Mali: "We Help Them Help Themselves"

MSF health promoter Madinata Maiga arms people in southern Mali with the knowledge to fight malaria

Mali 2010 @ Barbara Sigge/MSF

Madinata Maiga talks to school children in Kangaba about malaria.

“Do you know who I am?” Madinata Maiga asks.

“You work for Médecins Sans Frontières,” the children answer.

“And what does Médecins Sans Frontières do in Mali?”

“You help treat diseases like Malaria.”

“We treat malaria, that’s right,” Maiga responds. “And that is exactly what I have come to talk to you about today.” Maiga’s audience is a group of eighth and ninth graders at a school in Kangaba, a town in southern Mali. Maiga is a health promoter for Doctors Without Borders/Médecins Sans Frontières (MSF). She visits villages, schools, and health centers in the Kangaba region and talks to people about malaria.

At the school, when she asks questions—What is malaria? How does one catch the disease? How do we protect ourselves from it?—she does not have to wait for answers. The pupils stretch out their hands and shout out—“Moi, Madame, moi!” (“Me, Madame, me!”)—to catch her attention.

Finding solutions together

These adolescents know a lot about malaria. Most have been sick with the disease several times in their short lives. Fifteen-year-old Cissé Koné says that mosquitoes transmit the parasites that cause malaria. His friend, Ibrahim Traoré, knows that water, rubbish, and plants attract mosquitoes. And Mariam Si lists the main symptoms of the disease: fever, headaches, nausea and shivering. “The pupils have a lot of knowledge,” says Maiga. “I don’t come here to lecture them. Rather, they themselves work out the problems that their families face. And together, we look for solutions.”

For instance, there is the challenge of finding adequate protection from mosquito bites. “We distribute bed nets that are treated with insecticide,” Maiga says. “The people sleep under them and so cannot be bitten at night. But the mosquitoes are active in the evening as well. This is a problem because, for the most part, life takes place outside, on the fields, where the children play, and around the huts, where the families sit, eat and chat together until late into the night.”

Maiga and the students identify additional protection measures they can take—wearing long clothes, for example, through which the mosquitoes cannot bite them, or avoiding puddles in their villages, closing off the wells when they aren’t in use, and generally keeping their villages as clean as possible.

Antenatal check-ups save lives

In Kangaba’s health center, the nurses are carrying out antenatal check-ups and vaccinations. It is Wednesday, which is market day, which brings women and mothers into town. From some villages, it takes more than two hours on foot, so many take the opportunity to visit the health center as well as the market.

Madinata Maiga has also come, intending to talk to the women about malaria prevention and, more specifically, malaria in pregnancy. The disease is dangerous for pregnant women, because their immune systems do not function normally and the usual symptoms are less pronounced. An undetected, untreated case of malaria can lead to miscarriage or severely damage the baby.

That is why regular check-ups are important. Among other things, they allow pregnant women to get tested for malaria. If they test positive, they receive a combination therapy based on the active ingredient artemisinin—artemisinin combination therapy, or ACT—which is, at present, the most effective treatment for malaria. If they test negative, MSF provides them with “intermittent preventive treatment” against malaria, pills they take in the fourth month of their pregnancy and again in the seventh to protect them against the disease.

Maiga and 14 other Malian staff members carry out MSF’s health promotion activities in and around Kangaba, a region that is home to around 100,000 people. The teams travel often, visiting four villages each week. “I am proud to be doing this work,” Maiga says. “The people here are strong, but they are also very vulnerable. They live in poverty and the nearest health center is often far away. We help them to help themselves, so that they and their families stay healthy.”