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On the eve of World Health Day, I emerge from the Blue Ventures office in Ambanja under a sky laden with clouds. “Do you think it’s going to rain tomorrow?” I ask for the third time.

Five days of celebrations, awareness-raising activities, health services, screening for various illnesses and consultations are planned with partner communities in four municipalities in the region. Many organisations are due to attend, including the district health services, non-governmental organisations, programme partners, and associations… but so much depends on these black clouds.

Here on the northwest coast of Madagascar it is still the rainy season, and one storm can create impassable floods. The team carefully protects and packs the necessary equipment before loading it into our truck, and we set off crossing our fingers that the road ahead is clear.

We’re in luck. We arrive at dusk in the village of Antetezambato, where the official ceremony will take place. The village president warmly welcomes us. The podium is already prepared. Everything is ready for receiving the guests the next day, thanks to a collective effort that touches me. We are familiar with this community, whose mangrove reforestation and fuel-wood plantation activities are supported by Blue Ventures.

Daily activities ended earlier than usual, and small groups begin to gather in front of the president’s house, who gives a welcome address. From all sides we are being asked: “Please, which films will you show us?” As night falls, the screening begins: a video on good hygiene practices to prevent diarrhoeal diseases, a quiz, a film on the management and protection of mangroves, songs… The animations flow from one to the next. Questions and answers fuse. We’re off to a great start.

The next day, the teams gathered together at 6 AM; everyone is working around the exhibition stands and the podium. As Blue Ventures’ Community Health Coordinator, I’ll soon be addressing the large assembly gathering in the village centre. An hour before the opening of the official ceremony, I find myself locked in a room, armed with pen and paper, going over the key elements of my speech; “health for all”, “basic health promotion”, “integrated approach to health and environment issues”.

My speech was not alone in highlighting these important messages, and I continued to hear them throughout the day, both in the speeches of the attending mayors and neighbourhood presidents, and in informal discussions with representatives of local associations and health services.

From one stand to another, in a courtyard by the side of the road, each partner is busy working towards a common goal: to provide a set of basic complementary health services, in response to the needs of these remote communities.

The NGO Marie Stopes Madagascar has mobilised teams from the capital Antananarivo to offer cervical cancer screening. The Lion’s Club offers a diabetes screening, the Ambanja Service Médical Inter-Entreprise (SMIA) and the Action for Justice and Progress of Populations (AJPP) provide HIV-AIDS screening. The mutual fund Tsiharofy recalls the link between health insurance and access to care. Dentists from SMIA distribute toothbrushes and toothpaste to children, while teaching them good dental hygiene techniques. Community health workers are conducting nutritional monitoring of children and screening for malnutrition. Most importantly, the district health service provides general consultations, prenatal consultations, child immunisation and deworming. In front of its stand (the busiest, by far!), a large crowd is waiting, revealing how much work is still needed to improve access to basic health services in this area.

This has been a great chance for us and the health of children. I informed many pregnant women and mothers on the benefits of vaccinating their children.” – Jeannette, a traditional midwife from Ambalahonko

And the Blue Ventures team? We promote the fundamental right of every human being to be in good health. But according to the World Health Organisation, being in good health does not just mean the absence of disease. It is also a question of connection and balance between human beings and ecosystems. And that’s why our team, committed to marine conservation by and for communities, has a role to play in such an event.

We are there to show that a healthy community is essential to enable successful fisheries and mangrove management. We are there to show that the reverse is also true: healthy ecosystems under effective community management allows people access to food security, clean air, wood for housing, drinking water or flood protection. This is the rationale for our integrated approach to community-based resource conservation.

Once again, seeing the effects of basic health provision in these villages, I feel the power and effectiveness in this approach, as we take to the road under a swathe of blue sky.

It’s a great success. Many community members have come and are satisfied with the services offered during this day.” – Angelina, Community Health Technician, Blue Ventures

Learn more about why Blue Ventures supports community health service provision

Thanks to all those supporting our community health programme, including CEPF, the Ernest Kleinwort Charitable Trust, the Rasmussen Family Foundation, the Rufford Foundation, the Segal Family Foundation, the Vitol Foundation and the MacArthur Foundation.

Posted by François Rakotoarisoa

Since August 2017, François has coordinated Blue Ventures' community health programme in the Ambanja district of northwest Madagascar.

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