Miriam Scothern

In October 2008 Miriam went to serve the Lord at the Good News Hospital, Madagascar.

Here are some highlights from her recent email followed by her account of her previous time there in 2006/2007.

On Monday 3rd November Miriam wrote:

I have just got back from my evening walk- today I went up a nearby hill, it is easy to climb and there is a lovely breeze when you get to the top. It has to be carefully timed as if you go to early it is scorching hot in the sun and difficult to climb, but if you go to late it is pitch black by the time you get back!

On the way I saw 3 little boys trying to get mangos down from the tree and they excitedly jabbered away to me pointing at a plane that was passing overhead. I looked intently into the sky with them and nodded and smiled. I could only make out that they were asking me a question- I assume that they were speaking Tsy Mihety which is the dialect here. I said 'I don't know' and they seemed to be satisfied with my reply!

I have a short Malagasy lesson 4 days a week. I find that I can understand quite a bit of Official Malagasy but not speak much. I have picked up some useful phrases like 'the bin is full' and 'your hair band is beautiful'. It's surprising how much I can use my limited Malagasy but frustrating at how difficult it is to remember new words and phrases. It is quite difficult to pick things up as there is a mixture of Tsy Mihety and Official Malagasy. For example the Official Malagasy for bed is 'fandrinana' ('fan-jina') but the Tsy Mihety is 'Kobany' ('coo-barney')

Anna and I have just joined the theatre team as there aren't enough of them. We will be on call about 1 night a week each which is fine. The theatre team are really struggling because they have been working in the day and on call at night with no rest days due to the lack of staff. It would be really great if you could pray for them as there are three enthusiastic surgeons and many patients but only one small theatre team!

Anna and I work on the ward 5/6 days a week, it is busy at present, we have quite a few children and ladies with babies. It is sad to see that infant mortality is very high.

At the moment we have a lady in her early 20's that was brought in unconscious. She had had a stomach bug for 4 weeks and had been getting worse and worse so they took her to the witch doctor. After they realised that there was no change they brought her to the hospital. I really doubted that she would survive as she looked like a skeleton and had been unconscious for a while. We gave her fluids and also fed her a mixture that is for mal nourished children (oil, sugar, milk, water and potassium.) After being fed for about 24 hours via a tube she woke up. It was really amazing, obviously we still don't know if she will survive but she is alert and can speak with staff and relatives that are looking after her. She has an 8 month old baby that they were keeping alive in the village with a mixture of tea and anything they could find. Dr Mann has seen the baby and it is doing ok.

This week I saw a praying mantis- I went to pick him up and he turned his head to look at my hand, he then turned to look at my face and I was really surprised! He seemed very intelligent. I went back inside the ward to ask if he would bite and they said no. They told me that praying mantis are very friendly and can be trained! He was SO strange, eventually he flew off, I think he may have been bored of my company or maybe didn't like me staring at him.

6 months at the Good News Hospital - Madagascar

October 2006 to March 2007

As a newly qualified nurse, it was an amazing opportunity to be able to go abroad to work. I went with my friend Anna (who is also a nurse) to a mission hospital in Madagascar. Many people comment that I must have been very brave to go to the middle of nowhere, but as a Christian, I believe that wherever I go, God is with me. There is nowhere that we can go without God being there and this was an amazing thought. Psalm 139: "If I rise on the wings of the dawn, if I settle on the far side of the sea, even there your hand will guide me, your right hand will hold me fast." Working at the hospital, we all had the same goal - to work in a way that gives glory to God. It certainly wasn't 'heaven', but it was an eye opening experience!

A bit about Madagascar

Madagascar is the worlds 4th largest island. It is situated off the coast of Mozambique and is over four times the size of England. It has a population of about 19 million. The capital is Antananarivo which is a sprawling city made up of various buildings, slums and rice fields. Much of the country is mountainous and the infrastructure is very poor. It can take over 24 hours by road to reach Mandritsara where Anna and I worked - we were able to take a small plane that was taking out supplies for the hospital - this took approx. 2 hours. The hospital that we went to for 6 months is situated north-east of the country and serves the Tsimihety people. The town was called Mandritsara and only had one 'main road' leading to the north.

Although Madagascar is East Africa, many of the people that live there do not see themselves as African. They are a mixture of Polynesians, Indians, Pakistanis, Comorians, Africans and French people. There are also significant numbers of Chinese living in Madagascar. The people are commonly divided up in to two groups - the Merina people - who are usually Asian in Origin and the Cotiers - those who are African in origin. We worked for the Tsimihety, who are traditionally part of the Cotiers.

There are many different languages spoken - most people speak Official Malagasy along with another dialect of Malagasy. Those who have been to school usually speak some French. English has recently been named the official language, but not many people speak it as they have only just started teaching it in the schools.

