These archaeologists helped quell a wave of COVID in Madagascar

The SARS-CoV-2 coronavirus arrived in the fishing community of Andavadoaka, Madagascar, in April this year. At Vezo Hospital, a 17-room clinic that serves Andavadoaka and the surrounding area, a doctor and nurse were the first to test positive, followed by two of the other six medical workers.

About 200 people in the area, young and old, exhibited symptoms compatible with COVID-19 over a 2-week period, hospital coordinator Michele Sari said. He cannot offer an exact count because Madagascar’s public health ministry has not provided the tests that would have confirmed the cases in the community. Out of about 3,000 inhabitants, 5 elderly people died, as well as a 34-year-old fisherman from a nearby town. “Everyone was panicking,” says George ‘Bic’ Manahira, who is based in Andavadoaka as the field manager for the Morombe Archaeological Project (MAP) at Pennsylvania State University, which aims to rebuild the impact of human settlements in the Velondriake region, a protected marine biodiversity. hotspot on the southwest coast of Madagascar.

The first wave of the pandemic hit Madagascar in June last year, but did not reach Andavadoaka, sticking mainly to metropolitan areas, where it killed around 230 people. The second wave, however, reached all corners of the island. It is fueled by the beta variant of SARS-CoV-2, the difficulty of citizens staying at home and a president, Andry Rajoelina, who does not promote vaccination. Madagascar has so far received enough doses of the COVID-19 vaccine for only 1% of its population to receive a single dose, and some doses have been wasted due to reluctance.

So when SARS-CoV-2 arrived in Andavadoaka, Manahira knew he couldn’t expect the government to help. Through courage and community organization, he and a team of MAP archaeologists moved from conducting field surveys to collecting and distributing aid in their town. And when the news spread, communities across the region cried out for help.

A family matter

Throughout the pandemic, Rajoelina has encouraged the citizens of Madagascar to drink a locally brewed plant infusion that he says will protect them and treat coronavirus infections. “It has not been proven effective,” explains Fidisoa Rasambainarivo, co-founder and scientific director of Mahaliana, a laboratory training center in Antananarivo, the capital of Madagascar. “But it was given to schools, and it’s still promoted on TV and in hospitals.”

When the virus arrived in Andavadoaka, Manahira watched families in his community try traditional herbal remedies and knew he needed another solution. He works as a dive instructor, liaises with community leaders and oversees the MAP research team.

At a Zoom Lab meeting on April 9, Manahira described the outbreak to MAP director, Penn State archaeologist Kristina Douglass. Raised in Madagascar, Douglass started MAP in 2012. The project employs local people – including Manahira and her brother, Zafy Chrisostome, who died this month – and trains them in archeology and anthropology to lead projects on field. “Every member of this team feels like a member of my family,” says Douglass, who is based in University Park, Pa., And was unable to travel to Madagascar during the pandemic.

When Manahira told Douglass about the outbreak, she turned to MAP research funding to purchase personal protective equipment (PPE) for the community. Penn State approved the request, transferring US $ 1,500 of its grant to purchase the equipment.

With the money, Manahira organized trucks for an 8-hour drive to Toliara, a coastal town 170 kilometers south of Andavadoaka, to purchase bleach, sprays and other products. cleaning. The MAP team also purchased 1,000 fabric masks produced by a sewing group.

Back in Andavadoaka, the team stopped at each household to distribute supplies. Researchers also shared guidelines on preventing viral transmission and sprayed disinfectant at community centers, including the grocery store, church, and schools.

The situation has improved, Sari says: people have stopped arriving at Vezo hospital with symptoms of coronavirus. In fact, the distribution effort was so successful that neighboring communities reached out, asking for similar help, says Manahira.

During the pandemic, he says, trade has all but come to a halt in the region, where communities depend on the export of fish, so people cannot afford to feed their families, let alone food. buy masks. To help, he and the deputy mayor of Andavadoaka, Roger Samba, set a goal of raising $ 10,000 to provide masks and cleaning supplies to some 320 families in communities near Andavadoaka. Douglass ran an online fundraising campaign, which brought together the full amount. This enabled Manahira, the MAP team and volunteers from a youth club to distribute more than 10,000 disposable masks, along with disinfectant supplies, in the Velondriake area in April and May.

This type of intervention on the ground is rare in the region, explains Tanjona Ramiadantsoa, ​​an ecologist at the University of Fianarantsoa in eastern Madagascar. Typically, organizations responding to a crisis focus on giving and public relations activities. “What MAP is doing is amazing,” he says. “And that’s sad to hear, because if they help out in the southwest, that means it’s raging there and no one else is noticing.”

“MAP’s effort to distribute PPE was truly admirable,” says Bram Tucker, an anthropologist at the University of Georgia in Athens who has worked in Madagascar since 1996 and has contributed to this effort. “It had real preventive value. “

The intervention was possible because the research team is rooted in the community, says Douglass. “I know that many anthropologists and other scientists feel uncomfortable with the idea – that if you form these kinds of deep attachments, that somehow the work you are doing is less scientific, less rigorous or less objective. But having strong relationships with the community, especially when they are transparent, mutualistic, and reciprocal, improves the quality of the science you do and makes you more ethically responsible for the results.

Researchers have an obligation to put science aside for the needs of a community when necessary, says Tucker. “We make careers through our friendships with some of the poorest and least powerful people on the planet. We have an ethical responsibility to do more than just be objective. The MAP effort is particularly industrious, but similar efforts have been and should continue to be undertaken by research groups in other countries, particularly in anthropology circles, Tucker says.

The next chapter

MAP’s next goal is to facilitate vaccination, says Manahira. But first, he is organizing surveys to see who in the Andavadoaka region, if any, is ready to get the vaccine. If enough people want a jab, the team will raise funds to hire a helicopter to bring in doses. But there hasn’t been enough interest yet. It seems to be a model across the country. Madagascar received 250,000 doses of AstraZeneca’s Covishield vaccine in May through the COVAX program – an alliance of international organizations that aims to distribute vaccines to low- and middle-income countries – but health officials only administered 190,000 doses before their expiration on June 17, because not enough people showed up to receive them.

Michel Saint-Lot, representative of the development and humanitarian aid organization UNICEF Madagascar, anticipates another delivery of COVAX vaccines in August, which will be necessary for those vaccinated to obtain their second dose. “We are convinced that these problems can be overcome and we will step up the campaign,” he said. “We hope the entire government will join us in getting the country vaccinated. “

Covishield has not been shown to be as effective against the beta variant as other vaccines¹, but it’s still something, says Rasambainarivo. “Any vaccine is better than no vaccine at all. “

According to government reports, cases of coronavirus in Madagascar have been on the decline since the end of April. As of mid-June, 56% of hospital beds were available for people with illnesses other than COVID-19, Saint-Lot says, and UNICEF is working with government and other partners to prepare for any new wave of infection by restocking supplies such as test kits, PPE and oxygen, and immunizing health workers.

Still, government reports could indicate the situation only in metropolitan areas, where most COVID-19 tests are carried out, says Rasambainarivo. “It’s not necessarily in other areas, which have effectively been invisible.”

In Andavadoaka, Manahira continues to receive daily phone calls and texts from people living hours away, asking for masks and disinfectant.