Doctors of the World has been working in Madagascar since 1991 when we established our first Disaster Risk Reduction and Mitigation (DRRM) program to aid Madagascan communities. Today, we manage projects focused on three areas: maternal and child health, natural disaster prevention and mitigation, and complex child heart disease.
The country of Madagascar, an island off the east coast of Africa, is highly vulnerable to natural disasters such as cyclones and floods. These events regularly cripple the country’s infrastructure, including its transportation routes and access to health services. In turn, this has left Madagascar’s healthcare system fragile and outdated. The average life expectancy of a Madagascan is just 64 years. Despite Madagascar’s exposure to natural disasters, many homes throughout the country are not disaster-proof, which in turn leads to an increase in deaths, displacement, and the spread of infectious disease.
Since 2008, Doctors of the World has been actively involved in risk-reduction plans for local communities, specifically around the city of Vatomandry. As well as creating emergency plans, we have established a network of over 100 individuals who are trained in first aid and basic healthcare in the event of a disaster. In addition, we have trained local staff in surveillance protocol designed to prevent the outbreak of epidemics following an emergency. We have also assisted in the renovation of healthcare centers to ensure that they are cyclone-proof in preparation for future storms.
2009’s political crisis also had a deleterious effect on Madagascar’s healthcare system – which seriously impacted mothers and children. Modern contraceptive methods are difficult to obtain, resulting in high rates of unwanted pregnancies and terminations. The maternal mortality rate is one of the highest in the world – with over 353 women dying during childbirth for every 100,000 births due to the inaccessibility of birthing and healthcare centers.
To strengthen maternal and child health, Doctors of the World is currently working to improve emergency obstetric and neonatal care. We’ve performed over 18,000 antenatal consultations and assisted with over 10,000 births. Since 2014, our team has also led the NGO consortium on mother and child health in Madagascar with the aim of ensuring that the health of mothers and their children becomes a priority at healthcare centers across the country.
Since the mid-1990s, Doctors of the World has been working to prevent and treat child heart disease in the country. In developing countries such as Madagascar, it can be extremely difficult to gain access to the complex care needed for a child with heart disease. Only two hospitals in the country have the capacity to perform advanced heart surgeries. In addition, these treatments are prohibitively expensive and very few families are able to afford such care.
In order to address these issues, we partner with a surgical team from Reunion Island, a French island 500 miles east of Madagascar, who work alongside Madagascan teams in Antananarivo to train local surgeons and equip hospitals to handle complex cases of child heart disease. We have also trained the heads of numerous healthcare centers around the country to detect early signs of pediatric heart conditions and refer children to a hospital.
Whether it’s helping to build emergency planning systems or advocating for mother’s and children, our teams are committed to strengthening Madagascans’ health and livelihood across the country. For the latest information on our projects in Madagascar and around the world, follow us on Facebook and Twitter, or sign up for updates.
Photography © Bruno Fert & Myleene Zizzo