Conflict and climate crisis have led to a dire humanitarian emergency in Mali

Mali, a land-locked country in West Africa, has been struggling with ongoing conflict and climate crisis. With social indicators among the lowest in the world, the country ranks 184 out of 189 on UNDP’s 2019 Human Development Index. Since 2012, the conflict has affected millions of civilians, with the violence further escalating since 2018. Two coups d’etat also took place in 2020 and 2021 further destabilizing the area. 

The culmination of which has triggered mass displacement, socio-political instability, climate shocks, epidemics and unprecedented levels of food and nutrition insecurity. About 1.5 million people have fled their homes since 2012, some of them several times. 

Human Right Violations 

As the conflict continues, the number of serious human rights violations are rapidly escalating. Over 3.9 million people require protection assistance in 2023, as serious human rights violations, including sexual violence, have increased. Violent attacks by armed groups on civilian populations are frequently reported throughout most of the country. As a result, an estimated 8.8 million people (42% of the total population) require humanitarian assistance in 2023 – up from 7.5 million in 2022 and 5.9 million in 2021.

Food Insecurity 

The insecurity due to the conflict, combined with erratic rain patterns, are the main causes behind the food insecurity crisis. In 2023, 1.2 million people will require urgent food assistance during the lean season between harvests. 9 out of 10 Malians affected by hunger are in rural areas, where people need urgent assistance to protect and revive food production. Children are especially at risk during this period, and currently 367,000 children under 5 are suffering from severe acute malnourishment and are in need of urgent assistance. This is a 16% increase since 2022. 

Access to Healthcare 

The conflict, instability and poverty in the region have also badly affected the population’s access to healthcare. In the north and center of the country, 1 out of 5 health centers are not functioning, while the remaining ones are only partially functional due to lack of staff and insecurity.

Doctors of the World Action in Mali

The humanitarian situation in northern Mali is marked by a climate of conflict, food insecurity, extreme poverty and global warming. As a result of armed clashes, thousands of people are moving to other, safer areas. Doctors of the World has been working in Mali for twenty years, supporting health structures to improve access to free healthcare for people affected by the crises in the north of the country. Below are some of the programs that we are currently running in the country. 

PROJECT NAME: Children and young people on migration routes in North and West Africa

Several countries in North and West Africa are struggling with similar situations to Mali, leading to mass migration throughout the region. Out of an estimated 40 to 45 million international migrants, over 5 million are children and young people aged 0 to 24. Extreme poverty, flight from violence, political instability, conflict, and numerous other factors cause children and young people to flee their home countries and move, in search of a better future. However, migration, especially through areas experiencing insecurity and conflict, can be incredibly risky and can lead to trauma and harm. Many experience a deterioration of physical and mental wellbeing throughout their journey as well as in the country of arrival.

At Doctors of the World, our goal is to strengthen the protection and health resilience of children and young people along migration routes. Our health program encompasses primary care, sexual and reproductive care (including combating sexual violence) and mental health support. We facilitate access to health care for children and young people, and raise their awareness of hygiene so they can stay healthy throughout their migratory journey. We also carry out in-depth work with communities to change society and politics over time.

PROJECT NAME: Medical and nutritional support for the affected populations in the Gao and Menaka regions

Northern Mali is characterized by drought, political instability, growing insecurity, poor access to healthcare and a lack of qualified medical staff. In particular, we observe that many pregnant women are not monitored during pregnancy, nor assisted during childbirth. We also have seen that healthcare is even less accessible for nomadic populations and internally displaced persons. Thus we have implemented a program that focuses on providing healthcare and nutritional support for women, children and internally displaced persons. 

To achieve this goal Doctors of the World supports 50 health care centers in the Gao region, and 28 in the Menaka region. People suffering from acute malnutrition are cared for in each health center.  The nutritional component of our on-site activities is intended not only for children, but also for pregnant or breastfeeding women. We organize screening sessions, and as soon as a patient is considered malnourished, they are referred to the health structure that can take care of them. Our teams also provide monthly nutritional monitoring. Thanks to this project women can benefit from support before, during and after their pregnancy. 

Our organization also provides essential medicines, supports child immunization vaccination and trains the medical staff of these care structures. In addition, we regularly coordinate vaccination campaigns with regional authorities.

Our organization also provides care for victims of gender-based violence (particularly sexual violence). We have also set up mobile clinics in collaboration with local health authorities in order to reach people living in remote areas and on the sites of internally displaced persons.

With this program, Doctors of the World has achieved: 

• More than 200,000 healthcare consultations
• More than 19,000 assisted deliveries
• More than 18,000 children under 1 vaccinated against tuberculosis
• Over 18,000 cases of acute malnutrition (severe and moderate) treated

PROJECT NAME: Supporting victims of gender-based violence in the district of Kita

Violence against women, in particular sexual violence, is unfortunately a common tactic in conflict as a way to instill fear and control over the population. Physical, psychological and sexual violence, rape, early marriage, female genital mutilation have increased as conflict and instability mounts in the country. Many victims of gender-based violence (GBV) struggle to break the taboo and talk about their trauma, preventing many from processing and healing. 

As a result, Doctors of the World has started a program to offer quality care to survivors of GBV, train healthcare staff to provide sensitized care, and work to prevent future cases. Our approach focuses heavily on women empowerment and sexual and reproductive healthcare. We work in collaboration with Erad, a local NGO, to support 40 health care centers in the area, supplying medicines, building the technical capacity of medical staff and supporting patient care. For survivors of GBV, we provide medical, social, psychological care as well as legal advice should they wish to report their case. Additionally, we have provided 43,238 medical consultations for children under 5.

PROJECT NAME: Support for the health system and the fight against tuberculosis, HIV/AIDS and malaria 

In northern Mali, communities have little access to healthcare. As a result of multiple security crises since 2012, the healthcare system has been considerably weakened. The lack of access to healthcare (particularly in the fight against malaria, tuberculosis, HIV/AIDS, etc.) is notably marked by a lack of qualified personnel. 

In response, Doctors of the World has begun a health program focused on capacity-building of state healthcare services and epidemic control. Our activities include screening, vaccination, and treatment of HIV/AIDS and tuberculosis for at-risk populations. We are currently supporting 69 health centers in the area. 

With this program, Doctors of the World has achieved: 

• 270 tuberculosis cases monitored
• 425 people living with HIV on treatment
• 9,878 pregnant women screened for HIV

Photography

© MdM Belgium 

Sources

Mali

Humanitarian Response Plan 2023 – Mali | ReliefWeb.