Dr. Iftikher Mahmood on HOPE Foundation, Rohingya Healthcare, and Maternal Care in Bangladesh

Author(s): Scott Douglas Jacobsen

Publication (Outlet/Website): The Good Men Project

Publication Date (yyyy/mm/dd): 2026/04/08

Dr. Iftikher Mahmood is a Bangladeshi American pediatrician and humanitarian leader from Cox’s Bazar, Bangladesh. He earned his medical degree from Chittagong Medical College in 1987, later completed pediatric residency training at Brooklyn Hospital in New York, and pursued pediatric endocrinology fellowship training at New York Hospital–Cornell University. Settled in Florida since 1996, he founded the HOPE Foundation for Women and Children of Bangladesh in May 1999. Under his leadership, HOPE has expanded hospitals, birth centers, midwifery training, fistula care, and Rohingya refugee health services, linking rural Bangladeshi healthcare with global humanitarian partnerships and sustained community-based maternal care for underserved families nationwide.

In this interview, Scott Douglas Jacobsen speaks with Dr. Iftikher Mahmood about building the HOPE Foundation from a single clinic into a broader healthcare system serving Cox’s Bazar and Rohingya refugees. Mahmood reflects on Bangladesh’s preventable burdens of disease, maternal and child mortality, and the importance of training local midwives and refugee health aides. He explains how partnerships, ethical standards, and revenue from host-community hospitals help sustain care when donor attention wanes. The conversation also highlights the human reality beneath refugee statistics: grief, statelessness, trauma, resilience, and the long uncertainty facing families without security, citizenship, or stable futures in exile today. 

Scott Douglas Jacobsen: You founded HOPE in 1999 after witnessing the healthcare needs in Cox’s Bazar. What was the original problem?

Dr. Iftikher Mahmood: I was born and raised in Cox’s Bazar. During my elementary school years, Bangladesh became independent through a bloody war in 1971, separating from Pakistan. The country was war-torn, and there were widespread problems, including in the southeastern region where I grew up.

The primary issues were severe healthcare crises—high maternal mortality, high infant mortality, and high under-five mortality—alongside a lack of resources, doctors, and clinics.

I was fortunate to attend medical school. With these experiences in mind, I developed a strong sense of responsibility to help my community, as I was among the few who had that opportunity. At the time, however, I was unsure how to contribute effectively. I helped in small ways, but I wanted to do more.

I later came to the United States for higher education and completed postgraduate training at universities and hospitals there. About 26 years ago, I founded the HOPE Foundation to address these challenges by providing primary healthcare, including maternal, pediatric, and mental health services.

I began with a single clinic, which expanded over time.

Jacobsen: The organization grew from a modest clinic into hospitals, clinics, and training programs. What were the hardest turning points?

Mahmood: The organization grew from a modest clinic into hospitals, clinics, and training programs. The most difficult period came in the early years. When I started in 1999, I was in my 30s and lacked experience. I had a vision and a strong desire to help, but I did not yet know how to establish or manage an organization.

The first 12 years were especially challenging. Running the clinic required building a team and securing funding. Around 2005, after six years, I raised funds to establish a small hospital.

However, we lacked the resources to equip the hospital and hire sufficient medical staff. As a result, progress remained difficult for more than a decade.

A turning point came around 2011. I received a grant from the Japanese embassy to establish a training center, along with funding to launch a midwifery school.

This shifted the organization from being solely a service provider to also becoming an educational institution. In addition to clinical services, we introduced training programs. This strengthened our credibility with the government and local partners, enabling us to secure additional funding and support.

At the same time, I launched a program for obstetric fistula surgery. Obstetric fistula is a childbirth injury typically caused by prolonged obstructed labour without timely access to emergency obstetric care, such as a cesarean section. It can lead to urinary or fecal incontinence and usually requires surgical repair.

Recognizing this as a critical issue, I developed a program in partnership with the Fistula Foundation in the United States.

This initiative further strengthened our credibility as an organization.

These developments, particularly between 2011 and 2012, transformed HOPE into a more credible, viable, and sustainable institution.

Jacobsen: In Bangladesh, what are the preventable causes of suffering or death?

