Mali has seen a reduction in humanitarian assistance because of the presence of groups linked to AQIM (Al Qaeda in the Islamic Maghreb) in the country. Health needs are significant, and child mortality rates are high. Médecins Sans Frontières focuses on child healthcare in the regions of Sikasso and Koulikoro.

Child health in Koutiala

Rates of malnutrition and malaria are high in Mali. In the southern district of Koutiala (Sikasso region), near the border with Burkina Faso, more than one in five children die before reaching the age of five. In July 2009, Médecins Sans Frontières started offering paediatric care, including treatment for malnutrition, to children under five in Koutiala town and in five of the 42 health areas in the district. In 2010, staff conducted consultations with more than 48,100 children, 33,300 of whom were diagnosed with malaria. A further 5,360 children were treated for severe malnutrition.

Médecins Sans Frontières helped to increase the capacity of the paediatric department in the district hospital of Koutiala. A team of Médecins Sans Frontières and Ministry of Health staff set up a paediatric intensive care unit, built wards to allow the hospitalisation of malnourished children, provided medical care, offered staff training and assured a regular flow of drugs and medical material. More than 9,900 children were admitted to the hospital in 2010. Malaria was linked to more than 82 per cent of hospitalisations in the paediatric ward.

Early detection and prevention in Konseguela

The Ministry of Health and Médecins Sans Frontières began a joint project in the district of Konseguela, also in Sikasso region, in March 2010. The project aims to find new approaches to reducing mortality among children under five, and focuses on simplifying and decentralising the treatment, early detection and prevention of the main killer diseases – malaria, malnutrition, pneumonia and diarrhoea.

A baby clinic is held at the health centre in Konseguela, offering regular check-ups for children under two. These children receive ready-to-use food in an effort to prevent severe levels of malnutrition. In December 2010, more than 1,250 children were receiving this food. Families with young children also receive mosquito nets.  Almost 50 per cent of the 15,000 consultations held at the health centre in 2010 related to malaria.

Every month, a team visits all 17 villages in the district and carries out routine immunisations against tuberculosis, polio, diphtheria, tetanus, pertussis (whooping cough), hepatitis B, Haemophilus influenza type b (which can cause meningitis and pneumonia), measles and yellow fever.

In July 2010, trained staff in all of the villages began carrying out early screening for malaria, offering a rapid diagnostic test and treatment in order to reduce the development of severe forms of the disease. Staff treated 9,400 children under five for non-complicated malaria in 2010.

The programme has achieved a very high level of adherence. Of 1,775 children who received the first dose of the pentavalent vaccine (which provides protection against five diseases), 1,773 successfully completed the three-dose course. A sharp decrease in child mortality has been reported by local authorities and communities since Médecins Sans Frontières began activities in Konseguela.

Preventive meningitis vaccination campaign

In December 2010, Médecins Sans Frontières participated in the national preventive vaccination campaign against meningitis using a new vaccine that provides extended coverage against the disease (over ten years) and stops transmission by eliminating the carriage of the germ. With Ministry of Health staff, 85 teams vaccinated more than 728,900 people aged between 1 and 29 years in three districts of the Koulikoro region.

Malaria in Kangaba

Since 2005, our team has been supporting 11 health centres in collaboration with the health authorities in Kangaba province, Koulikoro region. As well as increasing access to basic healthcare, the project has a specific focus on malaria. Free care is offered to children under the age of five and pregnant women. Since the project started, the number of children under five visiting health centres has increased by 800 per cent. Our team has also trained 66 health workers, who visit villages that are more than five kilometres from the nearest health centre to test and treat people for malaria. Child mortality in the area has decreased by half thanks to the provision of good quality, free healthcare closer to home. Médecins Sans Frontières is using these results to support its advocacy for the government to provide free healthcare for all children under five.

Médecins Sans Frontières has worked in Mali since 1984.