Showing posts from category Beat on the Ground.
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Jeanne Nyirakamana, PHE Champion
Reaching Rural Rwandans With Integrated Health and Livelihood Messages
›This PHE Champion profile was produced by the BALANCED Project.
Rwanda is one of the most densely populated countries on the planet, with more than 11 million people in one of Africa’s smallest countries, most of whom depend on the land as subsistence farmers. The country has diverse mountain, lake, and savannah landscapes, and the Virunga Mountain chain in the northwest part of the country is home to one-third of the world’s threatened mountain gorilla population. At the same time, the population throughout the country suffers from high rates of unmet need for contraception, and three percent of the adult population lives with HIV/AIDS. In a land under such intense pressure on natural resources, rural livelihood initiatives are critical to ensuring people have options for meeting their daily health and well-being needs.
For the past three years, Jeanne Nyirakamana has served as head of the health program for the Sustaining Partnerships to Enhance Rural Enterprise and Agribusiness Development (SPREAD) Project. Supported by the U.S. Agency for International Development through Texas A&M; University, the SPREAD Project is integrating a dynamic coffee production and quality improvement program in Rwanda with health outreach to improve community well-being. The health component works to improve the lives of coffee farmers and cooperative members by providing them with health information and services related to family planning, maternal and child health, prevention of sexually-transmitted infections (including HIV), and water and sanitation.
Training Peer Educators
Working closely with the coffee program, Nyirakamana’s team has trained more than 540 men, women, and youth peer educators who have reached more than 95,000 coffee farmers with education and services. Key communication messages highlight the links between sound decision-making and health-seeking behaviors, productive farms and agribusinesses, and strong and healthy families.
The program also leverages and supports local health resources through referrals to existing public health services, organization of mobile clinics, and community-based distribution of a socially marketed water purification solution (Sur Eau) and condoms (Prudence). According to Nyirakamana, one of the project’s greatest successes is the increased acceptance of family planning by farmers and their families and the more than 7,500 farmers who have been tested for HIV. In order to draw in as many coffee farmers as possible, many of the health and livelihood activities take place at the stations where the coffee beans are washed, at other buildings used by the coffee farmer cooperative, or during combined community meetings or home visits. At the washing stations, Nyirakamana’s team supports local health center staff to provide voluntary counseling and testing (VCT) and de-worming services while at the same time SPREAD-trained peer educators and coffee/health extension agents disseminate family planning information.
The cooperatives’ buildings have clean water, hand-washing stations, and small kiosks where condoms and Sur Eau are sold. These community health agents work with SPREAD to ensure that the greater community, not just the coffee farmers, has access to health knowledge and services. They learn how to teach the community about a range of health issues and each month they submit reports showing how many people they reached and with what kinds of messages. They are also becoming increasingly engaged in coffee and agribusiness activities. Through the success of their health activities, these agents are seen as vital community resources.
Integrated Results
By implementing this integrated population, health and environment (PHE) approach, the SPREAD Project staff is ensuring the health of the people and environment and success of the agribusiness. “You cannot care for the environment without first caring for the people who live and use that environment, so when you transmit dual messages [agriculture and health] you are able to hit two birds with one stone,” said Nyirakamana.
According to a 2010 evaluation of the project, farmers and their families reported improvements in personal and household hygiene; an increase in understanding and acceptance of family planning; uptake of HIV and VCT services; and use of condoms and other local health services. As well, they noted shifts in gender norms affecting household revenue use, alcohol, and reproductive health. The agribusiness stakeholders value the integrated approach as a means to more holistically meet farmers’ goals of increased incomes and improved lives and livelihoods.
This PHE Champion profile was produced by the BALANCED Project. A PDF version can be downloaded from the PHE Toolkit. PHE Champion profiles highlight people working on the ground to improve health and conservation in areas where biodiversity is critically endangered.
