8th to 13th August 2023
Mangabe is a rural commune northeast of Maevatanana, along the Betsiboka river, in a region classified as “red” for insecurity. The village is surrounded by the river and a large lake. The climate is very hot.
The sources of income for the villagers of Mangabe are onion crops, rice cultivation and fishing.

We had 12 in the MMS team, including 2 cooks from Mangabe. The poor state of the roads meant that it took 6 hours to cover the 70km from Maevetanana to Mangabe.
We had a courtesy visit to the Regional Health Directorate in Maevatanana. This is the first time we have had the opportunity to meet the chief, who is very grateful of the health mission that we have been doing for years in Mangabe and he wants it to continue forever. After the courtesy visit, we went directly to Mangabe.
Drinking water is one of the biggest problems in Mangabe, so we brought water from Maevatanana. The tap water there has the same colour as river water (yellow brown). We had 9 cans of drinking water to cook for 3 days but to wash, clean kitchen utensils and vegetables, we use water from the river, very very dirty. To brush teeth and to clean medical equipment, mineral water is used.


The municipality of Mangabe collaborated a lot with the team; each fokontany prepared for 2 weeks before our arrival according to the order of the mayor, who also organised the place where we put our tents and people to carry water for us from the river 600 meters from the village by cart.
On the first day, we started with a religious service led by the village pastor, followed by a short speech by the village mayor for the official opening of the mission.

Mr Andry from our collaboration partners IMPACT made a speech concerning their protected area and raised people’s awareness to protect the environment.

A sad story
An 18-year-old woman, already seriously ill with a respiratory problem, was brought to the MMS. Her family had been was taken by her family to see our doctors, she was already seriously ill. Her family had been to the public hospital 1 mth before but doctors hadn’t found a problem in X-rays and she had been sent home.
We did an ultrasound and it was clear that she had an acute liver problem. We tried to revive her, but she had a lot of pain in her stomach. Our doctors explained to her family that there is very little chance of her survival but we did everything possible to resuscitate her. A few hours after their arrival, the woman died. She had a 4 month old baby. It was sad for the whole team. We did what we could but it’s God who decides.
Many of the surgical operations at this MMS were for appendicitis. For the medical consultations, most patients had hypertension due to the very high climate. The sonographer worked particularly hard, doing a record 150 ultrasounds. On the day of our departure, Saturday, the surgery team performed 3 more surgeries.
There were still a lot of people coming from very far away but we couldn’t operate on them because we had to leave Mangabe for Maevatanana before 1 p.m. because of insecurity. We arrived back at Antananarivo at 6:30 p.m. on Sunday.
STATISTICS
Medical consultation 310; Ultrasound 150; Dental extraction 52; Surgery 30 ( major 24, minor 6); Ophthalmology 51