I was sad to see Hannah and Steph go. They have been extraordinary members of the team and we all felt a little bit empty after they left. However, our schedule was tight and researched continued, while we slowly settled into Vohidamba.
One of the most common topics of discussion during these weeks has been quality of life for the villagers. The landscape is so immensely beautiful that it is easy to idealise the people here. Vohidamba, for example, is a village of about 300 wooden huts huddled on a floodplain that backs on to a steep hill. In the evening, one can see smoke from hearth fires seep through the thatched roofs, splitting beams of a setting sun. Around the village, the Nosivolo River winds, passing into the west as a golden, sunlit streak specked by little green islands, cutting its way through giant forested hills. This is the background of daily life for all the villages, a stunning mix of extreme isolation and beauty.
However, it is clear that problems run deep and occupy much of daily life. Houses are small, often crammed with several generations of family, and without electricity save the odd solar panel. Even in Marolambo, the central town, electricity depends on fuel import and road condition, meaning there is only 4 hours of electricity a day. During our stay, roads were so poor that the town was without electricity for 5 days. Access to clean water is also limited. In most villages there are taps with spring water, but these may be a 5-10 minute walk. In Ambohitelo, spring water was more than 15 minutes walk away; with the Nosivolo running directly next to the village, it is not surprising that most villagers drink and bathe directly from the river. Furthermore, although rice and bananas are abundant, meat is rare and most are malnourished. General health is poor, education is limited and in this isolated area, one doctor cares for 12,000 people.
Nevertheless, people here do seem to be happy. Even the sternest-looking Malagasy will crack into an enormous grin on greeting. There is an extremely strong feeling of community. Each village has both an elected chief and a Tangelamana, or village elder. Both are highly respected and run all village affairs, creating a unique blend of ability and wisdom. Everywhere, guests are treated to long greetings and unending warmth and generosity. At one point, a chief even slept with us in our hut, as his wife and children were spending the night in another village. As everyone knows everyone else, families and villagers look out for each other and crime appears to be low. During our trip, we were robbed on two separate occasions. However, both times, items were returned by chiefs or relatives within a day. Indeed, during our first evening in Ambohitelo, the robber was dragged into our hut by several other local boys, tried by the village elders, tied up and taken back to Marolambo, all before 11pm. Although sometimes unsettling, we feel privileged to witness village affairs and politics so rarely seen by outsiders.
Our work in Vohidamba finished, we proceeded on to Betampona, the most isolated village of our trip. On arrival we were joined by one of the Malagasy students, Elodie, and her guitar. It was quite an entrance, within about 20 minutes she had every child in the village singing their hearts out. Most interesting was a song that encouraged the children to wash regularly. Our first night we went to a town party, where we danced inthe local Malagasy style with two drunk policemen. It was a strange experience. The 3 days in the village passed quickly and are honestly a bit hazy for me as I was sick on one of them. Before we knew it we were hiking the 25km back to the central town Marolambo.
We spent a week in Marolambo, researching and treating children in the nearby village Ampasimbola and Marolambo itself. Having been living for the past two weeks on rice for breakfast, lunch and dinner, we were spoiled in Marolambo. A hearty breakfast of rice cakes, pastries and battered bananas was normally found in a wooden stall run by Madame Olivette, a Malagasy realisation of Molly Weasley. For dinner, we ate at Chez Martin, the only restaurant in Marolambo. How the cook, a hardened pregnant lady, could produce hundreds of delicious Zebu brochettes and shredded Papaya in such a remote area is a mystery. With one glazed, immobile eye, glistening with sweat and wearing only an apron, she laboured over glowing embers in her dark, lean-to kitchen like a hardened blacksmith in a forge.
As our expedition comes to a close, we often discuss the future of the Madex project. Our goal is to continue testing the burden of Schistosomiasis in the region, while establishing sustainable projects to reduce the disease. Regular Mass Drug Administration (MDA) is effective in reducing Schistosomiasis, but cannot operate alone. This was highlighted during the MDA in Ampasimbola, when only 30% of the children turned up to be treated. Although this was more than 100 children, we were disappointed after the 70%+ attendance rates we had seen in other villages. We later learnt that the chief of the village did not properly inform the villagers of our work. Furthermore, many of the families in the village were either unaware of the risks of Schistosomiasis or suspicious of the treatment. It was clear to us that the lack of support from both people and leaders of this village stemmed from insufficient education about Schistosomiasis. With Ampasimbola behind us, we approached the MDA of Marolambo more thoroughly, and we managed to treat 900 children in a single morning. This was very rewarding and reaffirmed our optimism that our project can succeed. Nevertheless, the experience in Ampasimbola has contributed to our growing comprehension of the immense importance of education. We plan to expand Schistosomiasis education in future expeditions, not only to compliment MDA, but to ensure sustainable efforts to reduce Schistosomiasis after the Madex project finishes.
Finally, after 3 weeks, it was time to say goodbye. It had been an extraordinary journey, helped every step by amazing people. I enjoyed my time immensely and was fervently hoping for our plane to be delayed. Unfortunately, it arrived, and our bags packed, we hiked up to the small landing strip, which lay on the plateau of one of the taller hills. A rainy day; mist lay on the Nosivolo valley, with only the tips of forested hills from the other side of the basin reaching through the clouds. As the plane landed, we had a lasting image of five villagers, walking away over the crest of the plateau, their faded red patterned umbrellas sharp against the white mist. 40 minutes later, we were back in Antananarivo.
Hopefully we will be back soon!