It’s the beginning of the rainy season, but we are lucky: it only takes us nine hours to cover the 250 km from Tulear to Fotadrevo. The savannah is still brown, dry and dusty. Just a few weeks from now all this will be covered in soft green, and deep puddles will have formed where there is now dust road.
In the little town of Fotadrevo with its 4,000 inhabitants, our Malagasy partner charity converted an old rice mill into a small hospital. The courtyard is crowded. Nurses bustle to and fro, and dozens of patients are sitting in the shade, waiting for their treatment. Many of their relatives seem to have made themselves at home – all around, there are cooking fires and grass mats used as beds for the night.
The staff and patients of the Zoara hospital greet us joyfully. They are thankful for any support - there is so much to do.
The doctors on our mission, a gynaecologist and an anaesthetist, help wherever they can. They operate and assist, join the rounds for the 25-odd in-patients and share their expertise with the local staff in the daily morning briefings.

The conditions in the hospital are basic, to say the least. During the first few days, there is no running water and a flashlight is necessary to sufficiently illuminate the operating area. The operating table is rigged up from wood and during the surgery patients are respirated with a pumping bag by the anaesthetist. There are few surgical tools. Without any air-conditioning, the operating room (OR) often gets as hot as a sauna. The German doctors are struggling to get used to the new environment.

The second week changes everything: the 40-foot container sent by Doctors for Madagascar finally arrives in Fotadrevo! The whole OR can be newly equipped with the donated materials from Germany. The bright light, hydraulic operating table and new instruments hugely improve the working conditions. The OR even has running water now, thanks to the new water pump and a quickly assembled water tower.

However, there are still long waiting times between the surgeries, as the room and instruments need to be sterilised after every operation.