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For better or for worse? The changing face of Africa
Developing countries have seen dramatic improvements in many areas over the last 15 years. Despite significant overall growth in population, the total number of people living in extreme poverty (<$1.25 1990 PPP) has more than halved during this time. Primary school net enrolment rate has risen from 60% to 80%. New HIV infections around the world have fallen by more than 40% and the number of mobile phone subscriptions has risen from 738 million to more than 7 billion. [UN 2015 MDG report] Think of where you were on the first day of the new millennium. All this has changed since then.
While much of this improvement is due to the dramatic rise of several Asian economies, in particular China’s, sub-Saharan Africa has also made marked improvements, for example in primary school enrolment, gender equality, child and maternal mortality and the fight against HIV/AIDS. Sub-Saharan Africa fell short of achieving the ambitious Millennium Development Goal of halving the ratio of people in extreme poverty between 1990 and 2015, but the 14% reduction that was achieved still represents millions of people enjoying a better life.
Madagascar achieved significant successes in reducing child mortality and increasing the rate of primary school completion.
These achievements are due to the everyday work of smallholder farmers, government officials, private enterprises and employees, members of faith communities as well as local and international NGOs. The steady work of millions of people rarely makes the news but it is changing the world for the better.
While most of Madagascar remains desperately poor, it too has made remarkable progress. Between 1990 and 2013, the fertility rate in Madagascar has dropped from 6.26 births per woman to 4.47 [World Bank], in the same period, under 5-yr child mortality has fallen by more than two thirds (from 160.7 to 53.4 per 1000) [World Bank Working Paper] and the primary school completion rate almost doubled between 1990 and 2012. On the other hand, economic stagnation and political turmoil have stalled many other aspects of development in Madagascar: extreme poverty has deepened and is affecting an increasing number of people. GDP per capita has continued its downward trend since 1960 (see graph), while it has on average more than doubled in the rest of sub-Saharan Africa. This unusual trend has been labelled the “Madagascan Paradox”.
Figure 1: GDP per capita in Madagascar and Sub-Saharan Africa. The long-term economic decline seen in Madagascar is highly unusual for the region (Source: Razafindrakoto et al. 2013).
These statistics paint a complex picture of the development trends affecting Madagascar. While demographic and healthcare indicators are improving, economic stagnation and ecological decline pose serious challenges for the future. A new government was elected in 2014, marking the end of the long-drawn political crisis, and the country has been able to regain the support of international agencies such as the IMF and the World Bank. This will hopefully help get Madagascar back on track towards sustainable and comprehensive development, but political tensions still linger. Madagascar faces a truly tremendous task.
PROJECTS
17.03.2016
80% of Madagascans live in extreme poverty. As there is no universal health insurance, Doctors for Madagascar covers the medical costs for patients who otherwise could not afford medical care.
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17.11.2015
Doctors for Madagascar organises regular aid missions with volunteer doctors and medical staff from Europe. These volunteers treat patients directly and also provide training for local staff.
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01.10.2015
Southern Madagascar urgently needs qualified medical personnel. Our project "Skills to Save Lives" provides medical training for doctors, nurses and technical staff in one of the poorest areas of the country.
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01.09.2015
Pregnant women with severe labour complications often only reach a clinic after traveling for hours on an oxcart – with serious consequences for them and their child. Most have no access to pre-natal care. Doctors for Madagascar is working to improve care for pregnant women and newborns.
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17.08.2015
In Madagascar, patients are generally fed and cared for by their families. So that food shortages don't get in the way of treatment, Doctors for Madagascar covers the subsistence costs of all in-patients in our partner hospitals.
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17.07.2015
Many hospital buildings and health centres in Madagascar are in a desperate state, with no money for even the simplest repairs. Doctors for Madagascar supports hospitals and health centres to build and renovate essential facilities.
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17.06.2015
Kept in good condition, hospital equipment saves lives. But extreme climates, inconsistent electricity and inadequate maintenance in Africa wear out medical equipment much faster than in the UK. We provide not only medical equipment, but also training on maintenance and care.
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CLOSE UP
FUNDRAISING EVENTS
The Junges Ensemble Berlin, one of Germany’s leading youth orchestras, bewitched its audience with Beethoven’s masterful violin concerto and Prokofiev’s fiery Fifth Symphony. What an evening at the Berlin Philharmonic!
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FUNDRAISING EVENTS
Since 2012, Doctors for Madagascar has been an NGO partner at Praxis Update, a continuing medical education conference for GPs.
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PATIENT STORIES
Today a mother came into the hospital carrying a baby – one week old with ashen skin and a belly distended like a barrel.
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BEYOND MEDICINE
For a long time, relatives cooked meals for patients on traditional open fires in the wasteland outside the hospital site.
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PATIENT STORIES
April 2012: Sweaty and shivering with exertion, two oxen drag a heavily laden cart the last few metres to Fotadrevo hospital. The passenger, Tiana, has a 40°C fever and is nine months pregnant.
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MISSION REPORTS
Financing an aid mission yourself? Yes, it’s possible - Johannes Häußermann is the proof, with his crowdfunding drive "An Engineer for Madagascar".
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BACKGROUND
Developing countries have seen dramatic improvements in many areas over the last 15 years.
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BACKGROUND
Madagascar stands apart from sub-Saharan African nations with regard to HIV/AIDS rates. Why?
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PATIENT STORIES
The sun burns hot on 7th December 2012. One of Médecins Sans Frontières’ white 4x4s pulls into the gate of the hospital in Fotadrevo, carrying three women from the town of Bekily, 60 km away.
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ON THE GROUND
Nine hours’ worth of parched land pass by our 4x4 as we travel from Toliara to Fotadrevo. Cacti, shrubs, scant trees and now and then a village of mud huts. Sand and dust reach as far as the eye can see, in shades of red, brown and grey.
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