Health & Sanitation Projects  
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Azafady Madagascar has been running health and sanitation projects for the last 7 years. Our initial long-term cholera prevention strategy project has been completed and we continue our work in other communities within Project Rano, funded by TRAID.  
Azafady now runs 20 village pharmacies and has installed over 30 wells, servicing with clean water and access to medicine over 20,000 people mainly in the Rural Commune of Mahatalaky.  
We have a new Health and Sanitation co-ordinator, Djahanguir Mazars, who has a background in water engineering. The construction team continues to provide sanitation infrastructure, wells, village pharmacies and latrines, to some 18 villages, most of which are sited a considerable distance from the nearest road and health point. In addition to this funding for a mobile doctor has been received from a number of trusts, and the search is underway for the best local candidate.  
It is not uncommon for the average Antanosy village to be threatened with a variety of diseases. These are prone to manifest themselves in the most fragile of the population, the eldest and the youngest. Malaria and diarrhoea-related diseases are the most common and in recent years epidemics of cholera have besieged the island.
 
Here are some of the main factors that contribute to the spread of sickness: Villagers have a tendency to bathe, collect drinking water and launder clothes in the same area of a river. Open defecation is also a common choice of disposing of human waste. The combination of these 2 traditions can be lethal and lead to the contamination of water sources and thus the health of the entire village. The time of highest risk is during cyclone season which can cause excessive flooding.  
Malnourishment is a factor of everyday life and it severely weakens a persons ability to fight disease; i.e. cholera has the chance to spread and kill faster than it would in healthier individuals.
 
The remoteness and inaccessibility of these villages prevents the occupants from being able to access important health care, advice and treatment on a daily basis. Often villagers will die of a disease that could have been easily treated if the right medicine was available and the symptoms were noticed at an earlier stage.  
In order to combat the problem of contaminated water it is clear that improved sanitation facilities coupled with a protected water supply must be implemented. We have managed to fulfil these needs effectively using hand-dug concrete wells and concrete sanitation platforms. The village is involved in all stages of project implementation and must contribute to the transport of local materials (sand, rocks, palm), construction (digging holes, building house) and maintenance and follow-up of the project (record keeping, training).  
     
 
Azafady is very pleased to have been awarded grants of £25,000 from the Isle of Man Overseas Aid Commission and £18,474 from TRAID towards Project Salama. This project integrates health education work, the activities of our mobile doctor and the builing of health and sanitation infrastructure.
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