The current deadly flu epidemic is spreading only throughout the rice producing areas, for now.
It mostly affects the farmers.
Some 95% of those who are infected die before receiving any kind of medical attention.
The magnitude of this catastrophe is such that it has forced Pety Rakotoniaina, Fianarantsoa’s special delegation president, to designate a portion of the province as “a disaster area”.
The central government intervened by calling on volunteer physicians, and paramedics, and rushing in urgent supplies of medications.
Generally, these rescue, and medical emergency operations are limited to the big cities, or the major highway networks, and medical supply shipments to remote health clinics.
In other words, they are confined to the rural county seats, and local physicians are responsible for dispensing care to the sick from the countryside, and the villages, as it was the case during the 2000 cholera outbreak.
When asked about the impact of the flu epidemic in his district, a local physician indicated that his particular area has, so far, been spared.
He stated, however, that it would not surprise him if the epidemic did reach his region, and left a lot of casualties in its wake.
The root of the problem is food or the lack of it.
He pointed out that the meager food ration they receive easily leave these farmers vulnerable to new viral infections.
Almost all year long, the inhabitants of the remote corners of his district only eat one daily meal of rice, spiced with peppers and salt.
Even though they are farmers, they are not used to drinking milk, and they refuse to do so.
A few eat their rice with dried fish, soaked in parboiled water.
They only eat meat during family events.
This young physician, who already has five years of experience working in other farming areas, maintains that, in a nutshell, as long as the nutrition awareness programs are confined to the urban health clinics, and at best, the surrounding areas, the farmers are not likely to change their ways.
As poor as they are, they are not likely to venture into uncharted waters.
According to this physician, social, and health related associations, and organizations must regularly criss-cross the countryside, and villages to conduct health and nutrition awareness visits because the local physician and the basic health clinic staff at his disposal simply cannot do this.
While they are out delivering a death certificate, five hours away, the health clinic must remain closed.
He also noted that while some mobile vendors go from village to village, selling medications, among other things, this is a double-edged sword, helping out the farmers, on one hand, and promoting the dangerous, and potentially fatal practice of self-medication, on the other.
Translated by J. F. Razanamiadana