Chinese doctors improve Malagasy medical results

When Chinese surgeon Qiang Yaosheng looks back on his two medical aid missions to Madagascar, memories return of patients queuing beneath flowering jacaranda trees, and operating rooms working against the limits of scarce resources.

China has sent medical aid teams to the African island nation since 1975. Over the past five decades, 24 teams, including more than 700 medical professionals from Northwest China's Gansu province, have worked in the country, which the United Nations classifies as among the world's least developed.

For Qiang, his first deployment came in 2010, when he joined the 18th Chinese medical aid team from the First Hospital of Lanzhou University. It marked the beginning of a bond with Madagascar that would span more than a decade.

Upon first landing at Ivato International Airport in the Madagascan capital of Antananarivo, Qiang immediately felt the weight of expectation. A red banner stretched across the terminal building, saying "Welcome Chinese Medical Team"."It made us realize how desperately we were needed," he said.

As they traveled east to their posting, the team was escorted through towns in a siren-led motorcade. "They wanted everyone to know doctors had arrived," he said."So people would know there was somewhere they could go."

The welcome soon gave way to the reality of working in a severely under-resourced health system. Qiang was stationed at a provincial hospital where shortages were acute. "Even in the capital, many hospitals have only two operating rooms," he said. "In rural areas, it can be one doctor for every 100,000 people."

Poverty, weak infrastructure and childhood malnutrition defined daily clinical practice. One day, a 13-year-old girl was carried into the surgical ward, exhausted and in severe pain. She was diagnosed with a serious intestinal obstruction. Years of malnutrition had stunted her growth so badly that she appeared far younger than her age.

Emergency surgery was the only option. But Qiang's local assistant delivered a blunt truth: the girl had no money to buy surgical supplies.

"I had a mixture of feelings,"Qiang said, adding that he decided to use his own savings to purchase the necessary supplies so the operation could proceed immediately.

Two years later, near the end of his first mission, he was walking along a rural path when a young woman suddenly called out,"Thank you, Chinese doctor!"

It took him a moment to realize it was the same girl. "She recognized me before I recognized her," he said."That little girl grew up."

It was experiences like this and the persistent lack of medical resources that drew Qiang back to Madagascar more than a decade later. This time, he returned as head of the northern station of the 23rd Chinese medical aid team in Sambava, an agricultural region where about 80 percent of residents rely on farming. Local healthcare infrastructure still lagged far behind township-level hospitals in China.

Anticipating frequent power cuts and supply shortages, he brought essential equipment from China, including a head-mounted medical light to use during power outages.

During this mission, beyond emergency treatment, his team focused on building long-term capacity. Qiang introduced standardized case discussions and surgical protocols adapted to low-resource settings. He mentored young Malagasy surgeons, teaching procedures such as thyroid, gallstone and colostomy operations -many of which had never been performed at the hospital before.

Across the two missions, Qiang carried out 4,323 surgeries, many representing "zero-to-one" breakthroughs for local facilities.

His contributions did not go unnoticed. In May this year, the governor of the Sava region awarded him a certificate of recognition for "exceptional and outstanding services". "These honors belong to all Chinese and Malagasy doctors,"Qiang said. "I was only doing what a doctor should do.

"A physician's duty is not only to cure disease, but to bring hope," he added. "My time in Madagascar taught me that every diagnosis is a renewed respect for life — never routine, always reverent."

The First Hospital of Lanzhou University has long participated in China's medical aid program to Madagascar. "The teams have relied on their clinical expertise to treat large numbers of complex and critically ill patients and to carry out high-difficulty anesthesia procedures and surgeries, significantly improving local capacity for the treatment of critical cases," said Liu Yatao, director of the hospital's office of international cooperation and exchanges.

He added that systematic training and hands-on mentoring have helped strengthen local medical capabilities and deepen China–Madagascar medical cooperation.