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PROJECT - Hospital ship ELPIS-African coasts and Madagascar

From the strong passion of a Sicilian non-profit organization, the idea of ​​a hospital ship was born for the populations that populate the African coasts. The circumnavigation of the continent was carried out from 2017 to 2019, touching different countries, and completely free health services were provided in each port. Gambia, Ghana, Sao Tome, Angola ... in every port where it was possible to stop, treatments, medicines and treatments were carried out. We as SMOModv have taken care of and take care of the dental part and it is an honor to participate in such a fascinating project. The ship arrived in Madagascar in the summer of 2019 where it is believed it will presumably remain operational until 2022, serving the northwest coast of the Grand Terre. These coasts, in fact so jagged and without access by land, are precisely the spring from which the idea of ​​a hospital ship was born. In fact, the same doctors have been collaborating with hospitals in Madagascar for over 20 years, but they cannot be reached by the populations of the northwestern coasts due to logistical difficulties. The Hospital Ship is the answer to this need.

Life on board flows between work and daily life, you have to cook, clean and be a doctor. A unique, indelible experience on which to reflect and throw yourself body and soul.

Mario Rosati

General objective

To improve the quality of life of the most isolated Malagasy coastal community.

Project actors

ELPIS non-profit hospital ship and Smom odv

Specific Objectives

  • Set up a dental clinic inside the ELPIS ship.

  • Send material and specialist volunteers.

  • Increase the available instrumental facilities, skills, operational protocols and patient accessibility to adequate care.


The population of the Malagasy coasts and the populations of the countries where the ship docked.

Needs Analysis

The Malagasy public and private health system does not allow adequate health care for the population which therefore, among the various health needs, has a high prevalence of oral disease. The logistical difficulties for travel and the economic difficulties of the population make medical care, and therefore also dental care, difficult and sometimes impossible. Poor urbanization and poor road networks make travel by land often impractical. Reaching certain areas becomes possible only by air where there are airports or by sea.


9th August. 10:45 am. The leap into the "void" has been made, all that remains is to touch up land on the equator line, in small Sao Tome. The worries that, for a few months now, had remained good on the sidelines in a corner of my head begin to become real. Now, as if someone had given them life, I hear them coming out insistently but, unexpectedly, even the greatest fears seem to have a smile.

The plane begins its descent, I attach my face to the porthole as if already from above I could get an idea of ​​what awaits us; as if the color of the earth, the number of houses or the type of car could give me a clue.

It is done, my feet touch the ground, the jump is no longer in the void but has a name, a thousand colors, scents, voices and smiles that hit me as soon as we cross the airport exit.

To welcome us there is Tiziano, our contact person on site. Quick introductions, two or three useful information and he entrusts us to his driver who, with expert guide in the "jump of the hole", takes us to the ship. The landscapes that flow from the window, due to the dark, I can see them in part. The sea is there but I have to imagine its color. After about forty minutes we begin to see some lights in the dark sea. It's the Elpis. Astigmatic eyes widen to focus it well, to see the details I love. Those ideas, anxieties, expectations are no longer alone in my head; they made room in the pit of the stomach, pleasantly accelerating the heartbeat. Can't wait to get to the dock. The last few minutes seem interminable but we are finally here. I open the door and smell the sea but at the same time also the waves, a bit "too noisy", crashing on the dock. The concern is pressing for this pitching of the much desired ship and I have confirmation, practically immediately, that I would have suffered for this. The first steps seem almost those of someone who has drunk one glass too much: awkward and clumsy. We know Jhon and Afful respectively sailor and captain, the guardian angels of our experience. Quick look at the different cabins: there is the kitchen, two bathrooms and the sleeping area. We enter, we put down our suitcases and I look for Francesco's gaze; I don't want to put it into words so as not to cause concern but it was enough to cross him for a moment and he said to me: "he moves too much". Worried, but a little relieved that I'm not the only one suffering from this, I go to bed. I close my eyes and the world seems to start spinning. There I understand that it would have been a little regenerating night and I fall asleep thinking of a possible solution; we have come here to work and this will not stop us!

It is almost six in the morning and to wake me up, in addition to the sunlight, is an indistinct shouting that seems very close. Intrigued, I lean out of the porthole and see about twenty fishermen with their pirogues all around the ship. I remain enraptured and I stop for a few minutes to look, then the stomach demands attention and this time it is not the emotion but simply seasickness. I get back down, then decide to get up. Francesco wakes up nauseated too, this worries me. We need a solution.

We took action immediately also thanks to the help of Tiziano who, with a lot of patience and availability, started looking for contacts to give us the opportunity to work in a local structure. Going into the hold to check the instruments and materials, we immediately realized that we would not be able to work accompanied by the continuous swaying of the ship.

The day passes waiting for authorizations, seasoned by the frustration of wanting and not being able to do, of not being able to help all those people who, as soon as they learned of our presence, rushed to the dock since the early hours of the morning. With the difficulty of those who do not speak the same language and the desolation that pervades us, we explain that we should have postponed the appointments to the following days.

It's Saturday afternoon, we finally breathe a sigh of relief, we have the permissions for the health center right there in the Neves district as well as a place to sleep on dry land. It seems that all the pieces finally go into place, all that remains is to move the necessary equipment and start.

