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144,000 Malagasy Children Die Every Year for Lack of Care.Ankizy Malagasy 44 000 No Mamoy Ny Ainy Isan-taona Noho Ny Tsy Fahampian'ny Fitsaboana.
2How Can We Stop It?Ahoana No Hanafoanana Izany?
3Madagascan children by Yves Picq - CC-BY-SA 3.0Zaza Malagasy, sary avy amin'i Yves Picq - CC-BY-SA 3.0
4In Madagascar, 44,000 children under the age of five die each year, according to the latest UNICEF figures.Ankizy 44 000 no mamoy ny ainy isan-taona eto Madagasikara (tarehimarika tamin'ny taona 2012).
5That number is the same as the population of all children five and under in the entire Alpes-de-Haute-Provence region of France.Toa tsy mahataitra tahaka ny tarehimarika rehetra anefa izany isa izany, izay mihitsoka eo afovoan'ny tabilaon'ny vokatry ny fahasalam-bahoaka.
6It's also the number of victims in the 9/11 terrorist attacks, 15 times over.Toe-javatra mampahonena tsy misy anarana miverimberina in-44 000 anefa izany hoan'ireo fianakaviana matetika tsy mahita vonjy.
7The tragedy behind the number - losing a child - most often affects families of limited means.Ankizy 44 000 izany dia mitovy isa amin'ny mponina latsaky ny 5 taona ao amin'ny faritra Alpes-de-Haute-Provence.
8Two groups in Madagascar are particularly vulnerable in terms of public health: children younger than five, and pregnant women.Sy in-15 avo heny amin'ny isan'ireo niharam-boina tamin'ny 11 septembra . Vokatra mampalahelo momba ny fahasalamam-bahoaka.
9According to the World Bank, half of all children under five experience delayed growth, “a larger proportion than in any other country in Africa.”Eo amin'ny sehatry ny fahasalamam-bahoaka, vondrona roa no tena marefo eto Madagasikara: ireo ankizy latsaky ny dimy taona sy ireo vehivavy mitondra vohoka.
10The maternal mortality rate is estimated at approximately 498 per 100,000 live births, and the causes of death are many, including limited access to skilled staff during delivery, poor prenatal care, and lack of emergency care.
11The health record is appalling, yet there is no shortage of initiatives to change the situation.Indreto isa vitsivitsy mamehy ny vokatra mampalahelo mikasika ny fahasalamam-bahoaka eto Madagasikara :
12In Toliara in southern Madagascar, a school lunch project is helping to fight the problems of chronic malnutrition.• 72 ao anatin'ireo zaza 1000 teraka velona ny taham-pahafatesana eo amin'ireo ankizy latsaky ny dimy taona.
13The organization Les Enfants du Soleil (Children of the Sun) houses and educates street children and children from needy families.• 50 %-n'ireo ankizy latsaky ny dimy taona dia manana fahatarana eo amin'ny fitomboana, tarehimarika goavana raha oharina amin'ireo firenena Afrikanina hafa
14The children also receive a noontime meal in the school cafeteria.Ny vondrona faha-roa tena marefo - ireo vehivavy bevohoka - izay anisan'ny mponina manana filàna lehibe eo amin'ny resaka fanohanana ara-pahasalamana.
15Take a look at photos of children who benefit in this French-language YouTube video: Other programs target specific problems such as sickle-cell anemia or malaria.Ny taha-pahafatesana eo am-piterahana dia tombanana eo amin'ny 498 ao anatin'ny fiterahana 100 000 mahomby ary maro ny antony mahatonga ny fahafatesana :
16The organization LCDMF (the initials stand for Fight Against Sickle-Cell Anemia in Madagascar) works to make the population more aware of this genetic disease affecting 2 percent of the Madagascan people.• Voafetra ny fandraisana mpiasa mpampiteraka; • Ratsy kalitao ny fitsaboana alohan'ny fahaterahana; • Tsy fisian'ny fitsaboana vonjitaitra hoan'ny fiterahana; • Tsy fahampian'ny fanaraha-maso aorian'ny nahaterahana ; • Mitombo ny tsy fahafaham-po mikasika ny fandrindram-pianakaviana.
17In the following video, the team leaders of LCDMF describe the past activities of the NGO and its objectives for the next three years.Vehivavy roa ao anatin'ny telo no tsy miteraka any amin'ny toeram-pitsaboana, ary nihena 51 % hatramin'ny 44 % ny taham-piterahana atrehina mpitsabo tao anatin'ny dimy taona.
18Two of their objectives for the upcoming years are to give better access to antibiotics for sickle-cell anemia patients and to convince Malagasy political leaders that sickle-cell anemia ought to be included in the nation's public health priorities:Ao amin'ity lahatsary manaraka ity, mampiseho ireo hetsika tokony atao haingana mba hampihenana ny fahafatesan'ny zaza ny UNICEF, tahaka ny vakisiny sy ny fanaharamaso ny sakafon'ireo zaza vao teraka [en]: Inona no fepetra azo raisina?
19In an open letter to Prime Minister Malgache Kolo Roger, LCDMF stressed the importance of treating this problem, especially in isolated regions without modern health facilities:Tsy ny fisantaran'andraikitra akory no tsy misy mba hamonjena ireo filàna vonjimaika hoan'ireo ankizy kely. Ao Toliara (Atsimon'i Madagasikara), manampy hiadiana amin'ny tsy fanjarian-tsakafo mitohy ny tetikasa toerana fanomezan-tsakafo hoan'ny mpianatra .
