Healthcare in Chad and the commitment of Magis Foundation

Emotionally and with some satisfaction, we still remember Oumar, the first child to be vaccinated at birth against hepatitis B and saved from the disease, even though his mother was a carrier. He is still the symbol of the activity that the Magis Ets Foundation, a missionary work of the Euro-Mediterranean Province of the Society of Jesus, is carrying out in Chad within the framework of the project “For a resilient and quality health system in the country of Toumai – AID 12590/09/8 SiSaTou. This project is being carried out in particular at the “Le Bon Samaritain” hospital area in the capital, N’Djamena – the hospital is also a university complex – and in the town of Goundi, in the Mandoul region, 700 km from the capital, and at the other health facility, “Notre Dame des Apôtres”, also in N’Djamena.

The project, largely financed by AICS, the Italian Agency for Development Cooperation, has the general objective of “contributing to the reduction of premature mortality caused by communicable and non-communicable diseases in Chad through access to quality health care and the fight against child malnutrition”. The specific objective is to “enable the population of the urban and peri-urban areas of N’Djamena and the Mandoul region to have access to improved health facilities in terms of quality and services”.

All this in a country, Chad, that is one of the poorest in the world, characterized by strong political instability (an attempted coup d’état has taken place just recently), third from last in the Human Development Index of the UNDP Human Development Report, and with a life expectancy of 54.2 years. The campaigns being carried out in the Magis-led project include prevention and early detection of major communicable and non-communicable diseases affecting the population, the fight against HIV and its mother-to-child transmission, hepatitis B, cancer and acute malnutrition.

“Hepatitis B seropositivity is still a big problem in Chad because of the strong stigma,” Sabrina Atturo, project manager for the Magis Foundation and international collaborator states. The biggest challenge is screening, most young people and especially men are reluctant to know their serological status. Through the project, we want to help reduce transmission through the ‘vertical mother-child gateway’: the mother is positive, gives birth and automatically transmits the virus to the child during delivery. This, which is often seen as a fatal thing, can actually be avoided by economically and psychologically taking over the expectant mother. We put her on antiretroviral treatment to lower the viral load and reduce the risk of transmission”. “This is all an activity that we do,” Atturo continues. And one mother said to me, ‘Ah, thank you for following me during my pregnancy, explaining to me what it means to be a carrier, what I can and cannot do. But most of all, you reminded me that even though I am a carrier, I can still live a dignified life by taking medication regularly. I have a great responsibility towards my whole family.” And in this way, there is a whole multiplication of positive effects that go beyond the activity itself in the project.

Health care is one of the fields in which the Jesuits are active in Chad: the others are agriculture, with the “community gardens” and “grain banks” in the Vicariate of Mongo, pioneered by Fr. Franco Martellozzo, and education, a traditional “specialty” of the Society of Jesus. The first hospital was founded by Fr. Angelo Gherardi in Goundi, then a very poor village in the savannah of the south of the country, soon to become an internationally recognized model of health care, with two awards from the WHO, and with the principle of creating around the hospital area “rural health centres” – there are now twelve of them – as places of first aid, where nurses provide medication for primary needs and basic illnesses (malaria, hepatitis, pregnancy, etc.), and only when this first aid is not enough do they send the patient to the hospital.

However, the problems and difficulties of health care in Chad are still many. “There are few doctors, few nurses compared to the number of people,” Sabrina Atturo remarks. “But there is also the problem of medicines; there is no company that produces medicines locally, nor equipment, so everything has to be imported from abroad at very high costs. There are few biomedical engineers, so if a piece of equipment breaks down, you still have to wait for the person and/or the replacement to come from Morocco, Egypt, Italy, and that means months and months of waiting.” Also in Chad, “health is still not a right, you pay for everything. Even in the emergency room, you have to pay for the drip, you have to pay for the syringe, you have to pay for everything.”

Then there are the many critical contextual issues that also create unknowns for the future, such as political instability, with French forces leaving Chad, an advancing Russian presence, and an increasingly economically entrenched Chinese presence, or the recent warnings of an advance of jihadist terrorism, with Boko Haram so far confined to the Lake Chad region. Or again, the large number of refugees from Sudan fleeing the war – a massive presence that is pushing the local population westward, toward the capital. On the social level, the many young people without jobs, who fill the suburbs of the cities, not knowing how to make ends meet, turn to alcohol to overcome hunger pangs.

Last but not least, climate change – the Le Bon Samaritain hospital in N’Djamena was completely flooded last year – is having a particularly strong and tough impact on Chad. “Apart from the flooding caused by the rains coming from the south of the country, there is less and less rain in N’Djamena, the drought is increasing, the desert is increasing, it is so obvious,” Sabrina Atturo continues. “The dry season is getting longer and longer, and you cannot live without water. Last year, during April-May-June (the hottest months of the year), thousands of people died from dehydration or cardiovascular problems due to the intense heat. This year, the forecast is just as severe.”

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