Photo Credit: BALANCED Project. -
George Washington University’s PISA Helps Share Rural Vietnamese Climate Adaptation Strategies
›“Climate change is not a topic of debate in Vietnam, it’s a real challenge to future prosperity and security,” says George Washington University’s Partnerships for International Strategies in Asia (PISA) program in this video about their climate adaptation and mitigation work in Nam Dinh province. “[Vietnam’s] population density (265 people/square kilometer), its long coastline (3,444 km), its two major rivers (the Red and Mekong) – all help make it one of the 10 countries considered most vulnerable to climate change,” the narrator says.
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Pascal Gakwaya Kalisa, PHE Champion
Coffee Farmer and Extension Manager Promotes Improved Health and Livelihoods in Rwandan Coffee Communities
›This PHE Champion profile was produced by the BALANCED Project.
Mr. Pascal Gakwaya Kalisa has produced coffee in the densely populated country of Rwanda for the past nine years. A proud member of the 1,200 member Maraba Coffee Cooperative in Huye District in the Southern Province of Rwanda, Kalisa knows that a larger income alone does not ensure a better quality of life for his fellow coffee farmers and their families. He also knows that a successful coffee growing/exporting enterprise depends on preserving the fragile Rwandan soils, as well as on the health and well-being of farming families and communities. Therefore, Kalisa and other cooperative members treat the land and trees with a level of personal care that is necessary for optimum organic production and soil preservation.
Kalisa and the community have set up small, garden-sized coffee farms that are more productive than usual. Cooperative washing stations have enabled the small-scale farmers to improve product quality, and the cooperatives themselves are learning to negotiate better coffee prices with international buyers. Through such efforts and the support of many international donors and industry partners, Rwanda has become a producer of high quality specialty coffee since 2005, and its coffees are being marketed through renowned coffee roasters and importers in the United States, Europe, and Japan. In just six short years, Rwandan farmers have doubled their incomes and created 2,000 jobs, and the first renowned specialty coffee competition Cup of Excellence in Africa was held in Rwanda in 2008.
SPREAD: A Community Partnership
Recognizing the broad-based health, social, and economic needs of coffee farmers and their families in this part of East Africa, the U.S Agency for International Development initiated the Sustaining Partnerships to Enhance Rural Enterprise and Agribusiness Development project (SPREAD) to provide rural cooperatives and enterprises involved in high-value commodity chains with both appropriate technical assistance and access to health-related services and information. It is this combination of technical assistance and health-related outreach and services that has resulted in increased and sustained incomes and improved livelihoods.
Kalisa and other members of various cooperatives that SPREAD supports recognize that not only should farmers and their families preserve the land, but they must also preserve their own health in order to perform the labor needed to farm the crop that will produce the steady stream of high quality coffee upon which their livelihoods depend. Initiating community dialogues around issues such as protected sex, gender roles, and how coffee revenue is spent within households has also been crucial to project success among both youth and adults.
In his role as coffee zone coordinator for the SPREAD project, Kalisa works with coffee cooperatives to implement improved agricultural practices that improve the quality of their crop. This includes using cleaner environmental practices during coffee processing, such as introducing composting of coffee cherry pulp. Kalisa also helps disseminate integrated health and coffee messages through a weekly coffee talk-show produced by the National University of Rwanda’s Radio Salus, called Imbere Heza (“Bright Future”). In one show, for example, a man explained to a fellow farmer that to get good coffee cherries, he should thin his trees to renew his plantation.
Integrating Healthy Lives
Kalisa has also helped the SPREAD project’s health team deliver integrated messages on family planning, maternal and child health, alcohol, nutrition, gender issues, and the linkages between these. He uses examples such as the one about tree thinning to explain that families that space their children tend to be healthier, as they can plan the number of children to better fit with the financial and natural resources at hand.
Kalisa sees the benefits of using community agents to deliver integrated health, environment, and livelihood messages. This includes training extension agents to discuss environmental and human health issues in the context of coffee growing. Also, having coordinators from the coffee program and the health program go hand-in-hand to the field saves time, fuel, and other project costs. Kalisa believes that this campaign to educate coffee farmers and their families on the linkages between human health, a healthy environment, and strong livelihoods will lead to long-term change in their behavior, attitudes, and knowledge – change that will help them live better lives today and into the future.
