Announcements March 20, 2020

A letter from our co-founder, Robin Herrnstein, on our COVID-19 response

Dear PIVOT friends and family,

Like many of you, I woke up today to another day of social distancing on Long Island: five kids home from school, Jim working in the kitchen, and no outsiders in our house in nearly a week. I am tracking developments online and through friends in the global health community while simultaneously trying to get used to the idea that this may be our “new normal” for the foreseeable future.

As COVID-19 spreads in the US, PIVOT continues its operations in Madagascar while bracing for the almost inevitable impact of the pandemic. While drafting this letter, I was notified by our staff in Madagascar that President Andry Rajoelina has just announced the country’s first confirmed cases of COVID-19. We know that people in countries that lack strong public health systems and supply chains are particularly vulnerable, especially in populations where many are already immunocompromised by conditions such as malnutrition, tuberculosis, and diarrheal disease.


For the past several weeks, the PIVOT team has been working closely with Madagascar’s Ministry of Health to prepare for a national response and establish emergency measures in Ifanadiana District. A recent field report by our Chief Medical Officer, Dr. Alishya Mayfield, gives a great introduction to PIVOT’s perspective and initial approach to the challenge of COVID-19.

This week, in coordination with the government and implementing partners, we have procured 6,000 sets of personal protective equipment for staff and 7,000 COVID-19 testing kits, a large percentage of which we will donate to the capital to help them prepare for their response in a city of over a million people. In Ifanadiana District, we have additionally procured five oxygen concentrators and 1,500 N-95 masks. Our clinical teams are launching awareness-raising campaigns, preparing to conduct testing and contact tracing, and implementing protocols for treatment of patients who present with symptoms.

Furthermore, our strength in data and research is allowing us to contribute to the global understanding of COVID-19’s threat to vulnerable populations. We are using integrated modeling to forecast the disease’s spread, ready facility-based staff for potential surges, and develop early warning signs of an outbreak.

Amidst all of this preparation, we are careful to maintain daily operations that provide critical healthcare to the population we serve: screening and treating for malnutrition; providing social support to our most vulnerable patients; training community health workers; monitoring and evaluation of our programs and impact; and all the other services you’ve generously supported over the years.


Yesterday, PIVOT’s Board of Directors had a video conference to update everyone on our response to the pandemic. As we all joined the call, I learned one board member and his family are recovering from weeks of being sick with COVID-19 symptoms. I saw another board member wearing a mask in self-quarantine at home after having likely contracted the virus in Spain, and a third joined in full-body scrubs during a break from running a suspected COVID-19 unit in Boston. COVID-19 is real, it is close, and it is going to affect all of us in the weeks and months to come.

Despite the worry that comes with seeing members of my community facing this pandemic head-on, I found it reassuring to be surrounded by highly competent, thoughtful, and dedicated people who are working day and night to get ahead of what is yet to come. The collaboration between our staff, advisors, and peer organizations around the world demonstrates that there is a united and powerful movement to understand and mitigate the impacts of COVID-19 as fast as possible.


Now, more than ever, we need to be connected with you, our PIVOT community. We may be physically isolated, but it feels like our lives are more connected than ever before – we are seeing in real time how the actions of a person on one side of the globe can truly affect the health and safety of people half a world away. To this end, I have included below a list of ways to stay informed and connected to us during these times of uncertainty.

The strength of a community is best observed during times of stress. We are deeply grateful to have you in our community and hope you will stay engaged with us as we navigate this unprecedented event together as a global community.

In solidarity,

Robin Herrnstein
PIVOT Co-Founder


We aim to keep you informed about our response to the pandemic as it evolves. Here are a few ways to stay connected with us in the coming weeks:

  1. Follow us on social media @pivotmadagascar and explore our blog to learn about our work and the joys, hopes, and resilience of the communities we serve. You may also find it interesting to read a personal letter from our Executive Director, Tara Loyd to our New York supporters in response to the cancellation of a major annual fundraiser.
  2. Tune in to our upcoming “Voices from the Field” webinar next Wednesday, March 25 at 12:00pm EST. We will host a live discussion with PIVOT leadership to share more about the current situation in Madagascar and our response to COVID-19. You will have the chance to ask our staff any questions you have about our patients in Madagascar or the pandemic more generally.
  3. Make a donation to support PIVOT and help us ensure we can continue delivering essential health services to vulnerable communities in Madagascar while supporting the nation’s response to the COVID-19 crisis.