Sri Sathya Sai International Organization

Selfless Service at Madagascar - A Path to Self Realization

Transformation Through Love - An Offering for the Centenary Birthday of Sri Sathya Sai Baba

With profound gratitude to Bhagawan Sri Sathya Sai Baba, we are humbled to present this report on the Madagascar Medical Camp held from 21 to 25 April 2025. The camp was organised under the banner of the Sri Sathya Sai International Organization (SSSIO) as a humble offering of love and service to the people of Madagascar. Rooted in the principles of Sai Ideal Healthcare - free, universal, and compassionate - the camp aimed to provide high-quality medical care to underserved communities while fostering unity, spiritual upliftment, and transformation among all who served and received.

Sacred Preparation and Divine Guidance

This sacred mission was the culmination of months of preparation, beginning as early as December 2024, and was carried out under the loving guidance of our beloved Swami, who brought together His children from across the globe to serve those most in need.

A United Global Team

The camp brought together a united force of 185 volunteers, comprising an international team of 55 members—35 healthcare professionals and 20 general volunteers—from Zone 1 (Canada and USA), Zone 3 (Australia and New Zealand), Zone 6 (UK), and Zone 9 (Botswana, Mauritius, UAE). This was powerfully complemented by a local team of 130 members from Madagascar and Mauritius, coordinated by the local organisers. The local team included 47 healthcare professionals, 37 interpreters, and 46 general volunteers. Volunteers of all age groups, including enthusiastic and capable young adults, played an active role across all areas of service, bringing fresh energy and a spirit of dedication.

Our healthcare team comprised specialists across a wide range of disciplines: General Practice/Family Medicine, Paediatrics, Gastroenterology, Cardiology, Obstetrics & Gynaecology, Surgery, ENT, Physiotherapy, Pain Management, Dentistry, Ophthalmology (Optometry), Nursing, Laboratory Services, and Pharmacy.

Support from general volunteers was crucial, covering roles such as interpretation, crowd control, registration, cooking, media, transportation, and cleaning. Of special note was the kitchen seva team, which included devoted members from Mauritius, who worked tirelessly to provide hearty meals for the entire group—a true demonstration that the strength of the camp lay in the wholehearted participation of every volunteer, regardless of the task.

The groundwork for the camp was solidified through the exceptional coordination and support of the host team, SSSIO Madagascar, under the leadership of Br. Krishna Rambojun, National Council President of Madagascar.

A wide range of diagnostic and treatment services were provided during the camp. Testing facilities included routine blood investigations, eye examinations, ECG, ultrasound, echocardiograms (ECHO), and gynaecological screenings for cancer, where indicated. Treatment services were equally comprehensive and included free dispensation of medications, minor surgical procedures (such as excision of lumps and bumps), dental extractions, wound debridement and dressings, physiotherapy, and the distribution of mobility aids and other essential supplies.

Pre-camp Outreach

In the morning of 19 April, Dr. Ramadevi conducted an EASE workshop at the Sai School in Antananarivo, touching the lives of 250 children and parents.

Late afternoon on 19 April, an insightful orientation session was held for local healthcare professionals, where the core principles of Sai Ideal Healthcare were shared by Dr. Ramadevi (Co-Chair, International Medical Committee), Dr. Dinesh (Co-Chair, International Medical Committee), Dr. Yatish (Member, International Medical Committee), Dr. Sunil (Zone 9 Medical Director), Br. Ankur (lead Pharmacist) and Dr. Hasit (GP).

On Easter Sunday on 20 April, the team members proceeded to set up the campsite

Later that day, we visited the Sai Center in Antananarivo, where we conducted a feeding seva for 400 children, followed by a heartfelt team meeting with bhajans and prasadam. It was a beautiful spiritual curtain-raiser to what was to come.

Daily Operations and Logistics

The camp commenced on Monday 21 April.

Each morning during the camp, our international team departed the hotel by 5.45am in three coaches, eager to begin the day’s service.

