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Anna’s Resilience: Supporting healthy people and a healthy planet through Women-Led Community Resilience

By Cara Honzak and Cheryl Margoluis. Originally posted on Pathfinder.org

Anna farms the small plot next to her house on Uganda’s Jaguzi Island. She relies on what she grows and the fish her husband catches to feed their six children. Every day, she works to keep her vegetables growing to feed her family. When there is extra, she sells her crops at a local market and saves some cash for emergencies. She knows that just one major illness or an unplanned pregnancy could tip the scales.

But so far, she considers herself lucky.

As Lake Victoria rose to its highest recorded level and swallowed whole villages last month, her village was spared. The massive swarms of locusts ravaging crops across East Africa never came to Jaguzi Island. Despite avoiding these catastrophes, Anna battles new challenges every year—floods that drowned her crops and droughts that starved her cows.

Yet through each challenge, Anna has arisenresilient.

This is, in part, due to Anna’s participation in Pathfinder’s programs focused on Women-Led Community Resilience.[1] Pathfinder’s Women-Led Community Resilience approach increases communities’ resilience to withstand and thrive through depletion of natural resources caused by climate change and other shocks—specifically through the empowerment of women and girls.

This approach builds on learning from Pathfinder’s Population, Health, and Environment programs like  the Health of the People in the Lake Victoria Basin (HOPE-LVB)—which contributed to Anna’s resilience. For the past seven years, HoPE-LVB in Kenya and Uganda made women like Anna more resilient through:

  • Improved access to health services, including reproductive health care.
  • Diversified, environmentally friendly livelihood opportunities.
  • Improved sanitation and hygiene in households, schools, and communities.
  • Improved access to savings and loans groups.
  • Strengthened capacity to manage natural resources in sustainable ways.

This type of multisectoral support addresses the holistic needs of women—as individuals, mothers, and caregivers in their families and communities.

Through the HoPE-LVB program, Anna established her home as a “model household” to demonstrate positive health and natural resource management behaviors to her neighbors. She has become a community champion for healthy families and a healthy environment. Anna’s household is one of more than 1,500 model households established through HoPE-LVB.

Model households like Anna’s have strengthened resilience to COVID-19 by regularly practicing hand washing and using latrines. Model households are better prepared to sustain their own food supply through use of sustainable agricultural practices, obtain necessary health care for themselves and their children, and prevent unplanned pregnancies.

A Women-Led Community Resilience approach is now more important than ever as Anna and her community face the indirect impacts of COVID-19.

Since March, when the national government announced stay-at-home orders, daily life in Anna’s rural community has changed. She and her neighbors keep hearing more about the new illness, COVID-19—how it is killing the elderly and health workers, interrupting life, and ravaging even wealthy global economies. Yet she has not seen the sick people that everyone is talking about. While she has heard that Uganda has several hundred cases, no deaths have been reported (as of June 16, 2020).

Instead, Anna has seen the ripple effects.

There have been lockdowns and curfews. Until recently, public transport, including bicycles, motorcycles, and small boat taxis, were forbidden to carry passengers.

People interpret national guidelines in various ways, and no one is certain what will happen if they break the rules. In Anna’s village, people are anxious. Trading goods and services has slowed or halted. People worry about whether basic goods will continue to be available. Many are afraid to go far from their homes.

Anna and all the women around her are becoming more dependent on information they receive from men, who have access to radios and cell phones. Men with transport are the gateways to staple food products, bigger pieces of fuelwood, and charcoal that women need to keep meals on their tables. Anna wonders what choices women might feel compelled to make if there is more scarcity.

In the absence of nearby health facilities, community health workers (CHWs) still come around—and Anna is grateful for that—although she worries because they still lack protective equipment. As the weeks since lockdown have worn on, some CHWs haven’t been able to restock essential commodities like contraceptives.

As COVID-19 cases in Africa continue to increase, entire countries must shelter in place and respect quarantine rules. This will leave rural families like Anna’s to confront new challenges.

  • Clean water and soap. Many are left without clean water or soap in their households. Households, schools, and landing areas for fishing boats have set up makeshift “tippy taps,” but to refill canisters, most people must make regular trips to Lake Victoria. Making or buying soap requires cash and access to markets, which many people do not have.
  • New sources of food. People are not able to travel to community open markets to trade or obtain staple foods, and disruptions in global food supply chains will further exacerbate food insecurity and malnutrition. An estimated 29 percent of Ugandan children under 5 are already stunted due to malnutrition. Any restrictions on movement will multiply risks, including the risk of starvation, and risk of injury or death resulting from hunting for food, such as entering illegal hunting or fishing areas.
  • Alternative sources of cash. An estimated 70 percent of Ugandan women work in the informal sector. When markets close, they cannot make money from selling crops and other goods at markets.
  • Health care and contraception. Once overwhelmed by COVID-19, health facilities will be limited in their ability to help patients and provide essential family planning and reproductive health care. Women and their families will be left to fend for themselves or turn to traditional medicine for support.

Women-led Community Resilience programming is critical. 

COVID-19 is testing everyone’s ability to adapt, anticipate, absorb, and thrive in the face of stress and crisis. But for many women and girls across sub-Saharan Africa, it is not the first, last, or the most enduring threat they will face. Infectious diseases are on the rise. Human habitats are being altered at an alarming rate, significantly compounding the risks of infectious diseases jumping to humans. Each year, we see growing evidence of how climate change is increasing the strength and frequency of droughts and floods.

Global health programs need to recognize that maintaining healthy ecosystems and biodiversity are key components of disease management. The global conservation and climate sectors must recognize that human, ecological, and climate health are inseparable, and we must work together to protect health and well-being.

That’s why Pathfinder is building on the fields of One HealthPlanetary Health, and Population, Health and the Environment and embarking on a new era of Women-Led Community Resilience programs.