Reggio Emilia Enrica Salsi, 49, is helping to bridge a vast healthcare gap in Madagascar, managing both a rehabilitation center and a psychiatric hospital on the island nation’s southeastern coast. The work, rooted in a decades-long connection between Reggio Emilia and Madagascar, aims to provide critical care in a country where bringing physiotherapy and psychiatric care to underserved communities in Madagascar.
- Madagascar faces significant economic hardship, with a currency devaluation and widespread poverty impacting access to basic services.
- Salsi manages the Aina rehabilitation center in Manakara and the Ambokala psychiatric hospital, both vital resources in the region.
- Healthcare in Madagascar is largely pay-as-you-go, creating barriers for those without financial means, and relies heavily on family support.
- Civil awareness and advocacy for rights are growing, evidenced by recent protests led by Generation Z.
Madagascar’s economic realities are stark. “Currency is worth nothing, salaries are vrey low-we live on less than 2 euros a day-almost no one has regular contracts except state workers and almost no one pays taxes,” explains Salsi, a lay fidei donum missionary from the Diocese of Reggio to the Diocese of Farangana, who has lived and worked on the “red island” for 18 years. Life expectancy hovers around 60 years, and while communications have improved with widespread mobile phone access, infrastructure like electricity and water are often unreliable, linked to pervasive corruption.
Filling the Gaps in Malagasy Healthcare
Salsi’s work centers around two crucial facilities: the private Aina rehabilitation center in Manakara, which she has managed as 2022 following the death of its founder, Luciano Lanzoni, and the state psychiatric hospital of Ambokala. She emphasizes that Malagasy healthcare is entirely paid upfront, making it inaccessible to many. “Healthcare is the prerogative of the rich,” she states. Even hospital care frequently enough places a burden on families, who are responsible for providing assistance, food, and even cleaning duties, including delivery rooms.
What is the biggest challenge facing healthcare in Madagascar? The prohibitive cost of care, requiring full payment upfront, effectively excludes a large portion of the population.
Despite these challenges, progress is being made. Salsi notes that physical handicaps and mental illness,once stigmatized and hidden,are increasingly being addressed.Physiotherapy at Aina has demonstrated success in treating conditions like club feet and hydrocephalus, and psychiatric illness is no longer met with the same level of fear. The hospital now includes a canteen and a school for the children of patients.
A regional Hub Built on community Support
“When we started, few believed in it,” Salsi admits, referring to the centers’ early days. “Now Aina is the regional reference center for physiotherapy, and the psychiatric hospital is the only one existing in the whole south.” The centers rely on contributions from families and external supporters, as there is no consistent funding. This year, the physiotherapy center treated 315 new patients, with a growing number of young children benefiting from early intervention. Information is disseminated through radio broadcasts, reaching even the most remote villages.
Finding long-term volunteers is becoming more difficult, Salsi adds, as potential supporters worry about career interruptions. Despite the hardships,she finds fulfillment in her work. When she returns to Reggio, she appreciates the comforts of home, like a hot shower, but ultimately misses the people and the simplicity of life in Madagascar. “I miss people, moments of sharing, simple life.”