This PHE Champion profile was produced by the BALANCED Project. A PDF version can be downloaded from the PHE Toolkit. PHE Champion profiles highlight people working on the ground to improve health and conservation in areas where biodiversity is critically endangered.
Photo Credit: “Rwanda photos 060,” courtesy of flickr user counterculturecoffee. -
What’s in a Name? Watch Don Lauro on PHE, HELP, and HELPS
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Population, health, and environment (PHE) expert Don Lauro has worked on integrated projects for decades as a scholar, an implementer, a donor, and an evaluator. He recently visited the USAID-funded BALANCED Project in Tanzania as part of a wider look at this integrated approach. In an interview with ECSP, Lauro said the effort “made me think more broadly…about this area that we call population, health, and environment and what’s really in a name like that.”
“We commonly say PHE, and we all know what we’re talking about,” Lauro said of the population and development community, “but when you look deeply into these projects – or even not so deeply – you see that there’s other things going on as well.”
For example, Lauro pointed to the focus on livelihoods that many PHE programs have: “In the project I saw in Tanzania, there were many microcredit groups on the ground – mostly women – taking small loans for developing little enterprises that they had, like baking bread, raising bees, buying a cow…little enterprises to make their lives a little bit better.”
“Some people don’t use the term ‘PHE’…maybe it’s a ‘HELP’ project; that is health, environment, livelihoods, and population,” Lauro said. “Other people would say it’s maybe something even longer, ‘HELPS’ – health environment, livelihoods, population, and sustainability (or ‘security’ – Ed.).” When he was at the Wilson Center, Gib Clarke coined the “HELP” term in ECSP’s FOCUS Issue 20, arguing that livelihoods is such a critical component that it ought to be more formally recognized.
But, said Lauro, “on the ground they don’t use these terms – they say things like, ‘this is a healthy community program’ or ‘this is a green community program.’”
“I think it’s very important for us to realize what happens on the ground is lot different, and maybe more real, than how we talk about it.” -
Zo Zatovonirina, PHE Champion
Improving Human Health and Conservation in Madagascar’s Forest Communities
›This PHE Champion profile was produced by the BALANCED Project.
Madagascar is one of the world’s most unique ecosystems, with a total of eight plant families, five bird families, and five primate families that live nowhere else on Earth. Madagascar’s tropical forests and marine environments are home to endemic species of flora and fauna, although tragically 15 species are now extinct. At the same time, Madagascar is rich in freshwater resources, yet more than 60 percent of the island’s 19.7 million people do not have access to safe drinking water.Since 2003, Zo Zatovonirina has worked for Conservation International (CI) in Madagascar, and he has seen up-close the challenges of reaching remote forest communities, often requiring one- or two-day hikes over treacherous roads. As coordinator for USAID’s Healthy Families, Healthy Forests Program, Zo worked with two Malagasy nongovernmental organizations (NGOs), MATEZA, and the Association for Health Action and Security, to implement integrated population, health, and environment (PHE) approaches in response to community needs in the Ankeniheny Zahamena forest corridor in eastern Madagascar.
From 2003-2008, CI and partners reached more than 25,000 village residents with PHE messages; increased contraceptive prevalence in target zones from 17 percent in 2005 to 30 percent in 2008; constructed 3,000 latrines; and improved environmental health in all priority sites.
Today, biodiversity in Madagascar is under increased pressure, in light of political instability since 2009 and continued population pressures. Recognizing CI and partner experience and investments in conservation efforts to improve human well-being, USAID Madagascar and World Learning recently awarded a new 15-month grant to CI Madagascar and two Malagasy NGO partners – Voahary Salama and Ny Tanintsika – to implement an integrated PHE project in the southeastern Ambositra Vondrozo forest corridor. All three organizations have implemented PHE projects in Madagascar, and they have established trusting relationships with the people living in these fragile ecosystems.
