Leaving Île Sainte Marie
Sheer disbelief washed over me as I stood on the small airstrip for the tiny island of Sainte Marie, Madagascar. A plane called to pick up a dying man had just turned back and his now lifeless body lay inside a small van covered by a dirty white sheet. As the medical attendants climbed out of the van, the crowd, circling to watch the spectacle, dispersed. And, as the final radio call went out, car lights shining brightly on the runway went off one by one. Only one tiny light remained shining dimly from inside the van illuminating the frail, limp body held inside.
Two months prior, I had joined a small group of underwater archaeologists in search of a shipwreck once captained by an infamous 17th century pirate. We ran our dive operations from Ambodifotatra, the capital of Sainte Marie, and on our last day a call came in unlike any we expected. A local clinic needed medical supplies desperately for a seriously ill archaeologist who was also on the island searching for shipwrecks. He had been struck down by an unknown illness thought to be malaria and he could not get the help he needed on Sainte Marie.
Rushing to the clinic, we found lying on a small bed covered with filthy linens a man struggling to breath. His sheets, stained and soaked from sweat, reeked of a sour and foul odor. His hair was wet and matted and his dull eyes only partially opened. The frightened expression on the attendant’s face told us all we needed to know. It was clear this man was in trouble and needed proper medical attention immediately. Removing a sick man from a remote location is not easy to say the least so we called the US Embassy in Antananarivo to organize the needed supplies and have a plane sent immediately. Since the flight should take just over an hour we decided not to waste any time. Straight away we wrapped the invalid in his bed sheets and moved him to a van waiting outside. We felt that getting to the airport would allow the medical team to get him on-board and back to the mainland as quickly as possible.
Needing to confirm the flight, we made another call only to find that US officials felt a landing at night posed too much risk and had not given the plane authorization to leave. The small airstrip on Sainte Marie had no runway lights and a plane could not land in the dark. Emotions ran high as everyone offered different ideas on what to do. After a few moments, we decided to line both sides of the runway with cars and use their headlights to provide the needed illumination. So, after gathering together several drivers and their cars and trucks, the small convoy headed off. Once again, the plane was on its way.
As the caravan pulled onto the tarmac another call went out. Amazement turned into horror when the Embassy informed us the plane was still on the ground. As onlookers gathered quietly around the van looking in through the large glass panel windows, frustration mounted. Still, another call went out in hopes of persuading Embassy officials to release the plane. At long last, the plane was given the go ahead.
Still, it would need lights. As cars and trucks began pulling around the airstrip, they were directed to one side or the other and each was given a small handheld radio. The van stopped just off the edge of the tarmac and positioned so the breeze blew in gently through the open doors.
As the hour past, our hopes began to fade. The plane should have already arrived but still we waited. An hour later the final call came in and the plane had just left. Unfortunately, we knew it was too late. The dying man continued to struggle. The attendants continued to monitor his condition although there was nothing they could do other than make him as comfortable as possible.
The crowd watched despondently as a man none of them knew took his last breath. Gasping deeply, the man writhed raising himself up. He thrashed about and fell back racked with pain. Finally his head lurched forward and his mouth and eyes went wide in shock and disbelief. He held on for only a few seconds and then fell back with great force. He did not move again and his eyes went black. One of the attendants took his pulse and gently laid his lifeless arm back down. It was over. The attendant closed his eyes and covered his body with the same dirty sheet he had been wrapped in when he left the hospital. Since there was no need to put anyone else at risk, the plane was called off. The body could be retrieved the following day.
As we stood in silence, we tried to understand the culmination of the day’s events. The attendants felt the man probably died from malaria. A few days earlier the hotel manager, where he stayed, first noticed a possible problem. Known to be a heavy drinker, he stopped drinking altogether and kept to his room. At one point the manager entered to find him coughing up blood. Immediately he was rushed to the hospital. Friends said he had refused to take malaria medication or spray himself with mosquito repellent. Malaria remains rampant on the island and without either, he put himself at great risk.
We all waited at the airport for well over an hour. No one knew quite what to do. Finally, the Mayor decided the body would be taken to the community center where it could remain until a plane left the following day. As it happened, the next morning when we boarded our plane to leave the island, so too did the body of the American. Unfortunately his seat was in the cargo hold, but finally on his way home.
I remember before leaving the US, I visited the Center for Disease Control (CDC) website to see what advice they had for travellers going to Madagascar. Specifically, I wanted information related to malaria and how I could protect myself while traveling aboard. According to the CDC, malaria is preventable as long as you take precautions. Before traveling outside your home country, be sure to identify potential problems including infectious diseases. Always take precautions and never trust you will be lucky enough to come home unaffected. The article above illustrates the importance of taking precautions and getting the information you need to come home safely. This is a lesson I will never forget.