In Burkina Faso, increasing violence has caused the number of internally displaced people within the West African country to balloon from an estimated 47,000 in December 2018 to more than 765,000 in February 2020, according to the United Nations Office for the Coordination of Humanitarian Affairs (OCHA). More than four in five are women or children under 15 years old.
Both displaced people and those living in regions affected by insecurity face challenges accessing much-needed health services. In response, Doctors Without Borders/Médecins Sans Frontières (MSF) launched several emergency projects to address the most urgent needs.
Health systems disrupted
“We are living with a host family and have nothing left,” said Amina [name changed], who has been staying in Barsalogho, in Burkina Faso’s Centre Nord region, since June 2019, when armed men attacked her village nearby. “Our yard was riddled with bullets, causing a lot of damage,” she said. “We stayed holed up in the houses until the next day. In the early morning, we took what we could and walked. One of my sisters-in-law was pregnant and almost full-term. She had to walk with us and it was hard to see.”
A few days after they arrived in Barsalogho, where many displaced people have congregated since violence began to spread in early 2019, Amina and her husband tried to return home in order to get supplies. Armed men on the road ordered them to go back. They had no choice but to stay with a host family in Barsalogho, without any income to survive, afraid to move again.
“Fortunately, health care is free here, otherwise I wouldn't have come because I don't have any money,” Amina told an MSF team in Barsalogho. “Today we rely on the goodwill of others to survive.”
From January to March 2019, MSF teams launched an emergency intervention in the villages of Barsalogho and Foube, where a large number of people had fled following violent clashes in Yirgou, in the north of the country. When the situation deteriorated again, the team returned in August and set up two advanced health centers to ensure access to primary health care and treat malaria cases. Today as many as 65,000 displaced people are living in Barsalogho, according to official figures released in February 2020.
“The regular health system is completely disrupted today, which means, for example, that there is no advanced vaccination strategy that is done in the current context,” said Hassan Maiyaki, MSF head of mission in Burkina Faso. “Displacement increases the vulnerability of the population, and there is a heightened risk of epidemics. When our teams arrive on the ground, they assess the medical needs, as well as any other needs that could have a direct impact on health. In Barsalogho, for example, people didn’t have sufficient access to clean water. That’s the reason why, for seven weeks, we provided up to 4,225 cubic meters of water per day [more than a million gallons] before another humanitarian organization was able to take over this activity in September.”
Scaling up the emergency response
In addition to Barsalogho, we have also scaled up emergency responses in other parts of the country. In the last few months, the humanitarian situation in Burkina Faso has rapidly deteriorated, with increasing numbers of attacks on civilians. In late January, Human Rights Watch reported more than 250 civilian deaths in 2019 attributed to targeted attacks and summary executions carried out by armed groups.
In such a volatile context, most medical staff have fled. At least one hundred health centers have closed and over a hundred more are now operating at minimum capacity. Insecurity has made it particularly hard for people living in remote areas to access health services in towns, as well as for humanitarian organizations to reach people in need.
Since November 2019, MSF has been working in Titao and Ouindigui in northern Burkina Faso’s Loroum province, areas that now host at least 21,000 displaced people, most from the country’s Sahel and North regions. We provide medical consultations for all age groups and support pediatric and reproductive health services at the urban health center in Titao.
As Titao's district hospital is no longer fully functioning, we also set up an additional 20-bed unit to stabilize the most severely ill patients and organize referrals to the nearest hospital in Ouahigouya, in neighboring Yatenga province. Malaria is the most common morbidity among our patients, half of whom are displaced. In addition to medical treatment, MSF also distributes water and basic hygiene and non-food item kits to displaced people.
In the town of Djibo, in the Sahel region, which now hosts as many as 131,000 displaced people, MSF has run surgery activities since 2018. Teams also recently began trucking in water and set up two advanced health centers to facilitate access to health care.
The security situation has also deteriorated in eastern Burkina Faso. MSF started providing assistance to displaced populations in Matiacoali, Gayeri, Nagare, and Fada Ngourma, where we carried out medical consultations and distributed water and non-food items. Because many communities have no access to clean water, we also rehabilitated water pumps, dug boreholes, and trucked in water. In Matiacoali and Gayeri, MSF also supports preventive and curative medical activities through community health workers and traditional birth attendants.
Violence is also quickly escalating in the Boucle du Mouhoun area, where we provide support to local health staff in Tougan, Nouna, and Solenzo.
With 2.2 million people estimated by OCHA to be potentially in need of assistance in 2020, the situation is critical. MSF is deeply concerned by the deteriorating humanitarian situation in Burkina Faso and the plight of people in vast areas currently cut off from humanitarian assistance.
MSF has been working in Burkina Faso since 1995. In 2019, MSF teams provided more than 110,000 outpatients consultations in Burkina Faso and admitted close to 4,000 patients for emergency services.