Mali

A combination of factors makes access to healthcare difficult for Malians, including cost, the distance people live from health centres and, in the northern part of the country, the nomadic lifestyle. Malaria is a leading cause of death in children under five years old, and the maternal mortality rate is high.

 

Throughout 2009, MSF provided general healthcare, treatment for malaria and obstetric fistulas and nutritional support to children.

 

Malaria
Teams work in the Kangaba region in southern Mali, where malaria is most prevalent. MSF supports 11 health centres and mobile teams, including 66 ‘malaria village workers’. These people are trained to detect and treat uncomplicated malaria in children in remote villages during the rainy season. Workers also learn how to recognise signs of severe malaria so they can refer the more serious cases to health centres.

 

In 2009, MSF carried out more than 118,000 consultations. 60,000 people were treated for malaria and more than 1,150 patients were hospitalised for severe malaria. Early detection kept the number of people needing hospital treatment relatively low. 

 

Measles epidemic 
MSF responded to a measles epidemic in the north of the country by providing treatment in remote villages in the Timbuktu and Gao regions. The most severe cases were referred to MSF centres, where more than 2,800 patients received care.

 

Although the number of infected people had already surpassed the epidemic threshold, MSF carried out a vaccination campaign in the Timbuktu region in collaboration with the Ministry of Health in order to prevent the disease spreading further. More than 322,000 children between six months and 15 years of age were vaccinated.

 

Fistula operations

In the northeast regions of Timbuktu and Gao, MSF treated women for obstetric fistulas. These are common in remote regions because there are few hospitals and therefore little access to Caesarean section operations. They occur during childbirth when complications leave those who survive with permanent injuries to the birth canal. They can lead to chronic leaking of urine and/or bowel waste and women who suffer from the condition are often socially isolated and treated as outcasts.

 

In collaboration with the Timbuktu regional hospital and the Gao regional hospital, MSF operated on more than 80 women.

 

High infant mortality rate

According to a 2006 study by Enquete Démographique et de Santé du Mali, one in four children die before reaching the age of five in the southeastern region of Sikasso. More than 40 per cent of the 120,000 children in the region suffer from malnutrition, and high levels of infant malaria also contribute to this statistic. Diarrhoea and respiratory infections are also common and cause numerous infant deaths.

 

In collaboration with the Ministry of Health, MSF launched a medical and nutritional programme in 2009. MSF supports five health centres with supplementary staff and provides medicines and therapeutic food. Children requiring hospitalisation are transferred to Koutiala hospital where a Paediatric Intensive Care Unit and a Therapeutic Feeding Centre have been set up.

 

Between July and December more than 22,300 consultations were carried out in the health centres supported by MSF. Two out of three children were treated for malaria, 3,200 children were treated for severe malnutrition and more than 1,100 children were hospitalised.