Madagascar has a rich history of implementing successful PHE projects, and this project represents a new PHE pilot phase in the midst of political uncertainty. According to Zo, PHE approaches remain constant – simultaneously addressing several complex and linked problems such as poverty, child survival, and unsustainable dependency on natural resources. In Zo’s experience, CI’s PHE approach touches on all these aspects and delivers a pragmatic, integrated package of interventions designed to increase community capacity to better manage their health and environment. Utilizing PHE approaches, CI, Voahary Salama, and Ny Tanintsika will strive to reach communities for the first time ever with family planning, water, sanitation, and hygiene services while helping them conserve their biological heritage.
This PHE Champion profile was produced by the BALANCED Project. A PDF version can be downloaded from the PHE Toolkit. PHE Champion profiles highlight people working on the ground to improve health and conservation in areas where biodiversity is critically endangered.
Photo Credit: The forests of Madagascar, courtesy of Conservation International/Russ Mittermeier, and Zo Zatovonirina, courtesy of Conservation International. -
Ecological Tourism and Development in Chi Phat, Cambodia
›Chi Phat is a single-dirt-road town nestled in the Cardamom Mountains of Southwestern Cambodia, one of the largest intact forests in Southeast Asia. The town is only accessible by two routes: a three-hour river boat trip up the Phipot River or, if the road isn’t flooded by the rainy season, an exhilarating 30-minute motorbike ride from Andoung Tuek, a blip on the one paved road that runs along Cambodia’s southwestern border. Since 2007, Wildlife Alliance has been running an ecotourism project in Chi Phat (full disclosure: I used to work for Wildlife Alliance in Washington, DC).
The project has been featured in The New York Times and since its inclusion in the Lonely Planet travel guide, has become a destination for backpackers looking to leave the beaten path. I recently visited the project after spending time in neighboring Vietnam and was struck by the contrast between the densely populated and urbanized Mekong Delta and the visibility of rural poverty in Cambodia.
“Cambodia’s contemporary poverty is largely a legacy of over twenty years of political conflict,” reads a 2006 World Bank Poverty Assessment. The Pol Pot regime’s agrarian collectivization forced millions into the countryside and as a result, even in today’s predominantly-urban world, Cambodia remains 78 percent rural. Today 93 percent of Cambodia’s poor live in rural areas, two thirds of rural people face food shortages, and maternal and reproductive health outcomes in the country lag far behind those in the cities. Chi Phat and the sparsely populated northeast have over ten or twenty times the rate of maternal deaths of Phnom Penh.
A Town Transformed
Before Wildlife Alliance began the Community-Based Ecotourism (CBET) project in Chi Phat, most villagers made a living by slash-and-burn farming, illegal logging, and poaching endangered wildlife. Wildlife Alliance Founder and CEO Suwanna Gauntlett described the ecological zone around the town as “a circle of death,” in an audio interview with New Security Beat last year.Now, Chi Phat is a rapidly growing tourism destination offering treks and bike tours. In 2010 they brought in 1,228 tourists – not huge by any means, but over twice the number from 2009. The town now boasts a micro-credit association, a school, and a health clinic that offers maternal and reproductive health services. The village is also visited by the Kouprey Express, an environmental education-mobile that provides children and teachers with lessons, trainings, and materials on habitat and wildlife protection, pollution prevention, sustainable livelihoods, water quality, waste and sanitation, energy use, climate change, and adaptation.
One villager, Moa Sarun, described to me how he went from poacher and slash-and-burn farmer, to tour guide, and finally, chief accountant:Since I have started working with CBET, I realize that the wildlife and forest can attract a lot of tourists and bring a lot of income to villagers in Chi Phat commune. I feel very regretful for what I have done in the past as the poacher…I know clearly the aim of CBET is to alleviate the poverty of local people in Chi Phat, so I am very happy to see people in Chi Phat have jobs and better livelihoods since the project has established.
