Most of us have looked after someone who is ill. Even a short illness brings constant questions: Have they had something to drink? Can they wash themselves? Have they slept?
Now imagine asking those questions every day, for years, while caring for a daughter with a disability, a parent with dementia, or a relative with a serious mental health condition.
For unpaid family carers, this is their reality.
They care with love and commitment at enormous personal cost. Their health, livelihoods, education, and social lives can be pushed aside. They hold communities together and sustain health and care systems without pay, recognition, or even a break.
In 2021, Bangladesh valued unpaid household and care work at Tk6.7 trillion, which represents approximately 18.9% of the country's GDP. This calculation encompasses both unpaid domestic work and caregiving, revealing the significant scale of a contribution that is frequently overlooked.
Bangladesh’s National Healthy Ageing Strategy and Action Plan 2024-2030 acknowledges that family carers can delay or prevent the need for residential care for older people.
Recognition in principle is not the same as support in practice. Assistance may go to a person with a disability through the disability allowance or to a household through the Family Card. Too often, nobody looks beneath the surface, as carers are frequently the very people navigating applications and managing payments intended to support someone else.
Evidence from work in Bangladesh is described as striking by researchers. Through a partnership with the Centre for Disability in Development (CDD), research conducted in a project area in Savar revealed that 67 percent of households that included a carer and a person with a disability were living in extreme poverty on less than $1 a day.
Separate research highlighted that 95 percent of family carers in Savar had a health issue or disability of their own. These findings are local, rather than national estimates, but they expose the pressures hidden behind the word "care."
Caring has a profoundly disproportionate impact on women. In a three-year program with CDD in Savar, 93% of the 1,008 unpaid family carers supported were women and girls.
For many, caring means giving up paid work, perpetuating financial dependence, and having little time to look after themselves. When we fail to support carers, we deepen inequality for women and girls too.
In Dhaka, Kohinoor cares for her daughter Farea, who has autism. Having once struggled alone, she joined a local carers group that connected her with people who understood, and she eventually became its president.
Through livelihood training, she began poultry rearing. Within two months, her flock grew from five birds to 12, and she earned money by selling eggs.
Kohinoor's success is not isolated. Through a partnership with CDD, Carers Worldwide has supported 1,008 carers in Savar, established 50 carers groups, and trained 425 carers in income-generating activities. Additionally, six community caring centres have provided children with disabilities care and learning opportunities, while offering their carers essential time for work, rest, and social connection.
An independent evaluation found that 98% of participating carers reported improvements in their physical and/or mental health. These figures represent individuals transitioning from isolation to friendship, from financial insecurity to opportunity, and from being overlooked to being heard.
There are encouraging signs of wider change. Carers ID cards introduced in Dhaka last year acknowledge the contribution carers make and help them access priority services.
Salma, a recipient, said: “Within my family and society, I was without recognition. Now, my value and recognition within my family have increased.” The initiative aims to reach more than a thousand carers.
Bangladesh has a chance to lead. New social protection systems must identify unpaid family carers, not only the people receiving care, and recognize the financial costs they bear.
Health services should offer carers medical care, mental health support, and respite. Flexible livelihoods and carers’ groups should be part of community development, and carers themselves must have a voice in shaping policy.
The community volunteer network proposed in the National Healthy Ageing Strategy offers a promising starting point. It could finally provide an answer to parents who ask: “Who will care for my loved one when I am no longer here?”
This approach deserves a place in the broader National Health Policy, so that support extends beyond older people to families caring for people with disabilities and long-term conditions.
On the International Day of Care and Support, October 29, we should celebrate carers’ extraordinary contribution. But gratitude is not enough.
The real measure of progress is whether someone like Kohinoor can care for her daughter without sacrificing her own health and future. We must make that support a right, not a matter of chance.
Those who care for others deserve care too. It is time for Bangladesh to care for the carers.
Anil Patil is the Founder and Executive Director of Carers Worldwide. Anil has 25 years’ experience in the international development sector as a veterinarian, development worker, grant maker, and trustee.
Why it matters
Unpaid family carers sustain Bangladesh's healthcare and social fabric without formal recognition, making structural policy support vital for economic equality and community well-being.