How did it all start?
Just a short sketch of how our plans have evolved:
- In 2001 Charlotte first came across the hospital in Madagascar when she was looking for a place to work on her elective. I really liked the look of the project in Mandritsara and by chance Dr. David Mann, who is one of the main surgeons at the hospital, came to visit Cambridge that year too and I got to meet him. Unfortunately, I couldn't go out for the elective due to a general strike which started just a short time before my planned departure date and meant that there was no fuel to travel anywhere on the island.
- The idea of going to work in a developing country to see what life and medical work was like there was still alive though. However, as it was clear that I would go as a doctor rather than a student, I thought it was better to get some work experience first, as I expect to have much less back-up from colleagues in a remote setting.
- Fortunately, Hartmut caught on to the idea when my training had progressed a bit more. We chose a period of 6 months because we hope it will give us enough time to gain a glimpse of life in a foreign country, even though we know we won't be able to change the world in that time.
Where are we going?
- We are heading to the town of Mandritsara in North-Western Madagascar, home to about 12000 people with a large hinterland. Madagascar is one of the world's biggest islands on the Eastern shore of Africa with a host of unique animals and plants. The indigenous people arrived about 2000 years ago, not from continental Africa but from distant Polynesia. Thus the people and the language have common roots with several people groups in South-East Asia.
- The language was first put down in writing by Welsh missionaries and that is probably why it seems to bear only remote resemblance to the spoken language. A basic rule seems to be to omit the first 1-4 syllables and about the last 2-4 letters. We have started to learn first words of Malagasy but are working mainly on improving our French at the moment. Because Madagascar was a French colony (after having been a British colony) many people still speak French.
- Madagascar is one of the poorest countries in the world with scarce infrastructure and a very low 'human development index'. Unfortunately, new political upheaval in the last year has led to political isolation on the international scene, so that exports and tourism have declined rapidly and many people are facing unemployment.
- Medical care is very limited and under 5 year olds have a very high mortality. There are many infectious diseases, but not as much AIDS as in the nearby states of Southern Africa. Malaria and diarrheal illnesses including cholera are still big killers and affect mainly children.
Why do we want to support the project in Mandritsara?
- The „Hopitaly Vaovao Mahafaly“ provides regional hospital services for a population of about 250 000 people, who have no other hospital providing X-ray, laboratory or operating facilities. The main procedures performed are emergency cesarean sections and care of traumatic fractures. The next similar hospital is more than 200 km away.
- Additionally, people come from even further away for eye operations, as the only eye surgeon in Northern Madagascar is located there. She can perform many operations which enable people with cataracts to be able to see again.
- The project has a very comprehensive approach: While the hospital provides acute care, the community health team and monthly outreach clinics to distant villages bring healthcare to where it is needed. With a primary and middle school as well as a training school for nurses the project contributes to the local community long term. Even if we will only help for a short time, this is not a short-sighted project.
- While the hospital was founded by a foreign missionary agency, it is now under Madagascan administration, so it is not propagating a foreign culture. However, because several European volunteers still work there, there will be people who can help us cope with the culture shock.
- The motivation for the project is helping others as an expression of a living Christian faith. The Christian message is passed on to patients, but their decision has no influence on their medical care and there is no pressure to join a particular church. Christianity is widespread in Madagascar, however animism and fear of ancestors is still widespread, too.