Fordham University            The Jesuit University of New York

Liz Pfifer

Liz Pfifer
, a second year IPED student at Fordham (in the turquoise sweater with her running group), is in Madagascar working with Catholic Relief Services (CRS). She is there researching the efficacy of the Positive Deviance/Hearth model. This model arranges for mothers skilled in providing for their children despite poverty teach these skills to other mothers in the community. Other community educators offer supplemental instruction in sanitation and agriculture. Thus far, the program has reduced malnutrition rates and increased women's participation in community development. Right now Pfifer is contributing to a CRS proposal for emergency funding in light of recent hurricane damage.

See below for Liz's lastest update 3/25/08:

Hey yall,

Bonjour Bonjour!! I have had a busy and fruitful past few weeks. The traveling for work was wonderful, and now I have more to keep me busy in the office here in Tana. Just to recap, I spent one and a half weeks traveling down to the southeastern coast of Mada. The nutrition model (positive deviance/hearth model) that I am researching is part of a larger project. This project is being implemented in four different regions of Mada. Therefore, I am visiting all four of these regions in hopes of seeing if and why the nutrition model in each region is working. The two towns (in the same region) I visited were called Farafangana and Manajary. As I was reviewing my itinerary and preparing to leave the office, one of my colleagues mentioned it would take two days to get to our first destination, Farafangana. I asked how much driving we would do. He said, oh about 10 hours the first day and maybe 5-8 the second. I laughed then. But it was true. The first day we drove approx. 10 hours. No lie. However, it was probably one of the most picturesque drives I have ever experienced not to mention the CRS driver and my colleague really enjoyed my music selection. (We listened to everything from Linkin Park to James Taylor and Beyonce.) The central highlands of Mada are considered the bread basket per se of the island. I saw everything cultivated from rice and carrots to pineapples and kasava. Along the hills, farmers terrace their crops. 

Madagascar Rainforest

The saving grace as my bum numbed around the 9th hour was our drive through the rainforest. The Ranomafana rain forest is a lot of kilometers south of Tana. It is thick and green and lush. It was like being in another world. As we drove through, I kept my eyes open for lemurs that are very common in this area, but none happened to swing across the road as we drove. There was a lot of something else across the road though—mud and trees. We saw some of the effects of the cyclone. Huge trees had fallen causing mudslides onto the road forcing a slow crawl at times. I didn't mind though, my eyes were glued to the waterfalls, rocks, and trees that formed a surreal backdrop. Due to the tourism, there are electrical poles right along the road which brought me to reality and my thoughts drifted to the States. I saw a Stonybrook University sign. They are part of a research station in the forest. 

In both Farafangana and Manajary, I met with CRS partners, usually local NGOs or the Catholic diocese, who are implementing the Positive Deviance/Hearth model, and I also met directly with those involved in the village. It was much like my last trip to Toamasina; however, I was much more active and not simply an observer. I conducted focus groups with questionnaires and gathered more solid data. All of the villages I visited in this region were much poorer. They had experienced the worst effects of the cyclone. Each year they suffer droughts and extreme food insecurity. From initial research, I believe this region will be the crux of my report since they are making strides with very little resources. Farafangana is hot and humid and right on the Indian Ocean. The raining season was still in full swing there, so most mornings began with warm showers followed by sunny skies. I visited two different villages, both south of town. In each, I met with participating mothers, volunteer mothers, health educators and traditional leaders. It was amazing to interact with and question their participation and motivations. I literally sat under the trees on a raffia mat conducting interviews. It was brilliant and surreal all at the same time. My master's at work.

There is one story I have to tell about a little boy named Robin. In the first village I visited, I met 2 year-old Robin. He could not walk and only weighed approx. 10 lbs. He was tiny. His mother had died during childbirth and a friend had taken him in. Due to improper care and lack of nourishment, Robin's growth had been terribly stunted, and he did not develop during those crucial first years. However, now his caregiver is part of the Hearth program learning how to make extra nutritious meals for Robin, and he is growing and changing each day. One of the questions I asked the mothers was, "What changes besides weight have you observed in your children since you starting coming to the hearth?" They all looked to Robin with their answer and said, "He is stronger, happier, and wants to eat all the time." Many children are so unhealthy they have no appetite or will not breastfeed. In some villages, mothers are actually skeptical of programs unless they are distributing food. When people are in dire need, they would prefer to receive food handouts instead of learn how to make their situation better in the long run. Organizations that still practice this are actually creating obstacles instead of alleviating problems (Of course, this excludes emergency cases in which food aid is necessary.) After time passes, the hearth model is usually enthusiastically accepted. They see the results children like Robin  are making and want their children to benefit as well. Nutrition programs, such as this one, are changing from food "hand-outs" per se to more development based programs that focus on behavior change (cooking with locally available foods, getting vaccinations, boiling water, washing hands before and after meals, etc). It all seems so simple and common sensical, but many practices we take for granted in the western world are not practiced due to lack of resources and knowledge. I have found this program to be more successful if it also incorporates agricultural, marketing, and/or disaster preparedness. As one father told me, "You must start by making sure women and children are healthy. Then we can farm and produce for revenue." Holistic development, trying to get to the root of problems instead of band-aiding them.

In Manajary, it was raining more frequently. One of the villages we visited was inaccessible by car. We were told the CRS 4x4 would not be able to traverse where we were going (sounds ominous), so we walked.  It ended up being approx. 4 km mostly through mud which at some points was up to our knees. My sandals got lost in the sludge more than once. It was hysterical. When we arrived to the village, we looked like we had just stepped out of a mud bath at the spa. Far from this dream, we were greeted by mothers and children from two neighboring villages who were gathered for monthly weigh-ins as part of the positive deviance program. Each mother arrives with their child's weigh chart in hopes the baby is in the green category signaling a good weight. For many mothers, this is the first time they have ever been able to follow the weight of their baby consistently, and it gives the mothers a real sense of pride if their baby is healthy. If they are in the yellow or red, they will be singled out and strongly urged to join the hearth program to learn more about nutrition and cooking in the home. Along with the weighing, local health educators do what is called "sensibilization" which is basically awareness raising on topics such a malaria (important during rainy season) and diarrhea. The mothers ask questions and learn from the health educators and each other. After observing the weigh-ins (adorable by the way), I conducted the interviews and learned more about the village.

My research involves questioning and investigating, but I believe equally important are my observations of the attitudes and motivations and mindsets of the people I meet. They are resoundingly positive and enthusiastic. It is terribly unfortunate that many of the villages frequently face setbacks like natural disasters where in an instant progress is wiped away. With these kinds of experiences, my hope lies in the people I have met.

I wish you all well.



Countryside Liz (in hat) interviews with questionnaires

Terraced Countryside

Liz (in the hat) conducting interviews

Robin Weigh-in

Robin Eating

Baby being weighed

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