After a fortuitous meeting, a new Population, Health and Environment program was born in Madagascar


In the breathtaking setting of Marojejy National Park, I recently crossed paths with an environmentalist from a very different background, working on the other side of Madagascar. But, it turns out that the communities we work with face many of the same challenges, and our meeting spawned a new Population, Health and Environment (PHE) program.

After an intense and productive visit to Blue Ventures’ PHE program in southwestern Madagascar, where I am the medical director, I looked forward to my trip to Marojejy. Designated as part of a UNESCO World Heritage Site in 2007 for its immense biodiversity, large number of endemic species and stunning mountainous landscapes, the park is rightly on Madagascar’s list of priorities for the conservation. It is also the location of the new SAVA conservation project at the Duke Lemur Center.

The communities we work with face many of the same challenges.

Based in Sambava, one of the four towns in northeastern Madagascar that make up the acronym of the project name, SAVA started in January 2012 and takes a multi-faceted community approach to biodiversity conservation with strong collaboration between a multitude of partners. Madagascar National Parks deals with border demarcation and forest monitoring; Duke University offers undergraduate and graduate research on lemurs; Graine de Vie supports reforestation activities; CARE provides training on yam and tarot farming; local schools integrate conservation into their curricula; Aleyin Andapa’s Private Producer Association provides training in freshwater fish farming; and all of them work with the Antanetiambo Nature Reserve, one of the few protected areas created entirely by a local Malagasy resident.

Different but similar challenges

The day before I started my five-day hike in the park, I had the chance to eat at a table adjacent to Erik Patel, world-renowned primatologist and director of SAVA. It wasn’t long before some enthusiastic presentations were made. Although working literally in opposite parts of the country (Blue Ventures projects are in the southeast of Madagascar, SAVA in the northeast) to conserve completely different ecosystems (coastal marine habitats versus rainforest), I have was immediately struck by the similarity of the challenges of our respective organizations. face.

One of the least challenges facing the communities we work with is poor health, and poor reproductive health in particular, resulting in large part from a lack of access to family planning services. Fertility rates, as well as maternal and infant mortality rates, are high in both regions. Madagascar is regressing in its progress towards Millennium Development Goal 5 – reduce maternal mortality by three quarters by 2015 and achieve universal access to reproductive health.

By working so closely with our respective partner communities, Erik and I have both witnessed first-hand the impact of this harsh reality. Regardless of the enormous health and social impact of high fertility rates on women and their families, women’s ability to engage in biodiversity conservation is limited, and the resulting population growth is one of the factors. main drivers of unsustainable use of natural resources that threaten biodiversity conservation efforts. .

It didn’t take long for me to realize that separately we had come to similar conclusions: An integrated approach, which meets the needs of the communities and threats to ecosystems, is probably the most effective way to achieve our conservation and development goals.

The case of PHE

As someone who has devoted a lot of time and energy to extol the virtues of this population, health and environment approach to those who need a lot of persuasion, witness to Erik’s openness to incorporating services of Voluntary family planning in their project and the recognition of conservation as well as health benefits, was refreshing and exciting.

An integrated approach, which responds to the needs of communities and threats to ecosystems, will probably be the most effective way to achieve our conservation and development goals.

I didn’t need much encouragement to talk about Blue Ventures’ PHE program, and over the next few days Erik and I discussed the details of family planning service delivery and its integration into initiatives. existing biodiversity conservation options, ranging from the details of different contraceptive options to different service delivery methods, integrated education and the importance of maintaining a rights-based approach. Having provided PHE training to partner organizations in the past, we also discussed the follow-up support Blue Ventures could provide.

These conversations were interspersed with visits to the impressive portfolio of projects SAVA supports around the national park, from conservation education to aquaculture, reforestation and lemur research. Once again, I was struck by how the Duke Lemur Center’s approach so closely mirrors that of Blue Ventures: a candid assessment of the range of threats to biodiversity conservation and a willingness to pioneer, to test and implement community solutions.

Quick implementation

By the end of my stay, as luck would have it, we had booked a flight back to Antananarivo together, which kept the conversation going, and in the months that followed, Erik quickly laid the foundations for fruitful partnerships.

Marie Stopes Ladies
Marie Stopes nurse discusses family planning options with residents of Belaoka Lokoho, near Marojejy National Park (Lanto Andrianandrasana)

I put Erik in touch with our health partners, Population Services International and Marie Stopes Madagascar, and SAVA began to host “Marie Stopes Ladies” – nurses and midwives trained to provide family planning services in local communities. remote areas – in Marojejy. So far, nearly 100 women in several villages adjacent to the park have received long-acting, reversible contraceptive implants, which provide up to three years of continuous contraception. By all accounts, the interest of the community has been enormous, with many women walking long distances to receive information and advice on the range of contraceptives available to them. Many are very young mothers (some as young as 14) who have expressed difficulty accessing family planning services in the past.

Learn more about the inspiring work of SAVA and see how quickly and effectively they have been successful in facilitating improved family planning service delivery in their existing efforts – without additional resources! – filled me with immense hope for the future of Madagascar and of PHE in general.

I felt a growing interest in exploring the potential of integrated programming in many informal conversations with health and conservation partners, but this was the first time it resonated so immediately. If a chance encounter like this can yield such exciting results, imagine the impact of a more systematic, nationwide effort to promote more interdisciplinary development and conservation.

PHE is making waves again in Madagascar, and the waves are getting bigger!

Vik Mohan is a practicing physician in the UK, founder of the Blue Ventures Community Health Program and architect of Blue Ventures’ PHE approach.

Photo credit: View of Marojejy National Park, used courtesy of Iñaki Relanzon / SAVA Conservation; A nurse from Marie Stopes talks to residents of Belaoka Lokoho, courtesy of Lanto Andrianandrasana / SAVA Conservation. Video: “Promoting indigenous freshwater fish farming”, courtesy of DLC SAVA Conservation Videos.


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