What do you picture when you think of Madagascar? If it's not a scene from the infamous cartoon of the same name (complete with talking penguins), then it's most probably a nation ravaged by ecological disaster.
Madagascar doesn't often make the news, but when it does, it generally seems to be the passive subject of a singular crisis narrative: biodiversity jewel (with 80% of its plants and animals found nowhere else on the planet) devastated by illegal logging, slash and burn farming, political instability, plagues of locusts, and so on.
Its forests are being razed, its red soils are being eroded, its lemurs are disappearing, its oceans are being emptied, and its people are shedding blood over prized cattle.
The problem with this dominant discourse is not exactly that it's untrue, but that it's incomplete.
Yes, half of Madagascar's most easily identifiable 'primary' forest has been converted to other types of land cover since 1950*. Yes, almost two-thirds of its population are affected by food insecurity. Yes, 92% of its population live on less than two dollars per day. But these statistics are only part of a more complex reality.
Those of us living and working in this very special country long to tell different, more nuanced stories.
One such story is about how people in Madagascar are taking courageous steps towards sustainable development, addressing tough social and environmental issues through imaginative responses that reflect the messy intricacies of such challenges.
At a growing number of the island's most precious biodiversity hotspots, so-called "Population-Health-Environment" (PHE) initiatives are combining health education and voluntary family planning services with community-based natural resource management and biodiversity conservation efforts. This bold, pragmatic approach is rapidly gaining traction across the health and environmental sectors in Madagascar.
As the United Nations seeks to redefine our collective vision for sustainable development post-2015, here are three things that we can learn about improving human and ecosystem health from experiences in Madagascar:
1) We have to think outside the box.
The greatest challenges facing our world today defy straightforward definition. They're complex and messy, and they don't respect the boundaries that we often try to impose to make them amenable to neatly planned interventions.
Looking at social or environmental problems in isolation blinds us to the bigger picture. There's rarely a magic bullet answer, and this kind of tunnel vision holds us back from finding truly comprehensive solutions.
PHE initiatives are developed and adapted locally in response to the ways that communities experience the links between various sustainable development issues; reflecting the intimate connections between people, their health and the environment.
Holistic approaches break down barriers between the health and conservation sectors, and get organisations thinking outside of their siloed boxes.
2) Integration kick-starts positive chain reactions to achieve real change.
Poor health, unmet family planning needs, food insecurity, unsustainable natural resource use and environmental degradation interact and compound each other in increasingly negative ways.
PHE initiatives stop and reverse this vicious cycle by integrating health services with conservation efforts to kick-start a series of positive chain reactions: empowering couples to plan and better provide for their families, invest in their children's education, improve their livelihoods, and take an active role in the management of fisheries and forests.
These programmes are proven to be more effective at generating results than single-sector approaches, especially in terms of engaging men in family planning and enabling women to take an active role in natural resource management.
3) Sexual and reproductive health and rights matter.
All couples and individuals should have access to the information and means to decide freely and responsibly the number and spacing of their children, without coercion or discrimination. This is absolutely not controversial; it's a fundamental human right, and the key to empowering women to take control over all aspects of their lives.
Three-quarters of a million women in Madagascar would like to space or limit their births but aren't currently using contraception, and the country's population is predicted to double by 2040. Population dynamics, in addition to consumption patterns, set the scale of the global development challenges that we face.
Advancing sexual and reproductive health, including increasing access to voluntary family planning services in ways that respect and protect human rights, not only improves health and gender equality but also food security and environmental sustainability.
Most importantly, it enables women to exercise their own personal choices and fulfil a universal desire to "bring every good thing" to each of their children before having another.
PHE initiatives represent a highly effective mechanism for reaching some of the most isolated and under-served communities with voluntary family planning services, as health agencies can partner with conservation organisations already working in such remote areas to make use of their existing infrastructure.
Collaborations between health agencies such as Marie Stopes Madagascar and conservation organisations such as Blue Ventures are demonstrating how such integrated programmes can be a "win-win" for all involved; empowering communities to live more healthily and sustainably alongside the unique natural environments upon which their livelihoods depend.
The PHE model is gathering momentum in Madagascar, with strong support from the new democratically elected government, and a vibrant network of implementing organisations coming together to galvanise and reinforce the broader adoption of this integrated approach, particularly through cross-sector partnerships.
A daring story is unfolding in response to this beautiful country's immense environmental and social challenges, and it promises to be an exciting one that we all can learn from.
More information about the inaugural Madagascar PHE Network meeting held in the capital city of Antananarivo this week can be found in this news story.
Blue Ventures is a marine conservation organisation whose integrated approach has been endorsed by Sir David Attenborough as "a model for everyone working to conserve the natural life-support systems of our troubled planet".
* Contrary to popular reports, Madagascar has not "lost 90% of its forests" nor does "only 10% of its forests remain". This 90% deforestation myth unfortunately persists as a powerful trope in the literature, despite being based on wholly unfounded assumptions by colonial botanists which have since been disproven by paleoecological evidence and analyses of satellite imagery.