The few public health facilities in rural areas in Madagascar often fall into disrepair due to a lack of funds for renovation and maintenance. Reliable water and electricity supplies are also often lacking. Without the admirable improvisational talent of Malagasy doctors, nurses and midwives, it would be impossible to treat patients well. The defective toilets and lack of incineration facilities for medical waste are also a constant challenge in terms of hygiene and cleanliness. With the support of Genialsozial, we therefore launched the “Bright and Clean” project in 2020.