Universal Healthcare in Mali
In early 2019, the Malinese government made an announcement that shocked the global health world: it would make healthcare free at the point-of-service to pregnant women and children under 5 years of age. The country had achieved universal healthcare in Mali.

The Situation

In a country where poverty and healthcare outcomes were in dire straits, the move to provide universal care for the most vulnerable demographic in Mali was welcome and necessary. Previous to the 2019 decree, Mali had disastrous health outcomes.

About 106 children out of 1,000 live births would not survive delivery. Adding to the issue was the fact that 587 per 100,000 mothers would not survive delivery either, one of the highest rates of maternal mortality in the world. Only malaria and digestive diseases claim more lives in Mali.

In order to diagnose the problems with Malinese healthcare, a historical context is necessary. With that understanding, the new approach reveals itself to be necessary, positive and inclusive.

Post-Colonialism

After Mali’s liberation from France in the 1960s, the nascent country fell back on the healthcare system that was already in place. That system emerged 50 years prior and had not evolved with the needs of the populace. It would not change until the 1980s.

The Bamako Initiative

Launched in 1987, the initiative came under recommendation from both UNICEF and the World Health Organization (WHO). Named after the capital city of Mali, the initiative proved problematic, pushing the Malinese into poor health outcomes.

The initiative called for patients to pay for things like health services and drugs to offset costs and insufficient funds. The system requirements led the impoverished to avoid seeking care.

Post-Implementation

The free to pregnant mothers and under 5-year-old children policy has already yielded benefits. The new model re-centers care away from costly hospital services to community-based care.

Nurses can now travel door-to-door to service mothers and children under 5-years-old without fees. The results have been stunningly effective, with infant mortality dropping by 95% in the Bamako district.

Dr. Ari Johnson, a professor of global health sciences at the University of California, San Francisco heralded the approach: “The ministry of health [in Mali] has taken a very brave and bold political move to make real, evidence-based healthcare change.”

The approach serves as a model example; One that Mali hopes will become the standard across Africa. Johnson continues with optimism, stating that he hopes the new approach will: “make Mali a leader in health sector reform on the African continent.” Universal healthcare in Mali was no longer a dream.

The COVID-19 Pandemic

Although Mali has experienced strain due to the pandemic, U.N. Secretary-General Antonio Gutierrez has noticed Mali’s new model of healthcare. He called on nations to implement Universal Health Care for all nations in order to beat COVID-19. He stated that “The pandemic has revealed utterly inadequate health systems, yawning gaps in social protection, and major structural inequalities within and between countries.”

Gutierrez continued on to make the connection between robust systems and access, stating that “ . . . we cannot wait 10 years. We need Universal Health Coverage, including mental health coverage, now, to strengthen efforts against the pandemic and prepare for future crises.”

Foreign Aid

A number of Western nations have come to Mali’s aid. The impoverished nation, just starting on its new policy, has found itself hobbled by the current crisis. Experts see support for the nation, and its new health policy, as crucial.

The Netherlands

The Project to Accelerate Progress Towards Universal Health Coverage (PACSU) is a joint effort between the Dutch Embassy and the Global Financing Facility, the World Bank and the Ministry of Health in Mali. Learning from the impact of previous health crises in the region, the Netherlands’ support will focus on pregnant mothers and newborns.

When the Ebola crisis hit the region in 2014, a startling trend of infant and maternal mortality gripped Mali. Resources were scant and pregnant women were unable to secure the necessary health services to ensure a successful birth. PACSU will provide facilities, professionals, equipment and any other resources necessary to the ailing system during COVID-19.

The US

The United States Agency for International Development (USAID) will join the fight as well supplying $45 million to Palladium, an international development firm. The organization will provide support to reinforce Mali’s health systems and financing, providing access to high-quality care. Two programs, the Human Resources for Health 2030 (HRH2030) and the Human Resources for Health Strengthening Activity (HRHSA), have not been successful and will undergo expansion.

These programs, in concert with Mali’s Ministry of Health, will focus on the decentralization of health services. Training, motivation and safety for new medical professionals, particularly in the prevention of illness among both patients and healthcare workers is crucial to the program’s success.

Universal healthcare in Mali is critical from many standpoints. Not only does it provide relief for the historically impoverished Sahelian country itself, but it serves as a model for the rest of Africa. The refocus on community health improves access and financing. Once again, Africa leads the way in methodology, access and care during the struggle against COVID-19.

