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 Wednesday 3rd December Miriam wrote:
It is Sat morning and having been woken up by the neighbour's cockerel I thought I would get up and write to you all.
The other day I walked in to work with our neighbour and asked him if the cockerel was a pet. He explained to me that he had bought it to eat but his young son doesn't want him to kill it. The cockerel is very handsome but very noisy so I hope they eat it soon!
This weekend is our weekend off, we are on call for emergencies on Sunday morning but this is just covering for one of the other staff who will be away in a village helping we evangelistic work for the morning.
This morning Dr Ted is taking the landrover to the market so Anna and I are catching a lift and taking the opportunity to stock up on things like boxes of milk, oil and margarine. Very soon we will get cut off from the surrounding area because of flooding and supplies for the market will not be able to get through. There are many advantages to the rainy season, including the fact that we can now have the occasional shower if there is enough water pressure. A cool shower in brown coloured water is surprisingly good!
At the moment the road isn't bad- parts of it are flooded things can still get through. There is one part of the road that floods on a regular basis ensuring that Mandritsara is cut off, repairs have not been done to the road here as the people there make money each year 'helping' people to cross the flood.
Rainy season has well and truly started, this week the hospital director read out the rules for crossing the river when it floods. Most of the hospital staff live on the other side of the river so when it floods, getting in to work can be a challenge. The basic rule is- if the water is up to your waist you must wade over with the help of the men from the maintenance department who will be there from 06:45- 07:00. However, if the water is up to your chest, you can turn back and go and do some work at home (!) The rules were read out very clearly as often there is confusion when the river floods.
Dr Adrien also solemnly read out rules for use of the hospital tractor. It is a really big tractor and very noisy and he wanted to make clear that it was for use of hospital work only. He said the tractor was not for personal use, for example the transport of bricks, building materials and produce. He also added that it was not to be used for funerals- at this point I couldn't help but giggle. I'm sure that the tractor would be used to transport all the relatives for the funeral but just the thought of a giant, noisy, dirty tractor being used for a funeral was very funny. I giggled away for about 10 minutes which was bemusing to Anna and embarrassing for me! I got a pat of sympathy on the back as they didn't know whether I was laughing or crying. Dr Mann's secretary also leaned over to see what the problem was- I had to wait until the end of what seemed a very long meeting to tell her!
A couple of weeks ago we got a little boy in who had fractured his femur. This is one of the most painful fractures you can get as the muscle here is so strong and it contracts, pushing the broken bits of bone against each other and causing a lot of pain. The little boy had fallen out of a mango tree trying to pick mangos. He had then taken the long journey here on a bus with his dad to get treated. The fracture was bad but Dr Mann fixed up traction and after 6 weeks with us he should be ok.
Many here have never heard of this man called Jesus. The other day in the morning talk the guy asked people to put their hands up if they had heard the name Jesus. Apart from the hospital staff, just 2 people put their hands up. It is really strange to think that this is possible - in the West it is hard not to have heard of the name of Jesus! It would be great if you could pray for Lova and his family. His dad is the one that is caring for him most of the time, bringing a big bowl of rice at meal times. His dad is very gracious and gently spoken, he can speak a little French and I try out my very limited Malagasy to chat with him. Would be great if you can pray for them that they would know the good news of the bible through our friendship and the witness of the hospital.
Coming here for the second time is in some ways very different. It seems that we understand a little more about how life works here. The people here are so diverse, there are a mixture of Polynesian, Indian, African and Chinese people. It is not uncommon for someone to have tanned skin and light eyes.
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.