Mahmood: Most preventable causes of suffering are very basic. Infections are among the leading causes, particularly those linked to poor sanitation, unsafe water, and inadequate access to basic needs.

Common infectious diseases include diarrheal diseases, pneumonia, dengue, malaria, and tuberculosis. In addition, road traffic accidents are a significant issue, often due to infrastructure challenges.

Among children, the most common preventable causes are respiratory diseases, diarrheal diseases, and malnutrition.

In maternal health, access to proper antenatal care during pregnancy is critical. Many women do not receive adequate care due to distance, financial constraints, or lack of available services. As a result, they face preventable deaths and disabilities related to pregnancy.

This contributes to high maternal mortality. When mothers suffer, their infants are also affected, leading to high rates of infant mortality, neonatal mortality, and overall child mortality

Jacobsen: You have invested in training midwives and local healthcare workers, building on the earlier discussion. Why is building local professional capacity so important?

Mahmood: In our case, the turning point came when we established the midwifery school. That grant significantly advanced our work because our organization focuses strongly on maternal health.

To provide high-quality maternal care, doctors alone are not sufficient. A strong support system is essential, including well-trained midwives.

It is difficult to recruit and retain highly qualified health professionals from major cities to work in rural areas. The most effective solution is to build local capacity. The midwifery school enabled us to train local women as midwives through a three-year program. After graduation, they work in rural areas and serve their own communities.

This reduces dependence on external staffing and creates a sustainable local healthcare workforce. These midwives are young and have long professional careers ahead of them. Over time, they will save thousands of women and infants.

Jacobsen: You also work in the Rohingya refugee camps. Why is local capacity building important there as well?

Mahmood: We also work in the Rohingya refugee camps. A few years ago, we recognized that the Rohingya population has distinct cultural and social needs compared to the local population.

To provide effective care, we began training Rohingya community members. We developed a program for young Rohingya refugee women to become health aides. They receive nine months of training and then work within their communities.

They help ensure that healthcare services are understood, accepted, and properly utilized. They also educate community members about health practices and the importance of care.

This creates a bridge between external healthcare providers and the communities we serve. That is why local capacity building is essential.

Jacobsen: Following from your last response about the Rohingya refugees, what did that moment reveal to you?

Mahmood: The Rohingya refugee crisis began in 2017, about eight or nine years ago. It was a pivotal moment for our foundation because it was entirely unexpected. Within a few months, nearly one million people arrived in our area.

The HOPE Foundation had already been working in the region for over 15 years, so we had some operational capacity. We were among the first organizations to respond. When the refugees arrived, many were sick, exhausted, traumatized, and injured. They urgently needed medical care.

We quickly established clinics and health centers within the camps. This experience helped us in multiple ways. We were able to serve the most vulnerable populations, which aligns directly with our mission—to provide care to those who lack access to essential services.

The Rohingya community represented one of the most vulnerable populations we had ever encountered. At the same time, humanitarian crises attract international organizations such as World Vision, Médecins Sans Frontières (MSF), UNHCR, and other United Nations agencies.

We were able to work alongside these organizations, learning from them while also building partnerships. This strengthened our network and enhanced our credibility. As a result of our work in the Rohingya camps, we received international support and recognition, including awards. These developments helped us sustain and expand our services.

Jacobsen: In refugee settings, healthcare is often discussed in numbers. What human realities are missed when displacement is reduced to statistics?

Mahmood: That is an important question. Numbers are necessary—we need data on refugee populations and the number of patients treated. However, numbers do not capture the human reality.

The real story lies in individual experiences. Over the past eight years, I have met thousands of refugees, and each person has a story—stories of loss, suffering, resilience, and hope for the future. These lived experiences are not reflected in statistics.

Two encounters have stayed with me. Early in the crisis, I visited one of our clinics and met a woman holding a baby while waiting for treatment. When I spoke with her, she expressed gratitude to Bangladesh for providing shelter, food, and medical care.

However, she had lost seven family members, including her children and her husband. The baby in her arms was the only family she had left. Despite that immense loss, she remained grateful. I found that deeply moving.

In another case, a colleague of mine was treating a patient who had also lost his entire family. He had not slept for weeks due to trauma.