It’s hard to imagine what the town would have looked like before Wildlife Alliance arrived. The visitor center, restaurant, and “pub” (really, a concrete patio with plastic chairs and a cooler filled with beer), together make up nearly half of the town’s establishments. For two dollars a night, I stayed in a homestay and lived as the locals do on a thin mattress under mosquito netting, with a bucket of cold water by the outhouse for a shower, and a car battery if I wanted to use the fan or light (but not both). These amenities place Chi Phat above average for rural Cambodia. According to 2008 World Bank data, only 18 percent of rural areas had access to improved sanitation and only 56 percent had access to an improved water source.
Poaching Persists
Real change has certainly hit Chi Phat, but illegal activities persist, as a Wall Street Journal review of the project noted. In one Wildlife Alliance survey, 95 percent of members participating in the project made less than 80 percent of their previous income and 12 percent of people made less than 50 percent. “That, to me, is a red flag,” Director of U.S. Operations Michael Zwirn acknowledged to me. Nevertheless, he said “it is well documented that it’s the most lucrative community-based ecotourism project in Cambodia. That doesn’t mean that everyone is making money, or that they’re making enough money, but the community is clearly benefiting.”
Harold de Martimprey, Wildlife Alliance’s community-based ecotourism project manager, told me in an email interview:We monitor closely the impact of the CBET project on the diminution of poaching and deforestation. We estimate that since the beginning of the project, the illegal activities have decreased by almost 70 percent.
As Chi Phat ecotourism continues to scale up, de Martimprey expressed hope that more and more villagers would participate in the project and stop destructive livelihoods.
After four years, Chi Phat has already developed enough to operate financially on its own. Wildlife Alliance will stop funding the project later this year and transition it towards total self-sustainability. The plan is to then ramp up efforts at a neighboring project in Trapeang Ruong, due to open to the public next month.
A Land of Opportunity
So far Chi Phat lacks much of what do-gooder tourists are hoping to find when they come in search of ecotourism. There is little to no information about the work of Wildlife Alliance and how ecotourism benefits the town, or the health, education, and economic benefits the villagers have received. A little more obvious justification for ecotourism’s inflated prices might appease the average backpacker used to exploitatively lower prices elsewhere in the country. The guides, staff, and host families for the most part speak little English, which does not bode well for its tourism potential. “This is a work in progress,” said de Martimprey.
Most of my time in Chi Phat, I felt like the only foreigner to ever set foot in the town – refreshing after witnessing much of the rest of Southeast Asia’s crowded backpacker scene. As Chi Phat continues to grow, hopefully it will “bring in enough people to support the community without the adverse effects of tourism,” said Zwirn. “They don’t want it to turn into the Galapagos.” Thankfully, de Martimprey told me, “Chi Phat is far from reaching this limit and can be scaled up to much bigger operation,” without negatively impacting the environment.
Luckily, plans to build a highly destructive titanium mine near the town were recently nixed by Prime Minister Hun Sen in what was an unexpected victory over industrial interests. However, soon after, the town was again under threat – this time by a proposed banana plantation nearby.
“The Cardamom Mountains are still seen as a land of opportunity for economic land concessions for some not-so-green investors looking at buying land for different purposes, and often disregarding the interest of the local people,” said de Martimprey.
Eventually Zwirn hopes that as more tourists come to the Cardamoms, they will become “a constituency for conservation,” he said. “We need to build a worldwide awareness of the Cardamoms as a destination, and as a place worth saving.”
Sources: BBC, IFAD, Phnom Penh Post, New York Times, United Nations, Wall Street Journal, Wildlife Alliance, World Bank, World Wildlife Fund.
Photo Credit: Hannah Marqusee. -
Rukia Seif, PHE Champion
Making Life Easier in Rural Tanzania
›This PHE Champion profile was produced by the BALANCED Project.
