"A cholera epidemic has been devastating Madagascar for more than ten months, the first of such magnitude in the country's recent history. Any and all prevention and treatment measures undertaken by the authorities have up to this point been unsuccessful in averting the aggravation and spreading of this epidemic," declared Thierry Durand, Operations Director at Swiss office of MSF.
Officially, the total number of cases has currently surpassed 15,500 and five provinces out of six, including Antananarivo, are affected. More than 1,000 people have already died; more than a third of these deaths have occurred over the past month, the equivalent of ten deaths each day. The mortality rate in Toliara province is 14%. However, the true figures are most likely much higher. According to MSF, only when the mortality rate can be brought below 5% can the epidemic be considered to be under control to an acceptable degree.
In spite of all the efforts made by communities and their leaders, requests that public health authorities and the government allow MSF teams to intervene to provide comprehensive treatment of the disease have been in vain. Negotiations were unable to bring about an acceptable solution for such a comprehensive treatment program.
MSF, a humanitarian medical assistance organization, has been present in Toliara province for more than three years, supporting the National Health Program in its bid to meet long-term public health development objectives and respond to emergency situations. One month ago, approximately ten tons of supplies and medication, as well as a team made up of a significant number of experienced personnel were sent to the region and are ready to be deployed.
With these resources, MSF is in a capacity to contribute to the efforts of the Ministry of Health and to cooperate to save hundreds of lives. Assistance from health care workers and the exchange of experience would have made it possible to reinforce the abilities to cope with the disease today and in the future, while simultaneously reinforcing prevention at the community level.
"We cannot carry out long-term prevention programs at the same time as we stand by and watch people die of cholera for lack of urgent, adequate treatment. The scope of intervention our programs possess is not sufficient for us to justify remaining in the country. Our withdrawal is immediate and total," Thierry Durand added.
MSF expresses the hope that, in the name of populations in danger, this immediate and total withdrawal will serve to promote an increased awareness of the gravity of the cholera epidemic and will contribute to the Malagasy authorities adopting a new attitude with respect to the treatment of cholera. In this eventuality, MSF will remain available for the redeployment of its medical teams and resources.
The MSF Swiss section has 13 expatriate and 43 local employees in Madagascar and has been active in Madagascar since 1996.