The weather

After landing in a cow field in Mandritsara the only thing that shocked us was the heat. It can get up to 50°C in the sun and whilst we were there it was normally 30°C in the shade. Just before the rainy season temperatures soared and it was extremely humid. The thunderstorms were amazing and incredibly loud. Mandritsara is usually one of the last places in the country to receive rain due to the mountains that surround the area. If you thought English people liked talking about the weather you should talk to a Malagasy! So much depends on the weather as they live off what they can grow. Their staple diet tends to be rice which 'drowns' if there is too much rain and dies if there is too little.

One of our first trips out was to the river bed where people were digging holes for water to wash themselves, their clothes, water their animals and take home for drinking and cooking.

Our welcome

After just a couple of days it seemed that the whole of the town knew who we were and why we had come. News travels fast in such a small town, and also the only reason white people come to this area is to help with missionary work! It certainly isn't a tourist destination. The people were welcoming although a little shy of us. They tend to be very meek people and are generally quite short in stature. It was difficult to go anywhere unnoticed and children often playfully shouted out 'foreigner!'. Sometimes it frustrated us that it wasn't easy to integrate, but many of the hospital staff were used to 'white people' and treated us in a more normal way! At first it felt very strange being in the minority and feeling that you stuck out like a sore thumb but we got used to it. Many of the patients at the hospital had never seen a white person before and must have been wondering who was the more poorly - us with our pale skin or them! Some evenings before it got dark we would sit in the shade outside the house and read or chat - often we had spectators who would watch and giggle is we started talking. The bolder children would try to speak in the same way we did making English sounding noises!

Religion

Many of the Malagasy practice traditional religion which seems to emphasise a link between those who have already died and the fate of the living. They practice Famadihana which is the 'turning of the dead'. This is where they take the body out of the grave - normally on the first anniversary of their death and they wrap them in new grave clothes and carry them around the town in a parade with singing and dancing. This seems very distasteful to us but to them it is part of traditional life. There are approx. 45% of the population who are Christian, equally divided between Catholic and Protestant and a large number of churches discourage the practice of Famadihana. If someone dies in your family it is a big disaster as you are expected to sell everything that you have to pay for the burial. Quite often is a baby dies they are thrown in the river or thrown away like rubbish as they aren't seen as 'real people'.

Health

Due to poor education and being far away from medical help many didn't come to the hospital until they were seriously ill. This meant that we saw very serious cases and there were lots of emergencies. The Malagasy are amazingly strong people and rarely show pain or emotion. If one of them was in severe pain you would just hear a 'tut tutting' sound. One man had his leg amputated and just screwed up his face and kept taking sharp intakes of breath. The ladies that came to us for labour were equally amazing - a specialist in Obstetrics came out to work at the hospital for a month and was surprised at the lack of 'fuss' the ladies made! The hospital does not have a good supply of pain killers - especially the opiates as they are difficult to get hold of as they are controlled drugs.

The Hospital

The hospital has a number of different doctors - Dr Mann, an English doctor who has lived out there for 12 years with his wife, Dr Adrian who comes from the capital, Dr Francis who works in the community and surrounding villages, Dr Jeanine who is an anaesthetist due to retire in 2008 and Dr Hanitra - she also comes form the capital and is a very skilled ophthalmologist. All of the doctors are missionaries and work extremely hard both in the hospital and the surrounding areas.

The hospital employs many staff including cleaners, a maintenance team, receptionists, nursing assistants, lab technicians, those who work in the pharmacy, the theatre and x-ray. The hospital is extremely well run and has no funding from the government.

The hospital sees many outpatients and admits those who need operations or have serious illnesses. While Anna and I were working there we saw a lot of people with Meningitis, Pneumonia, Typhoid, Haematemasis, Burkett's lymphoma, malaria, heart failure, TB and epilepsy to name a few! There were quite a few people who came in with injuries from falling out of trees during the mango season, crocodile bites during the rainy season and some who had been 'speared' by their oxen.

The hospital works closely with the school and the church. The school is a Christian school and has a good reputation. Many of the rich and influential Muslims in Mandritsara send their children to the school. The church is growing quickly and over 400 people attend on a Sunday morning.

I am unable to say a lot about the church or the school other than that they are both growing and those who work there are extremely busy! If you would like to know more about this work you can access the website at Friends of Mandritsara or www.mandritsara.org.uk.

Going out to Madagascar was such a privilege. The pace of life is different, people are different in their attitudes and their outlook on life. The Malagasy rarely plan for the future as their lives are just a case of living from day to day. The place that we stayed was beautiful, it was unspoilt and surrounded by mountains. The work at the hospital was varied and interesting. A lot of people ask if I miss Mandritsara - I think about it a lot but I'm content where I am now. I would be happy to go back and work there again for a short while as it was a very valuable experience.