It was humbling to see that patients had begun queuing as early as 3am, and on the final day, many had waited overnight from 6pm, demonstrating their eagerness to be seen by the medical team. The crowd management team played a vital role throughout, patiently engaging with the waiting patients, monitoring the flow, and regularly coordinating with the medical team to ensure patients were allowed to trickle through in an orderly and compassionate manner.

Camp Locations and Support

Following recommendations from the Ministry of Health, the medical camp was held in two interior locations in Antananarivo, both Catholic schools identified and arranged by SSSIO Madagascar. The respective Mayors extended full cooperation, facilitating local announcements and security arrangements. The first two days were held at Ecole Catholique de Fiombonana St Vincent de Paul, Antananarivo. The next three days were held at Ecole catholique d’Andoharanofotsy St Pierre Malaza, Antananarivo.

Patient Turnout and Statistics

Over the five-day period, a total of 6,633 patients were seen – the highest number recorded in any of our weeklong medical camps – made possible by the large and dedicated team that supported the camp. Many of these patients received consultations across multiple disciplines, resulting in over 20,000 individual consultations delivered across the camp’s various medical, surgical and diagnostic services. The daily patient attendance was as follows:

• Day 1:    980 patients
• Day 2: 1,193 patients
• Day 3: 1,438 patients
• Day 4: 1,563 patients
• Day 5: 1,459 patients

It was both humbling and heartbreaking to witness that, for some, this was their first time seeing a doctor—aside from occasional immunizations at local health centers. In addition to medical consultations, the camp offered a wide range of services including blood tests, malaria screening, ECGs, ultrasounds, ECHOs, and cancer screening where indicated. Patients also benefited from minor surgical procedures (such as excision of lumps and wound care), dental extractions, physiotherapy and pain management. Essential treatments were complemented by the free distribution of medicines, optical glasses, dental kits, and hygiene kits to selected patients/families. To ensure a warm and caring environment, biscuits were distributed to children accompanying patients in the waiting areas, bringing moments of comfort and joy amidst the long hours of waiting.

Medical Teams, Services Provided and Medical Observations

General Medicine

Regarding the medical diagnoses, our doctors encountered the following cases: Hypertension, Heart failure - chronic and compensated, cardiomyopathies, strokes with residual deficits, diabetes both insulin and non-insulin dependent, anaemia, Protein-Calorie Malnutrition, dehydration, pain abdomen, GERD, constipation, diarrhoea, chronic arthritic pain, few cases of suspected tuberculosis, HIV, metastatic cancer, polycythaemia, some alcohol, social stressors with effects on mood and behaviours, scabies, skin fungal infections - tinea, acne were some of the conditions encountered. Certain cases of Abdominal pain were investigated with ultrasound to exclude malignancies. A few patients with GIT alarm symptoms were referred for further evaluation.

Reflections

Cardiology

The cardiology team of 3 Cardiologists provided critical diagnostic support through daily echocardiograms and electrocardiograms (ECGs), performing an average of 7 to 9 of each test per day.

The echocardiograms revealed no cases of coronary artery disease, but a significant number of patients exhibited left ventricular hypertrophy (LVH) - a condition commonly associated with longstanding, uncontrolled hypertension. A few patients were also diagnosed with dilated cardiomyopathy, presenting with severely reduced heart function. These findings were instrumental in tailoring treatment plans on the spot.

Similarly, the ECGs revealed abnormal heart rhythms and further cases of LVH, confirming clinical suspicions and enabling more targeted management.

Both diagnostic tools played a vital role in enhancing the quality of patient care, giving physicians greater insight into each patient’s cardiac status and allowing for more confident and informed medical decisions.

Among the patients seen was a young individual diagnosed with dilated cardiomyopathy and severely reduced cardiac function. The prognosis was poor. After the camp, the SSSIO Madagascar team helped coordinate further investigations to explore potential treatment. Sadly, the patient did not survive. In a spirit of loving support, SSSIO members assisted the family with funeral expenses. This case was a poignant reminder that our seva extends beyond clinical care—it is about standing with others in their most difficult moments.

