#phevoices

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Cara Honzak, Senior Technical Advisor for Population, Health, and Environment (PHE), Pathfinder International

U.S.A.

During my tenure at World Wildlife Fund, my supervisor and I worked hard to try to develop a population policy within WWF, across the whole global network, to see if the network was ready to directly address population, women’s health, and family planning. It would have been one of several WWF network-wide social policies – there was one on gender, indigenous peoples, etc. But the population policy didn’t go through. It didn’t get the buy-in across the network. It was at that time that I began to see where the rifts existed, and what it would take to do this work. By the end of the eight years [working at the WWF], I concluded that – at least within WWF and maybe for other conservation groups – it made the most sense to do this work through a gender lens, focusing on women’s empowerment. I also had concluded that the biggest impact you would have would be on women’s empowerment and natural resources management in the places we deliver this work, and that was the lens we should be working through for the sake of conservation. I was ready and primed to do similar kinds of work from within the sexual and reproductive health and rights sector. From that vantage point, I could reach out to the conservation sector and help them see what can be gained for health and conservation if they join the health sector in tackling these issues.

Interviewer: Sarah V. Harlan

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Befekadu Refera, Consultant, Environment/Biodiversity

Addis Ababa, Ethiopia

We have PHE [population, health, environment] integration work in the form of school clubs. We have organized population-related clubs, health-related clubs, and environment-related clubs. We organize them, and we provide them with media materials and speakers. We encourage them to write poems, to draw art, and to establish nursery sites for plants, especially indigenous trees. And we encourage them to share whatever they know or understand about PHE integration.

Before PHE integration clubs started operating, we organized a “SEGNI”—it means “seed” in Oromo language. We selected 24 students—12 male and 12 students. We sent them inside the forest for five days to experience the wilderness. And in those five days, we were only facilitating. The biodiversity and cultural lessons were given by elders selected from the local community, based on their knowledge about biodiversity and culture. Of the four elders, at least two of them knew the biodiversity of that area—the names of the plants, the use of those plants, the medicinal value, and cultural value of the plants. There was a camping site, and around the campfire, they also told them stories, the history, and everything. They told them riddles and  poems, and they talked at nighttime. At around 11:00 at night, the youth members wandered and watched the group for one hour each, taking turns. They were not given any weapon or anything. The students exercised their sensory organs, and just watched. That was a time for developing confidence and love of nature, understanding of nature. In the nighttime, your eyes aren’t working because it’s dark. But your ears, your nose, and everything become active, and you can sense the natural beauty. In these five days, they learned about biodiversity, they learned about culture, and also they developed confidence to live in harmony with nature. And when they were back at school, they were expected to share what they had gotten from this experience.

Interviewer: Sarah V. Harlan

Photographer: Amy Lee

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Cara Honzak, Senior Technical Advisor for Population, Health, and Environment (PHE), Pathfinder International

U.S.A.

I always say that Population, Health, and Environment (PHE) is a strategy, but it’s also a social movement. That’s my mantra. But PHE is hardly a name for a social movement, right? Maybe it should be “survive and thrive,” which also helps capture the contemporary turn towards utilizing the PHE platform to support the most vulnerable communities, and women and girls, impacted by climate change. We need to acknowledge that PHE functions at different levels with different audiences in different ways. It’s not just one thing. And if it’s a social movement, you can frame that in many different ways, although there are some core pieces. For me and many of us who have worked in PHE for a long time, the core is to make sure that family planning, reproductive health, and gender rights are considered to be core to achieving sustainable development.

Interviewer: Sarah V. Harlan

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Josaphat Mshighati, Advocacy and PHE Director, Pathfinder International

Tanzania

I work as the Advocacy and Population, Health, and Environment (PHE) Director for Pathfinder International in Tanzania. We are an active member of the Tanzania National PHE Network. The Network supports the efforts of civil society organizations, universities, government ministries, departments, and agencies to institutionalize PHE in Tanzania. My responsibility in service delivery takes me to villages in Western Tanzania to support efforts of communities, village, and district governments in establishing knowledge that informs national level PHE efforts. Over the last three years, we have witnessed two significant positive PHE scale-up actions in the country – the Government of Tanzania has developed its National Five-Year PHE Strategic Plan, and the University of Dar es Salaam has developed a curriculum for its Master of Arts program in PHE, both of which are launching as of mid-2019. These twin efforts are landmarks for future PHE work in Tanzania, and I am proud to be associated with both! I love PHE work because I believe the sustainability of protected natural resources relies on the people’s understanding of the return they get from them, and how they are associated. In their eyes, sector-specific laws are mere threats that can be breached if human needs are not met.

