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MSF in Mali, 2011
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Although significant progress has been made in reducing child mortality in Mali, 178 of every thousand children born in the country still die before they reach the age of five. Malnutrition and malaria are the cause of at least half of all these deaths, and malaria is the leading cause of illness and death throughout the country.
In southern Mali, Doctors Without Borders/Médecins Sans Frontières (MSF) runs two pediatric programs, focusing in particular on these two deadly conditions.
Malaria treatment in Kangaba
The number of people who die from malaria is especially high in Kangaba, Koulikoro region, and MSF has been providing treatment for the disease since 2005. In 2011, MSF supported 11 health centers in the province, delivering free basic healthcare to 6,500 people, about half of whom were children under five.
To improve access to care, a team of 66 malaria experts, elected by local communities, has been trained and equipped to screen and treat people living in villages more than five kilometres away from a health centre. In five years, the mortality rate among children under five has dropped by 50 percent. Eight times as many people are attending health facilities.
In April, MSF handed the project over to a Malian association, the Medical Alliance against Malaria, which is continuing some of the activities in partnership with an international non-governmental organization, Alliance for International Medical Action (ALIMA).
Basic healthcare in Koutiala
In Koutiala district, Sikasso region, MSF has worked in five health centers and the pediatric ward of the district hospital since 2009. In four of the centers, MSF assists Ministry of Health and community health centre (CSCOM) health workers, providing additional staff, supervision, donations of drugs and logistical support in carrying out outpatient consultations and vaccinations, as well as screening and treatment for malnutrition. Staff treated 53,000 children – 30,000 of them for malaria.
In the fifth, Konseguela, MSF offers comprehensive health services for children. Healthy children aged between six months and two years receive supplementary milk-based food, routine vaccinations and mosquito nets, and are seen every three to six months.
In 19 villages in the health area, community health workers test for and treat malaria. They also refer people with other conditions, such as malnutrition, to the centre. The community health workers treated 7,500 people for malaria in 2011. MSF carried out 20,000 pediatric consultations at Konseguela health center, and provided 1,700 children with supplementary food.
In Koutiala hospital’s pediatric ward, MSF has also set up a therapeutic feeding center and a pediatric intensive care unit. During the annual malaria peak, between August and November, the hospital is able to receive up to five times the normal number of admissions, as total capacity is increased to 350 beds. In 2011, more than 6,600 children were admitted to the paediatric ward, and another 4,800 were admitted to the therapeutic feeding center.
In 2012, MSF plans to start offering antimalarial drugs to all under-fives as a preventive measure during the annual malaria season, since this age group is most at risk of developing severe malaria.
At the end of 2011, MSF had 360 staff in Mali. MSF has been working in the country since 1992.