– Christopher Millard
Photo: Flickr

impact of conflict on poverty
Conflict can be a catalyst for an array of poverty-related events. It can impact poverty by depleting resources, interrupting supply chains, destroying infrastructure, taking lives and much more. Unfortunately, this trend has held in the country of Mali, which currently shows the significant impact of conflict on poverty.

Conflict Background and Economic Impact

The Mali War is an ongoing conflict that began in January of 2012. Since then, violence between the North and South of Mali has ebbed and flowed in severity but never subsided. Malian people, including the Tuareg, in the North of Mali, have expressed resentment and concern, as they feel that governmental groups and political factions have been neglecting their concerns and treating them unfairly. Ethnic divides, fundamentalist fighters and an unstable political system are a few issues that have caused this conflict.

There have been thousands of deaths and thousands of more people fleeing the conflict. As mentioned previously, many connect the weak economic sector in Mali to the outbreak of unrest and violence. Almost cyclically, this violence is now negatively impacting the economic sector. Before the conflict broke out, tourism accounted for more than 40% of Mali’s GDP. Researchers estimate that 8,000 people lost their job due to the drastic decrease in tourism after the conflict began. The economic connection highlights the ranging impact of conflict on poverty.

Many of those living in the North of Mali, mostly Tuareg and Arab groups, depend on the agricultural sector for their income. The government has invested very little in this sector and focuses primarily on tourism and the export of gold and cotton from the South. This has led many agricultural producers in the South to grow jaded towards the government due to their increased likelihood of experiencing extreme poverty.

The Impact on Public Health

Roughly 1 in 3 children in Mali are facing chronic malnutrition. An annual average of nearly four million people in Mali do not have access to an adequate amount of food. More than half of Mali’s children and young adults are illiterate and have been pushed out of school due to displacement. Many children in Mali are at great risk of being recruited into militant groups, further threatening their safety, educational resources, and ability to climb from poverty.

At its base level, the conflict in Mali threatens public health by the sheer loss of life it has caused. In 2018, hundreds of civilians were killed by armed groups. The byproducts of this violence caused even more people to experience extreme poverty, malnutrition and death. Additionally, more than 200,000 people have fled Mali altogether to avoid the violence. This stunts Mali’s economic growth, which reaffirms the dangerous impact of conflict on poverty.

Current Aid and Support Efforts

A military coup ousted the former President of Mali, Ibrahim Boubacar Keïta, on August 19th, 2020. President Bah Ndaw became the interim leader of Mali and will hold the position until an election can be held. Some are hopeful that if a legitimate election can be held, much of the conflict in Mali will subside. In the meantime, many local and international nonprofit organizations have mobilized to aid in poverty-reduction efforts throughout Mali.

  1. For example, World Vision began providing aid in Mali in 1975, even before the conflict. In 2012 during the height of the conflict, World Vision provided aid in the form of food, clean water, and shelter to more than 150,000 people throughout Mali. Additionally, more than 60,000 children in Mali are currently benefiting from World Vision’s child sponsorship program. The program allows donors to provide monetary assistance to and communicate with an impoverished child. Many of these sponsored children in Mali reside within conflict-ridden areas.
  2. Peace Direct, another nonprofit organization, focuses on peacebuilding efforts in Mali. They support communities in their implementation of peacebuilding; in 2019 alone, they supported more than 20 projects throughout Mali. Peace Direct realizes the importance of community growth, both physically and emotionally, to peacebuilding. A lack of communal trust can be detrimental to poverty reduction, as teamwork makes progress more effective and efficient. Additionally, the building of trust and understanding among conflict groups is essential to support continued growth and stability throughout Mali. This trust will prevent future conflicts and allow Mali to focus on joint economic growth and poverty-reduction tactics throughout their country.

    3. “The Peacebuilding Stabilization and Reconciliation Project,” run through USAID, began in April of 2018 and is scheduled to be completed in March of 2023. This project focuses on rebuilding many of the conflict-ridden areas throughout Mali, providing rehabilitation resources to those impacted by the violence, increasing civic engagement and helping Mali’s government introduce barriers to prevent violent outbreaks in the future. USAID believes that providing community members with an active role in their governance will decrease dissent, enhance democratic values, reduce the likelihood of future conflict and decrease the joint poverty level throughout Mali. Success will also ideally increase GDP and overall well being while mitigating the impact of conflict on poverty in Mali.