Paediatrics

Across five days, the Paediatric team of 4 Paediatricians collectively saw hundreds of children, many of whom were receiving medical attention for the first time. The cases reflected the burden of preventable and manageable conditions that persist due to limited access to healthcare, malnutrition, poor hygiene, and extreme poverty.

The most common conditions across the camp included:

• Allergies, asthma, and other respiratory illnesses
• Diarrhoea, dehydration, and malnutrition (including severe protein-energy malnutrition)
• Skin infections (scabies, tinea, eczema), seizures, cerebral palsy, and developmental delays
• Ear infections (including foreign bodies), otitis media, and sinusitis
• Dental caries and poor oral hygiene
• Behavioural issues and undiagnosed neurodevelopmental conditions
• Down’s syndrome and congenital anomalies such as cleft palate, nodular nevus and undescended testes

A significant number of surgical cases such as inguinal hernias, umbilical hernias, hydroceles, and traumatic injuries were identified, several of which were referred for inpatient care or future surgical consideration. Individual paediatricians reported seeing between 150–200 patients each over the five days, with at least 12 documented referrals made per doctor, including urgent surgical cases and complex medical conditions.

Additional Observations and Reflections

In addition to the high burden of common conditions, the paediatric team encountered several complex and emotionally striking cases. These included children with gross obstructive hydrocephalus, post-surgical complications (e.g., a boy with urethral damage post-circumcision), and a 4-week-old with hypoxic-ischemic encephalopathy requiring nasogastric feeding. A 6-year-old girl with deafness was found to be excluded from school due to affordability, while many children with cerebral palsy and seizures had no access to physiotherapy or long-term medication. One child presented with ophthalmic shingles, successfully treated through collaborative sourcing of acyclovir.

Issues of maternal mental health and misinformation were also evident, with one case involving a grandmother feeding tea to a 2-month-old due to the mother’s likely postnatal depression. Dietary education was provided where possible, including referrals for free RUTF supplies for malnourished children. Vitamin A deficiency was suspected in a child with night blindness.

The team strongly reflected on the need for long-term systems of care – particularly for conditions requiring regular medication (e.g., epilepsy, asthma, and allergy), access to assistive devices (wheelchairs, hearing aids), and nutritional supplementation. They also noted the need for on-site diagnostics such as chest X-rays in future camps.

Recommendations from the Paediatric team

The Paediatric team collectively proposed several important initiatives, which are yet to be discussed and will be organised in collaboration with the host team – some of which they have already been engaged in over the years.

• Surgical Camp: A follow-up paediatric surgical camp within the next six months, focusing on hernias, hydroceles, cleft palate, and other operable conditions. This would require pre-surgical nutrition support and collaboration with a local private hospital.
• Chronic Care Clinics: Establish alternating weekly epilepsy and asthma clinics at the Sai Clinic to ensure continuity of care for children with chronic conditions.
• Health Education: Regular health screening and hygiene education in schools, focusing on dental care, handwashing, and scabies prevention. Incorporating “Sai Protein Balls” could address malnutrition on a sustained basis.
• Dental Hygiene Campaign: Given the widespread poor oral health, an intensive yearly dental education program is recommended, supported by local schools and public health workers.
• School and Community Engagement: Adopt local schools for long-term preventive health engagement, including regular screening (hearing, vision, dental), and community outreach.
• Capacity Building: Train local nurses and physicians in basic paediatric care through initiatives like EASE, with possible telemedicine support from overseas paediatricians.

The paediatric team expresses profound gratitude for the opportunity to serve and stands ready to contribute further, not just in future camps, but in building sustainable, long-term healthcare solutions for the children of Madagascar.

Reflections from Paediatric team

Gynaecology

The gynaecology team was both busy and highly productive, conducting an estimated 200–250 consultations daily between the two gynaecologists. They were ably supported by a local trainee doctor undergoing training in Obstetrics and Gynaecology. The team provided him with close supervision, guiding him through patient assessments and discussing management plans as needed, thereby contributing to his clinical learning and development.

Key services included pregnancy assessments, made possible through the use of a portable ultrasound machine brought from Botswana — an invaluable tool in the field setting.

