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There were also cases where traditional birth attendants tried to deliver babies, and the child died during the process. When women here go into labour, people have no option except motorcycles or horse carts to take them to health facilities.”

She said most women in the area experience repeated pregnancies, with some giving birth to as many as 12 or 13 children. Early marriage remains widespread, with many girls married off between the ages of 14 and 16, while family planning services are almost non-existent.

“Families often try delivering at home before bringing mothers here. By the time they arrive, both mother and baby [are in] critical condition.”

In Bangladesh’s remote char regions, where river erosion and isolation often cut communities off from basic services, healthcare has long been a matter of survival.

BRAC’s CHARMs (Char Health and Resilience for Mothers and Society) project has been changing that reality through “Sushasthya” healthcare centres in Char Ghorjan [in Sirajganj], serving nearly 30,000 residents who previously lacked access to local maternal care.

Operating 24 hours a day, the centres provide safe delivery services, maternal care, vaccinations, diagnostic tests, and telemedicine support in one of Bangladesh’s most climate-vulnerable and geographically isolated regions.

Taherima said, “Now almost everyone comes to this centre because there is no other place across these char villages where pregnant women can get treatment. We handle all normal deliveries here, but if complications arise and a normal delivery is not possible, we are still forced to refer patients to hospitals in Shahzadpur Upazila or Enayetpur.”

The centre keeps motorcycles and horse carts ready for emergency transport. But even after reaching government hospitals, many women struggle to receive proper care and often prefer private hospitals -- an option many cannot afford.

“In those cases, BRAC provides Tk 5,000 in assistance for referred patients,” she said.

The facility, which operates with three midwives, one paramedic, and a 24-hour telemedicine doctor, now treats more patients than it was originally designed for.

“The maternal death rate has dropped significantly,” Taherima said. “This healthcare project was planned for three years. But if the people here want it to continue, perhaps BRAC will extend it further. It’s already been a year and a half since we began.”

Since opening, the BRAC-run facility has conducted more than 100 deliveries and referred 21 women for caesarean sections.

Before the health centre opened, many pregnant women in the char villages sought medical help only after complications had already turned life-threatening.

Community health workers recruited from the char villages are visiting homes to raise awareness about maternal healthcare, safe deliveries, and postnatal care, while BRAC works with midwives, adolescents, and community leaders to challenge long-standing taboos around institutional childbirth.

According to paramedic physician Amit Hasan Hridoy, more women in the remote char region are now seeking regular check-ups and early treatment, improving outcomes for mothers and newborns.

“However, early marriage remains a major concern. Many girls become pregnant before their bodies are ready,” he said, adding that early pregnancies often leave both mothers and babies malnourished and vulnerable to complications.

Mohammad Jobbar Ali, a community leader in his 60s, said, “Maternal and infant deaths have fallen a lot compared to before. When this centre was first proposed, we believed it would change our lives, and it has.

“Our roads and transport are still very poor,” he said. “Earlier, many mothers died on the way to the city while trying to get treatment. But now our situation is much better.”

Although some nearby villages technically have government community clinics, Jobbar said residents rarely receive meaningful healthcare services there.

“It feels like neither the government nor anyone else even knows that so many people live here. Nobody thinks about us. But this BRAC health centre is saving our lives.”

The healthcare project is currently scheduled to run for three years, but Jobbar said villagers are desperate for it to continue.

“When the project period ends, the centre is supposed to close. But we need it to survive. For us, this health centre is essential.”

Mahfuzer Rahman, project manager of BRAC’s CHARMs project, said the initiative is working not only to provide healthcare but also to improve the overall quality of life for people living in remote char communities.

“Through these healthcare services, we are trying to ensure they receive the treatment and support they need. Our goal is to ensure safe motherhood and childhood.”