Samira Hussain
BBC correspondent in South Asia
Bbc
Kajol, who is the only family support in his family, contracted tuberculosis in January
When Kajol contracted tuberculosis in January, USAID maintained it alive. Now, she and her family are again in danger after the Trump administration has ordered that most of the United States helps end.
Tuberculosis can be fatal if it is not treated. Very contagious bacterial disease, which generally infects the lungs, is not widespread in rich countries, because the treatment is relatively inexpensive. But in Bangladesh, it is a scourge.
This is particularly true in neighborhoods like Mohammadpur, a slum in the capital Dhaka where Kajol lives, 17 years old.
“We are poor,” she said. She is the only family support for herself, her mother and her little brother. His work in a clothing factory keeps them all afloat.
So when she fell ill in January, it could have been catastrophic.
Instead, the help arrived by Dipa Halder. Over the past three years, she has brought Mohammadpur residents about tuberculosis and made people need so desperately, free.
The initiative is managed by a local aid organization, Nari Maitre. He was funded by the American Agency for International Aid (USAID) until February, when he received a letter from the United States government saying that the funds had been terminated.
This brought the treatment of Kajol, only partially completed, to an steep end.
“Now I have to get the medication myself,” she said. “I have a lot of trouble.”
Cutting the drugs in mid-treatment makes the chances of tuberculosis to become much more resistant to medication. It makes illness much more difficult to fight and puts patients to a greater risk of serious illness and death.
“People here are quite vulnerable,” said Dipa, 21. “I can tell them to go to a particular doctor, which would help them save money.
“Or I try to provide them with a certain financial assistance from our organization so that they can continue their treatment.”
The reports show that thousands of cases of tuberculosis in Bangladesh have been cured thanks to the support of the USAID
According to a performance report by the American government observed by the BBC, the support of the USAID in 2023 led to the identification and declaration of more than a quarter of a million new cases of tuberculosis in Bangladesh. The same year, there were 296,487 new cases or relapses of tuberculosis which were healed or successfully completed following the USAID.
The agency was considered to be an integral part of the country’s struggle against tuberculosis.
“You ask people on the street, they will say that yes, it is the United States, they are the ones who keep it (tuberculosis) in control,” said a director of a USAID project in Bangladesh, who is not allowed to speak publicly and did not want to be appointed.
“Bangladesh was the biggest program in USAID in Asia,” said AIF Saleh, executive director of non -profit BRAC organization. “In terms of its impact, especially in the health care sector, it was massive.
“In particular around vaccination, reduction in infant mortality and maternal mortality, USAID played a massive role in this country.”
In 2024, Bangladesh received $ 500 million in foreign aid. This year, this amount completed $ 71 million. To put this number in context, during the three-year period compared to 2021-2023, USAID engaged on average $ 83 million a year in Bangladesh for health initiatives, including the fight against TB.
The USAID cuts have meant that Nari Maitre can no longer offer his TB stop program, but this also means that DIPA is without work. She supports her elderly parents and her younger sister.
“I am completely broken now that I have lost my job. I wear the family’s burden. Being unemployed is a devastating situation,” she told the BBC.
In a document seen by the BBC, 113 programs financed directly by the USAID office in Bangladesh arrested. The list does not include the myriad of programs funded directly by American agencies in Washington.
“The NGO sector (in Bangladesh) employs at least 500,000 people,” said Saleh. “It’s huge. Thousands and thousands of jobs will be eliminated.”
Hundreds of thousands of refugees at the Cox bazaar are just enough to live and not much more
It is not only the United States that moves away from foreign aid. The United Kingdom has announced discounts of its foreign assistance programs, as is Switzerland. It is likely that other countries can follow the plunge.
It is a reality that gives to think for the Bangladesh. The country’s government was overthrown last year and the economy is trembling, with inflation almost 10% and a job crisis, especially among young people.
The acting chief Muhammad Yunus says that Bangladesh will offer a new strategy on how to survive after the help cuts – but does not say how.
When he is in a hurry in an interview with the BBC on how the country will cover the USAID deficit, Yunus said: “It was a small part, not a big problem. It does not mean that the Bangladesh will disappear from the card.”
Asif Saleh says the way the cuts have been implemented were abrupt and chaotic. The impact on a country like Bangladesh is immeasurable.
Nowhere is clearer than in Cox’s Bazaar, a coastal city in southeast of Bangladesh, which houses the largest refugee camp in the world. More than a million Rohingyas, a persecuted Muslim minority community that the United Nations calls victims of ethnic cleaning, fled violent purges in their country of origin, the neighboring Myanmar.
Unable to go home and unable to work outside the refugee camp, the Rohingyas depend on international aid for their survival.
The United States has contributed almost half of all aid to the Rohingyas refugees.
“We no longer have a soap,” said Rana Flowers, representative of the United Nations UNICEF agency campaign. “We must now truck water in the camps. This is an absolutely critical moment. There is an epidemic of cholera with more than 580 cases, as well as an epidemic of scabies.”
The water sanitation projects in the camps were funded by USAID.
Given that the order to stop the work has entered into force at the end of January, hospitals such as the CoX’s Bazar International Red Cross Hospital are reduced to providing emergency assistance only. All hope that money would be restored this week, when the Trump administration has canceled more than 80% of all USAID programs.
Rehana Begum says that she believes that many people will die of hunger due to aid reductions from country like the United States
Patients like Hamida Begum, who received regular treatment for hypertension, are found with few options.
“I’m old and I have no one to help me,” she said. Her husband died last year, letting her take care of her four children alone, including her 12 -year -old daughter who cannot work.
“I can’t go to another hospital away from my home because of my daughter.”
In a nearby United Nations distribution center, Rehana Begum stands next to two large bags.
Inside, she says, are six liters of cooking oil and 13 kg of rice, as well as bases such as onions, garlic and dried peppers. These rations, given to her by the World Food Program (WFP), must last her and her family a month.
I ask how she will now manage that her rations will be reduced in two from next month.
She looked shocked. Then she started to cry.
“How can we survive with such a small quantity?” Asks Rehana, 47, who shares a room with her husband and five children. “Even now it is difficult to manage.”
The WFP says that it was forced to make the drastic cut due “to a critical financing deficit for its emergency intervention operations”.
The rations now attributed to the Rohingyas community will only meet their basic daily food needs, triggering the fears they find themselves just enough to live and not much more.
“This is an absolute disaster in the making,” said Rana Flowers of Unicef. “Persons desperately frustrated in camps will lead to safety problems. If that degenerates to the extent, we will not be able to enter the camps to help.”
