I will be traveling with the NGO Global Healing Hands on a surgical mission to Toamasina, Madagascar. I am an Adult Gerontology Acute Care Nurse Practitioner who will be working alongside one of two surgeons on the team intraoperatively. We will be accompanied by an infectious disease physician, a surgical physician assistant, and two nurse anesthetists. It is my understanding we will be collaborating with Dr. Fabruce, a local surgeon at Bethany Hospital Center, to provide much needed surgical care to the local population. We will be focusing on surgical interventions for hernia repair and thyroid surgeries as well as addressing conditions that significantly impact one's quality of life while there.
The mission of this trip is focused on education and training as well as the surgical aspect. I hope to enhance medical resources by donating essential medical equipment including and collecting updated surgical textbooks. We hope to build sustainable improvements in surgical education and patient care as we work alongside local providers in Toamasina Madagascar.
Toamasina (Tamatave) Madagascar is the country's chief medical seaport located on the country's East Coast. As of 2018, the city had a population of approximately 325,857. The median after tax monthly salary is approximately $127. Although there are both private and public facilities within the healthcare infrastructure, access to healthcare in rural areas surrounding Toamasina remains very limited, and the quality of life varies. If a patient has a hernia, whether umbilical or inguinal, this can cause chronic pain, disability, and loss of livelihood hugely affecting their quality of life and those around them. Our primary objective for this population is to provide life changing surgical intervention for those who would otherwise go untreated for an improved quality of life.
Our team also hopes to collaborate with Bethany Hospital Center to enhance and educate surgical training for local providers. We hope by strengthening the skills of the local physicians and surgeons and improving their core knowledge it will have a lifelong impact on the community.
There is a severe shortage of both local and international surgical support, especially in the vulnerable regions, according to Madagascar Ministry of Health. Patients do not seek out medical or surgical services because of where they live within the region, the rugged terrain, or the extensive distance to said available services. Discovered in a study in 2016, 95% would be financially ruined if surgery were required on a family member, and only 20% of the population can reach surgical services within two hours. Mercy Ships has coordinated with the Ministry of Health to perform thousands of procedures and provide education since 1996, however with only 20 physicians per 100,000 people, surgical care remains out of reach for many people.
Being a part of this mission trip with Global Healing Hands, we hope to establish a long-term partnership with local providers, such as Dr. Fabruce, for annual surgical mission trips to serve the people of Toamasina, and its surrounding regions. Providing education and training opportunities for local providers as well as surgical intervention for needed patients, we hope to improve long term health outcomes and make a difference in the health of the community.
We were in Toamasina, Madagascar from May 5, 2025 through May 9, 2025. Our team of 15 people from all over the United States arrived and was very warmly greeted by Dr. Fabruce and his team at Bethany Hospital. We began our day at 5:30 every morning seeing numerous Malagasy patients, who had come from all over in search of surgical care for different concerns. Given the terrain of Madagascar, patients had travelled for more than two days to reach us at the hospital. Some patients were seeking care for issues they had since birth to several years. Our services were requested due to the complexity required for surgical procedures for these Malagasy patients.
The surgeons on this mission trip with Global Healing Hands consisted of a general surgeon specializing in thyroid surgeries, a trauma/acute care surgeon specializing in general surgical care, and a physician specializing in obstetrics and gynecology. I had the pleasure of working with a very talented surgeon and we were able to optimize our time and services while spending the week there. We did multiple surgeries a day consisting of removal of lipomas, inguinal, scrotal, epigastric, and umbilical hernia repairs, as well as hydroceles. During our 5 days there, we were able to perform 15 surgeries for our room alone, which does not include the other two physicians on this mission trip and the care they provided. The people we impacted, could either not afford the required surgery or the complexity was to acute. The surgeries we did were truly life changing and will have a positive effect on the patients and in some cases, their families and ability to work.
We had the honor of performing inaugural surgeries at their new facility, Bethany 2 Hospital for a couple of our days there, which including transporting patients and equipment back and forth for the surgeries. We could not have done it without the assistance of the Bethany hospital staff and physician Dr. Fabruce. Their dedication and teamwork were crucial for the successful completion of all of our surgeries as well as their dedication to the patients for post op care.
I was amazed of the Malagasy culture and how supportive they were of each other; from the patient’s family and friends to the hospital staff, and everyone else we encountered during our travels there. The patients and family were very thankful and appreciative which left us feeling very humbled and grateful for the care we were able to provide them. We appreciated their hospitality, their culture, their amazing food, and their guidance while we navigated through the language barriers, customs, and helpful hands. We feel we have made friends for life. This mission trip was both mentally and physically exhausting, but it was truly an experience of a lifetime, and I look forward to returning.