20This is a critical public health problem that has a dramatic impact on the neediest inhabitants in a region with nearly a 20 percent disease rate and where one out of five children with major sickle-cell anemia is not likely to survive past the age of five.Mandray sy mampianatra ireo ankizy mirenireny eny an-dalambe sy ireo fianakaviana sahirana ny fikambanana “Les enfants du Soleil” (ireo ankizin'ny masoandro”). Mahazo sakafo isaky ny atoandro ao amin'ny toerana fanomezan-tsakafo hoan'ny mpianatra ihany koa ireo ankizy :
21The problem can no longer be handled with half measures.Misy ihany koa ireo fandaharan'asa hafa miady amin'ireo olana goavana, tahaka ny aretin'ny rà (drépanocytose) sy ny tazomoka.
22Because sickle-cell anemia is cross-disciplinary and involves all medical specialties, this disease alone illustrates how essential it is for you to immediately take stock of the healthcare situation in our backyard.Eo ohatra ny fikambanana Lutte contre la Drépanocytose à Madagascar - France (LCDMF) [Ady amin'ny aretin'ny rà] izay manao fanentanana mikasika ity aretina manaranaka mahakasika ny 2% n'ny mponina malagasy ity:
23Much remains to be done Another area with a pressing need for action is maternal health, due to rapid population growth in Madagascar.Tamina taratasy misokatra hoan'ny Praiminisitra Malagasy Kolo Roger, naneho ny maha-zavadehibe ny tokony hijerena ity olana ity ny fikambanana LCDMF, indrindra any amin'ireo faritra saro-dalana sy mitoka-monina izay tsy mba manana rafi-pitsaboana manara-penitra:
24For example, one out of five married women who wishes to space out or limit pregnancies has no access to family planning services (19 percent), and the abortion rate is estimated at one out of every 10 live births, according to the Madagascar National Institute of Statistics (INSAT) and the United Nations Fund for Population (UNFPA).Tsy azo hiononana handaisana fepetra tapatapany intsony ny olana makadiry ara-pahasalamana manjò ireo olona tena sahirana any amin'ny faritra ahitana taha 20% izany hoe ankizy iray ao anatin'ny dimy tratran'ny aretin'ny rà ary mety tsy ho velona mihoatra ny fahadimy taonany.
25Despite these efforts, Madagascar is faced with certain weaknesses that hinder improvement in health indicators. The source of poor and uneven health outcomes lies in the disparities in household incomes and physical access to health services.Satria mahatafiditra ny sampam-pitsaboana manokana rehetra io aretina io, dia efa ahafahana mitaky fa tena ilaina ny fandraisanao fepetra tsy misy hatak'andro amin'ny fahasalamana manakaiky vahoaka.
26Consequently, nearly one in four people (23 percent) with an illness did not seek care at a health center because they could not pay for it.Zava-dehibe indrindra ihany koa ny firotsahana an-tsehatra amin'ny fahasalaman'ny reny noho ny fitomboan'ny mponina haingana loatra eto Madagasikara.
27Availability of medication is also a real problem because the systematic failures in drug management and inventory tracking as well as distribution logistics hamper proper distribution of medications.Tsy afa-miditra amin'ireo fanaovan-draharaha momba ny fandrindram-pianakaviana ny vehivavy iray manambady ao anatin'ny dimy (19%) maniry hanelanelana na hametra ny fiterahana ary tombanana eo amin'ny 1 ao anatin'ny zaza 10 teraka velona ny tahan'ny fanalan-jaza.
28As a result, the wealthy use health services four times more often than the poor: 40.9 percent of total expenses in this sector were attributed to the wealthiest fifth, whereas 10.1 percent were paid by the poorest fifth, according to the World Bank.Na dia eo aza ireo ezaka natao, miatrika olana marobe manohintohina ny fanatsarana ny tondrom-pahasalamana i Madagasikara. Noho ny fahasamihafana eo amin'ny vola miditra ao an-tokantrano sy ny fahafahana mandeha eny amin'ny toeram-pitsaboana no mahatonga vokatra ara-pahasalamana ratsy sy tsy mitovy tantana.
29Experts agree that the need for action is urgent. UNICEF says vaccination and newborn diet monitoring are necessary to reduce infant mortality.Araka izany, olona iray ao anatin'ny efatra (23 %) izay mijalin'ny aretina no tsy mandeha any amin'ny toeram-pitsaboana satria tsy manambola handoavana sara-pitsaboana izy ireo.
30To improve the public health situation overall, the priorities should be: The situation is dire but not desperate, at least not yet.Olana iray hafa ihany koa ny fahazoana fanafody satria manelingelina ny fitsinjarana araka ny tokony ho izy ireo fanafody ny tsy fisian'ny fitantanana sy ny fanarahamaso ny ambim-panafody ary ny fampitaovana.
31The proposed policies can be readily implemented if given the political will. The Malagasy children have waited 50 years for their collective health to be at the top of the national agenda.Vokatr'izany, mankany amin'ny servisy ara-pahasalamana in'efatra avo heny mihoatra noho ireo mahantra ny mpanankarena: ny 40,9 % n'ny totalin'ny fandaniana eo amin'ny seha-pahasalamana no ampiasain'ny mpanankarena, raha toa ka 10,1 % no ampiasan'ny mahantra.
32It is high time authorities are reminded that no respectable country would tolerate the obliteration of its future in such a manner, 44,000 times a year.Mitovy ny toro-hevitra avy amin'ireo manam-pahaizana, ilaina ny mandray fepetra haingana. Ny laharam-pahamehana eo amin'ny sehatry ny fahasalamana dia :