The Future of the Region

The domino effect that violence can have on the prosperity of a nation is not a surprise. Violence decreases an individual’s ability to focus on economic growth or public health. It overtakes governmental initiatives and attention from the media, forcing poverty-related issues to take a backseat. The importance of the international community supporting peacebuilding efforts in Mali remains essential. The path toward peace will trickle-down benefits for many subsets of Mali’s society and will decrease the occurrence of extreme poverty throughout the nation.

Danielle Forrey
Photo: UN Multimedia

poverty in Mali
A land-locked, predominantly rural society with limited women’s rights, a poor healthcare system and constant conflict due to recent terrorism and political instability, Mali and its population are extremely vulnerable to poverty. In fact, 49% of Malians live below the poverty line.

Poverty in Numbers

The astronomically high rate of poverty in Mali affects various parts of its society, namely food security, education and women’s rights. Over 70% of families in Mali are four individuals or larger given that the average Malian woman gives birth to six children. Big families, combined with the rising number of droughts, food shocks and unsustainable agriculture practices, have adversely impacted food security and the cost of living in Mali. This leads to many children dropping out of school to support their family by working, a problem that will likely be exacerbated by the increased poverty due to COVID-19. As a result, the total adult literacy rate is just 33% while only reaching 22% for women, thus hurting the future prospects and opportunities for Mali’s population.

Furthermore, Malian women are treated as property to be bought and sold. This oppressive culture along with widespread poverty in Mali has greatly contributed to about 49% of Malian girls being forced to marry before they turn 18, as husbands will pay more money for younger brides.

The government of Mali has consistently viewed international cooperation and collaboration as the most effective way for it to reduce domestic poverty. Traditionally, however, Mali’s largest obstacle to overcome has been the constant threat of terrorism in its north, which has displaced hundreds of thousands of people in addition to reducing the government and NGOs’ ability to provide basic services to those who fled.

Programs to Help Mali

Governments across the world have provided aid for Mali’s people through a variety of programs. Notably, the United State’s Feed the Future initiative not only gives nutritional help to millions of Malian children per year but it advances long-term food solutions to food security in Mali by providing sustainable farming technologies for thousands of Malian farmers.

Canada has pursued a similar mission by funding hydro-agricultural infrastructure to help 7,500 women gain access to high-quality, irrigated land as well as helping about 470,000 women obtain crop insurance or agricultural credit from 2014 to 2017. This further bolstered food security for at-risk families, thereby building resilience to possible environmental events.

Finally, the World Bank has allocated $1.5 billion to 30 programs directly improving Mali’s infrastructure, financial sector and agricultural sector. The results of such ventures have been overwhelmingly positive for eliminating poverty in Mali. Almost 80,000 Malians have received cash transfers four times a year, over 100,000 women and children received nutritional supplements and new water sanitation facilities were established in communities threatened by water scarcity.

The Road Ahead

The efforts of Mali and its partners cannot stop now. COVID-19 will inevitably create even more poverty throughout Mali with numerous economic and health factors on top of a possible increase in terrorist activities. For many reasons, stepping up efforts to help Mali’s government is the only option. Failing to prevent Mali’s condition from further deteriorating could have dire humanitarian repercussions. On the other hand, acting now and collectively is essential to ensuring regional peace and prosperity for the future. Helping Mali is no longer a choice for the world; rather, it is fundamental to eliminating poverty by the United Nations’ 2030 target date.

– Alex Berman
Photo: Flickr

Sanitation in Mali
Access to proper sanitation and clean water is a relatively simple yet incredibly important part of protecting public health. For developing nations like Mali, it can be hard to come by. In rural areas, only 30% of people have access to clean water. This puts them at risk for diarrhea, which is responsible for one out of every nine child deaths in the world. Further, most schools do not have proper toilets for their students, and about half lack a clean water source altogether. People must undergo steps to provide safe water and improve sanitation in Mali. Luckily, some organizations, like Save the Children, are attempting to help.

Save the Children

The Save the Children Fund has been supporting kids around the world since 1919. It works to improve communities in many sectors, including healthcare, education, community development and more. Save the Children first arrived in Mali in 1987 and has been on the ground defending the country’s most vulnerable ever since.

Waterborne diseases pose a great threat to children in developing countries. One of the best ways to tackle this crisis is through proper water, sanitation and hygiene (WASH) products and services. Accordingly, Save the Children has made this a center of attention in its work through the Clean Household Approach (CHA) program. The CHA program emphasizes the importance of WASH products and services and is working to reduce the risk of childhood diarrhea and sanitation in Mali.

