Why We Work in Madagascar
The island of Madagascar is home to some of the most diverse plant and animal life in the world. But its people face extreme poverty—three-quarters of the population live on less than $1.25 per day. In a country of over 24 million people, where there are not enough doctors to meet the demand for basic maternal health care, childbirth can be a life or death matter.
Only 44.3% of births are attended by a skilled professional. This—combined with the country’s high fertility and teenage pregnancy rates—suggests that obstetric fistula is likely prevalent.
Tragically, many Malagasy women who develop fistula are hesitant to seek treatment even if it is available, due to a common belief that surgeons only operate to steal a patient’s kidney or other body part. Additionally, Madagascar’s infrastructure is poor, making rural patients’ travel to the hospital both difficult and costly. As a result, women often suffer for years with obstetric fistula, in isolation and shame.
Meet Our Partners
We are currently partnering with SALFA to deliver fistula treatment to women in Madagascar.
Sampan’Asa Loterana momba ny Fahasalamana (SALFA)
Sampan’Asa Loterana momba ny Fahasalamana (SALFA) is the health department of the Malagasy Lutheran Church. Coordinating the activities of 10 hospitals, nearly 20 urban dispensaries, and 15 rural health clinics, they cover 21 out of 22 regions of the island. Six of SALFA’s 10 hospitals provide routine fistula treatment.
Hopitaly Vaovao Mahafaly, Mandritsara
Opened in 1996 in Mandritsara, a town of 30,000 people, Hopitaly Vaovao Mahafaly (HVM), also known as the Good News Hospital, is the chief healthcare provider for a radius of approximately 200km. Some patients live locally, while others travel the 200 km or more to get there, often taking several days. Among other specialized services, HVM offers two operating theatres and a maternity ward.
Freedom from Fistula
In the past, we have provided grant support to Freedom from Fistula and several hospitals through Operation Fistula.
Our partner Freedom from Fistula has supported fistula treatment in Madagascar since 2014, through a partnership with Mercy Ships, a traveling charitable hospital providing free medical care to African coastal regions. In late 2016, Freedom from Fistula established a permanent Fistula Care Center in Madagascar at the Centre Hospitalier Universitaire Toamasina (CHUT), a hospital on the island’s east coast. Funding from Fistula Foundation covered the cost of surgery for 100 women at the new center, as well as pre- and postoperative care.
Through our partner Operation Fistula, a two-week fistula clinic was organized in August 2013, and a percentage of these surgeries were funded by Fistula Foundation. The clinic was held in southeastern Madagascar, as this is an area known to have a high prevalence of fistula based on a survey conducted by UNFPA. It included operations from both local and internationally renowned fistula surgeons, the former of which continued to provide obstetric fistula repair surgery throughout the year at their own hospitals under this grant.
- $450,000 in FY2019
- $391,613 in FY2018
- $25,000 in FY2018
- $207,500 in FY2017
- $75,000 in FY2016
Hopitaly Vaovao Mahafaly
- $4,500 in FY2018
- $6,500 in FY2016
Freedom from Fistula
- $179,473 in FY2016