Built in 1965, Manakara Regional Referral Hospital in the capital of Madagascar's Fitovignany Region is the primary hospital for Ikongo, Vohipeno and Manakara Districts. Here, doctors perform a variety of surgeries, treating everything from trauma related to road accidents to performing cesarean sections on expectant mothers.

But with peeling painted walls and exposed electrical cables, the hospital is starting to show its age.

"The first problem is infrastructure. The operating room has not been renovated for decades," says Dr. Prosper Randrianasolo, Head of Manakara Regional Referral Hospital. "The old operating tables, for example, are dilapidated, rusty and unstable, with jammed mechanisms and torn mattresses, making them unusable and unsanitary."

With corridors and rooms empty of much-needed equipment, the hospital struggles to provide care for the 300,000 people it serves. What equipment the hospital does have is often as old as the hospital itself.

The need for adequate equipment for the hospital to perform emergency surgery and provide other vital health services was urgent.

As part of two World Bank-financed projects implemented by the government, UNOPS procured medical and operating equipment and supplies for Manakara Regional Referral Hospital, one of more than 1,120 health facilities that received medical equipment.

Just two hours after a new operating table was installed at the hospital, Jacquis Razaiarimanana – pregnant with her second child – was rushed to the operating room.

"I had high blood pressure," says Jacquis. "So the surgeon decided to induce labour by cesarean section."

The operation went well – and the hospital welcomed a baby girl.

The new operating tables mark the beginning of a new era for surgical care in some of Madagascar's most remote regions.

“The new equipment in health facilities strengthens the health system in Madagascar, improving the quality of care and the well-being of the entire population,” says Emmanuel Tchokodjeu Kouemo, UNOPS Health Project Manager in Madagascar.

As part of the Pandemic Preparedness and Basic Health Services Project and the Nutrition Improvement Project – financed by the World Bank and implemented by the Ministry of Public Health's Project Coordination Unit – UNOPS procured and delivered medical equipment to 23 hospitals and 1,120 health centres across Madagascar as well as provided training on how to use and maintain the equipment.