Mali: "Worried and concerned by the crisis"

© Christophe Smets

No stranger to the world of missions, Caroline has built up a wealth of experience in the field of humanitarian aid. After an initial posting in Haiti, where she worked on our schools health education project, she decided to specialise in this field and took a Masters in public health. In 2005, after completing her course, Caroline began her first mission in Mali, where she spent two years as the maternal health project manager. Conscious that Handicap International’s mission was making a difference, she decided to return to Mali as health coordinator in 2009. Below, she tells us about the challenges facing the mission and her concerns about the current state of affairs in Mali.

“It’s great to see how much has changed in the health sector, five years after my first mission, and things are moving forward,” explains Caroline. “It’s taking time, but they are moving forward.” To instigate and support these advances, Handicap International works with a number of local operators (health centres, primary schools, disabled people’s organisations and rehabilitation centres) and focuses its activities on three key issues: reproductive health, particularly maternal health, HIV issues, and the early detection and case-management of impairments . “Our awareness campaigns are having an impact and habits are beginning to change,” says Caroline. “More and more women are going for prenatal check-ups, for example, which prepare them for possible complications and help prevent them and/or their child from developing impairments following obstructed labour. For traditional reasons, it’s still hard to convince women to give birth in a health facility, rather than at home. But we’ve been getting our message across and people now understand the need to put a system in place so that these women can get to a health centre if something goes wrong. Everyone lends a hand, including the men, who organise the emergency transport, such as carts or ‘ambulance’ canoes. We feel it’s essential to target them as part of our awareness actions because they have the final say on family matters. We’ve been trying to involve them as much as possible over the last two years by reminding them how important it is to plan childbirth and to monitor on their wife’s pregnancy.”

A lot of progress has also been made in reducing the vulnerability of people with disabilities to HIV. “They don’t have access to available information on HIV issues and are simply not - or hardly ever - targeted by awareness campaigns,” explains Caroline. “Our role is to build bridges between disabled people’s organisations and HIV services so that they can work together to increase the number of people screened for HIV and ensure care adapted to the needs of people with disabilities is available. The results of this project are already positive and the number of people with disabilities who volunteer for screening has risen considerably.”

Although Caroline is satisfied with the progress made so far, the threat of a major food crisis in Mali and the rest of the Sahel, combined with the political crisis that has gripped the country since the military coup d’état on 22 March 2012, and the occupation of three regions in northern Mali by armed groups have cast a shadow over these achievements: “Health is still our main concern but we’re facing renewed pressure to cover people’s basic health needs. The food shortages are really biting. During the ‘hunger gap’ people have to eat seeds normally used for sowing in July. Added to this, looted health facilities need to be reequipped and reopened, vaccination campaigns have ground to a halt, the rainy season has arrived, bringing with it a heightened risk of epidemics, and we need to educate people on the risk of unexploded ordnance. To complicate matters even further, a lot of people were displaced from their homes when they fled the fighting. We’re obviously very worried and concerned, and we’re working harder than ever to help the people of Mali get through this extremely difficult time.”