Since we have returned to Madagascar in early August an outbreak of the plague has taken on world-wide attention. In a country inadequately equipped to accurately track births, deaths, income and other useful social information, the latest confirmed cases of the plague by the World Health Organization as of October 12 is 684, nearly 10% (64) of which have led to death.
To put this in perspective, the population of Madagascar is at about 25 million, so according to WHO this problem is not on a scale with the Ebola virus of 2014 that claimed over 11,300 lives in Liberia, Guinea and Sierra Leone (total combined populations of 27 million).
Furthermore, according to WHO, the Madagascar Ministry of Health, the Centers for Disease Control and Prevention (CDC), the United Nations and other international sources the case/fatality rate is far less than the Madagascar plague epidemic of 2014 when there were 116 confirmed cases and 40 deaths between August 31 and November 16.
There are three types of the plague - bubonic, septicemic and pneumonic. According to WHO, bubonic plague infects the lymphatic system, septicemic attacks the blood and pneumonic is the infection of the lungs. Pneumonic plague is the most lethal form of the plague and has claimed most of the lives here in Madagascar.
Bubonic plague is transmitted by fleas that are carried not just by rats, but other animals - even cats and dogs. Pneumatic plague is transmitted through cough droplets from infected persons. The CDC states that pneumatic plague originates, “from untreated bubonic or septicemic plague that spreads to the lungs…typically (contracting pneumonic plague) requires direct and close contact with infected persons.”
Public gatherings, such as worship services and concerts are being cancelled. Public schools are closed until November 6. Here in the city of Toamasina we have noticed a noticeable drop in people frequenting public places such as the beach, the three small grocery stores, open-air markets, dining establishments and the like.
One of the most startling images for us is the burned-out pauper village on the beach overlooking the port. A mere three blocks from our house and 200 meters from where Mercy Ships once moored, it was a place where 100 to 200 people resided. It is an area where mounds of garbage are accumulated and the poor rummage for scraps of food and reusable junk. The inhabitants of the small community had constructed shelters from sticks, plastic bags, cardboard and discarded tin.
Of course, places like this are breeding grounds for rats and the fleas that carry the plague bacteria, so it is only reasonable that the government put a torch to the area. What went unaddressed was the health of the persons who were living there and forced to find refuge elsewhere.
So, for the time being much of our ministry work has been put on hold. We haven’t been to church in two weeks and we rely on the internet for sermons from our rector at The Church of the Cross in Bluffton, South Carolina. We don’t spend much time in public and when we do we take great care. We avoid groups of people, even resorting to the donning of surgical masks – although Yvonne is more committed to this precaution than me.
With all of this in mind and to put it into perspective, Yvonne and I know hundreds of Malagasy people. We have not heard from a single individual about a case where a relative has either contracted the plague or died from the plague.
Our final request is that you continue praying for the people of Madagascar and God’s will for this nation. We have seen the fruits of His labor and that of our fellow missionaries. The potential for change here is real and verifiable. The Malagasy are hungry and thirsty for a future and a hope.