Doctors Without Borders/Médecins Sans Frontières (MSF) head of mission Côme Niyomgabo discusses the humanitarian situation—and MSF's response—in the north of Mali following a new outbreak of violence.
What is the current situation in northern Mali?
Northern Mali has been going through a serious crisis since 2012. Although the crisis initially began with demands for independence, it has in time evolved to take on different forms: a pro-independence but also religious movement, a battle for control of trafficking routes, and community exploitation against a backdrop of limited resources and crime.
While no significant progress has been made a year on from the signing of the Algiers peace agreement [a 2015 accord that aimed to bring stability to Mali's northern desert], what results have been achieved may be undermined by renewed fighting between different groups. Since July 21, 2016, violent clashes have broken out in the Kidal region in the far north of the country, leaving more than 50 people dead and 82 injured. A week before the hostilities, demonstrations escalated into riots in Gao, which resulted in several deaths and approximately 30 wounded. These developments partly reflect the exasperation of the population who, in spite of the peace agreements, have not seen any real improvement in their everyday situation.
Meanwhile, acts of criminality against humanitarian organisations continue.
This situation seriously affects the deployment of humanitarian assistance, as clashes between armed groups and an increase in criminality hamper and limit access by humanitarian workers to the population.
What are the main needs of the population?
Access to health care; problems linked to food insecurity, including malnutrition; access to water and to shelter: these are the areas where the main humanitarian needs are in these regions.
The regions in the north of the country have to some extent fallen out of state control, and the health care system has collapsed following the conflict.
There are also particularly vulnerable populations for whom access to health care services is very difficult. In Kidal, for example, and also in northern Ansongo, in Gao, the population is nomadic and settles for several months of the year in pastoral lands where access to health care is non-existent.
What aid is MSF providing in northern Mali?
MSF has been working in the Ansongo District in the Gao region since the start of the crisis in 2012, and in Kidal since 2015. These areas are among the worst affected by the conflict in Mali. MSF continues to provide quality health care free of charge to the populations affected by the armed conflict, and focuses its efforts on providing medical care to victims of the conflict (injured and displaced people), treating diseases commonly encountered in the primary and secondary health care services, preventing deadly childhood diseases through vaccination campaigns and seasonal malaria chemoprevention, as well as responding to emergencies.
In Ansongo, we are supporting the referral hospital (with consultations, child and adult admissions, maternal health, nutrition services, and surgery) and we also ensure referrals between the hospital and numerous health centers located in the surrounding rural areas. We have also launched a program for the period between September and December that is specifically aimed at helping children under five years of age and pregnant nomad women who move around the region during that time of the year.
The populations of these regions frequently have to travel very long distances (often more than 30 miles) before their first contact with a health care professional, and the usual coping mechanisms of the population have been weakened by more than five years of armed conflict.
In addition, we have begun to carry out seasonal malaria chemoprevention (SMC) in Ansongo Cercle, with the aim of protecting children during the peak malaria months. We are also planning to implement the same strategy in Kidal, although this is currently on hold for security reasons.
What are MSF’s activities in Kidal?
The Bamako government does not have a presence in the Kidal region. Very few humanitarian organizations are working in the area owing to the instability. The renewed fighting further complicates the current situation. But since last year, we have continued to work in Kidal to support two health centers in the town and numerous others in rural areas, in cooperation with a local organization, SOLISA (Solidarité pour le Sahel).
In addition to Gao and Kidal, MSF also works in the regions of Timbuktu, also in the north of the country, and Sikasso, in the south.
