Mission Madagascar

Great poverty remains the lot of a large majority of Madagascans. Despite annual economic growth of 6% and debt cancellation in June 2005 by the G8, Madagascans continue to fight for their survival. Awareness of HIV is still insufficient, and the number of people affected continues to grow. The obvious insufficiency of medical and surgical care and difficulty accessing it are making an already alarming situation worse.

STI/AIDS prevention and education

Tulear

Activities:

The joint venture between Sisal and MdM involves technical support defined by the following activities:

• evaluating and supporting human resources and monitoring the development of the Tulear centre. Training is also given;
• supporting and mentoring Sisal managers (national co-ordinator, technical manager, administrative and financial manager);
• providing group training and staff retraining;
• providing support for Sisal's institutional capacity;
• improving management skills

Outlook:

The Sisal team in Tulear has done a good job in taking over the centre and in developing the planned programme. MdM will withdraw support at the beginning of 2006 and will thus allow Sisal to confirm its autonomy. However, MdM and Sisal will continue to work together as privileged partners in the fight against STIs/HIV in Madagascar.

Integrated project to fight against STIs/HIV/AIDS

Ilakaka

Activities:

After a KAP survey and prior training of the Salfa (Madagascan NGO) team, the activities will be as follows:

• IEC (Information, education, communication) and close work amongst at-risk populations;
• prevention, screening and treatment of STIs;
• voluntary, anonymous and free HIV testing and treatment of people living with HIV;
• strengthening local capacity in the fight against STIs/HIV/AIDS.

Outlook:

MdM plans to provide technical support for 24 months, after which MdM should withdraw from the project.

Support for health in prisons

Ambanja and Antsiranana

Activities:

This programme is considered as a pilot project, as this is the first time MdM has got involved in prison work in Madagascar. The reference plan has six complementary aspects in order to act on the many factors behind poor prison conditions:

• medical;
• nutritional;
• rehabilitation;
• sanitation (in partnership with the Swiss NGO Medair, with whom MdM worked after the Gafilo cyclone);
• welfare and legal;
• co-ordination and continuation of the activities to ensure the effectiveness of the aforementioned aspects.

Outlook:

Extend the pilot project to a regional programme, by initiating and developing this project in other prisons.

Childhood Action, cardiopathy in children

Antananarivo

Activities:

A team from Reunion made up of 2 heart surgeons, 2 paediatric cardiologists and 1 anaesthetist and resuscitation expert carry out 2 visits each year to Soavinadriana hospital in Antananarivo. Each visit lasts a week. There are 3 aspects to the team's activities:

• consultations which in 2005 involved 454 patients, including 191 new cases, 15 cases of closed-heart surgery and 74 cases of open-heart surgery (medical evacuation).
• surgery, where MdM's surgeons in conjunction with Professor Hubert Razafindramboa's local team carry out closed-heart operations. 20 operations were carried out in Antananarivo and 11 at the regional Félix Guyon Hospital in Saint-Denis, Reunion, for the open-heart operations;
• skills transfer, which involves training a Madagascan heart surgeon in Reunion and mentoring of the local team during each visit.

Outlook:

MdM plans to continue its work in 2006 and is considering a possible consortium with other partners working in cardiopathy so that this project can continue.

July 2006