Feedback Madagascar

THE PRELIMINARY STUDY IN AMBOLOMADINIKA

Outline

In order to identify the specific activities of Feedback Madagascar – Ny Tanintsika's programme in Ambolomadinika, a preliminary study was carried out in May 2003. The aim of this study was to better understand the villagers' present situation, their needs and priorities, and to collect baseline data through the local authorities, schools, health centres and district health service. This data collection is essential in order to develop the project, and for subsequent monitoring and evaluation.

The study was carried out though visits to a sample of the commune's Fokontanys, the use of questionnaires, group and individual interviews, participatory tools and techniques, interviews with key informants, data collection at health centres, the commune and other government establishments. The study attempted to involve a representative sample of all population groups, and in total 184 villagers took part.

A Summary of Results

- The commune of Ambolomadinika
Ambolomadinika is an isolated commune, its central village located at 13 km from the district centre, Ikongo. The route linking Ikongo to Ambolomadinika has been impassable for several years due to a lack of upkeep, and the three-hour journey on foot involves a canoe-trip. Walking from Ambolomadinika to neighbouring Ambohimahamasina takes at least a day.

Ambolomadinika is divided into 12 Fokontany, and its registered population is 18,773 (February 2003). However, the rate of non-registration of childbirth is very high, and the number of people on the electoral register is just 2,846.

- Local authorities
The local authorities fall into two categories in Ambolomadinika; the administrational (mayor, executive committee and advisors, and local security committees) and the traditional. The traditional authorities are divided into hierarchies; from the different categories of “King” to the king's spokesperson, and the divisions within the village community (the elders, women's' group, young male village head, the youth group). Although there is a difference between the tasks of these two authorities, and the two collaborate together, the traditional authorities still hold more value in this commune.

- Traditional customs
Traditional customs are still very strong in this area, the heart of the Tanala culture.

Number of cattle	Reason	Commentary
1 minimum	Enthronement	During the harvest season; a favourable day must be chosen.
1 optional	Circumcision	May to October
2 minimum	On the King's death	Burial is at least 4 days later.
1	Incest with a close family member.	If the family member is more distant, “toaka gasy” (local rum)
1 (and a meal)	On the birth of the 10th child	It's a desire and an honour.
1	Death of parents-in-law	Obligatory for the son-in-law.
1	House-warming	October; according to the day identified by the ombiasa (traditional healer) as favourable.

As throughout Madagascar, culture is based on cattle sacrifice. In general, this costs a lot of money and deepens the region's poverty. However, it has seen a slight evolution recently when, since the fall in the price of coffee, several kings declared cattle sacrifice no longer compulsory upon every death.

- Wealth

Wealth is very unequally divided in this commune. According to the villagers, wealth can be categorised as the following:

	Wealth	% of the population
Wealthy	5 or more cattle and rice fields, no debt (often money-lenders)	2
Fairly well off	Less than 5 cattle and rice fields, no debt.	4
Quite poor	No cattle, small ricefields, Indebted	4
Poor	No ricefields, dependence on the wealthy	90

The population of Ambolomadinika is extremely poor, and this poverty is largely accentuated by the system of money lending which is called “Menamahazo” (which has an interest rate of double, and non-payment can result in the confiscation of land), as well as the fall in the price of coffee.

- Communication
There is no long wave radio in the commune of Ambolomadinika, no post, no telephone nor even local radio station. Very few people have access to a radio (which receives only short-wave), and those who do rarely have enough money to buy batteries. Consequently, very few people are informed.

Village	Total population	No. of radios which work	No. of households which listen regularly
Ambolomadinika	269	15	10
Ankarefobe	312	5	2
Tsarakianja-sud	262	4	3
Antaranjaha	184	10	8

- Education

There are 16 primary schools in the commune and one secondary school. The rate of school attendance for the commune actually decreased by 3.1% between 2002 –2003, mainly due to the closure of a number of schools. Equipment is extremely basic, teaching standards low and likewise teachers' salaries; very few pupils continue stay in primary school for more than a couple of years.