Many expecting mothers, who had not seen a doctor since the beginning of their pregnancy, were provided with nutritional supplements covering three to six months. Commonly diagnosed conditions included ovarian cysts and uterine fibroids. The team also carried out Mirena coil insertions, which were especially effective and well-received by patients.

Gynaecological ultrasound scanning was instrumental not only in detecting fibroids and ovarian abnormalities but also in identifying cases of ovarian cancer. They served to reassure patients who had previously been misinformed by external scan reports — correcting misinformation and offering clarity. Many patients requested unnecessary scans, which was quite challenging to manage within availability time. Tragically, several advanced cases of breast, cervical, ovarian, and uterine cancers were diagnosed and referred to local hospitals for further management. Consultations also addressed issues of secondary infertility, with advice provided on further diagnostic steps.

Reflections
 

Surgical

The surgical team of 3 consulted between 30 to 50 patients daily and carried out approximately 7 to 15 procedures per day, including 6 to 7 minor operations and 7 to 8 joint injections. Our surgical team performed the following procedures: reduction of shoulder joint dislocation, removal of a loose body from knee joint, ⁠excision of ganglions from multiple sites, excision of lipomas from multiple sites, excision of sebaceous cyst from multiple site, ⁠tongue tie release, excision of ingrowing toe nail, and various joint injections. Each day, they saw 4 to 5 children with congenital hernias and 6 to 7 cases of multinodular thyroid goitres. In addition, they managed three cases of advanced breast cancer and one patient with multiple neurofibromatosis.

Overall, the surgical team was well equipped to manage a range of minor surgical procedures with efficiency and confidence, supported by ample consumables and reusable instruments. For future camps, there is an opportunity to further streamline inventory planning to enhance cost -effectiveness and logistical coordination. Additionally, exploring the option of partnering with a local hospital to access operation theatre facilities for a day or two could allow the team to broaden the scope of surgical care and further amplify the camp’s impact.

Emergency Care

A 4-month-old infant in respiratory distress was brought to the camp and received nebulisation care over two consecutive days. With appropriate medication and monitoring, the baby’s condition stabilised—fever subsided, vital signs normalised—and she was safely discharged.

A middle-aged woman who had met with a road traffic accident just outside the camp site was rushed in with acute pain in her right shoulder. An on-site orthopaedic surgeon diagnosed a shoulder dislocation, successfully performed a reduction, and the patient was referred to a hospital for further evaluation and care.

In another incident, a young man collapsed while waiting in the queue and was brought into the camp unconscious. Upon assessment, the general physician discovered critically high blood sugar levels. It was determined that the patient was a type 1 diabetic who had been unable to afford insulin. After stabilising his condition, the team provided a sufficient supply of insulin and offered comprehensive health education. The patient was then referred to the local Sai Clinic for ongoing management of his condition.

Dental

The dental team comprised five dedicated members who worked tirelessly throughout the camp. Over the five days, they saw approximately 300 patients per day and carried out an impressive 375 to 400 tooth extractions daily. Given the high demand and the nature of presenting complaints, the focus was solely on extractions during the camp. The team’s efficiency and commitment ensured that hundreds of patients received much-needed relief from long-standing dental pain and infections.

Physiotherapy

The physiotherapy team of 2 Physiotherapists played a vital role in restoring comfort, mobility, and independence to many patients struggling with physical limitations. For some, it was the first time they received support to help them move with greater ease and dignity. The following assistive devices were thoughtfully dispensed, bringing relief and renewed hope to the recipients:

• Wheelchairs - 4
• Walkers - 12
• Front-wheel walkers - 3
• Standard canes - 25
• Crutches - 15 pairs
• Knee braces - 14
• Gel shoe inserts - 12 pairs
• Wrist braces - 2

These seemingly simple items made a profound difference in the lives of patients – enabling them to walk with support, move more freely, or regain basic functionality that had been lost for years.

Reflections

Pain Management

This department remained very busy throughout the camp. As with all other departments, it handled a steady flow of patients and delivered impactful care.

