Runa Khan’s Friendship organisation works for the poorest of the poor in one of the poorest countries of the world. Many of the people of Bangladesh to whom Friendship provides healthcare, schooling and financial support live on unstable river islands at imminent risk of being swept away by floods.

That doesn’t seem like a sound basis on which to build a multi-faceted portfolio of activities, and indeed much of Friendship’s funding comes in the form of grants from charities, corporate donors and governments.

But Friendship is also firmly committed to building a network of commercially viable activities and enterprises as spin-offs from its pro bono endeavours.

“The social business for Friendship is not (about) making business for the organisation,” affirms Khan, the organisation’s founder and Executive Director. It’s about “providing care and building small entrepreneurs in the best way possible … to ensure that these people are giving a value-add to their community which the community did not have before.”

Working with the ultra-poor

With around 160 million inhabitants, Bangladesh is one of the most populous countries in the world, and one of those at greatest risk from the flooding effects of global warming. Friendship was launched in the late 1990s when Khan and her husband, Frenchman Yves Marre, converted a barge that he had transported to Bangladesh from France into a floating hospital.

“It was the first mobile hospital in the country,” recalls Khan, who prior to founding Friendship was a consultant to leading telecom companies and owned boutique shops and tourism firms.

Today, Friendship has a staff of several hundred working in a network of regional offices. It operates two hospitals providing healthcare to people in remote coastal and riverbank areas, with a third one on the way, plus 250 mobile clinics backed by a community medical program and telemedicine facilities.

“We start with intervention in health because when a person is suffering no other intervention is really possible,” Khan explains. “Our mandate is to reach the areas which are left unaddressed by others, be it the government or other institutions. After we have addressed health, we go into food relief, rehabilitation, housing, water, sanitation …”

Friendship also runs schools for children and adults, and it has a cultural project aimed at preserving Bangladesh’s traditional wooden boats and the skills that go into making them. All in all, the organisation assists some 50,000 people a month in its clinics and schools and several thousand more with its micro-finance loan packages.

The combination of healthcare, disaster relief, schooling and micro-finance lies at the heart of its social action. At the community level, medical assistants are trained to earn a living by providing primary healthcare products while farmers and fishermen are developing their activities through provided loan packages.

The target says Khan, is that “within five years these people should move away from us and be part of the mainstream, have an account in the bank and be able to take off by themselves.”

Keeping a balanced relationship

In pursuit of that objective, Friendship works closely with the Bangladesh government, in some areas even occupying a desk in government offices. But Khan emphasises the need to tread carefully, both with the government and with private enterprise.

“We are working in these areas because there is a need that the government is not able to fulfill,” she says. “But we have to keep a very balanced relationship and involve the government as much as possible in our work so that they don’t feel threatened or left out.”

Equally, she adds, Friendship has to be very careful about infringing on the private sector. “I cannot start a business with donor funding and take money from the people when another poor man has sold his house and taken out a bank loan and I am in competition with him,” she says.

Ultimately, says Khan, Friendship’s objective is to be able to withdraw from disaster areas leaving behind a sustainable local economy. “The impact for social business can only come when thousands of people are making money and are entrepreneurs.”