Photographer: Shawn Sweeney

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Cheryl Margoluis, Senior PHE Technical Advisor, Pathfinder International

Aptos, California, USA

I am a conservation biologist by training, but have always worked at the intersection of well-being and conservation. I provide technical support to our Population, Health, and Environment (PHE) projects throughout Eastern and Southern Africa, and develop academic partnerships with U.S. and African universities on PHE. I love the PHE integrated approach because it is holistic and designs each program with a wider lens. Without this lens, development approaches can solve one problem while creating another. Partnering with the conservation sector for PHE allows us to work with the most vulnerable people and address their most urgent needs, while conserving some of the most amazing places on earth. People need a healthy ecosystem to be healthy. And for the ecosystem to sustain, the people living in and around it must be healthy. Once this connection is made in people’s minds, they feel empowered to make different decisions. PHE creates a motivation in people and drives individual agency in decision-making around health and natural resource management.

Photographer: Sylvana Margoluis

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Modest Kinawa, Project Officer, HoPE-LVB Project, Pathfinder International Uganda

Uganda

As a Public Health specialist, I have been working on the Health of People and the Environment in the Lake Victoria Basin (HoPE-LVB) project for the last seven years. When I started working in Jagusi, the people were underserved, less empowered, and believed in what I call the “GE” (Government Etuyambe) syndrome, literally meaning “the government must help us.” Though I believed that the government has a big role to play, communities also need to diagnose their priority needs and actively participate in finding lasting solutions from within. Ever since the Population, Health, and Environment (PHE) interventions took place, I have witnessed a lot of changes: deliveries at the health facilities rose from 5 to 35 and above monthly, contraceptive access improved, and the number of reported diarrheal cases reduced due to better WASH (Water, Sanitation, and Hygiene)—no more open defecation and no cholera outbreaks. I’ve realized that PHE work is sustainable and scalable, as neighboring communities have already copied and implemented some activities such as tree planting, energy saving stoves, agroforestry, and some WASH components through the model household approach. It is very pleasing to hear district officials give compliments to our work! The district has incorporated PHE activities in their five-year development workplan with budget lines on some interventions.

Photographer: Stellah Mbatudde

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Semere Sileshi, Population and Health Officer, PHE Ethiopia Consortium

Bale Zone, Oromia Region, Ethiopia

The Ethiopian Ministry of Health currently has the health extension package, which has 16 components. So for the government, there are criteria to select model households. Model households have to be those who implemented at least 75 percent of the health extension package. Based on this criteria, we tried to identify “model women” to be part of our village health committees. She has to be a family planning user, and she should be from a model household who has been implementing 75 percent of the topics, like latrine, handwashing facilities in the household. The other thing is that a woman who volunteers should share her experience and the benefits she gained from using family planning. She has volunteered to share with others and  be a role model. The other [criteria] is to be able to read and write, so she can take notes while doing these community mobilization activities. [Identifying literate women] was very challenging. In most rural and pastoral areas, most women are illiterate and don’t read and write. That was one of the challenges. But we used these criteria and selected them to be model women.

Interviewer: Sarah V. Harlan

Photographer: Sarah V. Harlan

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Eugène Andriamasy, Partnership and Youth Promotion Manager, Marie Stopes Madagascar

Madagascar

With regard to the PHE approach, I would say that I am proud that Marie Stopes provides family planning services in remote places where such services are not available. There are NGOs that work in those areas, but health facilities are sometimes far from people’s houses. Through our mobile teams or other strategies, we try our best to reach populations who cannot attend those health facilities.  By working with NGOs that are involved in the environment, we can contribute to both environmental preservation and health improvement in people. Sometimes we cannot convince people, but with the help of these NGOs that are regarded as trustworthy by the local population, we succeed in convincing the most hesitant people.

Je dirais que je suis fier que par rapport à l’approche SPE, qu’on puisse nous, Marie Stopes offrir des services de  planning familial là-bas, loin, au fond de la campagne où c’est quelque chose qui n’est pas forcément accessible. Il y a des ONG qui travaillent dans ces zones reculées, mais les centres de santé ne sont pas forcément à côté. Donc par notre approche d’équipes mobiles ou avec d’autres approches existantes, on arrive à atteindre ces populations et en collaborant avec les ONG qui protègent l’environnement, on peut joindre nos efforts pour à la fois convaincre du côté environnement et convaincre du côté santé. Des fois, on n’arrive pas à convaincre ces gens-là mais avec l’appui de ces ONG environnementales, qui ont déjà la confiance de la population locale, on arrive à convaincre certains des plus réticents.

Interviewer: Sophie Weiner

Photographer: David Alexander