One of the principal problems associated with education is the poor rate of school attendance, due mainly to parents' financial problems and to the lack of recognition of the importance of education. Few parents are literate. In addition, the rate of school attendance of girls is particularly poor (at primary level, and at secondary level there are no girls but just 15 boys!); girls are considered as destined for marriage and household chores and so drop out early.

School attendance rates are even lower than normal during the ‘hungry season' and the rainy season, when floods are common and pupils cannot cross the numerous rivers in the area. Likewise, when there is a death the pupils participate with the traditional ceremony and do not attend school.

There is a lack of agricultural – environmental school activities, and a very poor situation regarding school hygiene. Few schools have latrines, and none have drinking water. Consequently, a large proportion of pupils are absent each week due to diarrhoea (as well as other common diseases).

- Health

There are three health centres in the commune of Ambolomadinika; in Ambolomadinika, Antaranjaha and Ambodiara-dihy. However, there is only one doctor (two health centres are manned by nurses). Despite there being three health centres, there are still many villages situated several hours distance away, and so health access is particularly difficult in the rainy season. Hospital attendance is very low in the commune, and especially so during the hungry season when families are in a particularly bad financial situation.

Malaria is the main killer in the commune, which attacks easily due to the frequency of malnutrition, which itself is caused by poverty and ignorance as to the importance of a balanced diet. Respiratory diseases are also common, since 90% of men in the commune smoke or chew tobacco, and 80% of women chew tobacco. The rate of alcoholism is also very high for the commune, which is leading to an increasing number of acts of disorder and security (notably thefts). The preliminary study also investigated villagers' perceptions of the cause of different diseases and their treatment.

Ikongo was particularly hit by the flu epidemic in 2002; with 289 deaths registered at the health centres in Antaranjaha and Ambolomadinika. This high death rate was largely due to villagers' habit of consulting traditional healers, only attending health centres as a last resort. There was also a lack of medicines at the start of the epidemic, and transmission was promoted through the death ritual whereby villagers are obliged to stay in the king's house with the deceased for two nights or longer.

- Reproductive health

Most villagers become sexually active at the age of 12, and even as young as 10. Villagers identified numerous negative consequences of this, especially since in most cases it involves sex of a major with a minor.

On average women have between six and fourteen children; they are considered as a sign of wealth and a gift from god. Few women are aware of natural family planning methods. The rate of contraceptive use in the commune is roughly 3.4% of women of childbearing age. Negative rumours concerning the secondary effects of family planning are widespread and discourage women from practising it. However, women recognise the need to limit their family size.

STIs are widespread according to the preliminary study, most men being adulterers and condom use being virtually nil. The main constraint is the reluctance of villagers to go to hospital for treatment, preferring traditional healing or self-treatment with a small dose of antibiotics (openly on sale in village shops).

The rate of childbirth at hospital is very low due to high poverty levels, villagers having insufficient financial and material means. Often women do not like being seen by a male health agent. Therefore the vast majority of childbirths are with traditional birth attendants (TBAs), who number over one hundred in the commune. Their techniques used are traditional, and often dangerous, and they lack equipment and cleanliness.

- Hygiene

Latrines are a very rare occurrence in the commune of Ambolomadinika; villagers do not like using them since they are thought to facilitate the transmission of disease and due to their bad smell. Consequently, villagers go to the toilet near the river or amongst their coffee trees.

- Drinking water

There is a lack of drinking water in the commune; the vast majority of villages fetch their water from the river, although some even use water from the rice fields. Few use springs and there is an absence of wells. However, few villagers boil their water before drinking and therefore diarrhoeal diseases are common.

- The social environment

Legal marriage is a rare occurrence in the commune; 30 are registered. Men are often afraid of responsibility, often changing their “wife” on a regular basis for a younger one, as well as of costs involved in the celebration. In the case of a couple's separation, the woman is left with nothing except the children, and with no rights to claim assistance. The non-consideration of women's' rights in society is also evident in meetings; they must wait for men to finish speaking before they can talk, and at mealtimes; women eat after their husbands.

