The outside medical evacuation for cancer from Madagascar

Abstract

In developing countries, particularly Madagascar, the management of cancer is hampered by the unavailability of certain technical platforms, making resort to outside medical evacuation. Our goal was to describe the requests of outside medical evacuation for cancer in order to make an inventory of the missing technical platforms in Madagascar in terms of oncology. This was a retrospective cross-sectional descriptive study conducted from 1St January to 31St December 2012 at the Department of the Hospital System of the Ministry of Public Health: the only institution authorized to grant outside medical evacuation in Madagascar. We have included all cases filed and excluded non-oncological cases. We retained 25 requests for outside medical evacuation for cancer. The mean age of the patients was 45.12 +/- 18.11 years and the sex ratio was 0.47. The majority of patients lived in the capital. Metropolitan France and Reunion Island were the most popular evacuation sites. The most common clinical situations were breast cancer waiting for adjuvant treatment (36%), lymphomas waiting for second line treatment (8%) and brain tumors waiting for initial treatment (8%). The required technical platforms were mainly radiotherapy (52%), specialized investigations (20%) and some specialized surgeries (16%). Radiotherapy was the main lacking platform in Madagascar in term of Oncology in 2012. The optimal use of existing structures and/or the construction of new infrastructure could reduce outside medical evacuation.

Keywords

• cancer
• medical evacuation
• madagascar
• technical platforms