Madagascar: Cholera strikes for the first time in recent history

  • International staff: 11
  • National staff: 76 In early 1999, Madagascar was struck by cholera for the first time in the island's recent history. MSF worked quickly to treat the outbreak, which began in the north, and to get basic information on cholera to the island's population. MSF trained health workers in the province of Mahajanga and distributed medicine and equipment. At the time of the outbreak, MSF began an emergency cholera preparedness program in the western province of Toliary, which hadn't yet been hit. When the epidemic reached Toliary at the end of 1999, the authorities prevented MSF from carrying out preventive and curative work within the health system. MSF teams withdrew from the province to protest what was seen as government inaction in the face of the epidemic. MSF also responded to health crises caused by several cyclones and tropical storms that struck the island in early 2000. Ongoing MSF work in the country concentrates on about 6,000 street children in Antananarivo, the capital, and Antsirabe, the second largest city. A network of volunteer doctors, pharmacists and dentists also offers over 6,500 consultations a year to young people on the streets. Seventy young people receive psychological care. In Antananarivo, teams tour the city two nights a week, providing aid. MSF intervenes in both cities on behalf of young people (and, in Antsirabe, also on behalf of women) who have been institutionalized or placed in detention. The goal is to provide both preventive and curative care. Permanent medical files are created for patients. MSF also monitors the status of those in the judicial system and works with the judicial authorities to accelerate the processing of these cases.