How listening to communities can help save our oceans | Vik Mohan | TEDxExeter

How listening to communities can help save our oceans | Vik Mohan | TEDxExeter

Translator: Riaki Poništ
Reviewer: Ellen Maloney One of the greatest doctors of the 19th
Century, Sir. William Osler famously said, “If you listen to your patient,
they will tell you the diagnosis.” As a practicing doctor myself, I’m constantly reminded
of the importance of listening. But I also work in marine conservation
with coastal communities in the tropics. What if you could apply
Osler’s same wisdom, not just to individual patients,
but to whole communities? What would happen if conservationists were to listen to communities
at the frontline of conservation, and were willing to respond
to what they heard? When I first listened to fishing
communities in Madagascar, I completely changed
what I decided to do with my life. What they taught me is that efforts to protect
our oceans are failing. Failing to protect
our magnificent marine wildlife, and failing to protect the livelihoods of the hundreds of millions
of people who rely on fishing, People who, without fishing,
do not have an income, and do not have a source of protein. People like Noriko. Noriko is a fisherman
living on the island of Madagascar. He’s about to embark on a journey, taking his family with him. He’ll sail for 600 miles
north for nine months in a simple dugout canoe
in search of better fishing grounds. Noriko and his family are Vezo, a seafaring people,
who rely upon the ocean. If they don’t fish, they don’t eat. Their very cultural identity stems
from their relationship with the sea. There are more and more people
from Noriko’s community, who are making this trip because their local
fisheries are collapsing. A generation ago, Noriko
would have been able to catch enough fish to feed his family
in just a couple of hours thanks to healthy marine ecosystems. But now, he faces competition
from ever more local fishermen and women, as well as competition
from International fishing vessels fueled by demand for seafood
for our dinner tables thousands of miles away. 12 years ago, I joined Blue Ventures, a marine conservation organization
that works with Vezo communities and that prides itself on listening. Through listening to the stories
of Noriko and others, Our team were able
to develop an understanding of the challenges Vezo communities faced. As they gained the community’s trust,
they started to work with them, and together they developed a locally led approach to protecting
the marine environment that saw a rapid recovery
of one of their most important fisheries. When I first arrived in this
remote and beautiful place, I was the doctor
for the Blue Ventures team. It was my passion for marine
conservation that had taken me there. But I soon realized that actually
the team were quite healthy, and I became curious
about the health of Vezo communities. As I started to ask questions
about health care, what I heard was just as disturbing
as what we’d heard about fisheries. This is Irene. Irene was still at school
when she became pregnant and was unable to complete
her education as a result. When Blue Ventures started
to work in Madagascar, Vezo communities had little
or no access to health care. If women like Irene had wanted
to use family planning, they would have had to walk
13 miles to the nearest clinic. A lack of any kind of safe
birthing or maternal care meant that Irene would probably
have given birth at home, attended to by somebody
with no training with no running water, and possibly, not even any light. Women like Irene are over a thousand times more likely
to die in pregnancy or childbirth than women here in Exeter. Girls were having sex and having
their first child at a very young age, couples were having more
children than their intended, and all of this was impacting
upon the health of their children. The population of the region
was doubling every ten to 15 years, and the need to feed
growing numbers of people was contributing
to the pressure on fisheries and on the marine environment
that we were seeing. Women like Irene told us that they were desperate for better
access to family planning services. Men were keen to use family planning too. Dwindling fisheries could no longer
support large families, and they could see a clear link
between family size and food security. What was most interesting of all was that communities
were asking us to help. But Blue Ventures is a marine
conservation organization, as my colleagues reminded me. How could we conceivably
offer health care? Yet, what I’d seen in Madagascar stayed
with me long after I returned home. These communities were so remote. Their only mode of transport
was boat or oxen cart. It could take them three days
to get to the nearest city. There was nobody there
to provide them with health care. And yet, there we already were,
working with them, and they trusted us. I’d never seen such a huge
unmet need for health care, and I really wanted us
to respond to what we’d seen. So, we took what felt
like a brave decision. After a full two years of preparation, we opened the doors to the first
family planning service in the area. We had no budget; I took
whatever help I could get. I was donated a box of condoms by my local family planning
clinic here in Exeter. So I flew to Madagascar
with a rucksack full of condoms (Laughter) Not my best decision, (Laughter) but you’ll be pleased to know that we’ve professionalised
our approach since then, but I do shudder to think
what would have happened if the customs officials
at the airport had opened my bag. (Laughter) I was really excited to be opening
the doors to the first clinic, but was completely unprepared
for what was to happen. On that first day, 20 per cent
of all women of reproductive age came to our first clinic. I opened the doors to be greeted
by the sight of a beach full of women waiting to be seen; singing, laughing,
playing games with their children, some had brought their husbands along, We had no electricity, so we worked
until it was too dark to see, and yet, there were still
so many women waiting. So we promised them all that we’d come back and make
sure all of them were seen. The stories I heard from women and girls
on that day will always stay with me. [“Since the birth of my 5th child I’ve been too exhausted
to look after my family properly. I’ve had two more children since then.
Two of my children died. My husband won’t use a condom.”
– 28 year old woman] They gave me more insight
into what life is like for Vezo communities
than I’d ever anticipated. [“I had a baby a year ago,
and it was a difficult birth. I don’t want to go through that again.
If I meet a boy I’ll get pregnant again, so I’ve not left the house since I had
my baby.” – 19 year old woman] More importantly, on that day,
Blue Ventures changed. We became a conservation organization
that dared to think differently. and were willing to respond to the needs