Rukia Seif is a population, health, environment (PHE) peer educator who promotes simple economic, environmental, and health behaviors that make sense. In many ways, the Mkalamo village where Rukia lives is a typical rural Tanzanian agricultural village. In another important way it is very different. Mkalamo abuts the biodiversity rich Saadani National Park – the only wildlife park in Tanzania that borders the sea. Ironically, this park does not make life easier for people living in Mkalamo but more difficult. In the park, there is a ban on the cutting of wood, making it difficult to find enough to fuel villagers’ cooking stoves. Also, increasing numbers of the park’s wild animals often destroy the villagers’ precious crops.
As a PHE peer educator, Rukia talks with her fellow community members about simple things they can do to improve their lives. Her messages are clear:- By planning their families, women can ensure their own and their children’s health and can decide the optimal number of children that they can provide for.
- By using fuel efficient stoves, women can spend less time collecting fire wood, freeing up time for other chores or livelihood activities and reducing the amount of needed fuel, thus helping sustain the forests for future generations.
- By joining community-led savings and credit associations, women and men gain access to capital, allowing them to scale-up current livelihoods or diversify to new sources of income.
Rukia sets a good example of how doing these simple things can improve a family’s life and protect the environment. At age 36, she is a mother of three girls, ages 14, 12, and one and a half. Rukia and her husband, Seif Ramadhani, are taking measures to plan their family. Rukia used pills before they decided to have their last daughter. Now they are using condoms as a back-up while Rukia is breastfeeding the baby. Through her work, Rukia meets and talks to many people every day. She discusses family planning and if someone is interested, she refers them to community-based distributors and the dispensary for family planning services.
“I talk to my peers about planning their families so we have enough natural resources to meet the needs of the villagers who depend on these resources,” she said. “Also, when you plan your family, you will get more time to perform other activities.”
An active member of the savings and credit association, where she also acts as the accountant, Rukia is living proof of this last statement. Through savings and loans, Rukia has diversified her income by buying a sewing machine and a fuel-efficient oven. Today, she generates income from cow and poultry husbandry, tailoring, bread-making, selling soft drinks, and constructing fuel-efficient stoves. With this increased income, Rukia and her husband have been able to put an iron sheet roof on their house and send their first-born daughter to secondary school – a great achievement in a country where only five percent of women stay in school beyond the primary level.
Rukia demonstrated her two fuel-efficient stoves: one is a metal oven that she uses for baking breads and cakes, the other is a simple mud stove that she uses for cooking. The mud stove, which costs less than $2 to build, is getting increasingly popular in the community. It saves fuel wood, prevents fires, produces less smoke (a serious health hazard), and cooks the food faster!
“I can even wear my best clothes and put on some lip shine when I use this stove, because it does not foul up the air,” Rukia explains with a laugh. Seeing the benefits of the fuel efficient stoves, she has inspired ten community-based distributors and five village leaders to join the team of individuals showcasing the fuel efficient technologies.
Rukia is a perfect example of practicing what one preaches. She is improving her own life, helping others learn to do the same, and protecting the very natural resources upon which almost everyone in Mkalamo depends.
This PHE Champion profile was produced by the BALANCED Project. A PDF version can be downloaded from the PHE Toolkit. PHE Champion profiles highlight people working on the ground to improve health and conservation in areas where biodiversity is critically endangered. -
Sam Rugaba, PHE Champion
Encouraging Childhood Education and Birth Spacing as an Approach to Conservation
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This PHE Champion profile was produced by the BALANCED Project.
Fifty-one-year-old Sam Rugaba is a dedicated teacher who loves his job at the Bujengwe Community Primary School. The school is the result of a community-based project located in the Bujengwe Parish of the Kayonza subcounty in the Kanungu district of Uganda – just 18 kilometers from the Bwindi Impenetrable National Park (BINP). The biodiversity-rich BINP is home to many rare species including the endangered mountain gorilla. Sam is also a Conservation Through Public Health(CTPH) community volunteer and community conservation health worker.
