As with every mission to Nosy Varika, the team was divided into two groups: four people by road and nine people by MAF plane with the Pastor. The ground team left a day earlier because the road from Vatomandry to Mahanoro is in very poor condition, and the Tamatave route is often blocked by broken-down trucks.
Normally, the vehicle would continue on to Nosy Varika, but the ferries between Mahanoro and Nosy Varika have not worked for over a year after two sank in the river. This time the car stayed in Mahanoro, and the team continued by large canoe (“pirogue”). The pirogue carries up to 60 passengers and two tonnes of equipment. The journey takes around 18 hours, stopping at villages along the way where passengers can buy food or snacks, as there are no toilets or kitchens onboard.
The flight team also had difficulties. After landing, the hospital ambulance and another car were used to reach Nosy Varika. The airstrip itself was full of zebu cattle, so the plane had to circle six times before landing safely.
Arrival and Preparations
During our stay the District Chief was away, so we did not make the usual courtesy visit. Instead, we met the Medical Inspector at the hospital, who was very welcoming. The Chief Physician of Nosy Varika, who is also part of the MMS team as a surgeon, and his family gave great support — his wife and sisters prepared all meals for the team.
The hospital staff worked closely with us, and as usual, an awareness campaign had already been broadcast on local radio. Attendance was lower than usual because of a large festival just before our arrival, but patients still travelled from far away to seek treatment.
Two operating rooms were set up, and we rented a generator to cope with frequent power cuts (electricity is normally only available 9am–12pm and 4pm–3am). For three nights heavy rain flooded the team’s accommodation, but the work continued.
Consultations and Operations
Most consultations were for hypertension, coughs, sexually transmitted diseases, bladder stones, dermatitis, and splenomegaly caused by untreated bilharzia. Several patients with severe ascites were also treated. Surgical cases included many hernias and hydroceles, along with several emergencies.
Stories from the Mission
- Stroke patient: A man collapsed during consultation with blood pressure of 23/18 and was urgently hospitalized.
- Severe malnutrition: A six-year-old girl weighing only 10kg was treated for extreme malnutrition.
- Emergency surgery: A woman with an ectopic pregnancy underwent surgery, and another was treated for a uterine rupture.
- Canoe accident: On the last day, a traveller injured by a canoe propeller required urgent treatment and toe amputation.
We were also joined for a day by visitors from the MAF Norway team. They met the MMS team and assisted where they could, and were struck by the reality of rural hospitals, where post-op patients often sleep on the floor due to the lack of beds.
Looking Back
Despite travel difficulties, flooding, and fewer patients due to the festival, the mission went well. Though numbers were lower than usual, the team carried out major surgical operations and provided vital care for those who had travelled long distances to reach the hospital.
Statistics – Total 524