that communities told us about. And it turns out that the most transformational
of these is providing health care. Fast-forwarded a decade,
and we’ve expanded this service to reach all of the communities
that we work with across a huge area of Madagascar. We’ve trained local women
to provide family planning services, maternal and child health,
and safe water initiatives. We’ve called our health program “Safidy,” which means “freedom
to choose” in the local dialect, because it empowers couples
to make their own reproductive choices. Through health education communities are becoming more aware
of the importance of breastfeeding of childhood vaccination, of hand-washing, and so are better able
to choose to be healthy. Healthcare is now as much
part of what we do as fisheries management
and marine conservation. And when we talk to communities, we talk about the interconnection
between human and environmental health. What that means is: men may come
to meetings to learn about fisheries and to discuss fisheries, yet, they get
to learn about family planning. (Laughter) Women, who may have come
to discuss child health, get to take part
in discussions about fisheries. So, what have we seen? Before Safidy was founded, less than ten percent of women
of reproductive age in our area were using a modern
method of contraception. Ten years on, that’s gone up
to two-thirds of women. And the general fertility rate, which measures the number
of births per woman per year is half of what it was
before we opened that first clinic. Women are healthier, and because women are able
to space their pregnancies and better able to look
after their families, their children are healthier. Girls are better able
to complete their education. Because there are fewer mouths to feed,
this should mean less fishing pressure, and less pressure on marine resources. Now, these are all the results
we’d hoped we would see, but some of what we’ve seen
has been completely unexpected and this is the stuff
that excites me the most. Because we are offering a service
that communities want and value, and they see us as genuinely
interested in their welfare, their trust in us is growing. And this appears to be strengthening
their engagement in marine conservation. Because women are able
to space their pregnancies, they’re better able to work, often being able to gain
a livelihood for the first time. Not only is this increasing
household incomes, it’s raising the status
of women within society. [“Safidy is important for me
because it stopped me getting pregnant. So, I can do work because I have time…
I can get money to help my family. When I have more money
I can save a little bit for the future.”] And we’re also seeing
women taking a greater interest in the way natural resources are managed. Ten years ago, 13 per cent
of the marine management committee in the village where we first
started working were women. In last year’s elections, that figure
jumped up threefold to 38 per cent. And just to put that in perspective, 29 per cent of politicians
in the UK Parliament are women. Thanks to Safidy, Irene has been able
to delay having another child. To earn money, she grows seaweed, which she farms in the lagoon
in front of her village, and she’s able to sell that. Her confidence has grown. She’s built a house, and she’s able
to pay for her son’s school fees. She’s become a passionate advocate
of family planning in her village, speaking to women about the benefits
of making their own reproductive choices, even take them to clinic if they ask. Inspired by all that we’ve seen, the next stage of our journey is to see who else can benefit
from what we’ve learnt. We’re spearheading a movement
that supports adoption of this approach far beyond the reach of Blue Ventures. Health and conservation organisations
are forming partnerships all over Madagascar
to replicate this approach, and more and more communities are getting more and more
of their needs met. And we’re casting
a metaphorical net even wider. We’re hosting visits
from coastal communities as far afield as India,
Mozambique and Mexico. And through these visits, people like Irene and Noriko
are able to share their experiences inspiring these communities
to take these ideas home with them. What started in Madagascar is now attracting the interest
of organisations all over the coastal tropics. And by the end of this year, we’ll be working with partners
throughout the Western Indian Ocean and in parts of Southeast Asia. And we’re hoping
that through these partnerships, we’ll be able to reach
over a million people with this way of working. But wherever we end up, Madagascar will always
be Blue Ventures’ spiritual home. “Vezo” means, among other things,
“to struggle with the sea,” and Vezo communities continue to struggle
with their ever-changing seascape, but for the first time in many years, there are fishermen Noriko’s community
who are seeing fish stocks recovering. For the first time, couples
are able to plan their families. For the first time, women
like Irene are having a say in the way their marine
resources are managed. And back at Blue Ventures, we understand more clearly
than ever the value of listening and we’ve witnessed firsthand
the magic that can be created when you have the courage to respond
to what communities tell you they need. When we listen to communities,
they really did tell us the diagnosis and they taught us an important lesson: integrating healthcare
into conservation activities not only enables communities
to lead healthier lives. it also enables them
to better protect the ocean, something they’re doing for all of us. There are over a billion
people who rely on fishing, for food and for income. Many of them live in some of the most
remote parts of the world alongside the same amazing marine wildlife
facing the same challenges as the Vezo. Imagine, if all of these people could be met with the same
willingness to listen, the same willingness
to respond to their needs. Just imagine our oceans, once again, teeming with some of the greatest
wildlife this planet has ever seen. Imagine fishing communities
being able to enjoy good health and an abundance of food from the sea, secure in the knowledge they will always
be able to provide for their families. Imagine children from these communities
never having to go hungry. Imagine these communities
becoming more resilient to whatever challenges they might face
and being able to live truly sustainably. Now, that’s the future
we want to help create. Thank you very much. (Cheers) (Applause)

One thought on “How listening to communities can help save our oceans | Vik Mohan | TEDxExeter

  1. Vik Mohan knows of what he speaks, walking the walk. A real pioneer in delivering integrated responses to the needs of communities. Very useful for anyone wanting a tangible example of why it is worth tackling multiple challenges in a coordinated way.

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