Stories from the Small Continent- Week 1
I’ve been in Tana a week now and have learned so much in such a short period of time. I stayed in a hotel for the first week and moved into a studio apartment not too far from work yesterday evening. It was a great feeling to unpack my suitcases and get a bit settled. Tana is very different to anywhere I’ve ever been and I have to admit I find the scale of poverty here quite shocking. Of course I’d read all the figures before coming; about Madagascar being the 7th poorest country in the world with 77% of the population living on less than $1/day but nothing quite prepares you for seeing it firsthand. I also knew that Madagascar has a very young population with approx 50% of the population under 18 years but seeing the number of malnourished and neglected children begging on the streets this last week really puts these statistics into context for me.
The country is still recovering from international isolation following a coup d’etat in 2009 which led to a significant portion of external aid being suspended. An elected government has been in place since 2013 and Madagascar has very gradually returned to stability and re-engagement with the international community and a new Country Program for Development was approved in February 2015. However the country faces many challenges, not least the weak governance and careless financial management of public structures and as a country that relies heavily on foreign aid, children are often those that suffer the most.
Tana itself is a buzzing city with a real French colonial charm. I went on a guided walking tour at the weekend to learn about Malagasy culture and familiarise myself with the city. I must admit I was afraid to walk across the street on my first day. It gets dark here at 6pm and there are hardly any street lights so I found it all a bit daunting at the beginning. The pollution and the sheer number of people on the streets took me a few days to adjust to. The traffic here is always a topic of conversation! It’s like shooting the breeze (no pun intended) about the weather back home and apparently when all the schools get back in October and the rainy season begins, it’s absolute bedlam! Speaking of the weather, it’s currently like a warm summer’s day in Ireland. Needless to say I’ve got my summer gear on but all my colleagues think I’m mad not to be wrapped up in scarves and woolly cardigans like the rest of them!
I am working within the Health Programme section in UNICEF Madagascar and their offices are based in Tana. I report to the officer in charge of Health, Dr Jean Claude Mubalama. His team are focussing on three main areas within Health; Policy and Strategy, Maternal and Neonatal Health Care and Immunisation. Much of the Health funding is received from the EU and is intended to strengthen the health system with a focus on 9 regions of Madagascar. I spent a lot of this week reading briefing documents, carrying out induction, safety and security training and sorting out IT issues. I was lucky to arrive just in time to attend the UNICEF Mid Year Review meeting where I was introduced to most of the senior management. It was also an excellent opportunity for me to learn how the Programme and Operations divisions within UNICEF Madagascar operate.
Maternal mortality is very high in Madagascar with 500 per 100,000 live births and under-five mortality is 56 per 1000 live births in 2014. To put this into context, a Malagasy woman is 55 times more likely to die as a result of a pregnancy than a woman living in Ireland and a baby in Madagascar is 14 times more likely to die before he celebrates his fifth birthday than a baby in Ireland. The deterioration of the primary health care system, including inadequate numbers and distribution of health personnel, shortages of medical supplies and the long distance and high cost of accessing services are major bottlenecks and barriers. My first task is to help my colleagues in the Maternal and Neonatal Heath programme to secure much needed funds to work with the Ministry of Health to reduce maternal and neonatal mortalities. I’m looking forward to getting started.
Until the next time,