Final report from Madagascar

Since February 2013 Cap Anamur has been providing assistance with improving health care in the two rural regions around Bezaha and Fandriana. After all structural measures had been completed, we were able to hand over the responsibilities for the two hospitals to our local colleagues. Over the last two years, they have acquired the necessary skills to manage the hospitals both administratively and medically.

Location 1: Fandriana

With the beginning of the rainy season, all outdoor work at the Fandriana hospital had been completed. The previously ailing buildings are now in very good condition. There is a spacious delivery room with direct access to the surgical department. The ward is completed with sanitary facilities, such as toilets, showers and a washing area. And after we repaired the photovoltaic system, broken down after a lightnig strike, a reliable electrical power supply is now ensured.

With the support of our architect, we have finished a new hospital building with a surgical ward. So finally, surgical interventions can be carried out locally and patients no longer have to take it upon themselves to get to the nearest hospital in Ambrosita, 50 kilometers away. The construction of the operating room improved the medical status of the hospital significantly. We are very pleased that we have been able to contribute to the health care of 260,000 people or so in the Fandriana district. In large part, the two local surgeons take care of the numerous cases of hernias and Caesareans.

In the past 24 months, doctors from various medical disciplines have trained and supported local staff in their everyday work. Another focus was on improving the hygiene measures and familiarize the staff with the new ultrasound device. The hospital’s on-site laboratory has also been running smoothly for the last six months under the direction of a former laboratory assistant. An extensive on-the-job-training allows him to now carry out all basic microbiological tests independently.

Location 2: Bezaha

Bezaha, also known to the locals as ‘zone rouge’ for its often feisty residents, is located in Madagascar’s driest region. The hospital is the only one within a radius of 150 kilometers. The structural condition of the buildings here was also very poor: doors and window frames were destroyed by termites. The sanitary facilities were in a terrible condition- we completely renovated them to ensure a more hygienic environment. Similar building measures improved the operating room and the maternity ward. After all, up to 600 children are born here every year. In addition to the supporting measures for the hospital, Cap Anamur also provided medical and technical support for five rural health care centers in the region: minor repairs on roofs and windows, the provision of medicines and technical equipment as well as the installation of a photovoltaic system.

Background: Beyond the natural paradise

Madagascar is often perceived as a tropical natural paradise with a unique variety of plants and animals. But the natural environment of  the world’s fourth largest island is in danger as people’s poverty is destroying the habitats. Economically, Madagascar is one of the poorest countries in the world: exploitation during colonial times and corrupt governments are the main reason why one third of the population of Madagascar lives below the poverty line. The soil is by no means as fertile as the lush vegetation of the eastern high plateau suggests. As a result there is not enough food for the people and even staples such as rice have to be imported. In particular in the rural areas in the southwest of the island people face great hardship. The villages here rarely have running water or electricity. It was in these regions that Cap Anamur got involved with improving health care.

Fandriana is located in the province Amoron’i Mania in the center of Madagascar. It is south of the capital Antananarivo, about a six hours drive from there. Fandriana is a mid-sized city in the central fertile highlands. Around 100,000 people live in the catchment area of our hospital. Our project’s main goal was to bring a surgical ward into service – also with regard to a relatively well functioning maternity ward, so that safe Caesarians can be performed in the future.

The mid-sized city of Bezaha is located around 700 km south of our hospital in Fandriana in the ‘zone rouge’.  As the region is dry and the soil is not very fertile, the people here focus on Zebu cattle breeding. Everyday life here is much harder than in the fertile high plateau of Madagascar. The catchment area of the hospital we support here includes the entire district.