We began our day traveling to a rural village — Manankavaly.
This village is about an hour and half outside of Tana and mostly only accessible via dirt roads. We pass the time on the drive to the village getting to know Dr. Rabary and her husband better. Dr. Rabary has an excellent sense of humor and likes to laugh.
The ride was bumpy and beautiful. Below us we could see rice fields with an occasion worker tending to the fields. Above us we saw rich red soil and Mountainous soil trails. The road was unpaved, windy and narrow and at one point our car was over taken by a few zebu!
In addition to participating in the conversation, I (Joanne) am intently looking into any tree-lined areas for lemurs. I am rewarded when I spot one running through the forest. Finally, I can tell my son I saw a lemur.
A couple times a chicken/rooster cross the road in front of us. Dr. Rabary asked us if we knew what that meant. For a split second I (Angeline) thought—is she really going to tell us a why did the chicken cross the road joke??? Instead she explained that in Malagasy tradition, a chicken/rooster crossing in front of our vehicle suggests that we are bringing good fortune to the village.
When we arrive at the village, we are duly impressed. The mayor has made a huge effort to make a town for his constituents. There is a community center, an office building for the Mayor and a health center. It truly is a good-looking village center with a beautiful garden between the town hall and the health center.
First, we tour the health center. We are shown what would be the maternity ward and informed that each new mom-to-be must bring her own linens for her delivery. One of the main reasons for this is that there isn’t any capacity to wash the sheets at this time—there is no reservoir to bring water into the hospital area and the closest water source is 2 kilometers away. The room consists of four tables that are slightly cushioned and these are “beds” for labor and delivery. I (Joanne) think of my own upcoming labor how I will be delivering in a labor and delivery suite at Georgetown Hospital in Washington DC. I feel incredibly blessed to have the access to health care that I do.
We meet various women from the village who are waiting for various reasons to see the doctor on call. They are kind enough to let us take their pictures and be interviewed so that we can include their stories in Lifelines, our online global community for women. One woman in particular stands out, she is a new mom and she is dressed brightly in pink. Through our translator, I compliment her on her beautiful baby girl and she laughs. She offers me the baby, saying that she can be a very difficult baby at times. I empathize with her about how hard parenting is and tell her that I have a four year old at home. It strikes me that this woman and I would make really good friends if we lived closer. Motherhood is truly a universal bound.
We soon learn that the many women we saw walking towards the cultural center next to the Mayor’s office were not going to see an event. (We I guess they were going to an event, we just didn’t know we WERE the event) Apparently the Mayor had called a Town meeting in our honor. Over 400 hundred women (and a couple of men) came to hear us explain why we are in Madagascar and why Dr. Rabary’s work is so important. The village has a population of 4000 (…10% came to greet us!) but the mayor explained both for our visit and for medical services, people from other villages travel to Manankavaly.
The mayor spoke about what UNFPA could help them do to make the village even better and asked us to also speak to the audience about the work of UNFPA, Dr. Rabary and also our visit. I should note that the hospital for example is one that doesn’t currently get funding from UNFPA. The requests were big and small- from bed linens to an extension wing to the center. The mayor explains that a water source would enable them to provide water to the hospital as well as 2-3 surrounding villages. He explains that the village has enough money saved to pay the maintenance costs of a much needed ambulance, but they don’t have the savings for the actual vehicle.
When I (Angeline) addressed the crowd, I couldn’t believe the outcry of support. The number of standing ovations that both Joanne and I and the Mayor received when discussing Dr. Rabary’s achievements was a true sign of hope. We explained that Dr. Rabary would have the opportunity to speak to supporters in the U.S. about the needs of women in Madagascar.
Then the children’s choir sang us a welcoming Malagasy song and dances for us. It is amazing to witness. Both Angeline and I are very touched by the effort these children put into welcome us to their village. The mayor explained that a cultural center was necessary in town to give the children, in particular, a safe space to meet and interact. It’s interesting to see the investments in getting youth off the street.
The Mayor invited us to his home for lunch. The Mayor’s wife runs an apprentice program for Malagasy women to learn how to weave clothes and stitch intricate designs on fabric. These beautiful creations are then sold to help pay for the school. We tour the workshop and meet the women who are in the process of learning this craft and watch them turn thread into beautiful creations.
The Mayor’s wife is also a former nurse, and we chat amicably through our translator. It's a fantastic opportunity to learn more about the people of Madagascar and see how those with means live in Madagascar.
After lunch, we return to Tana to visit a UNFPA funded Hospital. The difference between the rural village health center and this hospital is night and day. We are amazed to find out that thanks to UNFPA, this health center has high tech c-section equipment and all the doctors are trained in performing of c-sections. Since they received the equipment in November 2007, they’ve successfully completed 30 surgeries and have had no cases of fistula since then either. But the doctor reminds us that their resources are still scares. They still need a labor room and a delivery room. And as a reminder that so much more needs to be done for even this hospital, in the room just next to the c-section room, three members of the hospital staff were making their own bandages and band aids.
We are blown away by the statistics that at the hospital they have only had one maternal death since 1998. Of course, that’s of the population of pregnant women with complications that make it to this hospital in Tana. We must remember that most women can’t actually get to the hospital and at best they are lucky if they are at least able to get to a clinic like the one we saw this morning in time to save the baby and the mother.
The doctor at the hospital explained to us that in Madagascar there are a lot of myths about family planning (and grave side effects) and often hesitation to use contraception due to religion. Contraception is available free of card, officially, however the hospital choices to charge a nominal fee because “things that are free are not valued.”
Next we leave the hospital to travel to the southern part of Tana to meet with a women’s networking group to interview them for our lifelines web page. These fascinating women from various economic backgrounds have come to meet us to talk about growing up in Madagascar and their various life experiences. Everything from what their childhood was like, what education background did they experience, to their marriages, life partners, and children. Definitely check out these stories on lifelines--for me the most poignant part of the conversation was after we finished the interviews and I was asked about life in the U.S.
One woman explained to me that the hardest thing for her was that she was a mom of two children, and both her husband and her had to work in order to keep a roof over their heads and keep the children fed. This woman felt lucky to have her mother helping her watch the children while she and her husband worked, but that the children were getting mixed up with other children that were introducing alcohol and drugs to her children. She asked me what we do in the U.S. about these problems. I explained to her that we face identical problems in the U.S. and that I wish I had the answers, but the best I could offer was what do with our children when we are home with them is to talk about these difficult issues.
Tuesday, July 1, 2008
We began our day traveling to a rural village — Manankavaly.