Hunger in Süd-Madagaskar

Eine Ärztin über das Leid von „vergessenen Menschen“

vom Recherche-Kollektiv Afrika-Reporter:
13 Minuten
Commune of Ranobe, Amboasary District. People in the south-east of Madagascar are facing the most acute nutritional and food crisis the region has seen in recent years. MSF began setting up mobile clinics in Amboasary district in late March to screen and treat acute malnutrition in remote villages like those of Ranobe commune, providing ready-to-use therapeutic food and medical care. It is not only children who suffer from malnutrition, some adults who come to our mobile clinics also suffer from malnutrition.

Hilfsorganisationen schlagen Alarm: Im Süden Madagaskars hat sich die ohnehin prekäre Ernährungslage dramatisch zugespitzt. In einigen Dörfern ist jedes dritte Kind unter fünf Jahren mangelernährt, ganze Familien sind von Hunger bedroht. Es geht buchstäblich um Leben und Tod. Das ist, wie in anderen Ländern im Südlichen Afrika auch eine Folge des Klimawandels.

„Laut aktueller Zahlen der Behörden in Madagaskar, von UN-Agenturen und anderen Organisationen sind 74.000 Kinder im Süden des Landes akut von Mangelernährung betroffen, 12.000 davon schwer. Das ist eine Zunahme um 80 Prozent gegenüber dem letzten Quartal 2020. Fast 14.000 Menschen in Amboasary, dem am schwersten betroffenen Bezirk, leiden an Hunger“, meldet Ärzte ohne Grenzen.

Amy Neumann-Volmer ist Vorstandsvorsitzende der deutschen Sektion der medizinischen Nothilfeorganisation. Und sie ist selbst Ärztin. Gerade erst ist sie von einem Einsatz aus dem Süden Madagaskars zurückgekehrt. Vier Wochen lang war sie mit mobilen Kliniken unterwegs, um auch jene Menschen medizinisch zu versorgen, die aufgrund schwerer akuter Mangelernährung zu schwach sind, um kilometerweit zu den dünn gesäten lokalen Gesundheitszentren zu wandern.

In Berichten anderer humanitärer Helfer, die wie Sie selbst schon viel Leid gesehen haben, heißt es, die Situation vor Ort sei so verheerend, dass sie nur schwer in Worte zu fassen sei. Welcher Eindruck hat sich Ihnen eingeprägt?

„Mir ist sehr aufgefallen, dass nicht nur einzelne Personen, sondern ganze Familien komplett verarmt sind. Sie sind nur noch in Lumpen gekleidet, also in T-Shirts, die aus mehr Löchern bestehen, als aus Stoff. Und was ich noch nie gesehen hatte in Afrika: Diese Mütter und Väter, die zu uns kamen, hatten nicht einmal ein Tuch, um die Plumpy’Nut – das ist diese therapeutische Nahrung, die wir vor allem für die Kinder verteilen – zu transportieren.

Diese mobilen Klinik-Einsätze mache ich schon lange und es ist mir noch nie passiert, dass die Leute nicht einmal ein Gefäß oder ein Tuch hatten, um die Sachen mitzunehmen, die wir ihnen geben. Es wäre mir sonst nie eingefallen, auch Plastiktüten zu verteilen. Das ist für mich eine Erfahrung, die diese nackte Armut beschreibt.

Ich habe mit Müttern gesprochen, die mit schwerstkranken Kindern zu uns gekommen sind und erzählt haben, dass sie in den letzten Monaten schon zwei bis drei Kinder verloren haben. Das sind schmerzhafte Konfrontationen mit dieser Armut. Wir sehen, dass diese Menschen für alles wirklich kämpfen müssen. Auch darum, überhaupt sichtbar zu sein in dieser Gesellschaft.

Man spricht bei uns von vergessenen Krankheiten, aber in diesem Kontext würde ich von vergessenen Menschen sprechen, einer vergessenen Bevölkerung. Auch was Strukturen angeht, also Straßen, Wasser, medizinische Infrastruktur: Da ist nichts da oder es funktioniert nicht mehr. Also das war schon beklemmend, die Begegnung mit diesen Menschen.

Was auch besonderes war, ist diese sehr lokale Verteilung: Also Sie kommen in Gegenden in diesem Hinterland, da gibt's ein Dorf, das hat vielleicht Zugang zu Nahrung und Wasser, dann geht's den Leuten besser, aber 20 Kilometer weiter herrscht nackte Armut, da verhungern die Leute. Und dass es da nicht viel solidarischen Zusammenhalt gibt, hat mich auch getroffen.“

