Madagascar has a serious lack of doctors, nurses and technical staff: there are only 3 trained nurses and midwives per 10,000 inhabitants. That is four times lower than the average for Sub-Saharan Africa and 40 times lower than in Germany. Doctors, too, are urgently required - every second position for a doctor is vacant. In addition, barely any doctors undergo structured, multi-year training to become specialists.

Particularly in smaller clinics and in the countryside, doctors often provide treatments for which they have been insufficiently trained. To make matters worse, the medical infrastructure in rural areas is in disrepair - another unfortunate result of political crises which have unsettled Madagascar for some years. Many health centres and hospitals have closed over the past years, and many valuable medical specialists have left the country.

Sustainability and long-term thinking are key factors for Doctors for Madagascar. Training for local medical staff, with standardised procedures for different medical interventions, is crucial in this regard. This way, the quality and safety of patient-centred care in the south of the county is improved for the long term, and trained personnel in the region benefit from better career prospects - a reason for them to stay.

The project is evaluated on a yearly basis by a team at the renowned Charité hospital in Berlin. There they identify the project’s current achievements and potential areas for improvement.

A two-week hygiene course for one nurse costs approximately 75€. Advanced training for an x-ray-technician in the capital costs around 500€.