It has been four months now since I landed to Antananarivo, and am working all the time at Unicef offices in Tana. Being invited to join the “Mother-Child Health Week” with Unicef colleagues was really a privilege for me, and a wonderful occasion to see how Malagasy people are living in another part of the country.
The “Mother-Child Health Week” (= SSME, in French = Semaine Santé Mère-Enfants) supervision is organized twice a year by Unicef with the Ministry of Health (MoH) staff people from the regions and the districts. This year, the second visit was supposed to be held mid-October, but, because of the plague epidemic in September and October, all activities on the field, for all the regions, have been postponed to mid-December.
I had the chance to join a small Unicef team going to the West coast, near Morondava. Morondava, is one of the 5 districts of the Menabe region (& there are 22 regions in the country), and there are 18 CSB in the district (CSB means “Centre de Santé de Base” in French). That city is at around 650 km from the capital and it takes more than 12 hours to go there. Colleagues have decided to travel by car (and not by plane), to be able to move locally more easily with the Unicef car to visit the different Basic Health Centers (CSB) outside Morondava city.
There are +/- 2600 CSB in total in the country, and all of them should be able to manage the SSME week to help the population. Of course, Unicef is sending colleagues to only few of them (max 40), to double-check if everything was correctly organized, and whether all inhabitants have been traced, contacted, and medicines (especially Vitamin A and Albendazole) available for young children and pregnant women. The Albendazole is prescribed twice a year as a deworming treatment.
Then, we left Tana on a Sunday afternoon, we stopped in Antsirabe city (180 km South of Tana) for a first night after more than three hours drive, and left very early the day after to reach Morondava on Monday 11th December in the afternoon. You should know that, due to the bad road conditions in the country and nearly absence of maintenance, the average speed for such a long distance is around 50 km per hour.
Upon arrival in Morondava, I was introduced to the MoH people from the district first in that afternoon, and then to colleagues from the regional office the day after. The goal was to check the readiness of the health workers for medicine distribution to the different CSB of the region, in order to reach the maximum possible people in the city and the countryside. See also some pictures of a CSB visit, in a remote area, with local health worker living in the village with the other inhabitants, and without vehicle (then, not easy for them to go the Morondava, at +/- 40km, in case of urgency for exemple).
The first three CSBs we visited were located in the field, between 20 to 40 km from Morondava, in villages far from everything. Roads are made of dirty track, full of mud during the rainy season, and full of holes also. Fortunately, it was not raining during that week when we were there.
On my way back to Morondava, we passed through the “Avenue of Baobabs” (Allée des Baobabs) which is famous worldwide. Really impressive trees. These trees are having leaves only 2-3 months a year, during the rainy season (which is now, between November and February). Of course, there was also an strong request from Unicef colleagues in Tana to bring back some mango fruits from Morondava (hotter region)… that’s why I bought some kilos to share at the office and with friends. They are so delicious in production country … and this is the right season now !
There is also a small village of fishermen on the other side of the river, at the extreme south of Morondava city, and every day, many children have to cross the river and take a dugout canoe to go to school… much more complicated than in Belgium of course. Congratulations to all these children, which under difficult situation, are still willing to learn.