More than 840,000 people have been displaced by worsening violence in Burkina Faso over the past few months, according to the United Nations, and the country’s health system is in shambles. The upcoming seasonal peaks of malnutrition and malaria will likely worsen the situation. On top of this humanitarian crisis, Burkina Faso is also experiencing one of the highest coronavirus infection rates in sub-Saharan Africa.
Djibo, a town in the Sahel region, was home to around 36,000 inhabitants in 2012. It now hosts more than 140,000 displaced people. “When you go to the medical center, you can spend the whole day waiting for a consultation because there are too many patients,” said Salam, who came to the Djibo medical center with his two children. “But we are grateful that we have access to medical care at all.” More than a hundred health facilities have closed in areas affected by the violence, and others are operating at minimum capacity.
Doctors Without Borders/Médecins Sans Frontières (MSF) has been working in the surgical ward and emergency room of the Djibo medical center since March 2018, helping to improve the quality and availability of secondary health care for both displaced people and the host community. We have also opened two advanced health posts for primary health care, offering services such as malaria treatment or prenatal consultations. We’re also distributing clean water.
As insecurity grows around the town it has become more difficult to reach people living on its outskirts. To ensure these people have access to care, MSF has set up and trained a network of community health workers to treat children under five suffering from common ailments like malaria, diarrhea, and minor respiratory infections.
Preparing for peaks of malaria and malnutrition amid the coronavirus pandemic
MSF medical teams provide primary health care to people in Barsalogho and Kaya in the Centre-North region, Gayeri and Matiacoali in the East region, and Titao and Ouindigui in the North region. In addition to supporting the urban health center in Titao, MSF also runs mobile clinics to provide health care to people in remote areas. One of the main health issues our teams are seeing is malaria, and this is likely to worsen during the annual malaria peak starting in June.
"Last year, malaria was the most common medical issue among our patients,” said Hassan Maïyaki, MSF head of mission in Burkina Faso. “We now fear the worst as the seasonal peak between May and October is approaching, many health facilities have closed and people are stranded in inaccessible areas with very limited access to health services.”
At the same time, these communities are struggling to survive in precarious living conditions, with a lack of access to water and food shortages. According to the World Food Program, the number of people suffering from food insecurity could double from just over one million to 2.1 million as the annual food shortage season approaches in June. Last year's harvests were poor, and people are already weak and vulnerable. Between January and March—months before the traditional start of the “hunger gap,” our teams cared for nearly 400 malnourished children in Barsalogho, Gayeri, and Matiacoali.
"In such an unstable security context, with a weakened health system and difficult access to populations, humanitarian organizations, including MSF, are finding it difficult to prepare for this critical period,” said Maïyaki. “And the COVID-19 pandemic is going to make our task that much harder.”
Integrating a COVID-19 response
Since Burkina Faso confirmed its first coronavirus case on March 9, the country has seen a rapid increase in the number of cases, with outbreaks in nine of its 13 regions.
MSF is preparing to support health authorities’ COVID-19 response through a number of initiatives, including health promotion, staff training, and strengthening the capacity of health facilities to manage and care for COVID-19 patients, including infection prevention and control measures and the establishment of isolation areas. Our teams are in discussion with health authorities to assess how we can help contain the spread of coronavirus in Burkina Faso, focusing on helping to identify and care for patients in Ouagadougou, Fada N’gourma, and Gayeri. We are also preparing to support case management in the capital Ouagadougou, and have started patient care in a dedicated facility in Burkina Faso´s second-largest city Bobo Dioulasso.
MSF teams will prioritize continuity of our regular medical activities in Burkina Faso while adapting to the new challenges posed by the pandemic. In Fada N'Gourma, in the East region, for example, the MSF team had to temporarily suspend and reorganize a mass measles vaccination campaign due to new government regulations of mass gatherings. The vaccination campaign will resume in the coming days. In western Burkina Faso, an area already affected by the pandemic, an MSF team has just completed a measles vaccination program in Mouhoun province. More than 72,000 children under 10 years of age were vaccinated in Dedougou and close to 37,000 children under 14 were immunized in Boromo.
“Temporary interruptions of preventive programs, such as seasonal malaria chemoprevention or measles vaccinations, could trigger new outbreaks,” said Maïyaki. “We have to make it clear for all stakeholders and donors that any COVID-19 response must be integrated with other major health programs, including measles, malaria, and malnutrition.”
“Seasonal shocks, such as the period of food shortages or the seasonal malaria transmission peak, will soon affect people across Burkina Faso and young children in particular,” he said. “We must be fully prepared for the post-COVID-19 situation, as its indirect consequences could lead to a new phase of emergencies if basic needs are not met.”
MSF has been working in Burkina Faso since 1995. Since 2018, our teams have been present in Djibo, supporting the emergency room of the medical center. In 2019, MSF stepped up its response throughout the country. Our teams now work in Barsalogho and in Kaya, and will soon launch activities in Kongoussi. We are also continuing our assistance to people in Titao, Ouindigui, Matiacoali, Gayeri, Nagaré, and Fada N'Gourma. In March, following attacks in Yatenga province, our teams began providing medical consultations and water to thousands of people who had taken refuge in Ouahigouya, the capital of North region