- Written by Kimberly Pepmiller Kimberly Pepmiller
- Created: 25 October 2014 25 October 2014
After our morning routine of fresh pastries and egg omelets with cheese, we loaded up the two vans and headed south to a village called Soavina. The drive took a little over an hour and took us through beautiful terraced landscapes of crops. Rice is a large crop here in Madagascar, but when rice is not in season, the farmers plant other crops such as potatoes and wheat. Interestingly, the farmers are out in the fields harvesting the wheat by hand with machete-like devices. Then it is bundled up in bunches and carried back. This is hard labor!
It is captivating to drive through the countryside and see the workers out in their fields doing all manual labor. The roads are filled with zebu pulling carts (envision oxen pulling a cart) or a single man or boy pulling a cart piled high with goods. It is just amazing to see this. The roads are quite the spectacle with vans, zebu carts, bicycles and pedestrians walking. The drives to clinic have been inspiring.
We again pulled up to a Malagasy Lutheran Church with the LCMS symbol outside surrounded by people waiting for our arrival and clinic. They are always smiling and welcoming. Some of these people walk ten to fifteen kilometers to get to the church to receive the medical care, so they walk for several hours in both directions to just get to the medical clinic. Many of the individuals do not have shoes. I cannot imagine walking even a quarter mile without shoes, let alone all day. We have also noticed that the people here wear multiple layers of clothes. This has been surprising because it has been so warm outside! The people who come to the clinic often walk the distance and then wait all day without food or water. They are incredibly patient and are grateful for what they receive. It's just amazing to me. None of this would occur in the United States.
Today we managed to see 387 patients, and we filled 831 prescriptions in the pharmacy. We have two Malagasy doctors working with us, and they are so efficient in seeing patients. However, it appears that they spend minimal time examining or assessing them. Perhaps they just know the common ailments and are familiar with the medical treatments. Jo and I both stayed in our familiar roles for the week. Jo worked in triage, and I continued to fill prescriptions in the pharmacy. Neither one of us is lacking things to do.
The disparity between how medical conditions are treated here and in the United States is almost shocking. We saw a man with a broken fibula (leg bone) that was told to take Tylenol and return home (no cast or stronger pain medication!). There was a family today who carried a paralyzed man all the way to the church for pressure ulcers (from being bed-bound). In the United States this man would have been taken to the operating room for surgical debridement and then wound vac placement. There were several people with osteomyelitis (bone infections) who received a week's worth of oral antibiotics. In the United States this patient would receive several weeks of IV antibiotics followed by several weeks of oral antibiotics. We again saw multiple patients with goiters today, all who will need surgery that they may not be able to afford. If we could get iodized salt to these people, I think that would fix many problems. A woman came into the clinic today who had been raped by the gangsters in the bush. It sounds like these gangsters have really become quite violent towards people. However, you will still see children roaming the roads and villages alone. The Malagasy people in these villages live a life that involves hard work, spending quality time outdoors and searching for the daily means of survival. This lifestyle takes a toll on their bodies, and medical care is not super prevalent here. What a different perspective.
After clinic our group went for a stroll through the village and down toward this gorgeous Aviavy tree. The roots of the tree are magnificent and pronounced. Domonia said that these trees are usually only in places where royalty has lived. This village also has several Jacaranda trees, which we have seen throughout the villages and here in Antsirabe. These trees are a vibrant purple color, and apparently they are only in bloom this time of year. I think these purple trees might be my favorite.
Today, in the van, we traveled with one of our interpreters, Eleanore. She was able to fill us in regarding some parts of the Malagasy culture. For women in the country, the average marrying age is sixteen. In the towns, women get married around the age of 22. The man's family is expected to give a gift to the bride's family. Money is now the typical gift, but in the past the dowry was a goat's rear end. The bride's family also gives her a gift, such as kitchenware or perhaps an appliance. The typical Malagasy family in the country will have six to seven children, while a family in a town will usually have three children. Families in the country often struggle to find food in the rainy season due to crops being between seasons. Learning about cultures is just fascinating.
This evening we were able to drive to the Shoprite to purchase some goods to take home, such as Madagascar tea, coffee and chocolate. The Shoprite is really like a regular grocery store. On our drives, even here in Antsirabe, there are stands lining the sides of the road where people sell produce, fresh meat and goods. It sounds like Domonia normally shops at the little markets and stands when she shops for her family. However, when she is preparing food for our teams, she shops at the grocery store. It was just shocking to walk into the grocery store and see this side of Madagascar. We have mostly been observing and interacting with the poorer and more rural aspects.
While out and about tonight, we did experience the culture firsthand as we took a short pousse-pousse ride, in the pull-cart type. As soon as we expressed interest in taking a ride, about ten drivers immediately pulled up in front of us. Then it was mass chaos as the Malagasy people with us negotiated. What an experience!
Tonight we had another excellent dinner of chicken wings, french fries, cauliflower casserole and green beans. For dessert we had yogurt made by a local company here in Antsirabe called Socolait. Our dinner table reminds me of a family Thanksgiving dinner with all of the food and people at the table. There are actually eighteen chairs at the table! Dr. Harison is often missing at dinner. I learned that when the Medical Mission Teams are here, he does his normal rounds at night, after we return from clinic. Since he cannot be here during the day, he puts his hours in at night. He has to be exhausted! What a dedicated man to give his time to serve the people of Madagascar.
Tonight will be our last night in Antsirabe, so we packed up all of the medications for clinic tomorrow and then packed up our own bags in preparation. We look forward to another great clinic day tomorrow and being able to show mercy to those here in Madagascar through our service.
“Hesed” is a Hebrew word that means “kindness”, “mercy”, “loyalty”, “loving-kindness” or “steadfastness.” It’s the way God intends us to live together—a “love your neighbor as yourself”, active, selfless, sacrificial, caring-for-one-another brand of living contradictory to our fallen natures. The “Heseders” are continually looking to work together to share some small measure of God’s extraordinary love. Won’t you join us?