My work at UNICEF Madagascar while plague epidemic was at its highest level earlier this month.

Nearly two months now, since I arrived at Antananarivo, It’s time for me to explain a little bit more what I am doing at UNICEF Madagascar.

As explained earlier, UNICEF Madagascar is divided into 6 sections (see blog n°1), I am part of the Planning section, which includes Fundraising and Business evaluation.  I have three main objectives for my mission:

  1. Develop foundations profiles, meaning check for/select potential (existing or new) sponsors, like private families or foundations, which could support one or several UNICEF projects from one of the sections. Evaluate the foundations new interests or orientations for giving and compile all the data in a database.
  2. Test the Ressource Mobilisation Plan (RMP) in place in the Team Site and propose an easier process (simplification) in order the different sections use it more regularly when they have to look for new fundraising for their specific projects.
  3. Participate in building a “scientific case” for the first years of secondary schools, mainly with Education, Nutrition and Wash sections. These cases will help in promoting science at school, in order the students (and especially girls) stay at school and pursue their education for a longer period.  To find out how UNICEF could finance this case is also one of my objectives (via sponsoring or crowdfunding).

Then, a lot of new things to do, with colleagues having too many projects to be implemented, too many priorities and too few people to deal with, but with very kind colleagues coming mainly from Madagascar (of course), but also from many other international countries (Germany, UK, Spain, Mexico, US, Bolivia, France, …). On the featured picture is the UN building where I am working.

How is Antananarivo ?  Where am I living ? How do I survive here in such a huge overcrowded city with more than 2 million people, with currently a plague epidemic, and more than 124 people who died already from the disease (and more than 1200 cases) ?

The city is really divided in “rich” and “poor” areas (see the picture), and I am staying in a small guesthouse near the “Lycée Français”, in a more secure “rich” area, but not too far from rice fields and from “poor” areas, and at around 10 km from the UNICEF Offices.  Small flat, but cosy.

Traffic is awful and extremely polluted with many people walking in the streets… you can even see zebus… and many other kinds of carts which are slowing down the traffic.  Going at work with local taxis is also bringing you 40 or even 50 years in the past…  most of them are Renault 4L and Citroën 2CV, which are going slowly, and with a lot of holes between the engine part and the cockpit… then polluting a lot the air inside the car. With such bad car conditions, you never know in advance if you will reach your destination :-). In the street, all cars and trucks exhausting pipes are releasing a lot of black smoke particles, and this is the reason why many people are wearing  specific mask while driving by scooter. We are very far here from the mandatory Euro 6 norm in Europe for all vehicles!.  But you get use very quickly to such living conditions.

Few words about the plague epidemic, which is particularly severe this year in Madagascar, with all schools closed for more than three weeks now.  Historically, during the third plague pandemic in 19th century which started from China, via India, the first plague cases arrived in Madagascar via the Tamatave harbor, from infected rats (with fleas as reservoir for the bacteria) via boats coming from India.  It was in late 19th century, and since that period, plague is endemic now in the country and there is annually some cases observed between September and April, mostly the bubonic plague (via bites from fleas infecting rats = primary infection), and always in the countryside, and not in cities.  This year, the epidemic came out via an infected person (with pulmonary plague = secondary infection), and that person died in the bus (we call them here Taxibe) between Tamatave and Antananarivo last August.  The two persons who were sitting close to the infected one were later on infected and also died few days after. It was the beginning of the infection this year, in majority pulmonary cases, very contagious, and affecting mainly two cities, Tamatave and Antanananrivo.

This very contagious disease is caused by Yersinia pestis, with fleas (& rats as reservoir) biting humans and (giving the bubonic plague).  The bacteria was isolated by Alexandre Yersin in Hong Kong in 1894, and the role of fleas in the transmission was demonstrated by P. L. Simond in 1898. However, the most contagious disease is the pulmonary plague (= secondary infection), when people with lungs full of bacteria are coughing and releasing around them, in their immediate environment, thousands of droplets containing the infectious bacteria.

While bacteria are sensitive to antibiotics, if people are not treated on time at the early stage of the deadly pulmonary plague, they will die within 24 to 72 hours.  There is less risk to die with bubonic plague. You can see below one of the poster/advertisement placed everywhere in the city, in all villages and towns of the country, on taxis, on TaxiBe, on buildings, everywhere, etc… in order to educate people on the disease, on the importance of hygiene (incl. remaining food in the sewage system), and stop the epidemic.

But no panic, despite this is a deadly disease, if you can detect the first signs of infection, and be treated early enough with antibiotics, you will survive  !.  We also have been well trained by WHO and Unicef doctors and colleagues and are tested for temperature every day when coming to the office…. “Même pas peur J”…

You can of course follow the situation on the web, if you are interested.

Peste 2 Blog2
The cycle of Plague
Zebus in Tana street, close to the UN offices

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