Previous programs often looked at the issue from a communal perspective. Public resources became the focus rather than looking at what people could accomplish in each individual household. “People care for and maintain personal belongings better than communal property,” Save the Children reported. With this in mind, the CHA program directs efforts at the household level and not at the community level. Instead of providing sanitation equipment at a communal well where people draw water from, the program is making change directly in the homes where people consume the water.

The Clean Household Approach Program (CHA)

The CHA program differs from other programs with similar goals because it does not simply offer financial aid, it also uses a market-based approach. Save the Children recognizes that household sanitation commodities are not something that people tend to prioritize. Families put food and shelter above the often expensive equipment necessary to secure clean water. To circumvent this, Save the Children is making household sanitation commodities both accessible and desirable.

The CHA program provides vouchers that subsidize the cost of WASH products and services. The program typically provides vouchers after a household member attends a meeting on proper handwashing or a visit to a physician. It also uses a variety of incentives to encourage families to invest in WASH products and services. For example, a home can meet “Clean Household” status by satisfying certain criteria pertaining to proper sanitation practices. They then receive the award of a flag to note their success.

The CHA program also uses marketing strategies and social norms to try to emphasize the importance of WASH products and services. Additionally, Save the Children provides training and collaborates with local business owners to ensure that a supply of WASH products and services is always available.

WASH products and services work. The risk of diarrheal infections falls 47% with proper handwashing, 17% with better water quality and 36% with better sanitation. Through projects like the CHA program, Save the Children has been able to keep over 1 million children healthy and nourished in Mali. It continues to change lives around the world and has shown no signs of slowing down in its support for sanitation in Mali.

– Evan Driscoll
Photo: Flickr

Healthcare in MaliMali has suffered from the presence of terrorist groups in its north and western regions, lethal diseases such as malaria and tuberculosis, and a coup d’etat in the past two decades. These circumstances have created a strained and ineffective healthcare system. Mali’s infant mortality rates are among the highest in the world and average doctor visits per person have been one in every three years. This is in part a result of its system’s user fees, which many in Mali cannot afford.

Free Healthcare to Address High Maternal and Child Mortality Rates

In 2019, Mali announced that it would begin offering free healthcare to pregnant mothers and children under 5. This is a monumental step forward that came after decades of adhering to a system that had barely changed since the 1960s when the country gained independence. This radical new change will benefit the healthcare system’s most vulnerable recipients and work to lower the infant mortality rates as well as the lack of citizens’ use of the healthcare services. However, the program’s success is dependent upon how effectively they can roll out the changes to avoid flooding their healthcare systems.

Besides user fees, other issues persist in Mali which put citizens at risk for disease and insufficient care. A large issue is the lack of education regarding women’s health. Mali has the third-highest fertility rate in the world, and its capital is one of the fastest-growing cities in Africa. The absence of health education leaves young women vulnerable to shorter birth intervals, lack of skilled birth attendants and female genital mutilation, which all result in Mali’s high maternal mortality rates. With an average of six children per mother, education measures that address health and family planning are necessary to address high maternal and infant mortality rates as well as alleviate poverty.

USAID Helps Tackle Infectious Diseases

Another large concern is the prevalence of infectious diseases. Mali’s degree of risk is ranked at very high for diseases like malaria, dengue fever, hepatitis A, meningitis and typhoid fever. These illnesses result from living in poverty, with a lack of clean water and adequate health services, as well as contact with animals and parasites carrying disease. As of 2018, USAID is supporting 991 health programs in regions across Mali to alleviate these health issues. Supplies such as bednets, diagnostic tests and medication are disseminated to prevent, diagnose and treat malaria.

This is very important work, that needs increased funding in order to continue spreading these life-saving services, as malaria cases reached 3.3 million in 2017 and the disease was responsible for almost a quarter of child deaths. With a larger budget and increased reach, USAID could provide Mali with the tools to create a self-sufficient healthcare system capable of tackling the maternal and infant mortality rates as well as the rampant infectious diseases.

Ellie Williams
Photo: Flickr

Livestock Fattening in Mali
Livestock has always been a crucial part of Mali’s economy. Traditional methods of cattle and other livestock fattening in Mali, though, are outdated and inefficient. In the past 20 years, the government of Mali, along with international organizations focused on development, has focused on modernizing the livestock economy of Mali with the intent of creating economic growth and prosperity for both producers and consumers.

