On Bangladesh’s temporary islands, Runa Khan helps families stand with dignity

Runa Khan is a Bangladeshi humanitarian and social entrepreneur who founded Friendship in 2002. Her work began after she witnessed families living with severe poverty on temporary river islands. She believed recognizing suffering creates a responsibility to act. Her goal was to help char communities live with health, opportunity, and dignity despite displacement and isolation.

Khan converted a river barge into a hospital ship along the Jamuna River. Friendship later built a broader system with mobile clinics, local medic aides, education, livelihood support, and climate-resilience programs. The health network reaches people who otherwise must cross rivers or rely on alternative medicine. Khan also visited communities regularly, using their needs to guide new services.

Friendship now provides services for 7.5 million people annually. It operates seven hospital ships, two land-based hospitals, 550 mobile clinics, and employs 700 medic aides. Khan received the 2026 Ramon Magsaysay Award for leading this work, but worsening climate risks mean her mission remains unfinished.

Char islands are sandbar islands formed by sediment deposition from major river systems. In Bangladesh, many lie along the Brahmaputra and its branch, the Jamuna. These islands are not stable landforms. Rivers build them from deposited sediment, then reshape them through erosion and flooding. This constant change makes homes, roads, and services difficult to maintain.

The communities face two opposing forces. Flooding can cover low-lying land, while erosion can wash away riverbanks, villages, and farmland. Residents may have to move even when their incomes are already unstable. During illness, they may also need to cross rivers to reach mainland hospitals. These pressures reinforce poverty and make everyday life uncertain.

Some estimates place the char population at up to 20 million people. Friendship works in these remote communities because fixed services cannot reliably reach people across shifting waterways. Its hospital ships, clinics, and local aides bring support closer, while climate-resilience programs respond to growing environmental risks.

Some estimates say up to 20 million people live on Bangladesh’s char islands. These communities occupy low-lying sandbars along major rivers, including the Brahmaputra and the Jamuna. Their land is repeatedly reshaped by erosion and flooding. The large population therefore faces a problem that is both geographical and social: many people live far from dependable services on unstable ground.

Friendship has expanded from one hospital ship into a large service network. It now reaches 7.5 million people annually through health care, education, livelihood support, and climate-resilience programs. Its medical system includes hospital ships, mobile and satellite clinics, and trained local medic aides. This structure allows services to reach families in scattered communities rather than requiring everyone to travel to the mainland.

The figures show both the scale of need and the scale of the response. Friendship operates seven hospital ships, two land-based hospitals, 550 mobile clinics, and 700 medic aides. Climate risks are worsening, so continued access and adaptation remain important for char communities.

Char communities are low-lying and flood-prone, so reaching mainland hospitals can be difficult. People may suffer infectious and water-borne diseases during the monsoon season, while mothers and children face additional health risks. Friendship makes care more accessible by bringing services directly to the islands and by connecting local screening with specialized treatment.

Local women trained as medic aides conduct door-to-door check-ups, provide maternal care, and collect patient information through a mobile app. Roving medical teams operate mobile and satellite clinics for primary care. Hospital ships then provide surgeries, specialist services, consultations, and medicines. They treat conditions such as cataracts and clubfoot and offer pediatric, gynecological, dental, and eye care.

This three-tier system reduces the need for every patient to cross a river. Friendship now has seven hospital ships, two land-based hospitals, 550 mobile clinics, and 700 medic aides. The organization also offers free or low-cost consultations and medicines, helping families who might otherwise rely on alternative medicine.

When river erosion and flooding repeatedly disrupt char communities, families lose more than shelter. Villages can be washed away, forcing residents to relocate again and again. Their incomes are already unstable, so moving adds another burden. The cycle leaves families vulnerable to extreme poverty and makes it difficult to maintain schooling, work, and access to health care.

Illness deepens the problem. Floods trigger common infectious and water-borne diseases, while mothers and children may face elevated risks. A sick person may need to cross a river to reach a hospital or rely on alternative medicine. A mother in one community fed her sick child only two meals to save money for lamp oil, showing how poverty shapes health decisions.

Friendship responds by bringing care closer and supporting livelihoods, education, and climate resilience. Its local aides identify needs early, mobile teams provide primary care, and hospital ships offer specialized treatment. Yet worsening climate risks continue to threaten homes, incomes, and the stability of char communities.

Friendship combines services because char communities face connected problems. Poor health limits a person’s ability to learn, work, and pursue opportunities. Displacement and unstable incomes can also make treatment difficult to afford or reach. Khan says good health comes first, but she also links health with empowerment, hope, and dignity. The article does not describe a Friendship legal-help program.

The organization therefore began with medical access and expanded into education, livelihood support, and climate-resilience programs. Its health system shows the approach clearly: local medic aides identify needs, mobile teams provide primary care, and hospital ships handle major interventions. Education and livelihood services address longer-term opportunity, while climate programs respond to the forces threatening homes and incomes.

Friendship now provides these services for 7.5 million people annually. Khan says the organization’s expansion came from listening to community needs rather than following development theory alone. As climate risks worsen, combining immediate care with resilience and opportunity may help communities face repeated disruption.

Char islands form when major rivers deposit sediment into sandbars. The Brahmaputra and its branch, the Jamuna, create these temporary islands through changing river flows. The same rivers can later erode their edges, flood their surfaces, or wash away entire villages. This natural process means the land itself is continually changing beneath residents’ homes and livelihoods.

The mechanism creates a cycle of arrival and loss. Sediment can build new land, while erosion removes existing land. Flooding makes communities harder to reach and increases exposure to infectious and water-borne diseases. Families may have to relocate repeatedly, even when they have unstable incomes. Access to hospitals, schools, and other services becomes difficult when routes and settlements keep shifting.

The article says char communities are becoming more vulnerable because of the worsening climate crisis. Floods and erosion already threaten displacement, and greater climate pressure can intensify that instability. Friendship is developing climate-resilience programs alongside health, education, and livelihood services, but Khan’s work remains unfinished.