Madagascar-native Herlyne Ramihantaniarivo left the University of Hawai’i at Mānoa with more than a master’s degree in public health.
“Starting a non-profit organization aimed to reform Madagascar’s public health system was a new idea I got from Hawaiʻi,” she says, chuckling. “I went to Hawaiʻi as a public agent to learn and study about healthcare, not to start a project of my own!”
Ramihantaniarivo, widely known as Dr. Ihanta for the shortened version of her last name, came to UH as a government physician charged with reforming Madagascar’s public health system. The country provided free public health services for its more than 16 million inhabitants, but with little money, few resources and a multitude of health issues, improving Madagascar’s public health system involved many challenges.
At Mānoa, Ihanta discussed those challenges with friend and classmate Jeannette Koijane.
“My husband and I have been involved for a long time in various public health issues around the world, so we had a lot to talk about in terms of what the reality was for her country and the incredible challenges her country was facing,” Koijane says.
Ihanta was introduced to the concept of non-profit organizations. “At the School of Public Health, Ihanta learned that public health is very community-oriented,” Koijane says. “She liked the idea that you could have more flexibility to implement something in a non-profit organization.”
Ihanta completed her degree in 1997 and returned to Madagascar. She continues to work for the ministry of health, spearheading the Zahana project on her private time.
The participatory rural development project encompasses several aims, including creation of sustainable agriculture, reforestation of villages, education and the revitalization of traditional Malagasy medicine.
Zahana strives to make local village life more livable so people aren’t forced to leave home to seek a better life.
In Fiadanana, home to about 1,000 people, Ihanta held a series of community meetings to determine residents’ priorities for their village. Zahana’s initial projects were to install a water system and build a school. In neighboring Fiarenana, population 350, Zahana is helping build a plant nursery.
The organization’s name reflects both its focus on reforestation and goal of bridging traditional Malagasy medicine and western medicine. “Zahana is a plant used in traditional medicines,” Koijane explains. “We use collaboration with traditional medicines. It’s hard to revitalize traditional medicines, but it’s necessary in order to fight diseases like malaria.”
Koijane, now a program coordinator at the University of Hawaiʻi’s Cancer Research Center of Hawai’i, and her husband Markus Faigle visited Madagascar for the first time about four years ago.
“It was clear that, with some public health intervention, people’s lives could be drastically improved,” she says. So they agreed to help with fundraising and serve as advisors.
Living 11,000 miles from the country they’re helping—which sometimes seems like a world away to Koijane—the couple describes the organization’s work in talks at schools and churches.
“The Zahana project is a great way to increase awareness about how the rest of the world works, what kinds of issues people are facing and the different challenges they have,” Koijane says.
Faigle also maintains a website that he created for the project, and the couple communicates with Ihanta at least once a month via Internet phone.
The project’s success is due in large part to the villagers, says Koijane. “The participation of these people is really what makes a difference. It’s not coming in and deciding for people what they should have, but asking them what they want and working with them to realize some of those goals.”
Although Ihanta, Faigle and Koijane spend hours discussing next steps for the project, they ultimately want the choice to belong to the people of Madagascar. Ihanta discusses proposed goals and solutions with her team in Madagascar and the villagers.
“It’s not just like somebody from the outside gave them something,” Koijane says. “They built the project themselves; they’re very clear that these are now their obligations.”
A participatory approach ensures change and community interest, Ihanta believes.
“We ask them, ‘What do you think will change your life for the better?’ We ask what they think will improve the current situations, then we set priorities and try to accomplish them.”
Community development and participation are key concepts taught in the School of Public Health, Koijane says. She and Ihanta were able to apply what they had learned in the lecture halls within a practical environment.
“You know, you’re reading about things in school and you’re learning about how things could work, but now, they’re actually coming to fruition, and it’s very exciting,” she says.
Other people’s support is heartening, and achieving goals, exhilarating, but the true reward comes in seeing the villagers’ lives being changed for the better, she adds.
“It’s cool to take what you learned at UH and go out and use it in the world. Change is possible and there’s a role for all of us to play.”