Growth in the Livestock Industry

It is important to first define how valuable livestock is to the economy in Mali. Livestock provides over 40% of the agricultural GDP in Mali. Furthermore, 80% of all livelihoods in Mali are in the agricultural sector. Clearly, improvement in the livestock economy will supply enormous benefits to huge populations of the country.

Mali has successfully invested in the livestock economy. Between the years 2000 and 2016, the average livestock stock per 100 people in Mali was 70.9 TLU (tropical livestock units). This is over three times the median for African countries (23.44). Moreover, the gross production of livestock in Mali grew at 3.87% annually, far above the 2.2% median for African countries.

Between 2000 and 2018, the yield for cow’s milk increased by 25%. Additionally, the total output of cow’s milk increased by 185%. Similarly, goat’s milk production doubled, while sheep’s milk increased by a factor of 1.5.

The successful growth of livestock fattening in Mali stems from concerted, focused government efforts to improve the infrastructure and knowledge base of those working in the livestock industry. Additionally, international development organizations have provided both funding and know-how to help these workers.

Successful Government Programs

One program in particular has focused on improving livestock fattening in Mali. Implemented jointly by the governments of Mali and the United States, the Livestock for Growth Project (L4G) emerged with the idea of helping producers get access to microfinance loans that would allow them to modernize their livestock fattening programs.

L4G also trains local farmers in business acumen that will help their businesses thrive. By teaching producer groups things like banding together and buying supplies in bulk, introducing modern fattening methods such as creating multi-nutritional licking blocks, and explaining how to use fodder crops as future animal forage, L4G has slingshotted thousands of local livestock farmers into the modern age of agriculture.

Plenty of other agencies and programs also exist that serve livestock producers. The Ministry for Livestock and Fisheries helps traditional livestock industries through improved infrastructure and ensuring a healthy market for delivering goods to the public.

The Institute of Rural Economy is Mali’s main research institute that helps find new ways for farmers to maximize their earnings. The agricultural sector has six research centers across the country, which helps to make sure each region is given personalized, individualized attention for their specific problems.

Individual Success Stories

These nationwide, infrastructural programs are incredibly valuable, but of course, the real benefit comes in the form of individuals increasing their welfare through modernizing livestock fattening programs.

Adama Togola has sold cattle since 1985. In the past, he had no organized plan or schedule. He fed his cows in a sort of haphazard, random fashion. Then, the Agricultural Competitiveness and Diversification Project, a World Bank initiative, taught him modernized methods of cow fattening. His newly gained knowledge contributed to his business growing immensely. After the training, the price he could sell his cows for doubled from 300,000 CAF to 600,000 CAF.

Similarly, Yissa Djiguiba fattened her sheep and goats in an outdated, traditional fashion for many years. She was a beneficiary of the previously mentioned L4G programs. L4G taught her modern fattening methods, which allowed her to raise sheep and goats to full maturity in three or four months rather than the full 12 months it took her prior. This essentially tripled or quadrupled Yissa’s income, allowing her to send her children to school, setting up her family for future success.

Mali serves as a model for other developing countries seeking to improve their agricultural infrastructure. Important modernizations in livestock fattening techniques can drastically boost the production and welfare of farmers and consumers alike.

– Evan Kuo
Photo: Flickr

Saving Lives in Mali
The words “Health can’t wait” are on the website of the Drapers Richard Kaplan foundation. This foundation helps fund the upstart Muso Health, a venture philanthropy group. The statement captures the essence of the Muso Health mission: to deliver healthcare quickly and affordably to people living in poverty. By taking a unique approach to healthcare, Muso Health is saving lives in Mali.

Muso Health uses a proactive health care model; health care workers receive training to seek out, diagnose and treat patients in local communities. Unfortunately, children can die from malaria within 48 hours of contracting it. The Muso model increases the likelihood a child will get treatment in time.

The Origin

A coalition of Americans and Malians founded Muso Health in 2005. The tragedy of child funerals moved the founders of Muso and motivated them to make health care more accessible. Therefore, they began a simple operation of volunteers, dedicated to saving lives in Mali.

Volunteers assist the communities in Mali’s capital city, Bamako. The organization has expanded since 2005; the Muso Health website boasts that it has “grown 2000-fold.” At the beginning of 2020, an additional 50 new Community Health Workers (CHWs) joined Muso Health.

Muso’s CHWs are a group of local Malians who provide in-home health care. Most CHWs are women, and Muso means “woman” in the Bambara language of Mali. Muso Health chose its name, in part, because of the common Malian expression, “If you educate a woman, you educate her family, her community and her entire country.”