- Commerce – Agriculture

There is no market in the commune, the nearest being in Ikongo. The poor route discourages commercial activities. Therefore the principal commerce is with Ambohimahamasina, where rum and coffee are carried to market.

Cash crops, and specifically coffee, dominate agriculture in the commune. However, since 1997 the price of coffee has fallen from 10,000 fmg / kilo (roughly £1) to 1,000 fmg / kilo (roughly 10p) in 2003. Therefore villagers have lost interest in tending their trees and have turned to the production of rum to substitute their lost income from coffee. However, rum producers gain just 1,500 fmg per day. Bananas are also very abundant but there are no buyers for the produce.

Villagers lack the knowledge, equipment and training to develop the agricultural sector. The productivity of rice farming is poor largely due to a lack of fertiliser and compost, lack of water, and due to disease, the abundance of rats, and the mountainous nature of the area. The ‘hungry season' is very pronounced, from March to May and August to December, and most families' staple food is cassava. The price of rice is inaccessible to most families other than at harvest time. Villagers are keen to learn new rice farming techniques.

Vegetable growing is virtually non-existent in the commune, due to a lack of seeds as well as techniques.

- Environment

Aside from the Fokontany that border the rainforest corridor, and which has recently been transferred to community management, there is very little forest that remains in the commune. The practice of ‘tavy' or shifting cultivation (“slash and burn”) is still widespread, despite recognition of its negative consequences. Conflicts have started recently between the two ethnic groups on either side of the rainforest corridor, the Tanala having exceeded the limit of their land and crossed into Betsileo territory. There has been only a very minimal attempt at reforestation in the commune, and consequently firewood is a problem; coffee trees are used as firewood.

A summary of the preliminary study's principal findings:

Low rate of school attendance, particularly for girls.
Lack of respect for women's' rights.
Hospital attendance low; preference for the traditional sector.
Some traditional customs are obstacles to the region's development (e.g. the punishments).
Rapid environmental degradation
Large decrease in the population's living standards, mainly due to the drop in coffee prices.
Reduction in agricultural yields.
Increase in the production of rum and in security problems.
Food insecurity worsened by the practice of “Menamahazo”.

Priority activities identified:

The training and subsequent follow-up of traditional birth attendants.
Consultation with traditional healers in the area, and collaboration with them concerning the treatment of certain diseases and their referral in urgent cases.
Community training on reproductive health, STI/AIDS and family planning.
Awareness-raising on disease transmission and the services available at health centres.
Hygiene promotion and latrine construction.
Awareness-raising on alcoholism and smoking, and promotion of sport as a pastime for the young.
Training on maternal and child nutrition, including a child-weighing programme.
Promotion of legal marriages and campaign against the abuse of minors.
Awareness-raising on women's' rights and collaboration with local and traditional authorities.
Training on maternal and child nutrition, including a child-weighing programme.
Promotion of legal marriages and campaign against the abuse of minors.
Provision of safe drinking water to villages, and training on the precautions to take before drinking water.
Awareness-raising on women's' rights and collaboration with local and traditional authorities.
School assistance and awareness raising on the importance of schooling, especially for girls.
Adult literacy programme.
Promotion of income-generating activities, especially for women.
Collaboration with traditional authorities to adapt some customs.
Agricultural assistance (vegetable growing, rice farming, etc.) with the aim of preventing malnutrition and to develop income-generating activities.
Reforestation programme, via tree nurseries of different tree species especially fruit trees.
Construction of hydraulic dams to irrigate land.
Rat prevention measures.
Community rice store programme (collection of agricultural products in the harvest season, their stocking in the village and their re-sale at the same price during the “hungry” season).
Environmental education in schools, including vegetable growing.

And the continued use of participatory research and action tools and techniques together with local communities in order to determine programme direction.