COVID-19 in Madagascar

Delivering PPE to Fianarantsoa, Madagascar

For about four months in 2017, from August through November, Madagascar experienced an outbreak of plague.  Plague is endemic to Madagascar, but that year the country experienced an unusual urban epidemic, with many cases of bubonic plague, and many more cases of pneumonic plague which is more rare and can be spread from person to person through airborne droplets.  Efforts to mitigate the spread of the plague were eerily similar to those experienced during today’s pandemic – rules affecting international travel, non-contact thermometers to take temperatures at points of entry, avoid crowded places such as marketplaces, contact tracing.  Unlike the global reach of the coronavirus that causes COVID-19, the plague epidemic in Madagascar remained just that – confined to Madagascar.  The World Health Organization (WHO) reported a total of 2,414 confirmed cases after the epidemic was declared over. 

Despite some striking similarities, the story of COVID-19 in Madagascar is different.  Already, more than 15,000 cases of COVID-19 have been confirmed in Madagascar.  The first confirmed case was reported on April 25, 2020, according to WHO, more than a month after the coronavirus disease had been declared a pandemic.  By the end of August, four months later, COVID-19 was present in all 22 regions of Madagascar, impacting people across the island nation.  According to Dr. RASOARIMANANA Sahondra, CEO of SALFA, the Health Department of the Malagasy Lutheran Church, “COVID-19 is multi-faceted with complexities unlike the recent plague, measles, and cholera epidemics,” all of which have had devastating consequences in her country. 

 Role of Faith-based Organizations

 Faith-based organizations like SALFA are vital to mitigating the spread and treating COVID-19 in Madagascar.   SALFA itself consists of 10 District hospitals plus 50 clinics and dispensaries, most in remote, rural locations.  SALFA’s system also includes a network of “toby’s” - compounds that provide spiritual and physical healing for people most on the margins, including those suffering from mental illness, addiction, and epilepsy.  SALFA is engaged with toby’s across the country, providing medicine, diagnosis and treatment, and education about how to mitigate the spread of infectious disease. 

SALFA also networks with other faith-based organizations, including the Roman Catholic Church (EKAR), which operates 30 large hospitals and clinics, and the Reformed Church (FJKM), which operates 50 urban and rural dispensaries. Several private faith-based clinics are also in this network, focused on serving people with disabilities such as blindness, and hearing or mobility impairment.  SALFA collaborates closely with this network of faith-based organizations and altogether they serve approximately 12,500,000 people – half of Madagascar’s total population.

SALFA teams educate people about the importance of hand-washing, and ways to mitigate the spread of COVID.

Global Health Ministries’ Role

Global Health Ministries (GHM) has had an ongoing relationship with SALFA for over thirty years, donating medical supplies and equipment, providing logistical support for many projects and facilitating leadership consultations for SALFA’s Headquarters, Nursing School and rural facilities.  As COVID-19 began in Madagascar GHM (in partnership with the Norwegian Mission Society, the Evangelical Lutheran Church in America and HoverAid) provided immediate grants for the Lutheran healthcare system in Madagascar to buy Personal Protective Equipment (PPE). Malagasy teams distributed tens of thousands of PPE-related items to 50 Lutheran health centers and over a dozen toby’s across the island using 4X4, truck, and even small boats to reach even the most remote locations. GHM continues sending donated supplies, including over 25,000 items of PPE. In June, two sea containers went to Madagascar carrying a wide range of items, from delivery tables to syringes, plus N95 masks, gloves, medical gowns and face shields. A pallet of supplies has also been sent via air freight.