Reflections

ENT

The ENT team, composed of two ENT surgeons, attended to approximately 200–250 patients daily. The most common complaints were related to allergic rhinitis, with many patients presenting with deviated nasal septum (DNS). Otitis externa and otitismedia were also frequently seen, some of which were chronic—likely due to poor adherence to previous antibiotic treatments. Health education was provided where appropriate.

The team also observed:

• Around 30 patients presented with thyroid Balakrishnan Raju, many of whom were seeking surgical intervention.
• Several cases of chronic suppurative otitis media (CSOM) or tympanic membrane perforations were identified.
• A number of patients showed signs of tonsillar hypertrophy and chronic tonsillitis, with interest in surgical options.
• Few patients presented with hearing loss or significant sinusitis requiring advanced ENT intervention.
• Relevant cases, including those requiring surgical management for DNS and tympanic membrane perforation, were referred to higher centres for appropriate follow-up.

Reflections:

Eye

The Madagascar Medical Camp 2025 Eye Department consisted of 6 optometrists – 3 from the international team and 3 from the local team, supported by 4 volunteers from the international team and several local interpreters.

The Eye Department team and their patients were happy with the way things went throughout the camp and great results were achieved. With the majority of patients, the optometry team performed visual acuity and binocular refraction to work out what glasses could improve vision at both distance and near. 

Over the 5 camps, a total of 2,004 patients were seen and 2,088 optical glasses (with some patients receiving more than one pair based on their requirements) and 1,000 sunglasses were handed out to patients.

Case

“A 12 year old boy was referred to me for his first ever eye test from triage as he could not see the board at school and was getting very itchy eyes.

• His unaided visual acuity was 6/30 right and left.
• His ocular health revealed a sign of mild bilateral allergic conjunctivitis and
• The portable autorefractor confirmed that he had mild bilateral myopic astigmatism

Reflections
 

Pharmacy

177 boxes weighing 2.129 tonnes of medicine and medical supplies were procured from India, with urgent or bespoke items sourced locally during the camp.

A summary of the top medication that were used during the camp are set out below:

• Ibuprofen
• Paracetamol
• Omeprazole
• Multivitamin tab, syrup
• Iron syrup, tab
• Diclofenac Gel
• Doxycycline
• Amoxicillin
• Metronidazole.
• Cetirizine tablets, liquid
• Steroid Nasal Sprays

The pharmacy team didn’t see much of antimalaria, diabetic and deworm prescriptions as the other camps.

Remaining supplies relevant to the clinic’s needs will be utilised in the permanent Sai Clinic in Antananarivo.

Reflections

Nursing Services

The nursing team played a central role in ensuring smooth patient flow and comprehensive pre-clinical care. After initial screening, patients were assessed for vital signs, weight, and blood sugar levels. Nurses also took patient histories and coordinated referrals to the appropriate doctors. Volunteers supported the process by guiding patients to the assigned consultations.

Beyond their core responsibilities, nurses stepped in to support other departments as needed. They assisted in the eye clinic during periods of high patient volume and supported the dental team with medication preparation. The nursing team also collaborated closely with the pharmacy to help distribute medications efficiently.

Furthermore, nurses worked alongside our cardiologists and emergency medicine doctors, providing essential clinical support. Basic laboratory work and testing were also conducted by the team, ensuring a holistic and responsive approach to patient care.

Laboratory Services

The following tests were provided during the medical camps as point of care diagnostic tests: HbA1c, cholesterol tests, haemoglobin test, malaria testing for different strains, blood glucose and white blood cell differential test. These tests helped with the diagnosis of conditions such as anaemia, or diabetes and malaria. These were performed on both adults and children. 

Aradhana Day Devotion

On 24 April, Aradhana Day, the team gathered at the Hindu Samaj after the camp to offer bhajans in devotion to our beloved Swami. A group song offering of “Humko Tumse Pyaar Hai” brought the collective seva spirit into musical expression, followed by reflections, Arathi, and Mahaprasadam.

