entrevues : treize avec des représentants d'ONG, trois avec des porte-parole d'organisations internationales, trois avec des chercheurs, quatre avec des employés de l'appareil administratif du Bengale occidental, une avec le dirigeant d'un village, une avec le sous-inspecteur de la police locale, deux avec les responsables d'un comité mis sur pied à l'échelle locale pour lutter contre la traite. Puis, huit entretiens collectifs ont eu lieu avec des victimes, des parents de victimes, un groupe d'adolescentes et un groupe de femmes. Le travail n'emprunte pas la structure traditionnelle d'un mémoire de maîtrise en ce sens qu'il ne comprend pas un premier chapitre introduisant le cadre théorique ou conceptuel de l'étude. Du fait que la traite des femmes et des filles s'avère un phénomène complexe qui requiert le recours à divers concepts de base, nous avons jugé nécessaire d'intercaler ces derniers aux endroits appropriés du mémoire. Ainsi, dans le chapitre premier, nous faisons une recension des écrits sur le phénomène de la mobilité afin de faire ressortir clairement l'idée que la traite des femmes et des filles est bel et bien une forme de mobilité, une réalité qui n'est pas reconnue d'emblée par plusieurs chercheurs et intervenants impliqués dans la lutte contre la traite. Ce premier chapitre comporte également une description de la traite des femmes et des filles telle qu'elle s'opère à l'échelle internationale. Le deuxième chapitre s'attarde aux causes de la traite, aux facteurs qui contribuent à la vulnérabilité des victimes potentielles de la traite tels qu'on les retrouve en Asie du Sud. Or, nous retenons comme principale cause ce que nous appelons la « citoyenneté inachevée » des femmes sud-asiatiques; ce qui nous amène à explorer la notion de citoyenneté telle qu'elle s'est développée au cours des siècles. Le troisième chapitre porte sur les mesures et les actions retenues aux échelles internationale, nationale (Inde), régionale (Bengale occidental) et locale pour lutter contre la traite. Cela a exigé une analyse de la notion de gouvernance, laquelle est définie comme étant la nécessité pour les acteurs de coordonner leurs efforts. Le dernier chapitre est une synthèse des concepts de mobilité, de citoyenneté et de gouvernance en vue d'identifier une ou des pistes possibles pour véritablement contrer les problèmes de la traite des femmes et des filles. Notre conclusion est qu'il faut resituer le tir de la lutte contre la traite et s'attarder à la cause première qu'est la citoyenneté des femmes. Il faut de plus assurer une mobilité plus sécuritaire. Finalement, une organisation internationale ayant les pouvoirs pour protéger les droits des migrants nous paraît nécessaire. ______________________________________________________________________________ MOTS-CLÉS DE L’AUTEUR : Traite des femmes et des filles, mobilité, citoyenneté, gouvernance.