In a relatively quiet region of Mali, programme targets malaria deaths

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By Katarina Johansson Mekoulou

In a relatively peaceful part of Mali, a new programme is addressing pervasive malnutrition and malaria.

OUÉLESSÉBOUGOU, Mali, 27 March 2013 – Continuing conflict in the northern part of Mali has had tremendous impact on the country. Mali has also been facing food and nutrition crisis aggravated by the political instability and conflict in the north. Schools have been closed, health centres looted and vandalized, children’s rights violated.

But in the region of Koulikoro, where small villages of huts with mud walls and conical thatched roofs dot the land, things have been relatively peaceful, even with the large number of displaced people taking shelter here.

But children here could be fighting for their lives in a very different kind of conflict.

Different kind of conflict

In villages throughout the district of Ouélessébougou, malaria is all too common.

Combined with the chronic malnutrition in Mali, malaria is the main cause of death for children under the age of 5.

These deaths often occur at home, far from life-saving medical treatment.

But a dynamic programme financed by UNICEF and the European Union humanitarian aid department (ECHO) is improving the odds against the killer.

“I can’t even give you numbers for how many lives they have saved,” says son of the elder chief of the village of Bladier Salif Samake. He’s talking about the services of Alliance Médicale Contre le Paludisme (AMCP)/ALIMA, made available in this district last March.

Mr. Samake summons a young woman, who has just returned from the central hospital with her 3-year-old child. The girl had been gravely ill with malaria, he says – “so sick I thought she would die”.

The child and her mother, who had already lost four children to malaria, were admitted to hospital for free medical service. Ten days and one blood transfusion later, they are back home, safe.

Bridge between village and healthcare

In Ouélessébougou, AMCP/ALIMA comprises a team of 25 doctors, nurses, field agents and coordinators who have changed the course of child survival in the district. Young, Malian, and armed with scales, measuring tapes, therapeutic food and anti-malaria pills, they run a programme that is bridging the gap between remote villages and state health facilities that have been underutilized by the people who need them most.

“Before the programme, we had few children in the hospital, many dropped treatments and many deaths,” explains director of the central hospital Dr. N’Dji Boubacar Diarra. Dr. Diarra notes that few families could afford hospitalization, and even fewer understood the importance of following medical treatment. But, since the programme began, additional investments by ECHO have made it possible to waive hospital fees and to follow up cases with mobile teams of doctors.

Mobility is at the heart of the programme. Each doctor assigned to 20 villages spends the mornings in the field, where she or he screens each child under 5 for malnutrition and malaria. The doctors dispense therapeutic food and anti-malaria pills and instructions on how to administer the treatment. They refer cases with complications to the nearest health centre, where the parents are not only given free care, but are also fed and advised throughout their child’s stay.

As affordable and accessible as possible

Souleymane Ba coordinates field operations for the team in Ouélessébougou. He and Dr. Bakary Sidibe, the chief of medical staff, were both founders of the first AMCP/ALIMA programme in neighboring Kangaba, the success of which encouraged ECHO to expand the programme to Ouélessébougou and another district.

“Now, even more districts are asking us to come,” says Mr. Ba.

“Whenever I put a new strategy in place,” he continues, “you will find me checking how my team has implemented them, watching the results. Like when I realized that the low role of admission to health facilities for kids with severe malaria could be helped by including rapid malaria testing with malnutrition screening.”

Mr. Ba and three doctors will spend the next morning in the village of Manadougou, screening more than 100 children under 5. Over the course of two hours, they will identify 20 cases of malaria and three new cases of malnutrition.

None of these children will be in need of hospitalization. They will be seen by the mobile team again in two weeks. They will likely recover, without the stress and inconvenience to their families of having to reach distant health facilities.

But, before the team leave, Dr. Sidibe will make it clear that, if a child deteriorates rapidly, it will be imperative for parents to seek medical attention. And AMCP/ALIMA has made it as affordable and accessible as possible for them to do so.