Local Ombiasa [Malagasy Witch Doctor]
Ombiasa are typically self-appointed intermediaries between the living and the dead. Spirits of ancestors are understood to influence the physical world meaning communication with them is essential for a number of functions, particularly healing. In modern and urban environments the ombiasa still hold a degree of authority in fulfilling some ritual functions but in the bush they are typically the first point of call for any medical concerns.
13-year-old Fanjara has had a splinter lodged behind his tibia for 5 months. The infection has spread along the bone and he is barely able to walk let alone join his friends on the football field. His parents distrust doctors, preferring the ombiasa's methods.
Without the attention of a doctor, small incidents such as getting a splinter can become life threatening or in this case leave a young man crippled.
Daniel was shot while defending his cattle from bandits. The ombiasa has rubbed the wounds with medicinal plants and wrapped blessed cloth on the victim's limbs. His family then carried him to the nearest hospital for surgical treatment.
Grandmother, Mother and a Stillborn Child
This young would-be-mother was taken to the ombiasa during birthing complications. By the time she arrived at the hospital, it was too late to save her child, he had died in the womb just hours before. She wears is a gris gris [amulet], a token of good luck given to her by the ombiasa.
Cysts are rarely treated in the bush. These brothers have endured cysts for almost a decade. They first people from their village to seek help medical help.
HoverAid Volunteer Anaesthetist - Thalas
HoverAid runs medical missions in areas with little access to modern healthcare.
Volunteer doctors, surgeons, anaesthetists, dentists and nurses travel from all parts of Madagascar and abroad to provide high quality healthcare at a nominal cost. They operate from sometimes derelict district hospitals and run outreach programmes to local communities.
One Surgery Two Lives Saved
HoverAid's medical programmes save and transform lives and build trust in modern healthcare.
Perline arrived at the hospital with a belly grotesquely swollen and close to rupture. The doctors diagnosed an extra-uterine pregnancy and concluded both would certainly die if they did nothing. Operating might save one of their lives.
The surgery lasted over 3 hours. Perline underwent the procedure without general anaesthetic in the hope of also saving her child.
Perline’s bravery and our surgeon’s skill paid off. By some miracle they were able to save the mother’s life and move the unborn child to the uterus to enable a normal birth when the child reaches full term.
Poor access is not the only barrier to receiving treatment. In traditional communities, cultural norms can be far greater frontier to cross than any desert, forest or mountain.
Every Stitch Counts
Working with remote and often traditional communities, change can appear incremental. HoverAid does not attempt to force a preconceived idea of development. Instead the NGO serves the needs of the community as best they can, developing trust and relationship first and foremost.
HoverAid is invited by local leaders to work in the community. This initial leap of faith on the part of the community creates engagement, more relevant programmes and undermines the one-way "charity" dynamic so destructive in long term aid.
Axe to the Skull
The Bara people traditionally carry a small axe over the shoulder. Axe wounds - the result of escalated disagreements - are a common sight following parties and local holidays.
After a violent assault, the care and expertise of the doctors has this girl smiling once more.
A HoverAid surgeon removes fragments of gun barrel and treats facial burns of an embarrassed militia member. Homemade firearms present almost as much risk to the shooter as the intended target.
District radio broadcasts HoverAid's upcoming medical programmes 7 days in advance to give those people living a week's walk away a chance to attend the clinics.
There are rarely any private moments during medical outreach. In villages that see few - if any - outsiders, a team of doctors arriving by hovercraft is a spectacle worth watching.
Dahalo [Bandit] Victim
Growing poverty and dwindling herds are forcing young men into the firing line to defend or raid cattle - the most valuable resource in the region. Though anyone requesting treatment for gunshot wounds claims to be a victim of the dahalo, the doctors consider it their duty to care for the injured no matter their allegiances.
Denise visited the HoverAid doctors with a rare growth on her larynx.
Treatment with a particular variety of antibiotics - only available in the capital - as well as several weeks of consistent monitoring would be needed.
This case is beyond the scope of HoverAid's materials, equipment or budget. In these instances the doctors can only offer advice on the nature of the affliction, the implications of living with it and the best means of seeking further assistance.
HoverAid's medical missions offer a rare opportunity for people to receive dentistry with the luxury of anaesthetic. Dental hygiene is poor in rural areas throughout Madagascar but dental issues vary greatly by region according to the level of calcium in the water.
6-year-old Hortense was savaged by a crocodile while playing near her home.
Her screams brought her parents to the scene just in time to prevent her being dragged into the river.
However the reptile’s jaws had torn into the flesh of Hortense’s abdomen and snapped her radius, she was losing blood and still in serious danger.
Miraculous as her escape was, without HoverAid's doctors who were able to treat the wounds and provide the antibiotics, the inevitable infection would have certainly killed her.
Polio in Madagascar
In the bush, some Malagasies suffer from diseases almost forgotten about in richer nations such as polio or bubonic plague.
Many Malagasy men will not seek medical help until their condition prevents them from working. Though the resilience displayed is phenomenal - particularly among the elderly - many medical conditions become hard to treat when ignored for so long.
Some surgeries even take the seasoned HoverAid doctors by surprise. Skin cancer is not common amongst Malagasies but having to work out of doors in 40°C sun, the condition was almost inevitable for this albino lady.
Infant mortality across Madagascar is high - nearly 3.6% in 2015 - and much higher still in rural areas. Families typically have numerous children, in part to mitigate this risk. But the pragmatism does not stop parents loving their children. HoverAid works extensively with mothers to provide medical care and practical guidance.
Madagacar's Regional Nurses
Madagascar's regional hospitals have to cope with an array of medical complaints that would baffle even the finest medical professionals. But understaffed, underfunded and under-resourced, everything from delivering babies to sewing up gun wounds falls typically to a nurse who may have little more than a hands on training in anything beyond basic healthcare.
Walk for Life
Sylvestre’s distended stomach and yellow eyes are the result of an acid buildup in his abdomen - simply treated with a drain, fatal without. He walked 180km to seek help after hearing HoverAid's radio announcement.
Haingo waits while her mother is seen by doctors during a medical outreach mission to Volambita on the Makay River.
Short on luxuries but with his parents around him, Bila recovers from surgery in the makeshift post-op ward.
Amina faces 2 hours of surgery to remove an abdominal cyst the size of a football.
Future Healthcare in Madagascar
More people from remote parts of Madagascar - particularly mothers with young children - are choosing to put their faith in the professionalism of HoverAid's doctors and their mission to reach the unreachable. This developing trust paves the way for new programmes that will foster healthy growth inside these isolated regions.