Governing the Population
Self-assured commentators who saw Bangladesh as a 'basket case' not many years ago could not have expected that the country would jump out of the basket and start sprinting ahead even as expressions of sympathy and pity were pouring in... It is important to understand how a country that was extremely poor a few decades ago, and is still very poor, can make such remarkable accomplishments particularly in the field of health, but also in social transformation in general. (Sen 2013, 1966)
The powerful impulse to protect people against subsistence crises set the stage for people to become more resilient, by raising smaller, healthier, better educated families equipped to take advantage of the opportunities afforded by an open economy. New and extended services included family planning and basic health services delivered by frontline 'paraprofessionals', often women from the communities themselves; a massive expansion of the primary school system; and a series of public health campaigns that successfully changed mass behaviour, tackling in particular the main childhood killer diseases. To do this, the state needed to know its population, and the origins of the state's strong statistical effort are to be found in the turbulent early years, when the foundations for development planning were being laid. Given its limited capacities and the need to achieve these changes with aid, space for and partnerships with the growing number of NGOs became critical to delivering these services. These were all mass services, from which no Bangladeshi was excluded—or exempted. This was not about 'target groups', but about governing the population in its entirety, to become capable of reproducing itself in the numbers and quality necessary to compete in the global economy into which Bangladesh was now to integrate. Almost immediately, after a visible blip around the early to mid-1970s, life expectancy started to rise. Bangladeshis now expect to live among the longest lives in the region (see Figure 7.1).
The Aid Lab
Figure 7.1. Life expectancy in South Asia (years), 1966-2013
Source: World Development Indicators. Accessed 31 December 2015. http://databank.worldbank. org/data/reports.aspx?source=world-development-indicators.