He told us he had not slept for many weeks. He was an elderly man, likely over 60 years old, which is significant in that context. I found myself wondering how someone could endure such prolonged sleeplessness and still continue. It spoke to the resilience of these individuals. Stories like this are everywhere.

The Rohingya people also lack statehood. Their citizenship was effectively stripped in 1982, leaving them without nationality. They are not recognized as citizens of any country. Even as refugees, they face profound uncertainty.

They do not know where they will go, what their future holds, or whether their children will receive an education. They lack the basic assurances that most people take for granted. There is no clear sense of stability or direction in their lives.

These are the realities that statistics do not capture—the depth of loss, the psychological impact, and the resilience of individuals facing unimaginable circumstances. To understand them, one must engage directly with individuals and hear their experiences.

Jacobsen: You live and practice in the United States—speaking from Florida now—while leading work rooted in Bangladesh. How has that dual perspective shaped your understanding of responsibility?

Mahmood: It has made a significant difference. I grew up in a remote part of Bangladesh, surrounded by poverty, hardship, and struggle. I experienced those conditions myself.

At the same time, I was fortunate. I was ambitious and able to pursue a medical degree, and later I came to the United States for advanced training. At that time, the United States represented an opportunity for higher education and professional development.

If I had remained in Bangladesh, it would have been much more difficult to establish the HOPE Foundation and expand its services. There are many structural challenges—social, financial, and institutional—that make large-scale initiatives difficult to sustain.

In contrast, being in the United States allowed me to focus, build networks, and access resources without the same level of daily struggle. I was able to connect with donors, partners, and supporters who played a critical role in building the organization.

I continue to travel regularly to Bangladesh, but my training and position in the United States have enabled me to mobilize support and serve millions of people through the HOPE Foundation.

Jacobsen: Humanitarian work depends on donor attention, not only funding. How can serious organizations sustain care once public attention fades?

Mahmood: This is a critical challenge. The Rohingya crisis began in 2017, and for the first few years it received significant global attention. It is one of the largest refugee situations in the world.

However, attention shifted with the emergence of other global crises, particularly the COVID-19 pandemic. As a result, the Rohingya crisis has largely faded from public discourse, even though the population remains and continues to grow.

The needs have not diminished. Both the refugee population and the local communities still require support.

For organizations like ours, sustainability depends on diversified strategies. Humanitarian work cannot rely solely on external donor funding.

One approach is to generate local revenue. We have developed this model by operating hospitals that serve the host community. We charge affordable fees for services, which allows us to generate income and maintain operations.

This hybrid model—combining donor support with locally generated revenue—helps ensure continuity of care, even when global attention declines.

We are working to expand our services to support the refugee hospital, which does not generate revenue. We collaborate with partners to strengthen our local hospitals through equipment, infrastructure expansion, and construction. This allows us to increase revenue, and any surplus can be directed toward sustaining services in the refugee hospital.

The second key principle, from the beginning, has been quality. As a physician trained in the United States, quality and ethical service have always been my top priorities. These are the standards I learned during my training, and I wanted to apply the same principles in the hospitals we operate in Bangladesh.

Despite resource limitations, maintaining high standards of care is essential. We ensure that quality remains the top priority. When people visit our hospitals, they experience an environment comparable to an international facility, even in a rural setting. The hospitals are clean, infection-controlled, and staffed by professional personnel.

When donors visit, they are often impressed by the level of care and professionalism. As a result, they not only continue to support us but also advocate for us within their own networks.

Our reputation for quality and ethical service has helped us attract additional donors. Fundamentally, our approach is not to chase donors or partners, but to focus on delivering high-quality, ethical care. When we do that consistently, support follows.

We cannot control others, but we can improve ourselves. I regularly encourage my team to focus on continuous improvement—how to deliver better care and how to meet the expectations of our donors.

Every donor has a mandate, but at its core, that mandate is to ensure that recipients receive the best possible care. That is why they contribute. We aim to fulfill that responsibility, and fortunately, our donors have been satisfied with our work.

Jacobsen: Thank you very much for your time today. I appreciate it.

Mahmood: Thank you. It was a pleasure speaking with you. I appreciate the opportunity, and I hope we can stay in touch.

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