Week 14: The Unique Challenges of Madagascar

The longer I’ve been here, the more I realize that Madagascar has provided some unique challenges for Mercy Ships, but also some opportunities to try some new things. In most countries we go to, the port city is also the capital city, so that majority of the people live in or around where we are docked. However, in Madagascar, the challenge has been two-fold. For one, the capital, Antananarivo, is more in the center of the island (around an 8 hour drive from the Toamasina, where we are docked). This is where around 2 million people live, whereas only about 300,000 live in Toamasina. This means the majority of our patients will have to travel from very far away, especially if they are in the north/west/south of the island. Secondly, this island is HUGE. Madagascar is the fourth largest island in the world, and far bigger than a lot of the countries we have been to previously. To add to the complexity is the fact that most places lack good roads and infrastructure, which makes getting to many parts of the island very difficult. Many of our patients have to walk for days, take a combination of bus/boat/taxi or get flown in by MAF (Mission Aviation Fellowship). They often have to sell their rice paddies, fields or other possessions to get enough money to come see us.

This is where I am amazed at the thought that Mercy Ships puts into everything they do. Knowing all of these things, they have done several things to help with this. For one, they transformed an abandoned building at the nearby hospital into the biggest HOPE Center we have ever had. It has 240 beds, and houses and feeds people as they are waiting to be admitted, after they have been discharged from the hospital (but still have checkup appointments) and while they are doing rehabilitation with our physical therapists. Normally, we could just send patients home in between many of these appointments, but because they have to travel so far to come here, we host them at the HOPE Center for the entire duration of their healing process. Mercy Ships also reached out to the business community in Madagascar, creating an opportunity for them to donate money to a travel fund that would specifically be used to bring patients to the ship (and return them home). This is a really amazing way of opening the door for the Malagasy people who are well off, to help their own people. We also partnered with the telecom companies, and every time we would go to a screening, they would text all the people in that area, letting them know that we were coming. We also used the radio to let people know we were coming.

That’s something else that is unique – we did 11 screenings, across the country. From what I’ve heard, normally they would only do one or two screenings in giant stadiums, of 20,000+ people (which sounds intense). Here in Madagascar, to make sure they reached people from all over, they went out and conducted many screenings, giving people appointment cards to tell them when to come to the ship. I find it truly remarkable that Mercy Ships is able to select thousands of patients, bring them to the ship, and provide surgery, while keeping things very organized and on time (for the most part). However, I would say that the screening team definitely has one of the hardest jobs – they are the ones who have to say no to thousands of people that we are unable to help. For every patient we help, there are hundreds of others that we can help. That’s why it’s important to keep in mind what Dr.Gary says, that we can’t change the whole world, but we can change the whole world for one person. A Canadian surgeon who was recently aboard the ship, Dr. Sherif Emil, puts it this way, when you save a child, you’re not just saving a life, you’re saving a lifetime. That really struck me, this idea that you’ve given this child years and years they may not have had, and now they can impact so many people in that lifetime they’ve been given.

One new thing: We went on a 6 hour long hike on Saturday – what an adventure, but I was definitely exhausted by the end of it. We walked through many small villages, rice fields, up and down hills, through the forest. We hung out in a field with Zebu, got lost following a small path through a field, crossed makeshift bridges and said salama (hello) to a lot of people. It’s amazing how beautiful this country is. Ambatovy, which is a huge mining project in Madagascar (one of the world’s largest nickel mines), had to displace some villages to build the pipeline from the mine to their refining plant in Toamasina. They relocated these villagers and built them new homes, which is why we saw many homes that were built with concrete bases and wooden slats, rather than the houses that are typical for small villages here. Interestingly, Ambatovy is operated and 40% owned by a Canadian mining company (Sherritt).

One thing I observed: So much thought goes into every aspect of the community life on this ship. This weekend, they had a father daughter dinner and dance, to give the families some special time together. A lot of people pitched in to help decorate, to get the girls dressed up and ready and to help make the evening special for them. They also played The Lego Movie in midships so that the boys didn’t feel forgotten. There are some really thoughtful people aboard the ship, who constantly go above and beyond when it comes to serving their fellow crew.

One thing I felt God was telling me: When you feel far from Him, making a list of all the things you should (or shouldn’t do) to draw near to Him, isn’t going to help you. We can’t do it by our own strength. We need to submit to Him completely and ask Him to draw us back, to give us pure hearts and clean hands. Our chaplain made an interesting point, she was saying that if we focus on all the things we don’t want to do, on all the sins we are trying to avoid, we will just end up doing them. Instead we need to just focus on God. To spend our energy and effort focusing on the one true King. This is one of the songs our worship team sang last night: Jesus at the center of it all, from beginning to the end, it will always be, it’s always been You Jesus. I think this is the key – putting God at the center of every aspect of our lives.

Do not conform to the pattern of this world, but be transformed by the renewing of your mind. Then you will be able to test and approve what God’s will is—his good, pleasing and perfect will. - Romans 12:2