Heartfelt Closure and Acknowledgements

The camp officially concluded on 25 April with a closing dinner, during which IMC Co-Chairs Dr. Ramadevi and Dr. Dinesh, Zone 9 Medical Director Dr. Sunil Kadiyala, NCP Madagascar Br. Krishna and IMC Secretary Sis. Urvi extended heartfelt thanks to all participants for their tireless service, both in person and through generous financial contributions. This camp would not have been possible without them.

Post-Camp Outreach

On 26 April, Dr. Ramadevi and Dr. Hari conducted a second EASE workshop at the High School Library, in partnership with LIME’s Club. This outreach engaged 10 college and high school students, planting seeds of compassionate service in the next generation.

Reflections

• RAMAHAFINARITRA Fitahiana Anjara Fanomezana (LIME cohort 14):
  “I learned new things like we must eat responsibly, and we must do exercises every day because it is good for our health. The session made me feel comfortable and I could express myself even if I am a little bit shy. I am very satisfied because I learned a lot and Dr. Ramadevi and Conjeevaram are really kind and sociable. If there was another session like that, I will surely attend it.”
   
• NATSIRISOLONIAINA Lahiniriko Jean MARCELLIN (LIME cohort 9):
  “I have learned how to exactly be wealthy physically, emotionally, mentally and socially. It helped to realize that my wellbeing is important not only me but also for my community. If I give a rank from 0-10 of how satisfied I am…I’d say a straight 9. I only wish we had more time to continue the session as I still had a lot of questions to ask. If there is another session like “EASE into health,” I would definitely attend it again, because I really liked it.”
   
• Lundie Marielas Z. Tonie (LIME cohort 13):
  “Thanks to Dr. Ramadevi and Conjeevaram, I became more aware of the relationship between health and social life. I have learned that by simply taking care of oneself, we can inspire others and therefore contribute in creating a better community and environment for all. So, that drives me to do the right thing all the time. ‘When I am bad, I am sad.’ That simple statement touched my heart so deeply. It emphasizes the importance of taking responsibility for one’s own emotions and actions. That entails that we should do more good deeds to everyone, because it can make us happier and healthier.”

Strengthening Local Healthcare Services

As mentioned in the report earlier, remaining supplies pertinent to requirements in the clinic will be utilised in the permanent Sai Clinic in Antananarivo.

In addition to the recommendations set out in this report, we have also requested the host team to plan for a five-day a week permanent clinic – expanding from its current two-day a week format – to better serve the local community. Given the large number of paediatric patients seen during the camp, we proposed the hiring of a dedicated paediatrician given the high number of children treated. The host team is currently considering this recommendation.

The host team is also helping us manage any cases referred during the camp, for long term solution.

Gratitude

While the camp was a resounding success, we acknowledge that no effort is without scope for improvement. The reflections gathered from team members will guide us in refining future camps.

We remain deeply grateful to you, the Sri Sathya Sai World Foundation, and all our donors for your steadfast support. The final camp costs are currently being consolidated, as some unexpected medical needs required additional spending. A full financial report will be shared within the month.

We extend our heartfelt thanks to all participants – for their time, dedication, and loving service – both in person and through generous financial contributions.

Above all, we recognise that it was Swami’s divine grace, love, and invisible hand that made every detail of this camp possible. From uniting teams across continents to easing the suffering of thousands, His presence was felt at every step. We bow our heads in love and gratitude to our beloved Sai.

In Gratitude to Our Beloved Swami

As we reflect on the journey of this sacred medical camp, we are reminded that every act of service was not merely a task fulfilled but a prayer in motion – offered at the divine lotus feet of Bhagawan Sri Sathya Sai Baba. May He continue to guide, inspire, and bless all future endeavours in His name. This mission, as an offering to His 100th Birthday, was made possible only through the invisible Hand of our beloved Bhagawan Sri Sathya Sai Baba. He orchestrated every step—from uniting the right people, to ensuring every patient received care, to uplifting every heart that served. We offer this humble effort at His Lotus Feet with boundless love. We remain instruments in His hands, ever grateful for the opportunity to serve.

Madagascar Medical Camp Team
Love all, Serve all Help ever, Hurt never