Blessings from Marofatsy

imageimageimageimageI write from Marofatsy in the district of Marolambo, Madagascar.
James and Corty are analysing faecal samples under the microscope by candlelight. The night air of the rainforest is humid there is a damp smell to match. Cicadas buzz smoothly in the background, whilst ‘Blame it on the Weatherman’ (by B*Witched) is playing from our small speaker.
The wet season in Madagascar is over the British winter. I was told in 2013 to avoid this season and so planned to come to Marolambo in May-June.
During the wet season in Marolambo, roads become un-driveble, and walking paths become muddy and arduous. Despite being here in the dry season, today was the first day it hasn’t rained and it’s been glorious!

We are as remote as can be. Hannah has spent the evening taking me through the expedition medical kit which has been planned to cover every emergency possible. It would take a minimum of 4 days (weather permitting) to reach the nearest hospital in the case of an emergency, so the kit really has everything in it up to performing minor surgery!

Since returning from Madagascar in June 2015, not a day has passed that we haven’t been planning every detail for this trip. It has been so worth it (even in the constant rain).
Prior to Marofatsy we visited the main town of Marolambo where we spent two days planning and meeting the chiefs (traditional chiefs, official Chiefs, medical Chiefs and school Chiefs). Sleeping in the Priest’s hut was just as surprisingly luxurious as last year (hot water and toilet with a seat).

We were joined by the village chiefs (official and traditional) and head teachers accompanied by many village faces looking through the windows. Dr Alain (head of Neglected Tropical Diseases in Madagascar) gave an introduction about our project in Malagasy, the Chiefs blessed the project, and the team and I warming thanked them for their hospitality.

Research day 1: education on schistosomiasis and hand hygiene preceded the study. We divided the school but into several ‘stations’ through which the fifty children (aged 5-14) would rotate through.
Daniel, Zo, Emmanuel and Dr Alain completed the questionnaires with each child (assessing the impact of schistosomiasis in their daily life),
Jamed and Corty measured each child’s height and weight, Hannah performed ultrasonography, and Steph and I took blood to test for anaemia and malaria.

We had hoped to run through 25 children each day but the first day had gone much quicker than planned; we had only 19 children left for day 2 meaning extra time for faecal and urine analysis!

Our third and last day involved treating every child in the village for schistosomiasis via ‘mass drug administration’ as advised by the WHO. This was completed by Dr Alain and the Malagasy side of the team. Many pictures with the village and videos (including the use of a drone) were accompanied by the sounds of a hundred screaming children who had received their Praziquantel – this marked the end of Ambohitelo.

Three hours along a very muddy (but sunny!) route took us into the larger village of Marofatsy. A much more efficient day 1 of research meant that we performed research on all 50 study participants on the first day. Day 2 in Marofatsy brings us to the day of writing. Poo smearing in the morning was overcome by sunny weather and knowledge of a local waterfall (photos to come)! Well worth it and a very well received break! We have completed a third of our research and have 4 more villages, 200 more children to work with and we love it.

The reason Hannah has been taking me through the medical kit is because she will be leaving with Steph in two days to return back to England for other commitments.

Every child in Marolambo whispers Stephanie’s name – she is becoming the most well known person in the district. She even managed to make children laugh when they have their blood taken?!?!?!?

We are now in the swing of things, have gotten used to the long drops and feeling dirty, and can distinguish the different varieties of rice for breakie, lunch and dins (I must learn how then make it taste so smokey!). James and I are beating out initial infections and coming to the end of our courses of antibiotics and turning a corner health-wise. The team are all well, in great spirits, and having a really fun time. The research is filled with laughter amongst team, children and locals.

Everyday of work for this expedition was so so worth it. It’s beautiful, serene, peaceful and people are wonderful and their way of life is extremely humbling, an honour it is to be welcomed into these tribes and get a glimpse of how they function in one of the most isolated parts of the world.

I am so glad that both Stephanie and Hannah joined the expedition – the MadEx team and children of Marolambo have been much better off for it. Vohidamba, Betampona, Ampasinbola and Marofatsy to come, as we continue further into the bush.

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A journey of serendipity

I write from an Arriva Trains Wales carriage, armed with a coffee and on my way to Herefordshire.

It’s taken a long time to get to this stage. We’ve fired off countless heavily caffeinated emails from Anthony’s living room over the past year and arranged meetings with experts all over the country. I have spent car journeys daydreaming about the trip (with James and Anthony warbling to a background soundtrack of The Lion King), but it has always felt like something that was a long way into the future.

And now, with three weeks to go, it’s all getting a bit real. Booking flights has made it feel like we’re going. I can’t believe we’re actually going.

Today I began to think about the things we’ll need out there. Number one on the list: passport. Aha, now that was something I hadn’t seen since February.

Feeling like a complete mug, I called up Her Majesty’s Passport Office to arrange a replacement; yet another lesson learnt from all of this. It’s easy to forget the basics and be swept away with impressive things like communicating with WHO leaders.

I’m spending the next four days on a course, learning how to be a safe Medical Officer for the expedition. It’s a course designed for doctors but hey, we’ve spent most of this process feeling a little out of our depth and it’s something that I have become quite accustomed to.

It’s been hard work, but now I understand what it takes to organise an expedition. I’ve developed those cliché CV-boosting skills, as well as the ability to compose comprehensible emails at 3am and reel off a three-sentence synopsis of the expedition in my sleep.

With Anthony’s self-assurance, James’ charm and Steve’s experience, we’re a pretty fab team. A team that has used the word ‘serendipitous’ so many times that I was forced to Google what it actually meant but wow, what a journey. Something I’d recommend to almost anyone… and we’ve barely even started.

Written by Hannah Russell (Medical Officer, Madagascar Medical Expedition 2015)