Bush Medicine 101: Sex, Drugs & Illegal Activities in Madagascar

When the end justifies the means.

Dear Reader, dear Jane-Your-Younger-Self,

I hope you are well. We are well.

School has closed this week for 2 months - may God help all of us parents! This is when we are reminded of the true value of teachers and schooling.

Why do I begin many of my posts with updates about my family? Well it’s obvious, isn’t it? They are my beginning and my end.

Skip to the middle if you only want to read about a story of sex, drugs and illegal activities in Madagascar and a “Robin Hood” community clinic.

Rory, our 14 year old is currently “identifying as a 16 year old” and he has informed us that he should subsequently be able to own and ride his motorbike to school every day.

ABOVE: Rory learning to drive our motorbike.

We’ve obviously told him that he is under the legal age limit to own and drive a motorbike to school.

To which he “reminded” me of all my illegal misdemeanors in Madagascar, which include (but are not restricted to) buying drugs…. which are in actual fact, Family Planning products off the black market so that women and families can choose to have sex but have less children, space their children, and plan their way out of poverty.

Said with humor and some seriousness, how does a parent justify their illegal activity while prohibiting their son’s?

Work in progress the both of us.

In my defense (Rory!), when I was younger and more idealistic, I truly believed that the end justified the means. You owning and driving a motorbike to school is not an end justifying the means.

Now that I am older and wiser, I realize that all I have done is create and support the black market which cannot easily be undone, particularly with USAID having pulled out leaving many health projects wanting for products including Family Planning, HIV and TB treatment.

Mykayla (12) and her BFF Zafy (13) have launched their own (legal) business of handmade book marks which they sell at our favorite beach restaurant “Le Spot” every Friday night.

ABOVE: Mykayla and Zafy selling their handmade bookmarks on Friday night at our local beach restaurant.

In the current climate of e-books, we’ve suggested maybe they branch out to include greeting cards, because nothing beats a hand written “Thank you”, “Thinking of you”, “I love you”, or “Guess what, I’m pregnant”.

Now greeting cards could become a booming business in the current climate of AI, social media, social disconnection, and one of the most fertile and over-populating countries in the world.

I have recently been hit with significant and potentially life-changing challenge in my clinic which I established and have been running for almost 15 years, where I started with 4 employees, now have 50 employees, and where we proudly provide free health programs for our community thanks to an ongoing donation-investment by Professor Ulrich Hengge from Joachim Kuhlmann Stiftung, including:

1. Family Planning.

2. Pregnancy Care.

3. Post Pregnancy Care.

4. Childhood Vaccinations.

5. Malaria Treatment.

6. Treatment for our Prison Project.

All shall be revealed in time and I wish I could write freely and transparently regarding my “significant and potentially life-changing challenge”, but it could affect the outcome, so to my older self who will read this and smile having made all the right decisions and navigated this challenge we are in.

Hard times build strong resilient people. Don’t forget that. You thrive on challenges even if you won’t admit it.

We have always ever had 4 options:

1. Stop it all.

2. Stay the same.

3. Strive for more.

4. Sell it all.

Each has their merit, and I wasn’t even trying to make it rhyme.

It reminds me of the illogical story of our Family Planning drugs we are illegally buying off the black market.

This decision, in my opinion, was one of the worst decisions my Younger Self made in 2012 when we opened our doors to serve our community and I insisted that we HAD to give free family planning to the women in our community because the injustice of their situation was unacceptable to me.

My older wiser self now tut-tuts at my ego, savior syndrome and idealism, but hey, it has got our clinic where it is today.

Firstly, my decision never made ANY logical business sense.

Before we even earned one ariary (our local Malagasy currency) we were running at a loss because we were buying the family planning products and giving it away for free.

My naive idealistic rational was that we would have (future tense) enough paying patients that of course we would beat the odds of every business who takes 3-5 years to turn a profit, and we would turn our profit within the first month of setting up my dream “Robin Hood” community clinic, and be able to support our own Do-Good projects, Family Planning being my absolute priority and “raison d'être”.

Long story short, contrary to my naively idealistic inexperienced business sense we ran at a significant loss for several years, but somehow we always managed to find money to pay for our Family Planning because I belligerently would not accept that women could not have the choice of falling pregnant, and for 10-15 consecutive years at that.

I read that women of childbearing age have on average 6,5 children in Madagascar, the most I have heard of is 21….all survived to adulthood, and the reason I know about them is because some of the 21 now adult children accompanied their mother who was sick in our hospital and who testified that all 21 kids were very much alive, and educated!

Ladies just imagine being pregnant AND breastfeeding for 21 YEARS OF YOUR LIFE!

Back to 2014, on the brink of closing my dream clinic due to lack of funds, two significant things happened.

I met Professor Ulrich Hengge, President of Joachim Kuhlmann Stiftung who was traveling with his wife in Madagascar, and a random expat Canadian I had never met who decided to donate CAD $15,000 to my crazy idea of running a clinic in a politically and economically “stabile-y unstable” 3rd world country, Madagascar.

God’s Will? Coincidence? Karma? Forces of Mother Nature?

Call it what you may, the energy of the universe collided to force me (yip, force), against my better judgement, to not close my clinic, but crazier still, to move to a bigger property while we were still in the deep red financially.

The point I am trying to make is that starting and running my clinic in one of the poorest countries in the world has never made logical business sense.

Buying family planning products off the black market and giving them away for free neither.

And yet here we are, 13 years later, still standing financially by spit, many tears, some prayers, and two few significant investor-donors.

I come back to our 4 options:

1. Stop it all.

2. Stay the same.

3. Strive for more.

4. Sell it all.

And I ask myself whether our 14 year old is only going to remember my purchase of illicit Family Planning drugs off the black market, or, will he remember my other Madagascan misdemeanors which justify our clinic’s means to an end, which I can only ever write about if / when we leave this island?

In which case should I just let him identify as a 16 year old, get a motorbike and be done with it?

Nope.

Ha ha - third world parenting problems.

Kind and mad regards,

Mad Madagascan Mum & Medic,

Jane