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World Malaria Day 2008

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Death from malaria is no longer inevitable

Every year, over one million people - 80% of whom are in Sub-Saharan Africa - die of malaria. In Mali, this disease is the major cause of death amongst children under five years of age.

The south of Mali, a marshy region crossed from west to east by the river Niger, is favourable to the development of mosquitoes that carry the disease. Malaria is omnipresent here, and children, who are more vulnerable to the parasite, are its main victims. Every child under five years of age suffers from malaria at least once a year, and some catch it a second or even a third time over the course of a year. While the needs are huge, the health system does not respond proportionately.

© Bruno De Cock/MSF
In Mali, MSF teams undertake 'rapid screening tests' to check patients for malaria

“During every rainy season, the children in my village would drop like flies, struck down by malaria,” explains the Imam of Kalakoro, a village in the Kangaba district. “I had to bury them two at a time, as there were so many deaths.”

It was here in the Kangaba district that Médecins Sans Frontières launched a project to fight malaria in 2005. In a region where the majority of the population lives on less than a dollar a day, it is difficult for the sick to access a health system in which services must be paid for. In the majority of cases, medicinal plants and concoctions are the only way to fight the disease. During the rainy season, which corresponds with the high-transmission period for malaria, many villages are isolated by marshes and unable to reach health centres.

In response to these alarming facts, Médecins Sans Frontières provides support to seven health centres in the Kangaba district by offering quality care that is accessible financially and geographically. After identifying the barriers to accessing health care, and implementing new measures, Médecins Sans Frontières managed to multiply by four the number of people coming for consultations. The introduction of new pricing practices is at the heart of this success.

© Bruno De Cock/MSF
Djaba Keita has brought her sick son Mambi to the MSF clinic in Narena, Mali. Mambi received free treatment for the malaria and recovered well

All care is currently provided free of charge to children under five and pregnant women, the most vulnerable populations. Patients over five years of age now only pay a fixed price of 200 CFA (instead of the usual 2000-6000 CFA) for complete treatment of feverish illnesses, which are the majority of the diseases encountered in this region. The loss of income for health centres is covered entirely by Médecins Sans Frontières so as to integrate the measure into the existing system. Most cases of malaria can now be tackled at an early stage in order to prevent the appearance of severe forms that often end in death.

“I used to have four patients a day in my health centre during the high-transmission period,” explained the head of one of the centres supervised by Médecins Sans Frontières. “Today, the team at the centre has to deal with 20 or 30 consultations on a daily basis. At last, we have the moral satisfaction of meeting the needs of our population.”

To overcome the distance problem Médecins Sans Frontières has set up mobile teams. During the six months of the rainy season, the “malaria agents” go off to isolated villages. These farmers and family men are trained and equipped by Médecins Sans Frontières to provide free screening and treatment for simple malaria cases in children under ten years of age.

Today, the population of Kangaba finally has access to quality healthcare. People can see a doctor without becoming even poorer; they can receive effective treatment; and, in the case of populations who are isolated during the rainy season, they can obtain free care at home.


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