In 1996 a small mission hospital called the Good News Hospital was opened in Mandritsara, a market town in the northern interior of Madagascar.
This is a remote but populous area, where almost everyone lives by subsistence farming — mainly of rice and cattle.
The hospital was begun by a team from Africa Evangelical Fellowship, working in partnership with Malagasy Christians from the Association of Bible Baptist Churches of Madagascar.
This indigenous group of churches, which is now fully responsible for the hospital project, was the fruit of the former Madagascar Bible Mission, begun in 1932 by Brynlee Evans and his wife, who were missionaries from Aberdare in South Wales.
Gospel work in Mandritsara is different from other parts of the island — such as the capital, Antananarivo, which has many Evangelical churches and much Christian activity, and some southern areas where there is opposition to the gospel.
Madagascar is bigger than France! Here are some further facts about it.
Who is Jesus?
In 1793 William Carey sailed past Madagascar on his 5-month journey to Calcutta. He wrote: ‘Africa is but a little way from England; Madagascar but a little further. A large field opens on every side, and millions, tormented by ignorance, superstition and idolatry, plead with every heart that loves God.
‘Oh, that many labourers may be thrust into the vineyard, and the Gentiles come to the knowledge of the truth.’
Western Christians, overloaded with information, may find it difficult to believe how isolated villages in Madagascar can be. The nearest internet access to Mandritsara is 600 km away!
When the people in one village were asked by our Health Team, ‘Tell us what you know about Jesus Christ’, the answer of many was, ‘Who is Jesus Christ?’
Only a tiny percentage of the population in this area would claim to be ‘Christian’. The majority worship the spirits of their dead ancestors and know nothing of the gospel of Jesus Christ.
Earlier this year, our community health team made a study of the causes of malnutrition among village children. The results surprised them.
Neither poverty nor ignorance was found to be the biggest problem, but pagan beliefs. When a child is born, the village elders and witchdoctor are called for.
A ceremony is held and, on the advice of the dead ancestors, certain foods (usually milk, eggs, chicken) are announced to be fady or taboo until the child reaches the age of two or three years or even older.
The result is malnutrition and high infant mortality. Pagan superstition is not merely an alternative belief system. It is killing normal healthy children in Madagascar.
Nevertheless, there is great freedom to preach the gospel in Mandritsara. A summary of what is going on underlines this point.
Twice a day, short gospel services are held in the hospital. Tracts are distributed and those who receive them look after them carefully.
Some folk study the Bible using the Good News correspondence courses that we distribute. 150 children, the majority from non-Christian homes, attend Sunday school in the local Baptist church each week.
In addition to this, time is rented on the local FM radio station for gospel broadcasts several days a week.
A children’s holiday Bible club is held in a different village during each long school holiday and many children attend. Also, the elders of several distant villages have written asking for visits from the health team — and ‘If the health team is too busy, could the team that preaches the gospel come?’
Even the Good News Primary School, initially established to teach the children of hospital workers, brings further gospel opportunities.
The school now has 120 children, mainly from non-Christian homes, including some from Muslim homes (second-generation Pakistani traders).
The possibilities for witness in our area far exceed our ability to respond; and this situation is typical of Madagascar.
Medical missions still needed
Some have suggested that the day of the traditional mission hospital is over. We do not think so for Madagascar.
An article in the British Medical Journal (18 January) reported on the incidence of Caesarean sections in 8 countries in sub-Saharan Africa during the 1990s.
This was used as an indicator of the quality of maternity services — a 5% rate would suggest that access to facilities was at about the right level. The figure for rural Madagascar was 0.3% and getting worse.
The nearest physiotherapist to Mandritsara is 600 km away, and there are no occupational therapists in the whole country.
Medical missionary services provide wonderful opportunities for the practical demonstration of God’s love, and for bringing the message of the gospel. This is our daily experience in the Good News Hospital.
A day of small things
We would like to be able to say that, with all these opportunities, many were turning to the Lord. Some are being converted and new churches have been established, but overall the work is slow.
The cry of Carey for more workers to bring the gospel to unbelievers in Madagascar is still our cry.
Our prayer is for a visitation of the Holy Spirit, to rescue men and women lost in darkness and superstition, and to bring to them the light of the gospel of the grace of God in Jesus Christ