Illness and injury happen both at home and abroad. One of our goals in preparing you to serve as a Volunteer is to help you understand the health risks of the country where you will serve.
The health of Volunteers is a key priority of the Peace Corps. Volunteers are given information on country-specific health concerns and trained in health risk prevention during pre-service training.
Each country maintains a Health Unit with Medical Officers who handle Volunteers' primary health care needs, including evaluation and treatment of most medical conditions. Upon your arrival in-country, the Medical Officers are available to provide health care services, mostly through telemedicine. The Peace Corps Madagascar Health Unit is in Antananarivo, the capital city, which is approximately a 3 hours’ drive from the Peace Corps Training Center. PCVs’ sites will be located from a few hours to up to 2 days travel from the capital using public transportation. The only vetted reference hospitals are in Antananarivo. The Health Unit will provide you with a country-specific health handbook and a medical kit with basic medical supplies to treat mild illnesses and injuries. The Peace Corps will restock your medical kit with supplies as needed throughout your service. Your prescription medications will be ordered for you during pre-service training and provided throughout your service, but these medications may take several months to arrive. Therefore, the Peace Corps requests you bring at least a three-month supply of your prescriptions and other specific medical supplies to use during your initial months in-country.
During service, there is always a Peace Corps Medical Officer on duty 24/7 who will coordinate and manage your medical concerns. You are always free to contact them by phone, text message, email, or in person if you have a physical, emotional, or other problem that relates to your health or well-being. Most concerns are initially managed via telemedicine, but in-person visits will be recommended for certain acute illnesses or for follow-up on chronic diseases. You will have physicals at mid-service and at the end of your service, and can be seen by your Medical Officer on an as-needed basis. Limited medical care is available at some regional health care facilities at the authorization of a Medical Officer. In case of an emergency, PCVs will be transferred to the most appropriate regional community medical facility while PCMOs are arranging for a medical evacuation to the capital. Community medical facilities located outside of the capital are very basic and do not meet U.S. standards for handling serious illnesses or injuries. Domestic medical evacuation (from site to the reference hospital in the capital) can take up to 48 hours given the size of the island and its limited emergency medical resources and transportation infrastructure.
If you develop a serious medical problem during your service, the Medical Officer will consult with the Office of Health Services in Washington, D.C., or a Regional Medical Officer in Pretoria, South Africa. If you cannot receive the care you need in-country, you will be transported to a Peace Corps-approved regional medical facility or to the United States. International medical evacuations to our medevac hub in Pretoria, South Africa, or to the United States can take up to 48-72 hours while you are being treated and stabilized in one of the vetted reference hospitals in the capital and under the supervision of the Medical Officer.
Given the low quality and availability of healthcare resources outside the capital, and the potential delays in care related to the limited transportation infrastructure and logistics of medical evacuation, it will be incumbent on all Volunteers to play an active role in maximizing prevention and following health care guidance to ensure their safety and health.