Madagascar: Multiple Evacuations!

10th April 2007

We wanted to call in the chopper, but it was busy!

A day in the life of expedition manager in Andavadoaka, with Blue
Ventures.

Morning arrives, I get a message from the medic that the patient is
improving and that he should be fine to continue with us on site. A
car is going north to Morombe, but the patient will be OK on site and
looks to make a full recovery. A massive relief as we do not want to
have to evacuate anyone when they have only just arrived.

BUT by 4pm the patient's condition has changed from stable and improving
to a medical emergency and we start the medivac procedure. How do we
get the patient out? There are lots of options but nothing is fast in
Madagascar and everything involves a lot of talk and planning. We use
the 3.5 Euros/min satellite phone to call the doctor in England for a
second and expert opinion and contact all medical facilities in
Tulear to find out whether we can have the patient fixed there.
Bingo, there are facilities with opthalmic divisions, but will they be good
enough to cure an eye ulcer? The night is drawing in and it
is getting late. Ideas of a 4x4 coming to pick up the patient are put
to bed, and an ever-worrying volunteer decides that if the insurance
company agrees the chopper is the way to go. The fastest means of
transport out of here. Even at 6.5K dollars that the volunteer was
prepared to pay for his sight. Of course that would be the case if all
the choppers were not being used in the north to help out with the
evacuation from the Cyclone up there.

I have to find an alternative. I call MAF pilots and am informed that
my best option will be to get the patient to Morombe (where the 4x4
went earlier, rubbish!) as a flight to Tulear from there will be
leaving at 10am the next morning. Late at night a lot of favours
needed to be asked. The rain was coming down and wind picking up.

(I failed to mention earlier that we were having a really bad bout of
bad weather,with what appeared to be the tail end of a cyclone. Transport
anywhere was an issue.)

I tried the catholic mission to see if their 4x4 or quad bike could
make the journey. Unfortunately the 4x4 was with the father
currently out of the village, and quad was not happening. Next port of
call was to ask Mr. Coco if he could drive us to Manga Lodge, a
French resort south of us, to ask them for use of their 4x4. However,
they had a baby with them and did not want their vehicle out of their
sight (understandable, but it wasn't going to help us). Asked Mr.
Coco if he would be prepared to drive to Morombe, as he was supposed
to be doing the journey in an extra day or two, though to be fair
with the bad weather destroying the road I was not convinced that the
car/ 4x4 would make it.
I also requested for one of the blue ventures local boat drivers to be
up at 5am so that I could make a decision
then (weather dependent) as to the mode of transport that the evacuee
would have. And after giving the patient a full briefing about all
that would happen, his medical options and who to talk to, it was
time for was bed for me, only to get up a few hours later to find
that neither boat nor car driver were up or ready to go.

Mr. Coco refused to go, so it was down to my speed boats to take said
patient all the way to Tulear, to meet some of our staff already
there, and be put in a 4x4 (arranged after he had left from Coco
Beach), to take him to the airport (a strip, not aware of the plane
that would be landing there at 10 00hours). My drivers returned at
1:30pm and my role in the evacuation was complete, apart from the
maternal worry about my volunteer getting his eye fixed somewhere in
Madagascar.

At lunch just moments after one evacuation has been finalised and out
of my logistical range, the daughter of a French lady working in the
village brought in her daughter with a head injury. The paramedic on
site treated the wound, but by the evening the request came to borrow
much of our fuel for another medical evacuation to Tulear, but this
time with the catholic mission speed boat. We found out a couple of
days later that this speedboat broke down on the way to Tulear and
took 2 days to get there!

And then.....local staff member Thomas had excruciating tooth ache
and needed to go to Tulear! Thankfully I found a 4x4 that was going
that way and managed to pack him off to get fixed.Now, 2 weeks later,
he has only just arrived back on-site as there is no power in Tulear,
there are student riots, and no transport!

Just another long day!

Our patient was very fortunate to be treated by a Malagasy educated
in Cambridge. He made it back to site on a fish truck, and a week
later was able to go in the water, undertake the PADI dive rescue
course and dive once again in Vezu (the tribe of fishermen on the
south-west coast) waters.

The sun is shining once again and all is well in 'remote' paradise