Mangabe is one of the rural communes of the Maevatanana District. The village is surrounded on the left by the Betsiboka river and on the right by a large lake. The climate is very hot and the main sources of income for the Mangabe villagers are onion & rice cultivation and fishing.
The poor condition of the road (very dusty when dry and slippery when wet) makes the village almost inaccessible during the rainy season. The final 75km in the 4×4 cars took 6hrs!
Our team of 17 people included 2 cooks from Mangabe itself.
Like every mission, we began with a religious service. This time led by the Mayor of the commune of Mangabe. He is not only the Mayor of the town but he is also a cathecist of the Lutheran church
After the worship, the whole team got to work. Everything went well, despite the heat and the problem of drinking water above all. The new mobile “Butterfly” ultrasound device has helped us a lot to detect certain cases; such as kidney stones and ovarian cysts.



Story – Woman with fibroma in uterus
A woman around 54 years old had an ultrasound which showed she had a fibroma in her uterus. The surgical team were unable to complete an operation as once they began to operate it became clear the fibroma was a cancerous tumour and was bleeding which could lead to further major complications. The patient was referred to a hospital in Majunga as she would require a blood transfusion during the major operation. She then remained in hospital in Mangabe whilst waiting for this operation to take place.
She was in good shape and released from the hospital the day we left. Five days after our return to Tana, her family phoned on of our Doctors (Thierry) to let us know that they had made it to Majunga for the surgery however she unfortunately died during the operation.

Most of the operated cases were appendicitis, hernias and bladder stones. For the consultations, 75% of patients had hypertension. Unfortunately the Malagasy people are not very enthusiastic about taking medication for hypertension.
Sexually transmitted diseases, malaria, diarrhoea and especially bilharzia are common. People use the water from the Betsiboka river for all of their cooking, washing and drinking.

Statistics
Medical Consulation 255; Ultrasound 126; Opthamology 18; Surgery: major 16; minor 10. Total 479
