Doug Tilton - October 2017 Update

Regional Liaison for South Africa

Dear friends,

It is 6:30 a.m. in the remote village of Andolofotsy, a six-hour drive from Madagascar’s capital, Antananarivo. Léa Harilalao opens the door and looks across the road to the thatched shelter where a dozen or so people have already begun to congregate. “The dispensary is only meant to open at seven,” she laughs softly, “but, as you can see, people come early.” So, often – when she does not have visitors to look after – Harilalao, a midwife, begins to examine patients well before 7 a.m.

Today, though, she graciously makes time to introduce us to her work and to the community she tirelessly serves. Harilalao runs the dispensary at Andolofotsy, one of 36 largely rural dispensaries established around the country by the Development Department (SAF) of the Church of Jesus Christ in Madagascar (known by its Malagasy acronym, FJKM). This is also one of seven facilities that SAF has opened with assistance from Presbyterian World Mission – which is why I have joined Dr. Josoa Randrianonivelo, the head of SAF’s Health Program, and Pastor Paul Razafintsalama, the president of the local FJKM regional synod, to visit the area. Several other PC(USA) mission co-workers are also with us, including Elizabeth Turk, a public health nurse – and indispensable translator – who works with the SAF Health Program.

SAF recruits medical professionals – typically doctors, nurses or midwives – and provides them with premises, a six-month supply of basic medicines, and ongoing supervisory support. The nominal fees that the practitioners charge for consultations and medications enables them to support their families, replenish their stocks, and provide a vital community service in a sustainable manner.

For her paramedical degree, Harilalao did two years of training in general medicine, followed by a year of specialized training in midwifery, so she is equipped to treat most of the common health complaints of the residents of Andolofotsy and surrounding areas. The dozen or so clients who have gathered this morning in the waiting area are fairly typical. Several are there to have illnesses treated, either their own or their children’s. Others have come to have wounds dressed or to get medication for chronic maladies. One man has cycled six miles over rugged terrain in the hope of getting medicine for his stricken father. (Sadly, though not surprisingly, Harilalao explains that she is not able to dispense medication without examining the patient.)

The townspeople are clearly grateful for Harilalao’s presence and the good care that they receive from her. “Before the SAF dispensary was here, life was very difficult,” a woman in her sixties told us. “People died because they did not have options for care.” In fact, the main concern that we hear expressed frequently during the day – even by municipal leaders – is that Harilalao occasionally has to go out of town for training in the latest medical protocols and procedures. Residents worry that someone will fall ill during one of those periods when the community lacks medical expertise. Dr. Josoa assures everyone that SAF is working on finding an assistant for Harilalao to ensure continuity of care.

While the head of the municipal district is effusive in his appreciation for the dispensary and for Harilalao’s work, a visit to the local primary school provides further indication of the facility’s importance. As we move from class to class to greet the teachers and the students, we ask one of the classes how many of the pupils have been treated at the dispensary. Roughly half of the children put up their hands.

When Dr. Josoa sits down with Harilalao to review her records and advise on any questions or challenges she has encountered, we learn that she has had more than 4,000 consultations with clients in the previous year. That is a substantial figure, given that the population of the district is estimated at 21,000!

But it is not just the medical treatment that people appreciate. Members of the community are also quick to point out that Harilalao lives among the people and is active in the local FJKM congregation. To enthusiastic nods, Dr. Josoa explains to clients that the dispensary is really a ministry of the church and that Harilalao is more than a midwife; she is also a church worker. The presence of Pastor Paul and two of the local FJKM Katekista Delege [similar to commissioned lay pastors in the PC(USA)] help to highlight the extent to which health ministries are an integral part of the overall care that the church provides for the community.

The SAF Health Program is just one of the many ways in which the FJKM is touching the lives of millions of people across Madagascar, sharing the good news of God’s love in Jesus Christ in a holistic manner so that all may experience life in abundance. I am so thankful for your prayers, letters, and gifts, which are a concrete sign of your partnership in God’s mission and which inspire and support me – and mission co-workers like me – as we accompany our partners in Madagascar and around the world. 

Grace and peace,

Read more about Doug Tilton's ministry by clicking HERE.

The Outreach Foundation is seeking $10,000 for support funds for Doug Tilton.