What Do Fisheries Have to Do With Reproductive Health?

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Part I: Disappearing Fish

By midmorning, the sun heats the beaches of Jaguzi, a small island in Uganda. Twelve fishermen find relief under the shade of a large tree. Behind them, Lake Victoria—earth’s largest freshwater lake—stretches for more than 200 miles.

“That’s where we were last night,” says a fisherman named Wilber. “We were patrolling the fish’s breeding area.”

In darkness, while his family slept, Wilber and the others set out in their boat. If they found someone fishing illegally—in a small, protected part of the lake where fishing is off limits—they could leverage a fine and even destroy the perpetrator’s vessel. It sounds intense. But Wilber explains why it’s just one part of the community’s strategy to promote sustainability, which is essential for their survival.

Wilber is one of the nearly 2 million people who rely on Lake Victoria’s fisheries for their household incomes. Almost 22 million people—including Wilber’s wife and children—rely on the lake’s fish for food and nutrition.

So how are families like Wilber’s affected by degrading natural resources, such as the loss of biodiversity and declining fisheries? And how will they meet the demands of a growing population—expected to double in the next two decades—that is already among the poorest and least food secure in East Africa?

It starts with knowledge. And a project called Health of People & Environment in the Lake Victoria Basin, or HoPE-LVB.

“Before, we didn’t understand how important it was to let the young fish grow before catching them,” says Wilber. “We used to fish in harmful ways without knowing or caring about the outcome. Over time, we saw our catches decrease. Many of the species of fish we used to see are no longer here.”

“Then HoPE came and trained our beach management unit,” he says, gesturing to the fishermen by his side. “They taught us sustainable fishing practices. Since we started protecting the breeding sites, we’ve seen results.”

“We used to deliver a basin full of small fish and get 1,000 shillings. But now, look—” Wilber holds up an iron hook. Three enormous fish hang in the air, spanning the length of his torso. “We can catch a 20 kilogram fish. Each kilogram is worth 12,000 shillings. And we don’t have to travel as far to get them, so we aren’t burning as much fuel.”

The sun is high in the sky. Dozens of local kids have pushed in under the tree to hear Wilber speak, not just about fish. Wilber repeats two words over and over, and it’s not what you’d expect. “Family planning,” he says. “We have learned a lot about that, too.”

Part II: A Reproductive Health Crisis

While Wilber and the other fishermen struggled with shortages of food and income from the depleting lake, local women suffered extreme health threats.

“Last May, a woman arrived at our clinic at 10PM,” says Sister Stella, a nurse midwife on nearby Bussi Island. “Her name was Edith and this was her 9th pregnancy. That night, she gave birth, but there was a problem. I couldn’t deliver her placenta.” It turns out Edith had the same problem during her 5th pregnancy, so Stella knew she must act. She had to get Edith to the nearest hospital—across Lake Victoria.

Today, Stella is making sure women who do not want to get pregnant again—whose lives may depend on it—finally have a choice.“Edith was bleeding,” says Stella. “So I set up IV fluids and found someone to transport us to the landing site.” For 45 minutes, Stella held Edith and her newborn baby tightly, as they bounced over dirt roads to reach the boats.

“It’s really hard to talk about,” says Stella, quietly. “By then, it was 9AM. Edith was uncooperative because she was feeling very restless. We didn’t even have enough money to hire the boat. It cost over 100,000 shillings, and her husband had only half that. I had just 10,000 to contribute.” Thankfully a few fishermen, getting ready for their day’s work, quickly pooled what little money they had. “It took five of them to help me lift Edith’s body onto the boat.”

Rough waves licked the sides of the vessel, spilling onto the floorboards. Stella tried desperately to keep Edith alive. After nearly an hour on the water, they finally reached the other side. “We had just enough money for the taxi to the hospital, but only if we shared it. It was tough for the other passengers,” remembers Stella, shaking her head. “There was a lot of blood.”

What about Edith’s human rights—to dignity and health care? What if she died? What would happen to her nine children? How would her family possibly recover the financial cost of this hospital trip? And how could they prevent this all from happening again?

“Today, the mother and baby are OK,” says Stella. She will never forget the ordeal, which stands as a testament to just how far she’s come. “Back then, I didn’t have the skills to manually remove the placenta myself. But HoPE gave me training on how to handle this and other obstetric emergencies here on the island.” That’s just the beginning.

“We have been trained to share knowledge about a variety of contraceptive methods, including long-acting ones, like IUDs and implants, which we didn’t know before.”

Today, Stella is making sure women who do not want to get pregnant again—whose lives may depend on it—finally have a choice.

Part III: It’s All Connected

“We don’t have to have a child every year. With family planning, we can care for our younger ones—to make sure we have enough money to keep them in school. The quality of their life is better."

Back on the beach, Wilber repeats the words “family planning.” Would you believe that of all the changes this fisherman has made, he’s most proud of his family’s decision to use contraception?

“HoPE has shown us how our environment and health work together,” says Wilber. “That poor management of one can have disastrous effects on the other. As fishermen, we used to have many, many children, without thinking about the effects. But today, we care about spacing our children.”

Wilber says he believes more children require more resources. “We don’t have to have a child every year. With family planning, we can care for our younger ones—to make sure we have enough money to keep them in school. The quality of their life is better. It also means less people relying on the lake. Less pressure on it.” 

But that’s not his only motivation. Like Edith, many of the fishermen’s wives grew sick during their frequent pregnancies. “We learned that having so many children affects our wives. Their health suffers,” says Wilber.

He looks around, surveying the twelve men beside him. “Almost all of us here have decided to use family planning. That’s the thing,” he says, “it was easy. When we got the information, our families could make informed decisions. Family planning is our decision for our future.”

Health of People and Environment in Lake Victoria Basin is led by Pathfinder International, in consortium with local communities and partners—Ecological Christian Organization and OSIENALA-Friends of Lake Victoria, Kenya. The project is funded by The MacArthur Foundation and The David and Lucile Packard Foundation.

To learn more about Pathfinder’s innovative “Population, Health, and Environment” work, visit www.pathfinder.org/PHE.

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