Joint Work Programme for Equitable Economic Growth in Cities Sylhet Figure 1: Campaign Cities map Dhaka Narayanganj Campaign City Brief Sylhet, Bangladesh Population Medical waste Working age population Urbanisation rate generated per day not in employment, (sub-district-level data)1 education or training 672,000 9,127kg 41% 64% A recognition of the importance of equitable In Bangladesh, the Campaign Cities Initiative was economic growth (EEG), and the need to understand implemented from December 2016 to December how EEG can be effectively promoted in secondary 2018 by the BRAC Institute of Governance and cities, led to the establishment of Cities Alliance’s Joint Development (BIGD). Work Programme (JWP) on EEG in cities. The initiative assisted the secondary cities of Sylhet and A trademark component of the JWP-EEG programme Narayanganj (see Figure 1) prepare evidence-based has been the Campaign Cities Initiative (2016–2020). policy recommendations concerning how municipal This initiative began by creating local partnerships in public goods and services could be delivered in a eight secondary cities in Bangladesh, Uganda, Ghana, manner that directly contributes to EEG. In Sylhet, the and Kenya. For each city, a diagnostic assessment focus was on Medical Waste Management (MWM)2 of constraints to EEG was produced, resulting in the and the Vocational Training Centres (VTCs). selection of a particular public good or service in the city that should be prioritised. Sylhet context 2. Preparation of an Institutional Enabling With a population of 672,000, Sylhet is a secondary city Environment Report (IEER): A description of the in north-eastern Bangladesh famous for its spiritual institutional parameters under which SCC operates sites and tea gardens. During the last two decades, was presented in the IEER. the city has experienced remarkable growth, driven by the hospitality and real estate sector, and flows of 3. Preparation of a Local Assessment Report (LAR): foreign exchange from its large diaspora community. Based on the outcome of a workshop reviewing the IEER, the CLP identified two priority interventions However, the metropolitan government, Sylhet City to be further explored within the LAR: (i) medical Corporation (SCC), is now facing the challenges of waste management and (ii) vocational training unmanageable urban growth, coupled with the centers. In order to investigate the feasibility and pressure of an ever-increasing population. nature of each of the two projects, the team conducted interviews and Focus Group Discussions The growth of the health sector has led to improper with women entrepreneurs, a field and GIS medical waste management. Sylhet counts 88 survey of healthcare establishments (HCEs), key Healthcare Establishments (HCE), including medical informant interviews with MWM and vocational colleges, hospitals, clinics, health service centres, and center stakeholders, and reviewed secondary dental and diagnostic centres. These HCEs generate data including official statistics, relevant acts, rules a daily average of 9,127 kg of medical waste, 30% of and policies to explore and assess the situation, which is hazardous. This hazardous medical waste is feasibilities and outcomes of the two projects. handled, transported and disposed along with other solid waste generated in the city. This represents a risk 4. Policy Briefs and the Recommendations: Two not only for sanitary workers and waste-pickers, but respective Action Plans were then developed also to the wider population because of its disposal based on the recommendations of the in unsanitary landfills and consequent percolation of stakeholders and on an assessment of the contaminants to ground water. investment requirements of each project. In addition, Sylhet’s job market is struggling to absorb The Campaign Cities initiative collaborated closely its fast-growing population. About 41% of the working with the Sylhet City Corporation (SCC), the Ministry age population is not in employment, education or of Local Government, Rural Development and training. The worst affected population segment is Cooperatives, and other relevant government and young women, whose inactivity rate reaches 69%. In non-government stakeholders, as well as with the JWP addition, 95% of women are employed in the informal members in Bangladesh including Cities Alliance, DFID economy, which is typically associated with unskilled and the World Bank. jobs and low wages. Although access to education has increased, a large proportion of the working population still lacks general education and skills training. In particular, 23 per cent of students tend to drop out at the primary school level. There is thus a particularly high demand for vocational training. Approach and methodology Each Campaign City initiative took around 24 months to complete, and consisted of the establishment of a City Level Partnership (CLP), followed by the preparation of three consecutive reports and associated workshops: 1. Establishment of a City-Level Partnership (CLP): The Campaign City process began by establishing a CLP that used existing local multi-stakeholder fora. The CLP consisted of representatives from local government, chambers of commerce, the informal economy and the broader community, as well as the JWP facilitator. Members of the CLP debated issues and were responsible for the preparing the reports throughout the process. Findings to abroad has increased, further enhancing the Governance fragmentation demand for skill development. As highlighted in the IEER, while the enactment of the Local Government Act (City Corporation) 2009 About 371,000 people are of working age but less than theoretically provided SCC with greater functional half (159,000) are in the labour force. About 212,000 mandates and responsibilities to provide public people aged 15 or older are not in the labour force, goods and services efficiently, the city remains the majority of which are women. Although access largely dependent on the central government to education has increased, a large proportion of the for development works, both in terms of funding working population still lacks general education and and decision-making. There is also a functional skills training. fragmentation in the delivery of public goods and services, which creates problems in both coordinating Women and youth who are pre-dominant in Sylhet their delivery and maintaining their quality. will be able to contribute highly in the economy with proper skills training. This group, in particular, needs Medical Waste Management training, because some of them dropped out from In terms of standards for MWM, a survey by BRAC formal education or others do not feel any urgency to Institute of Governance and Development in 2017 do something as they depend on foreign remittance revealed that two-thirds of hospitals and clinics in earned by someone else for livelihood. Sylhet do not segregate the medical waste. The survey team observed that even the HCEs segregating The SCC Mayor and other stakeholders also the waste were not following the Government of emphasized the need for vocational training centres Bangladesh guideline of using seven different colours to provide job-oriented training to the youth and bin for different types of wastes. women from marginalized groups. This can potentially reduce both unemployment levels and the gender Most of the HCEs surveyed have no specific storage gap in the labour force, while increasing labour system in their institutions. They store their waste in productivity and economic growth through skills colour-coded bins and large drums. During disposal, training. cleaners and SCC sanitary workers carry the bins or drums from the HCEs. In most of the cases, these The 2030 Agenda for Sustainable Development bins and drums are stored in bathrooms, under stairs, considers a skilled labour force as the key to achieving and in open spaces beside buildings of HCEs. After productive employment, gender equality and collecting the waste from the HCEs, trucks transport it inclusive sustainable economic growth. To achieve to the landfill site in Lalmatia, a place owned by SCC the SDG goal, different ministries of Bangladesh, and located about seven kilometres away from the including education, foreign, labour and employment, city centre. Drivers dump the waste using the truck’s have taken necessary skills-based trainings and automatic unloading system, but they do not have an programmes. excavator to move the waste. The broker, who is an informal worker in landfill site, gets verbal permission from SCC to recycle the waste from the landfill based on their mutual interest. Under the direction of the broker, male and female workers primarily segregate the valuable materials and keep the waste in bowls. The broker sends the sacks to wholesalers in the local market and gets a price according to the products. Wholesalers further segregate the waste to ensure the quality of the specific product and try to get the highest market price for the product by selling to local factories or other wholesalers outside Sylhet. The value added for recyclable materials at various stages (from landfill to factory) indicates that these materials have a large market at the local and national level. Vocational training The importance of skilled labour force is very evident as Bangladesh’s economy has been growing for the last few years, which is creating a huge demand for skilled labour force internally. At the same time, increasing labour immigration from Bangladesh