We meet, albeit virtually, Cinzia Catalfamo Akbaraly, President and founder of the Akbaraly Foundation.
Cinzia Catalfamo was born and raised in Milan, Italy, where she graduated from the Bocconi University with a degree in Economics.
She later moved to Madagascar, where she created the Akbaraly Foundation, a humanitarian organization that works to improve living conditions in the country, focusing especially on the health and well-being of women and children, and developed the 4aWoman project, the first integrated healthcare program dedicated to cancer prevention in sub-Saharan Africa.
Cinzia, your activities in Madagascar started 24 years ago, with the Fihavanana project, dedicated to the education and well-being of children. In 2008, you created the Akbaraly Foundation, to develop sustainable social and humanitarian projects, which according to the UN are the key to addressing the most urgent global challenges.
The whole world is currently experiencing a grave emergency because of Covid-19, how are you facing this situation in Madagascar?
Thanks to the terrible Italian experience, here we had prepared for the virus even before the first case was discovered, about three weeks ago.
We started with extensive awareness campaigns in our health centers, in companies, factories and administrative offices. Of course, initially, people were not particularly receptive, as the virus had not yet reached the country.
We put in place all the preventative measures available, including the ones indicated by the WHO and the ones used in Italy; in addition, we used medicinal plants of Madagascar, such as Ravintsara, both in the form of herbal teas and by diffusing them into the air.
The virus finally arrived with an Air France flight, carrying infected passengers, just before the President decided to close all incoming flights to Madagascar.
Since then, every day the government of Madagascar adjusts its strategy and the restrictions applied to travel, meetings, places of worship and so on.
Today there are about 100 official cases, mostly in the capital and in some other provincial towns. The country’s health facilities only offer 12 intensive care respirators, 2 of which don’t work. The government, together with the WHO, has put in a massive order of respiratory machines, but the date of their arrival is still unknown.
As a Foundation, we immediately put in motion our strategy: our newest health center was due to open in April in Antananarivo. Instead, we turned into a Covid-19 emergency center. We will be able to treat 10 patients at a time – it’s not much, but it’s something. The quality standard of our machines, equipment, medications and staff has nothing to envy any European health center. Everything was self-financed, with the significant support of our sponsor, the Sipromad Group. All material should arrive to Madagascar around April 20, and we hope to be operational by the end of the month at the most.
Obviously, we hope that the center remains empty. But unfortunately, we cannot predict how things will go.
Can you tell us how you’re dealing with the lockdown?
We are not under total lockdown: it only starts at 12 pm. This allows the population to survive, because here most of the people rely on subsistence economy. In addition, many homes lack running water and even toilets. In fact, a complete lockdown is impossible in poor countries such as Madagascar.
There is constant talk of social distancing as a means, or as the only means, to cope with the pandemic. What is its impact on the social life of the country?
I hope and believe that the population who lives in the countryside, which represents almost 90% of the total, won’t be affected by the virus: in those areas, there is little social contact as it is. The cities are a different, more difficult story: the living conditions of most people do not allow for any form of social distancing. If you go to the market in the morning, everything seems to be normal: hundreds of people gather to sell and buy vegetables, meat, fish, rice, among stray dog, live geese and garbage.
In May 2010, in partnership with local Ministries of Health and Education, the WHO, the European Institute of Oncology in Milan (IEO), represented by Professor Umberto Veronesi, the Institut Gustave Roussy in Paris, and many other international partners, you have created the “4aWoman” project, dedicated to the fight against female cancers and based on prevention, early diagnosis, training and raising the awareness of women in Madagascar. A way to offer support, health education and awareness for women and their families.
Can the health centers you have created help support the population during these trying times?
Our facility in the South, in the city of Fianrantsoa, the Rex Center, has been closing at noon: in the morning we mainly work with the women and children involved in malnutrition prevention and treatment programs. We have, for the moment, canceled the planned missions with our Mobile Unit.
In the North, in the city of Mahajanga, there are no cases of Covid-19, therefore our center works normally. I believe, however, that the turnout has decreased because people are still afraid of getting the virus. The new health center in Antananarivo, on the other hand, is the one that we have dedicated entirely to the Covid-19 emergency.
How is the country reacting, what preventative measures have been taken?
As I explained earlier, the measures adopted are as follows: a total stop of the flights, both international and local. Occasionally, there are Air France flights that arrive empty in order to bring back to Europe any European citizen who wants to return.
The areas around the capital and three other main cities are under lockdown, except for the transportation of goods. After noon, the lockdown begins, except for those who have a work or health permit. A curfew has been established, from 8 pm to 5 in the morning. All employees, whether in or out of their office or company, have been required to wear a mask.
The economic and social structure of many African countries means that a certain percentage of the population lives hand-to-mouth, relying on their daily work, which at the moment is impossible to sustain, because of the lockdown. What is the situation in Madagascar?
Even if the lockdown, as I said, is only partial for the moment, we don’t know how long this phase will last. A heavy recession is foreseeable, as well as the possibility of popular uprisings due to the scarcity of resources, especially food. We are preparing for hard times.
Fear or social responsibility. What do you, from your observatory, think about the behavior of people in Italy?
The situation in Italy still seems very confused to me. I am worried because everything still seems unclear and, most of all, because I still do not see a significant improvement; no one seems to be able to predict when the situation will actually improve. I am very sorry to see, through the media, that some people continue to go out, or that for Easter many people have tried to reach their holiday homes.
Staying home is difficult, we know, but it is necessary.
One last question about communication. What is Madagascar doing to explain to its people how to deal with these new rules?
The President speaks to the nation almost every evening on TV, and then there are also more traditional media, such as the radio, or more modern ones, such as social media, even though the latter can only be accessed by a small percentage of the population. I am afraid that, when the first deaths will be reported, the situation will escalate quickly and unsafely.
I imagine a significant increase in petty criminality and poverty.
Certainly, for a population that is already so poor, coronavirus will only make the situation worse.