Happy, 15, is pregnant and lives in a slum of Dhaka, Bangladesh.Not far from my hotel, in the heart of Dhaka, is the Jhilpar slum. By the bank of a lake, densely packed rows of tiny corrugated tin huts, separated by only narrow gutters with rickety bamboo walkways, are home to over 5,000 people. This is just one of many such growing urban slums across the city.

This morning I visited several families living there who are part of Nutrition International’s efforts to reduce anaemia in pregnant women as part of Right Start in Bangladesh.  Our initial plan to visit another location was cancelled due to flooding, so this event was unscripted and we were able to just sit and talk with several pregnant girls, ages 15-18.

We talked about nutrition, health, and life. They described the daily reality of living in Jhilpar, all struggled with domestic violence, all needed to find work. After a while I asked them what they dreamed of becoming, something I had just recently done with another group of young girls in Indonesia. But unlike their hopeful and inspiring answers, prospects for these girls were dim. One hopes to get a job, another wants to get out of the slum and go back to her village and work. However, it was the answer given by Happy, 15 years old and five months pregnant, that shook my world. “My dreams are over,” she said. “All I have now is the hope that my child will have a better life.”

In Bangladesh, 49% of girls get pregnant before their 18^th birthday. They’re under immense pressure, they have very limited choices or voice, and social services are not structured to support their health and nutrition ― or that of their children. I was shocked to learn that the top 3 ‘foods’ consumed by pregnant women in Bangladesh are: Tang, noodles, and Horlicks. That’s a marketing and information campaign the nutrition community is currently losing, and yet it is one that is so important to win.

Good nutrition is the foundation upon which Happy’s hopes for her child can be built but it is something she desperately needs for herself too. Good nutrition from conception to her child’s second birthday – the first 1,000 days – establishes a solid foundation of both immune system and brain development on which to build.  When you combine this ‘human capital’ with access to quality education, opportunities to change the status quo begin to multiply. Nutrition is essential but if we want to build a ramp up and out for girls like Happy to climb, it must be combined with a focus on sexual and reproductive health, protection from early and forced marriage and better education of men and boys too.  These types of combinations and integrations can help break the cycle of poverty that entrap girls like Happy.

Happy may be feeling hopeless right now with an uncertain future ahead, but we can’t give up on her, or the millions of girls just like her. By scaling up investments in nutrition for women and girls and seeking connections we can begin creating a virtuous circle connecting health, education, and economic empowerment. We can move the needle from barely surviving, to dreaming and thriving.

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