We set up in the best possible way a small room without windows and not very airy, but we are so eager to get active that everything is fine for us. However, having not taken into account the proximity of the equator, we overlook the fact that the evening comes early, so we just have to return the next day to start.

Is Sunday. During the journey that leads from Tiziano's resort, where we spend the night, in the center of the village, we notice that the road, very populated in the previous days, is now practically deserted. We are told that Sunday for the locals is a sacred day dedicated to rest and religious events.

This news leaves us a bit dumbfounded, will people come? At the center the answer comes immediately and fortunately it is what we hoped for, the first patients are already in the waiting room.

Excited, we enter the small studio, overalls and go. Let's go.

The captain, now popular on the spot, has drawn up a waiting list and shows us the first patient. He sits down and we begin to test our Portuguese which, a little creaky, allows us to communicate and, finally, to start this adventure.

A few minutes pass and we already understand that it would not have been easy: the vacuum cleaner does not want to cooperate and to my great surprise, I discover that Africans have really well "rooted" teeth.

The day goes by quickly, we are hot and a little tired, I personally am also a little hungry. Francesco encourages me: "go on as long as we have pliers and levers, let's continue". I stretch my sore legs a little, take a deep breath, as if to gather all the energy left, and we move on. It is 6:30 pm, the sun begins to set and even more tired we head to the ship to sterilize the instruments, taking a stroll along the only street in the district. At the moment I can't describe what I feel, there are different emotions, some a little conflicting that pervade me. The partial satisfaction of having finally started to do something and the concern, mixed with frustration, for the tools available. What if tomorrow it won't work? What if we can't cure everyone?

These thoughts are blown away in a second, as soon as I look up and see a spectacular sunset from the dock. What a peace. It is painted on the sea and in our tired hearts.

Segunda-feira, we are now great experts in the local language and Mondays almost seem nicer said in Portuguese. The waiting room today is pretty full, we certainly have another busy day ahead of us but we are loaded. Time passes quickly, except for some more complex extraction during which it seems to stop. I remain with my gaze fixed on that forceps as if with it I could help Francesco extract that tooth. He is dripping with sweat but does not give up, I shudder and putting my atheism aside, I appeal to any god, divinity or alien entity that can help him. Anything. He doesn't want to know. He decides to perform odontotomy and osteotomy, now I also feel like an expert with these high-sounding terms, and after a few minutes she is done. Relief.

It was the last draw of the day, the patient was a boy of about twenty. After having placed some salivary rollers to stop the bleeding, Francesco goes out to take a breath of air asking the patient to stay a few more minutes. I start to put the instruments in place and I notice that the boy is getting up. I tell him to wait but without listening to me and above all without shoes, which everyone takes off as a sign of respect before sitting down, he runs away. I reach the door of the door, I look for Francesco and in a mixture of disbelief and concern I tell him that the boy has run away. He doesn't know what to say, a little bit of both of us want to smile but we decide to wait a few minutes.

Precisely three minutes later the boy reappears, he has a plastic bag in his hand with two cans of orange soda inside that he hands us. And with the help of Valdemiro, another friend of this trip, who translates a few words into French for us, we understand that they were to thank us for the effort and sweat.

A shiver runs down my spine, I feel my eyes fill with tears and I begin to smile without being able to stop. I thought about that gesture for hours and even all the following night, I felt in a way that was difficult to describe. Those two cans had cost a full day of work and he was handing them to us smiling, like a small trophy he was proud of. Faced with such a gesture, I felt small and immensely grateful.

And this is how Osvaldo decided to visit us every day, sometimes with a fruit as a gift, other times simply keeping us company along the way that took us to the ship. One thing is certain, there was no moment in this experience in which we felt alone, on the contrary ... Always in good company.

The days go by quickly, the patients alternate. We have almost become a war machine capable of facing any difficulty: from the lack of electricity to the most resistant tooth. Nothing scares us anymore. We are beginning to feel a bit ours too. We are amused when, walking down the street, we recognize the patients who greet us warmly, or we find them at the ship waiting for us just to chat, often using two different languages.

I like this place: it is alive, chaotic and very dusty but despite the great difference with my land, here I feel at home.

Last day.

I open my eyes and I already feel the weight of this departure. We don't work today, we go to the health center to take all the equipment back to the ship. During the journey that takes us there I try to look at the faces that cross my path, I want to memorize them all and I want to see someone I know. I want to be able to say hello to them all or maybe, actually, I never want to have to.

Even the captain realizes that we have become more taciturn, the sadness becomes palpable. Last look. It's all in his place. We can go. We get in the car, the suitcases are in the trunk. Everything is ready, only I am not at all. I wear sunglasses to hide the tears I can't hold back and I feel like I already miss this place. I close my eyes and refuse to look around me because I cannot see the small and laughing village moving away.

Yet another leap, this time not into emptiness but towards home with the African sickness in our hearts, which they seem to say, will accompany us throughout our life, or more simply until the next mission!

Technical Project Data







Project start



7 YEARS (renewable)

Project status


Project manager


Project Cost

€ 15,000

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