Commune of Ranobe, Amboasary District. People in the south-east of Madagascar are facing the most acute nutritional and food crisis the region has seen in recent years. MSF began setting up mobile clinics in Amboasary district in late March to screen and treat acute malnutrition in remote villages like those of Ranobe commune, providing ready-to-use therapeutic food and medical care. 42-year old Vitasoa has six children. She?s brought four of them to the Médecins Sans Frontières mobile clinic. All the children are included in the nutrition programme launched at the end of March to respond to the food and nutrition emergency in southern Madagascar. ?We live in Fenoarivo, and it took us five hours to walk here from Ranobe. During the rainy season, we live off cassava, mangoes and edible leaves. But, nothing?s growing because there?s been no rain. We make do with manioc tubers we find in the forest, cactus fruit and edible leaves. We have to dig in the sand for water as there?s also less surface water. Every day we pray for rain. We?re staying positive, but we really hope it?ll come soon.?
Commune of Ranobe, Amboasary District. People in the south-east of Madagascar are facing the most acute nutritional and food crisis the region has seen in recent years. MSF began setting up mobile clinics in Amboasary district in late March to screen and treat acute malnutrition in remote villages like those of Ranobe commune, providing ready-to-use therapeutic food and medical care. 42-year old Vitasoa has six children. She?s brought four of them to the Médecins Sans Frontières mobile clinic. All the children are included in the nutrition programme launched at the end of March to respond to the food and nutrition emergency in southern Madagascar. ?We live in Fenoarivo, and it took us five hours to walk here from Ranobe. During the rainy season, we live off cassava, mangoes and edible leaves. But, nothing?s growing because there?s been no rain. We make do with manioc tubers we find in the forest, cactus fruit and edible leaves. We have to dig in the sand for water as there?s also less surface water. Every day we pray for rain. We?re staying positive, but we really hope it?ll come soon.?
Commune of Ranobe, Amboasary District. People in the south-east of Madagascar are facing the most acute nutritional and food crisis the region has seen in recent years. MSF began setting up mobile clinics in Amboasary district in late March to screen and treat acute malnutrition in remote villages like those of Ranobe commune, providing ready-to-use therapeutic food and medical care. The mobile clinics serve people suffering from malnutrition, but not only. Some patients suffer from associated pathologies such as parasitosis or bilharzia. Appropriate medication is prescribed for them.
Commune of Ranobe, Amboasary District. People in the south-east of Madagascar are facing the most acute nutritional and food crisis the region has seen in recent years. MSF began setting up mobile clinics in Amboasary district in late March to screen and treat acute malnutrition in remote villages like those of Ranobe commune, providing ready-to-use therapeutic food and medical care. The mobile clinics serve people suffering from malnutrition, but not only. Some patients suffer from associated pathologies such as parasitosis or bilharzia. Appropriate medication is prescribed for them.
Commune of Ranobe, Amboasary District. People in the south-east of Madagascar are facing the most acute nutritional and food crisis the region has seen in recent years. MSF began setting up mobile clinics in Amboasary district in late March to screen and treat acute malnutrition in remote villages like those of Ranobe commune, providing ready-to-use therapeutic food and medical care. The consultation room is located in a building, away from the heat and from view in order to guarantee the confidentiality of consultations. In Ranobe, three consultants (one doctor and two nurses), as well as a pharmacist, conducted consultations throughout the day.
Commune of Ranobe, Amboasary District. People in the south-east of Madagascar are facing the most acute nutritional and food crisis the region has seen in recent years. MSF began setting up mobile clinics in Amboasary district in late March to screen and treat acute malnutrition in remote villages like those of Ranobe commune, providing ready-to-use therapeutic food and medical care. The consultation room is located in a building, away from the heat and from view in order to guarantee the confidentiality of consultations. In Ranobe, three consultants (one doctor and two nurses), as well as a pharmacist, conducted consultations throughout the day.
Commune of Ranobe, Amboasary District. People in the south-east of Madagascar are facing the most acute nutritional and food crisis the region has seen in recent years. MSF began setting up mobile clinics in Amboasary district in late March to screen and treat acute malnutrition in remote villages like those of Ranobe commune, providing ready-to-use therapeutic food and medical care. Despite the beautiful landscape surrounding the commune of Ranobe, the people are isolated and do not have access to appropriate care. They have to walk for hours to reach the first functional health center.
Commune of Ranobe, Amboasary District. People in the south-east of Madagascar are facing the most acute nutritional and food crisis the region has seen in recent years. MSF began setting up mobile clinics in Amboasary district in late March to screen and treat acute malnutrition in remote villages like those of Ranobe commune, providing ready-to-use therapeutic food and medical care. Despite the beautiful landscape surrounding the commune of Ranobe, the people are isolated and do not have access to appropriate care. They have to walk for hours to reach the first functional health center.
Commune of Ranobe, Amboasary District People in the south-east of Madagascar are facing the most acute nutritional and food crisis the region has seen in recent years. MSF began setting up mobile clinics in Amboasary district in late March to screen and treat acute malnutrition in remote villages like those of Ranobe commune, providing ready-to-use therapeutic food and medical care.
Commune of Ranobe, Amboasary District People in the south-east of Madagascar are facing the most acute nutritional and food crisis the region has seen in recent years. MSF began setting up mobile clinics in Amboasary district in late March to screen and treat acute malnutrition in remote villages like those of Ranobe commune, providing ready-to-use therapeutic food and medical care.
Commune of Ranobe, Amboasary District. People in the south-east of Madagascar are facing the most acute nutritional and food crisis the region has seen in recent years. MSF began setting up mobile clinics in Amboasary district in late March to screen and treat acute malnutrition in remote villages like those of Ranobe commune, providing ready-to-use therapeutic food and medical care. The MUAC (Mid-Upper Arm Circumference) is a quick way of identifying children at risk of malnutrition. The gauge provides a number and indicates the colour range. Here, this child is suffering from severe acute malnutrition, and will be integrated in the program.
Commune of Ranobe, Amboasary District. People in the south-east of Madagascar are facing the most acute nutritional and food crisis the region has seen in recent years. MSF began setting up mobile clinics in Amboasary district in late March to screen and treat acute malnutrition in remote villages like those of Ranobe commune, providing ready-to-use therapeutic food and medical care. The MUAC (Mid-Upper Arm Circumference) is a quick way of identifying children at risk of malnutrition. The gauge provides a number and indicates the colour range. Here, this child is suffering from severe acute malnutrition, and will be integrated in the program.