Marine conservation and public health: a lesson in integration from Madagascar

Gender, Health, Methodology

Bob Dewar, a member of Oxfam’s Association, shares his experiences from a trip to Madagascar and shows the benefits of an integrated approach to development.

I recently visited Andavadoaka, a remote fishing village on the southwest coast of Madagascar. Oxfam is not working there, but the projects I witnessed there illustrate some development themes that are key to Oxfam’s approach.  

These relate to how to bring about sustainable development where all people, including women, are able to exercise their rights. Secondly it’s about producing the environmentally safe and socially just space that Kate Raworth spoke of in her ‘Doughnut’ paper. And thirdly it’s about working in a systemic, integrated way.

Children in a village near Morondava. Credit: Bob Dewar

Let’s take the last first. I felt rather pleased with myself and not a little intrepid on my journey to Andavadoaka. Here was I, travelling by open motor boat, whizzing in and out of traditional sailing outrigger canoes along networks of coral reefs as we went north. But it wasn’t intrepid at all. I had plenty of drinking water and three crew members. Motorboat travel was in fact the only way there as Cyclone Haruna – the worst storm to hit this region in 35 years –
had made a direct hit only days before. Bridges were down and roads were impassable.

Health epidemics are one of the primary risks when cyclones hit and this was precisely what the community in Andavadoaka was facing. Several public wells were contaminated with human waste and rubbish, inland communities had a lack of clean water and cases of diseases like diarrhoea were beginning to rise.

Like Oxfam, the organisation I was visiting, Blue Ventures uses research to back its approach (in this case to marine conversation). It also works in real partnership with local communities and takes an integrated approach. Blue Venture integrates health work into its conservation programmes in an
approach known as Population Health and Environment or PHE. And the cyclone brought home the value of this.

Its well established family planning, public health and sanitation outreach work meant that a trusted network of community based distributors was already in place when the cyclone hit. Chemicals for treating wells, water purifiers and diarrhoea treatments were quickly distributed and put to use. Not by a humanitarian organisation, but by a conservation NGO.

In an increasingly volatile world, this kind of integrated approach will be key to building resilience in local communities and NGOs. And it seems sensible to use the trusted relationship established in the context of community-based marine conservation to deliver other essential services.

Even more important, however, is that women should receive their rights.

And the feedback on the reproductive health strand of the PHE approach was also encouraging. In Andavadoaka, half of the population is under 15 and one in five under 5. Safidy, which means “freedom to choose” in the local Malagasy dialect has given women in the area the chance to choose the number, timing and spacing of their births for the first time. Between 2007 and 2012contraceptive use increased fourfold and it is estimated that over 500 unwanted pregnancies were prevented. With fish stocks under increasing pressure and a challenge to feed every mouth, having
reproductive health services at their doorstep has been very welcome indeed.

My final lesson in Andavadoaka was on sanitation.  One thing I learned was to be realistic. Only 1% of the population had access to a latrine, an awful truth. Sandy soil makes it difficult to build them. But the messages about washing hands and burying poo were being passed energetically! 

As I sped away on my motor boat, this time with nine on board, including some youngsters late for the new academic year at Toliara University, I was looking at shore-line mangroves. Would the community conserve them in the long term if the demand for wood gets too high?

And I pondered the integrated approach I’d seen in Andavadoaka and how it gave women choice. The world felt a little better already.

Author: Bob Dewar
Archive blog. Originally posted on Oxfam Policy & Practice.