I somewhat dreaded the long way back to our next interview which would be along Route National 2 that connects Tana to Tamatave. It would be first the ferry, 30 minutes this time because we went with the current, then another hour of the undulating sand piste, then another 3 hours to the main road and then another two hours west. We would arrive at sundown. And we did, also in the rain, at the next, and our last, health center.

The path to the health center was up a slippery red clay road. The doctor was running around, her white coat flying, as she was trying to induce an abortion of a woman who had walked 2 days while in labor. The baby had died inside her before she arrived at the health center and needed to be aborted to save the life of the mother. If only Trump and his prolife supporters would see this, I wished. I suspect Trump has probably never heard of Madagascar and couldn’t point to it on a map if his life depended on it.

While she was putting the traumatized woman on the abortion-inducing drip we talked with another woman who was waiting to see the doctor, 6 months old baby on her hip. She looked healthy as did the baby who smiled at us. It was her 11th child (she was 38 and had her first child at 16). The baby was called Sunday the 11th. She was here because the baby had diarrhea.  We asked about family planning. A woman behind her whispered in her ear ‘we don’t like it.’ ‘Husbands don’t like,’ corrected the doctor. They are not making good inroads on family planning yet. For now she concentrates on prenatal visits, especially the last one and delivery in the health center. She had reached the target she had set for her team. This was illustrated when we finally sat down in her office after she had seen the baby with diarrhea. By now it was pitch dark and we took notes with the help of our smart phones’ light.

The doctor had done what her higher ups only write (and dream) about:

  1. She mobilized community and local health personnel to contribute to the purchase of delivery kits – when women come to a health center and don’t have two bottles of water, a piece of clean linen, a clean shaving blade and more they are sometimes sent away. The kits are to keep this from happening – but some kits are accumulating where they are not needed and not available where they are, like here.
  2. She bought a blood pressure cuff (about 125 dollars) from her own pocket as the one at the center was no good anymore. She could not wait for a new one that might never come and couldn’t work without one. She does not expect reimbursement (things don’t work like that here).
  3. She mobilized the Commune to raise money and build four ‘cases d’herbegement’ places where the pregnant woman who is about to deliver can wait the last few days with her family so that she doesn’t have to walk for days while in labor like her unhappy sister on the drip in the room next door. We visited the two cases that were occupied with expectant families. Three cases are already completed and a fourth one is being built.

We asked what else was different since she completed the leadership program. She told us that she had never had an experience that gave meaning to the word ‘objectif’ (goal) until this program. She liked what it did to the team and is now also setting herself a goal to buy a piece of land and construct a house in Mahajuna on the west coast before the end of 2018. This will bring her closer to her vision of a happy family life. Currently her husband lives in the far southwest corner of Madagascar, about two days of travel (with a good car); her baby is with relatives in the capital. This means she is alone and on duty 24/7. She loves her work (which would explain the sacrifices). She  cares deeply about the women in her community.

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May 2017
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