FAMILY PLANNING at the FRONTIER
In the beginning, on the South West coast of Madagascar, fishermen would use condoms we supplied, to keep their torches waterproof as they searched for lobster. When they returned, those same fishermen might sell their condoms to the local kids, so to make footballs or catapults out of them.
"As inventive as these uses might seem, the truth is that contraception is not well understood in Madagascar, even less so in the rural South West coast. On average a Madagascan woman can expect to bear 5 children in her lifetime. In the Velondriake region, South West coast, that figure is closer to 6.7."
Family planning is not the only reason - there needs to be better education around condom use. As a nurse who has spent the past six months working in a remote fishing village on the South West coast, I’ve seen just how much of a problem syphilis and gonorrhoea are in Madagascar. The STI and HIV issue is set to get worse, as migrant workers begin to pour in from areas such as South Africa, to support the growing oil industry. HIV and STI’s are a huge problem for a country where only 12% of 15-24yr old men, who engage in casual sex, actually use a condom, and where not even 1 in 7 can positively identify ways of preventing HIV.
I went to Andavadoaka in the Velondriak region of Madagascar to work as a medic for a marine conservation NGO called Blue Ventures. I quickly learnt how critical the STI problem has become in Madagascar, particularly in the rural South West and I immediately developed and expanded upon a number of educational programmes for the local people, ranging from a formal family planning clinic to theatre productions promoting safe sex. The momentum to date has been amazing. The local taken complete ownership of them, by producing theatre pieces, songs and dances, through banners, and messages on t-shirts.
The Madagascan Action Plan (MAP) is an initiative of Madagascan president Marc Ravalomanana and among its ‘eight pillars’ is family planning. However, whilst services in the towns are good, providing them in outlying regions presents severe difficulties.
The clinic in Andavadoaka has been founded by Dr Vikram Mohan. The clinic provides family planning advice and supplies which otherwise would involve a 50 km journey to obtain.
In addition to supply of services, Dr. Mohan’s work has included the much needed publicising of family planning to local residents. Rebecca Hill states that the first and perhaps surprising reaction to be overcome has been a considerable shyness amongst the young people that the program has most wished to reach.
The path to the successful adoption of family planning as a way of living a fulfilled life has been through entertainment and theatre. Through this the initial shyness and reserve has been washed away. The illustrations indicate the fun that has been brought into it. Rebecca states, “it really was amazing to get to the point where people were so comfortable with the topics surrounding STI’s and no longer frightfully embarrassed as they once were, that they could proudly be photographed brandishing condoms. A momentous picture for me”.
Captain Kapoty developed over the months; he is Captain Condom. Initially embroidered on many t-shirts, he became a famous character in the village. This was going to be the ultimate form of advertising. He is holding a fishing net full of STI’s. The word FISA means family planning. It is painted on a sail. When we were making it, plenty of fishermen came to see it evolve and as a result word got around and it became a
sail that many wanted to take out to sea. The people of this area are called Vezo - that means to live by the sea, fishing is their primary source of income. This sail is now sailing around Velondriak and can be seen from afar - the message is clear and it is now well understood.
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Thank you to the Jackdaw an Optimum Population Trust Publication for this article from the www.optimumpopulation.org February 2010 Edition
Resources:
Press Release OPT:
Carbon offset scheme funds family planning projects. Helping women, young people, fisheries, and the planet
Following the November launch of their unique carbon offset scheme, ‘PopOffsets’, the Optimum Population Trust has announced funding for two family planning projects.
OPT’s first project is based in the UK where education is the key issue rather than access to family planning services. Young people’s sexual health charity Brook provides free and confidential sexual health advice and services specifically for young people under 25. Simon Blake, the National Director of Brook, commented: “We really welcome this £5000 contribution from OPT which will go towards updating and modernising our popular ‘Roll with it’ booklet for young people on condom use.”. OPT Chair Roger Martin responded: “Our contribution underlines our recognition of the far greater carbon footprint/environmental impact of each additional unwanted birth in the UK than in any developing country - hence our policy of dividing our funding between rich and poor countries. Our carbon offset scheme, PopOffsets, does not let developed nations ‘off the hook’. We simply must reduce both our own excessive carbon emissions, individually and nationally, and – by voluntary means - the number of our own carbon emitters. But we also have to help over 200 million women in the world, many with no access to family planning, to take control of their own fertility”.
The second project is based in Madagascar where the Velondriake community is seeking to achieve sustainability through family planning and protection of its traditional fishing grounds, which are in danger of over-exploitation. Dr Vik Mohan, a voluntary worker with the project, has hailed the contribution. “This is great news,” he said. “The £5000 contribution will help our community-based distribution of contraception this year, and increase our community education and awareness-raising work.” Dr Mohan added “While the carbon emissions of the average Madagascan are low compared to those in the west, we cannot expect people to continue to live in poverty; but as we work to improve the standards of living of the poor, we must also recognise the impact of affluence, not only on creating greenhouse gases but directly on the environment – and more people have more impact. We are experiencing a growing demand for family planning services, and we welcome the funding from the Optimum Population Trust to help us to deliver them to those who need it. Their families benefit, the fish stocks benefit, and the planet benefits – it’s a win, win, win situation”
Roger Martin commented, “All poor people rightly aspire to become richer; and the evidence is now conclusive that slowing the pace of population growth contributes to national development. Conversely, all other development programmes are doomed ultimately to fail if human numbers, rich and poor, keep rising indefinitely on our fragile and finite planet. As UNICEF* said, “Family planning could bring more benefits to more people at less cost than any other single technology” - it is indeed the ultimate "win, win, win" for women, their communities, their countries, and the planet. It both helps nations develop, and lowers their collective carbon footprint as they do so – very cost-effectively. To quote Kofi Annan**, “Population stabilisation should become a priority for sustainable development”. Carbon offsetting naturally has many critics; but the fact is that it is now a multi-billion dollar business; and the unmet need for family planning is huge and rising. Individuals or organisations considering offsetting their carbon emissions can do this on the PopOffsets website at www.popoffsets.com.
*UNICEF Annual Report 1992
**Key Recommendations of Global Humanitarian Forum 2009
