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MSF in Madagascar, 2011
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In 2011, Doctors Without Borders/Médecins Sans Frontières (MSF) opened a program in a remote area in the south of Madagascar, where many people have difficulty accessing healthcare because of the long distances to regional hospitals.
Madagascar’s health system is facing a number of serious problems, which are compounded by the current financial crisis. The health budget was recently cut by 50 per cent, and half of all medical personnel now working will retire within the next ten years.
Strengthening medical care in an isolated area
In April, MSF started to work in the hospital in the small town of Bekily, in Androy district. The hospital has 20 beds and offers general medical, maternal and pediatric services. There is no operating theater, so surgical and obstetric emergencies are transferred in four-wheel-drive vehicles to Ejeda or Isoanala hospitals, which are four and two hours’ drive away, respectively.
MSF staff work in all three departments of Bekily hospital. They assist around 25 births a month. More than 450 patients were admitted to the hospital between April and the end of the year.
The teams also assisted three health centers and mobile clinics in the surrounding area. Paying particular attention to maternal care, they renovated clinics, donated supplies, offered training and conducted joint consultations with local health staff.
Work was suspended at the end of December, however, following disagreements between MSF and Ministry of Health staff over ethical issues concerning the management of patient care, such as deciding when patients could be discharged from hospital. Since then, conditions have been agreed and activities have resumed in the hospital.
Towards the end of the year, MSF started working with the Centre for Tuberculosis Testing and Treatment. Staff in Bekily carry out TB awareness-raising activities and screen and treat patients for the disease.
Risk of natural disaster
Madagascar is affected by on average one natural disaster a year, and the risk of emergencies is therefore high. Cyclones and floods are a particular threat and tend to hit the island between November and March. MSF is in close contact with the National Office for Disaster and Risk Management – sharing information and carrying out evaluations – in order to be able to react quickly to such emergencies.
At the end of 2011, MSF had 33 staff in Madagascar. MSF first worked in the country in 1987.