In 2013 Conservation Through Public Health (CTPH) was awarded the Global Development Network 2012 Japanese Most Innovative Development Project (MIDP) Award for its integrated conservation, health and community development program that trains existing Village Health Teams to integrate conservation into their community public health outreach around Uganda’s protected areas.

The model integrates conservation and sustainable livelihoods into community public health outreach – an approach also known as PHE (Population, Health and Environment). Village Savings and Loan Associations (VSLAs) are created in each of the communities by Village Health and Conservation Teams (VHCTs) to create income generating projects that will sustain the program beyond donor funding. CTPH has successfully trained VHCTs living near Bwindi Impenetrable National Park in southwestern Uganda and, with funding from GDN, scaled up the program to Mt. Tshabirimu and Mikeno sectors around Virunga National Park in the Democratic Republic of Congo and three districts around Mt. Elgon National Parkin eastern Uganda.

In August 2016, CTPH trained 90 VHCTs across three districts—Bukwo, Kween and Bulambuli—in Eastern Uganda. In April 2017, the CTPH team visited the districts around Mt. Elgon to check on progress made and an opportunity to address challenges. The team met with the VHCT chair and vice-chair of all three districts as well as local government officials, Uganda Wildlife Authority and community members who are the beneficiaries of the program.

The communities living around Mt. Elgon are rural and some in Bukwo and Kween Districts are extremely isolated due to poor infrastructure and roads. These conditions limit access to health services resulting in a 28% unmet need for family planning in women, some of the highest rates of malnutrition of children in Uganda and less than 50% of children with diarrhea receiving treatments they needed (Uganda Demographic and Health Survey 2016). In Bukwo District alone the contraceptive prevalence rate is 18% and fertility rate is 7.6%—both are well above the national average of 34% and 5.7%, respectively. Furthermore, families rely on subsistence agriculture, making them especially susceptible to the effects of climate change. The communities tend to rely heavily on natural resources to meet their basic needs, but unsustainable use of resources can cause greater harm, especially as Mt. Elgon is an important water catchment area for the Lake Victoria basin in the African Great Lakes region. These challenges are compounded by difficult relations between UWA—which manages the national park—and the communities. UWA has a responsibility to protect and conserve the park while communities seek to use the park to improve their livelihoods. CTPH realized that these districts would greatly benefit from the integrated conservation, health and livelihood VHCT model, with potential to also improve relations between the local communities and UWA.

The communities across the three districts have come a long way since we trained the VHCTs last August. Sangayay James, VHCT Chair of Kapkoros Parish, Bukwo District, learned more about family training during the training and as a result he went home and spoke with his wife about family planning. Together, James and his wife decided to use family planning and he reports that it has been easier to ensure his four children have a balanced diet.

In Kapkwata Parish, Kween District Chesang Sophie, VHCT Vice-Chair, has gained skills that help her communicate with her community. She wants to see peoples’ health improve and is more confident in talking to her community about proper nutrition. She has also seen a shift in attitudes towards UWA and the National Park. When the program began, there was a group advocating for UWA to give them land, creating tension between communities and the national park. Now Sophie and the other VHCTs understand the value of conservation and plan on holding community dialogues in the coming months to discuss issues related to the park and conservation.

Namba Sarah is a community member from Mayiyi Parish in Bulambuli District. When the trained VHCTs began visiting her home monthly they educated her on the importance of good hygiene and sanitation to prevent disease. She now has a covered rubbish pit in her home and boils water that is then stored in a clean container. Because of these changes, she told us that her health has improved and money that before went to pay hospital expenses and for treatments is now saved.

The challenges faced by the communities in Mt. Elgon cannot be solved with a single sector approach. While health is a basic human right, only improving this will not address the issues between the national park and the people. If CTPH only focused on conservation, then the VHCTs and the communities would not realize the impact that poor hygiene and sanitation can have on their environment. But together, the integrated model is leading to better outcomes for the VHCTs and their communities.

As the GDN scale up project comes to a close we are optimistic that the changes we have seen in the past few months will continue. The VHCTs have formed VSLAs and already began saving money to use for community projects and to give small loans when people need them. CTPH provided each parish with livestock projects to generate income and sustain the work of the VHCTs beyond donor funding. We believe each of the VHCTs are an important change-maker in their community and they will continue to promote biodiversity conservation through improved health and livelihoods in the communities for years to come.