The challenges and our response
International Medical Corps has worked in Mali since 2013 following political instability and a coup d’état which caused mass displacement and the disruption of many public systems including health care. The violence and insecurity in the north aggravated the already fragile health and nutritional conditions in the region and women and girls became increasingly exposed to acts of sexual violence.
In response, International Medical Corps has been working with the most affected communities in Timbuktu and Gourma-Rharous districts through programs focused on health, nutrition and protection. When Ebola spread to Mali in 2014, International Medical Corps worked to equip Mali’s health care system to quickly detect, contain and respond to potential Ebola and other infectious disease cases through training of health care workers and other professionals in medical-level case management.
Today, we are building on these efforts to strengthen Mali’s disease surveillance, information and reporting systems for not just Ebola, but other infectious diseases with epidemic potential. In Timbuktu region, we support more than a dozen health clinics and two referral health centres through primary and secondary health care, nutrition services and protection activities aimed at preventing and responding to gender-based violence.
Infectious Disease Prevention and Response
International Medical Corps has provided didactic and simulation training in infectious disease case management such as Ebola to medical and non-medical personnel from the public and private health systems, Malian Ministry of Health, partner agencies and Red Cross volunteers. By the end of 2015, we trained over 2,200 medical and non-medical professionals from 62 public and 30 private health care facilities across the country—increasing the number of skilled, confident responders in the country. Most of the training was held at a centre we built in the capital, Bamako, which was handed over the National Center for Disease Control in late 2015.
We also created three rapid response teams in Bamako, Segou and Sikasso regions that were equipped to transport any suspected Ebola patients and support local health facilities in case definition and infection prevention control—knowledge and skills that are essential in preventing infectious diseases. The Mali mission is currently in the second year of a program to strengthen the Epidemiologic Surveillance capacity of the Sikasso and Segou regions (Southern Mali) through regular supervisions and technical coordination meetings at the national, district and community levels.
Our health response in northern Mali promotes free, quality, curative and preventive health services in areas highly affected by the recent war. We have helped local health care structures of Gourma-Rharous and Timbuktu districts regain self-reliance and credibility. We have done this by rehabilitating and supplying community health centres, recruiting and training health workers and strengthening the emergency response and disease surveillance capabilities. We have also enhanced water, sanitation and hygiene (WASH) facilities in all supported health centres and provided water pumps and tanks, hand washing stations, and latrines.
We also support community health committees’ management and handling of health facilities to strengthen community-based health structures. We provide training opportunities for health care professionals working in the facilities we support in northern Mali in areas such as emergency obstetric care, integrated management of childhood illnesses, clinical management and psychosocial support for GBV survivors, community management of acute malnutrition and Ebola response.
International Medical Corps supports community health centres in northern Mali to prevent and treat malnutrition. We do this by training health care providers in the treatment of malnutrition, providing nutrition supplies and medication and strengthening the referral systems between community health centres and regional health facilities and hospitals.
Within communities, we train community health volunteers in how to identify and refer malnourished children and pregnant and breastfeeding women—and ultimately identify malnutrition cases earlier before they are complicated and harder to treat. To prevent malnutrition, we promote the care group model, which uses volunteers to encourage mothers to adopt practices known to improve child nutrition. International Medical Corps implements Community-based Management of Acute Malnutrition activities focusing on prevention and management of Moderate Acute Malnutrition (MAM) and Severe Acute Malnutrition (SAM) for children under two and pregnant and lactating women.
Gender-based violence (GBV) rates in Mali significantly increased during the recent conflict in the north. We work in health facilities in Gourma-Rharous and Timbuktu districts, providing confidential and compassionate clinical and psychosocial care to GBV survivors. We also work with communities to train community volunteers and local health staff and design referral paths to other relevant services. Protection interventions focus on the prevention of sexual assault, clinical and psychosocial management of sexual assault survivors and increasing the resilience of communities.