I am a Support Technician for Blue Ventures’ community health programme, Safidy (meaning “choice” in Malagasy), and I am based in Maintirano on the west coast of Madagascar.
I work closely with coastal communities, supervising the community health workers (CHWs) that live in those communities and provide basic health services.
I also work with the migrant fishing communities that live for up to nine months at a time on the remote Barren Isles, located off the coast of Maintirano.
A remote community in the Barren Isles | Photo: Garth Cripps
Migrant fishers live in the Barren Isles for up to nine months | Photo: Garth Cripps
To improve my work, and expand the opportunities for the community health programme in Maintirano, I participated in an exchange visit to another Blue Ventures site, the village of Andavadoaka in southwest Madagascar.
After five days of travel in a taxi brousse from Maintirano, I finally arrived in Andavadoaka and was welcomed by the team there.
Toalidy with the Safidy team in Andavadoaka | Photo: Njaka Raveloson
It was amazing to see the strong cohesion between the Malagasy and International staff. Not only do they work well as a team but they also spend time together socially, something I saw when I attended a birthday party where everyone was singing and playing guitar.
As well as getting to know the Andavadoaka team, I was here to learn about Safidy’s work, and that’s how I spent most of my time. I attended the regroupment, which is a monthly meeting for local Community Health Workers (CHWs) and I was surprised to see that there were over 30 CHWs at the meeting! This was a big change from the 8 CHWs that I support in Maintirano!
During the regroupement, I saw that our work across sites is very similar. Blue Ventures facilitates the gathering of CHWs, and a Chef CSB (a government health worker who manages a public health centre) reviews all the monthly forms before leading a training with support from the Safidy team.
As the training progressed, I witnessed the CHWs listening intently and actively participating in the discussions. I had a chance to speak with one of them, and she told me that before becoming a CHW she didn’t know how to read and write or how to sew, but she has now learned both and it has transformed her life.
The engagement and effort I saw from the CHWs reflected the hard work and dedication that I also saw from the Safidy team in Andavadoaka.
Toalidy and the Safidy team with Community Health Workers after the regroupement | Photo: Njaka Raveloson
After the regroupement I participated in the Village Outreach Tour (VOT), which provides integrated messaging to cover pertinent health and environment topics with isolated communities. Within the VOT there were focus group discussions, community meetings, and theatre sketches that all engaged the community in conversations about natural resource management and positive behaviours to improve human health.
During the VOT, I saw that youth and students were participating in most of the outreach activities. In many of the communities and migrant fishing camps around Maintirano there aren’t any schools, so these activities might need to be adjusted slightly for that context, but I still think that we should develop more youth-focused sexual and reproductive health education and outreach in these areas.
Children getting involved in the Village Outreach Tour | Photo: Njaka Raveloson
A theatre sketch with an integrated message | Photo: Njaka Raveloson
Another new activity that I learned during my visit was how to use the Population-Health-Environment (PHE) story cards. These cards depict situations that commonly occur in the villages where we work and give community members the opportunity to create stories based on the cards they see. Integrating community and ecosystem health in discussions is often quite challenging, so I’m looking forward to bringing the PHE story cards to Maintirano!
In addition to Safidy, I also learned more about Blue Ventures’ aquaculture programme, which we don’t have in Maintirano. Traveling to the remote coastal village of Tampolove, I saw first-hand people farming seaweed and sea cucumbers. It was great to see this programme successfully offering an alternative livelihood for families, helping them send their children to school and better manage their marine resources.
Toalidy trialling the PHE story cards in the communities around Maintirano | Photo: Nick Reed-Krase
Aquaculture in Tampolove | Photo: Antoine Rougier
Altogether this exchange visit was a great opportunity for me to see the work of Safidy outside of Maintirano and to get new ideas on how we can improve our health work. I also learned more about conservation efforts like aquaculture and octopus reserves, and can now better explain Blue Ventures’ integrated approach.
I know that I will use the PHE cards and theatre sketches I witnessed as future activities in my own work. I am thankful to everyone who helped me to do this exchange visit, and I hope that I will have a chance to do another in the future to help me to keep improving our work in Maintirano.
Blue Ventures’ Medical Director reflects on ten years of integrating community health services into our work.
Join our award-winning expeditions for your medical elective!
