In this blog, I’ll explain how Malagasy people generally perceive illness and why AiNA soa exists.

In general, people decide to train because they don’t know. This is confirmed by the knowledge assessment we carry out before each training course. In 2024, when participants give you answers that date back to the beginning of the last century, all you can do is take a minute’s silence. Then you realize that the hours ahead won’t be easy.

A little anecdote that pointed me in the right direction

My name is Tsito, I’m a doctor and first aid instructor at AiNA soa. About ten years ago, as part of my doctoral thesis in the rheumatology department of one of Madagascar’s largest hospitals, I conducted research into how patients suffering from chronic illnesses perceive their illness. I wanted to focus my career on therapeutic patient education. I was moved by the story of a man whose wife suffered from a particular form of systemic lupus erythematosus (SLE), an autoimmune disease, which deformed her face into a mosaic. This man cried in front of me in the hospital corridor, he was desperate. But he approached me because he had a question: “Doctor, I come from a remote village where my wife was by far the most beautiful. All the men wanted her, but she chose me. Was she struck by a curse? Had she been bewitched? From that moment on, I wanted to know how and why patients went so far as to imagine a mystical dimension to their illness, because this wasn’t the first case.

Pictures 1: University Hospital JRB, Antananarivo.

Modern concept of illness

Nowadays, while most patients attribute their illness to a dysfunction of the body explained by science, divine will and witchcraft are still incriminated.

Several factors determine the individual’s perception of illness: culture, religion, level of education and socio-professional status, as well as the environment, i.e. history and politics.

In Madagascar, use of empirical therapies dispensed by a healer as a first-line treatment is still common. This is due to the difficulty of geographical and financial access to medical care. The distance from a health center considerably modifies the profile of patients, their perception of illness and the choice of treatment.

Preconceived ideas and distortions of past practices

In 2024, while almost everyone is using the internet, artificial intelligence is becoming increasingly sophisticated and sharing and access to knowledge is improving all the time, people do not seem to have completely changed their behaviour in the event of illness.

1. On social media, in a group for young parents, you can read in case of:

  • Burn: Urinate on it, or use toothpaste, saliva, flour, grated potato, etc.

Pictures 2: burned leg – where flour was applied.

Pictures 3: burned leg – where toothpast was applied

  • Seizure: Burn a chameleon and drink the ashes (with water) or give the child coffee (if the victim is a child)
  • Insect bite or sting: apply women’s smegma as an ointment.
  • Dislocations and sprains: eat cat or nymph.

2. In our training session, we often get these same answers from participants.

  • Fresh chicken blood for hemorrhage
  • Saliva for burn
  • Throw green grass at a seizure victim
  • Turn the person upside down in the case of drowning

As mentioned earlier, in the first aid training AiNA soa conducts, when we are told ideas related to mysticism or culture, we ought to double our efforts. This emphasizes the importance of education and awareness to correct these dangerous beliefs. Indeed, we must communicate without risking creating a cultural incident in the middle of a training session. Our strategy will be to provide clear information on the specific cases we are teaching, to give a simple but precise answer and above all to make the learner understand why we do so or so. This last part has allowed AiNA soa to distinguish itself from other first aid training providers.

In conclusion, AiNA soa is working hard to update and correct people’s first aid practices. We are organizing free first aid training sessions in remote areas, reaching more people through television broadcasts, and many projects are still being developed for other target groups, including children. All to make a greater impact in our society.

Greetings from Madagaskar!
Tsito, doctor and First-Aid-Instructor