Strengthening Access to Healthcare in Northern Mali: An Update

Mali has the unfortunate reputation of being one of the UN’s deadliest peacekeeping missions in recent history, with over 100 personnel killed since the operation began in 2013.

The situation has not improved and UN personnel are still frequently targeted by violence and IED’s. This is a highly unstable and dangerous environment for the people of Mali and for humanitarian and international aid actors who are working to provide critically essential medical care and infrastructure support in the country.

As a result of the ongoing insecurity Doctors of the World (DotW/MdM) has been the only non-governmental organization (NGO) providing medical aid in the Ménaka region of Northern Mali since early 2016. Despite the deteriorating security situation in the region, our community-based approach and long-standing presence in the area have enabled our teams to continue working. Due to the fact that many Malian communities are nomadic or located in isolated areas, our team operates out of both health facilities and mobile clinics in order to reach as many people as possible.

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DotW’s mobile clinics are especially valuable in reaching remote areas. Despite ongoing interruptions due to security concerns, our mobile clinics have greatly increased access to medical care including increasing vaccination coverage for children. From February through April of this year our teams participated in national vaccination days against polio and measles, while also conducting malnutrition screening. During these three months alone, we diagnosed and treated over 440 children who displayed signs of moderate to severe malnutrition.

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Over the last year, we have also supported six health centers that reach over 33,000 people in areas such as Inékar, Emiss-Emiss and Tinangaroft in the north-east of Mali. These health centers are vital to the communities they serve as they provide access to free medical care that is not otherwise available, especially sexual and reproductive health care (SRH). Our DotW team has conducted antenatal consultations with 1,500 women in order to improve maternal and child health during pregnancy. Our team has also trained traditional birth attendants (TBAs), midwives and obstetricians on safe delivery measures and on early detection of potential complications. Over 800 women received post-natal care in the 3 days after delivery.

As a result of our involvement, approximately 50% of the women in the region gave birth accompanied by a qualified health attendant – a 25% increase from the national average.

In addition to SRH and other types of primary care, our team promotes health education in the area, where we have trained 100 local residents to become Community Health Workers (CHW’s). CHW’s provide a variety of services to their communities, including information on hygiene practices, preventative measures for common diseases such as malaria and diarrhea and strategies to prevent and diagnose acute malnutrition. The role of CHW’s in the region has been highly successful: they have reached over 20,200 people – nearly 60% of the targeted population.

In April of 2016, loyalists groups recaptured the city of Ménaka from the rebel opposition group MNLA, causing further instability in the region. Despite these developments, our team did not evacuate and continued services and assistance to all who needed it. At a meeting in Algeria 2 months later in June, armed opposition groups (AOGs) signed the Alger peace agreement that aimed to end armed conflict, inter-ethnic fighting, radical jihadism, drug trafficking and separatist movements in Mali. Unfortunately, the agreement was not fully implemented and the fighting has continued.

Since January 2016, DotW’s work in Ménaka has provided thousands of people with vital medical and healthcare at a time when other medical NGO’s were forced to withdraw. Although many who fled to Niger, Burkina Faso and other parts of Mali have since returned to the region the situation on the ground remains unstable – in July over 30 protestors were killed by government troops. Despite the insecurity, our team continues their work with local communities.