Experience from Maventibao Clinic
Access to health care is limited particularly in rural areas of Madagascar.
The Maventibao Clinic, which is located in Northern Madagascar, provides a critical source of health care services
in an area where there previously was none.
Few basic facts about Maventibao Clinic:
• Was founded in 1998 by Ben Shipley
• It provides free medical care to local Malagasy people
• The clinic cares for the residents of villages in a 50 mile area around the village of Maventibao. (about 1500
people, over half are children)
• The medical staff is present at the clinic every day ( 24/7) and is becoming involved in providing care to the
surrounding villages. This has to be done by foot as the road is almost impassible.
For more information about the clinic you can visit: www.madaclinic.com
Access to health care - roads
The first barrier to health care we observed was
lack of adequate roads.
People have to rely on local resources as travel
for long distances is limited.
Similarly, the delivery of medical supplies to the
people is hindered.
It becomes evident that the health care services
need to come to the people since their access to
travel longer distances is compromised.
The village of Maventibao
Is located approximately 7 miles from the main
road, tucked into the mountains and surrounded
by many other villages within an area of roughly
50 square miles.
Historically the village was built around saphire
mines. While some families farm, others continue
to support themselves through primitive mining.
All of them live in primitive bamboo huts, without
water or electricity.
Mada Clinic ( www.madaclinic.com)
Simple four room clay building with one exam
table, supply room, and nurse's quarters
provides 24/7 services to the villagers.
Didier, a malagasy trained, french speaking
nurse, provides the health care to the people,
when no other volunteers are present.
Basic services are provided, but for ongoing
function it is dependent upon and outside
support and resources.
Services provided at Maventibao Clinic:
Primary medical services provided include:
prenatal care and obstetrical care
infant care- nutritional assessment, vaccinations
and treatment for basic infections including
malaria.
basic pediatric care
basic adult medical care
basic wound care
Summary of our experiences:
The children and adults of Maventibao and surrounding villages were medically assessed. This
including assessing their medical needs, measuring growth parameters, nutrition, performing a
comprehensive physical exam as well as complaint driven physical exam and providing medical treatment
for any illnesses.
Clinics set up in three villages with Malagassy coming from the region within 25 mile radius: Maventibao,
Tennenbao, Ambunimafay, etc. We have also visited Anivorano North Medical Center where we met with
the local physician who was assisting us with vaccines.
We have evaluated approximately 400 people ( 125 children and 275 adults).
We have conducted a comprehensive screening survey on approximately 240 patients.
120 children and 120 adults.
Evaluation and findings in Children: ( click here for summary)
Number of Pediatric Patients Seen: 120 Number of Boys: 52 Number of Girls: 68
Number of children: Malnourished: 58 Number of children: Severely Malnourished: 27
Vaccines Given: Oral Polio, DTC (Diptheria,tetanus, hepatitis B), VAR (measles)
Children's Diseases Seen/Treated:
Malnutrition- secondary to diet mostly consisting of rice-water, poorly nourished breast-feeding mothers,
and poverty. Poor diet was accentuated in non-farming communities such as Maventibao.
Malaria- very prevalent ailment among children. Individuals often infected over 10 times per year. Poor
prevention with limited mosquitoe nets and other preventive measures. Malaria was evident in the children
with the presenting signs of fever without source, splenomegaly, and anemia as evidence with pallor.
Worms/ Intestinal Parasites- presumption secondary to frequent use of stream water as water source
without boiling water. Signs and symptoms included protuberant abdomens, diarrhea, and weight loss.
Skin Infections
Otitis Media
Bilharziosis- bloody urine- tx with praziquantel PO, etamsylate IM Congenital syphilis?
Evaluation and findings in adults. (click here for summary)
Basic measurements of weight, height, Body Mass Index, waist circumference, blood pressure, screening
exam of head, lungs, heart, abdomen and extremities as well as complaint driven focused exams were
performed. Results of each examinations were documented and further analyzed through Excel program.
Averages were counted.
In summary, we have screened close to 300 adults, but complete measurement data were available only
on 115 as there was a lack of scale on two consecutive days.
Number of adults evaluated: 300
Complete screening survey: 115
Number of underweight adults: 27 ( 27.5%) ( malnutrition/ BMI < 18.5)
Average weight was 51 kilograms and average height was 159 cm.
Average BMI (Body Mass Index) was 20.6.
There were 27 people ( 27.5%) of screen were underweight ( BMI <18.5)
The lowest BMI measured was 15.
The abdominal waist circumference on average was 28 inches or 73 cm.
The average BP (blood pressure) was 121 and diastolic was 76.
Most common complaints:
Men: lower back pain, followed by cough, toothache, headache, rash, joint aches. Also complaints of
penile discharge, hematuria, fatigue and dizziness were common.
Women: lower abdominal discomfort, vaginal discharge, fatigue and dizziness were most common. Less
common were headaches, rash, toothache, insomnia.
Only one person exhibited signs and symptoms of depression.
The most staggering was the frequency of poor dentition which was observed almost in all screened
patients.
The second most staggering fact was the lack of seeing people over age 50.
Only few survivors over age 50 were seen, mostly women and a few men.