Showing posts from category PHE Champion.
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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. -
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 David Dewitt/counterculturecoffee. -
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. -
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
›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. -
Ruth Siyage, PHE Champion
Promoting Family Planning and Livelihoods for a Healthy Environment in Uganda
›This PHE Champion profile was produced by the BALANCED Project.
Meet 32 year old Ruth Siyage – a wife, mother, peasant farmer, shop owner, and population, health, and environment (PHE) champion. Ruth, her husband, Siyage Benon, and their three healthy daughters – ages 3, 6, and 11 – live about an hour from Bwindi Impenetrable National Park (BINP) in Uganda’s Kanungu District. The 33,000-hectare BINP is a World Heritage Site known for its exceptional biodiversity – with over 200 species of trees, 100 species of ferns, 350 species of birds, 200 species of butterflies, as well as many endangered species, including the mountain gorilla.
In addition to being a peasant farmer who grows potatoes, millet, beans, and groundnuts to feed her family, Ruth also has a small shop in the nearby trading center where she sells groceries and interacts with most of her friends. Ruth first learned of and embraced the PHE approach through a neighbor and local community volunteer, Mrs. Hope Matsiko – one of 29 PHE volunteers trained by the Conservation Through Public Health (CTPH) programs.
Ruth recalls:Hope used to approach us and tell us about family planning. Others refused to listen, but I took it up. Before, I used to refuse to go to Kajubwe Health Center for services and never got information because it was so far away. However, when Hope, the local volunteer, who is also my neighbor, visited me at home, I got more information about family planning. She also counseled me on the methods I could use, which was best for my health and how to use it. I now use family planning.
As a new champion, Ruth uses several ways to teach her community about family planning and PHE activities. One way is through face-to-face discussions with individuals attending village meetings. She focuses on women she sees often and who she knows have closely-spaced pregnancies. Recently, three of these women started using modern contraceptives.Ruth also spreads her PHE messages through her work with the local women’s association, Kishanda Bakyara Twebiseho (Kishanda Women Livelihoods Association), as an active member of a local church, and as a local village council member. In the council, she is in charge of teaching about agriculture and the environment – a perfect opportunity to share her PHE messages about the linkages between population, health, and the environment. Ruth is a great model of the benefits of taking a PHE approach, with her well-spaced pregnancies – which have helped ensure her own reproductive health and that of her three daughters – and her teaching of others, from what she now knows about the need to keep ourselves and our environment healthy to the impacts of each on the other.
Ruth says she believes that through a PHE approach much can be done and has been done:By teaching people about safe water use, I believe that we can stop diarrhea diseases. And by teaching about sanitation, we can help prevent diseases such as malaria, tuberculosis, and worms. Now my neighbors seldom get sick. We have a fairly healthy life. When we are not sick, we do not have to sell our goats and land to buy medicine. And when we plan our families, we are better able to care for and educate our children. Through our community sensitization, people now even understand the importance of gorilla conservation.
Ruth is especially appreciative of the CTPH program, which first taught her about and then turned her into an advocate for the integrated PHE approach.
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: Silverback mountain gorilla named Mwirima with a juvenille gorilla from the Rusguguar group near Bwindi Impenetrable National Park, and Ruth and her son in their shop in rural Uganda, courtesy of CTPH. -
Albert Lotana Lokasola, PHE Champion
Improving Health and Preserving Ecosystems in the Democratic Republic of Congo
›This PHE Champion profile was produced by the BALANCED Project.
In the remote forests of the Democratic Republic of Congo (DRC), Albert Lotana Lokasola is helping improve livelihoods by bringing much-needed health services to the communities living in and around the Kokolopori Bonobo Reserve. Officially recognized by the DRC government in May 2009, the reserve is a high biodiversity wilderness area covering an area about the size of Rhode Island (4,785 square kilometers).
Located 300 miles southwest of Kisangani, the reserve contains bonobos, a rare and highly endangered great ape species that is as closely related to humans as chimpanzees. In addition, the reserve is highly valued for its biodiversity, including several other flagship species such as leopards, elephants, Congo peafowl, Tshuapa red colobus, and Salonga monkeys.
Lokasola founded a nationally recognized organization called Vie Sauvage, or “Wild Life” in English. He serves as the president of the organization and works with international organizations to foster conservation and rural development in an integrated, holistic approach. As a native of Kokolopori, he believes that “the forest, men, and wildlife live together and should be protected together.”
In partnership with local residents and supported by the Bonobo Conservation Initiative, Lokasola and Vie Sauvage established the first medical clinic in the area in 2006. They garnered support for a doctor, nurses, and supplies from the Indigo Foundation in Australia and the Kokolopori-Falls Church Sister City Partnership.
Before the clinic was founded, community members had to walk or bicycle more than 50 miles to get to the nearest hospital in the territorial capital of Djolu. Now the Kokolopori clinic serves the 8,000 people who live in 30 villages along a 40-mile road in the reserve. One of the clinic’s goals is to help improve women’s health by training and equipping midwives and by providing access to other health services. Malaria and poor nutrition contribute to high maternal and child mortality, and women in Kokolopori do not yet have access to reproductive health services such as family planning.
Vie Sauvage articulates integrated health and conservation messages through their community education projects. They are also working with the community to prevent malnutrition by planting fruit trees in agroforestry fields to produce supplemental food supplies. At the same time, these trees will create corridors for wildlife movement and protect the genetic flow. They also create a sound micro-climate for people, sequester carbon dioxide, and filter the air. Through these efforts, Vie Sauvage and the people of Kokolopori are demonstrating the critical links between human well-being and conservation.
Vie Sauvage has garnered resources and participation from diverse partners (like the Kokolopori-Falls Church Sister City Partnership and the Indigo Foundation, mentioned above) which work together to support the clinic and fund medical staff salaries, training, supplies and equipment, and infrastructure improvements.
According to Lokasola, Vie Sauvage and partners are currently exploring potential partnership opportunities to integrate family planning and reproductive health into existing activities. His hope is that by providing these much-needed services, the community will be healthier and critical ecosystems will be sustainably preserved.
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: Building along the road in Kokolopuri village serves as a messsage drum for sending messages from one village to the next, courtesy of Ingrid Schulze and the BALANCED Project. -
Bringing PHE to a Muslim Community in Tanzania
Abdalah Overcomes the Odds
›This PHE Champion profile was produced by the BALANCED Project.
“Now, people can plan their families and know how to use a condom,” says Abdalah Masingano as he proudly tells how his community has come to accept integrated population, health, and environment (PHE) activities.
The 35 year-old Abdalah is a PHE provider. He lives near the Saadani National Park (SANAPA) — one of Tanzania’s newest, and the only terrestrial park with a contiguous marine area in southeastern Tanzania. Saadani is home to the rare Roosevelt Sable antelope and the nesting grounds for several endangered species of marine turtles. One of the largest threats to biodiversity in this area is the clearing of mangroves and coastal forests for firewood and charcoal-making. About 95 percent of households in the area depend on firewood for cooking and most use a three-stone fireplace that utilizes only about 10 percent of its energy potential. These are just some of many pressures that people living around the park place on the biodiversity-rich forest and marine resources of the area.
Abdalah and his 31 year-old wife have two children: a 14-year-old boy and a six-year-old girl. His wife has been on the pill for four years. For two years now, Abdalah has been selling condoms in his village store. He made this decision for simple reasons. He saw that people needed condoms for both family planning and health, and he had come to understand the linkages between the behaviors of people living in the area and the health of the environment.
Abdalah gained this understanding when he was recruited to become a PHE provider by the Tanzania Coastal Management Partnership as part of its work through the USAID-supported BALANCED Project, which is promoting PHE implementation in biodiversity-rich countries. In a two-day training, Abdalah learned about integrated PHE and the links between population (family planning), health, and the environment. He has been educating villagers ever since.
“In the past, it was difficult for people to plan their families because they were embarrassed,” recalls Abdalah. As a PHE provider, Abdalah delivers integrated PHE messages to his fellow villagers. After attending the BALANCED training, Abdalah learned that promoting family planning makes sense for reasons beyond health. Forest and marine resources found both around and inside the Saadani are heavily exploited by local villages – and from a biodiversity conservation perspective, reducing population pressures is just one critical step in protecting this biodiversity.
When people visit his shop, Abdalah takes the opportunity to explain the population and environment connection. Because deforestation is a particular problem in the area where Abdalah lives and works, he promotes the use of fuel-efficient stoves.
Showcasing his own stove, his explains that by using a simple clay stove – which is made locally – a household can save almost 1.5 tons of fuelwood annually and reduce by 50 percent the time women spend collecting fuelwood. At the same time, he reminds villagers that when they plan their families they help keep mothers and children healthy. Healthier families also tend to put fewer pressures on – and thus keep healthier – the very natural resources they depend on for food and income.
Initially, Abdalah’s Muslim neighbors were unhappy with him promoting family planning and condom use. They believed what he was doing encouraged sex and prostitution. “They thought I was lost,” he explains smiling. Fortunately, his wife has been very supportive of him despite the discouraging reactions of his fellow villagers early on in his efforts.
Today, Abdalah’s perseverance has paid off. He now sells more than 200 condoms monthly and takes the time to demonstrate to his customers how to use them properly. When there is the opportunity, he also refers his customers to the local health dispensaries for additional family planning services and commodities. Abdalah believes people respect him now. “I feel good because I am able to help,” he concludes. That “help” impacts both the health and well-being of his fellow villagers and the health and well-being of the environment. Abdalah and his wife plan to have their third child two years from now.
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.
Sources: Darfur Stoves Project, IPS News, TSN Daily News, UN.
Photo Credit: Abdalah showing a box of condoms for sale in his small shop by Juma Dyegula, courtesy of the BALANCED Project.