The Approach

Muso is saving lives in Mali through proactive community case management. This strategy consists of three main steps. First, Community Health Workers identify and diagnose sick individuals. If possible, the workers treat the illness on the spot. If not, they refer the patient to a clinic. Therefore, Malian families do not have to seek out treatment and diagnosis.

Muso Health also addresses obstacles to healthcare, including cost. Its door-to-door service eliminates transportation fees for the patient and their family. Additionally, Muso Health removes point-of-care fees, so even the most impoverished families can receive care. Lastly, Muso helps to boost Mali’s public health sector by expanding infrastructure and training providers.

The Impact

Muso was able to visit 358,379 homes during the first quarter of 2020. From January to mid-April of 2020, it treated 92% of peri-urban patients and 67% of rural patients within 24 hours. Thankfully, these efforts seem to be paying off. Studies suggest that Muso Health is having a positive impact on Mali.

A 2018 study in BMJ Global Health shows that the areas where Muso Health operates have seen the lowest rates of child death in Sub-Saharan Africa for five consecutive years. The study demonstrated that the child mortality rate was originally at 15.5%. After Muso interventions, the study found that the child mortality rate dropped to 1.7%. In making health care free, the health care costs shifted to Muso and the Malian government. This change only costs the Malian government an extra $8 per person.

Looking Forward

Ultimately, there is a high demand for innovative health care organizations like Muso Health. According to Muso CEO and Co-founder Ari Johnson, “The World Health Organization has estimated that 100 million people every year are driven into poverty by health-care costs.”

Although larger studies are necessary to determine whether the Muso model will work on a greater scale, Muso Health has been successful in Mali. Johnson and his team have received numerous awards for their work in saving lives through innovation. These awards include the 2014 UNICEF Innovation Challenge Award and the Harvard Presidential Scholars Public Service Award.

–  Joseph Maria
Photo: Flickr

Homelessness in Mali
Mali is a large, central country in the Sahel region of Western Africa. As of 2017, 42.7% of the population lived below the poverty line. In the first half of 2020 alone, humanitarian assistance became a necessity for more than 4.3 million people in Mali. Persistence of violence, food insecurity, drought and high poverty levels have not only deteriorated the quality of life for many Malians throughout the last decade, but have also actively aggravated the level of homelessness in Mali. According to the United Nations Development Program, approximately 80% of the population of Mali does not have access to adequate housing.

Violence and Instability

Violence and instability play a large role in worsening homelessness in Mali. The nation experienced a rise in homelessness in correlation with the violence of the 2012 crisis. At this time, multiple Islamic groups rose up in rebellion against the government. Despite the negotiation of a peace agreement in 2015, rampant violence and conflict continue today between unidentified armed groups throughout the country. The initial outbreak of violence left as many as 230,000 people displaced from their homes; eight years later, this violence continues to internally displace massive amounts of people. As of March 2020, 124,000 Malians were homeless. According to the Internal Displacement Monitoring Centre, the total number of displaced persons in Mali due to violence and conflict is 208,000 as of December 2019.

Child Homelessness

The census on homeless children reported that Mali’s capital, Bamako, has nearly 4,400 homeless children. However, unofficial estimates put that number closer to 6,000. On top of that, around 200,000 children nationally exist in “difficult living circumstances.” Many of these homeless children are considered “street children,” commonly sent out to beg and retrieve money for gangs to which they belong or for adults exploiting them. These children tend to either come from large families or be orphans, and both live in public urban spaces.

Natural Disasters

Homelessness in Mali is also aggravated by natural disasters, particularly flooding. The Internal Displacement Monitoring Centre found that 6,300 total people became displaced due to natural disasters in 2019, the large majority of which was flooding. Floods displaced as many as 19,000 Malians in 2018, and more recently, 4,600 in August of 2019 alone. The floods of August 2019 destroyed as many as 845 homes.

Looking Forward

While homelessness in Mali remains a complex issue, some organizations are coming together to start combating homelessness however possible. Domestically-based NGO Association Malidéni was founded in 2009 with the intention of helping street children out of homelessness. The organization now also provides aid to homeless adults, individuals suffering from substance abuse, prisoners and victims of sexual exploitation with community-building soccer programs. With efforts such as these, the elimination of homelessness in Mali seems achievable.

Alexandra Black
Photo: Flickr

Sanitation in MaliOne of the largest countries in Africa, the Republic of Mali sits landlocked in the northwestern chunk of the continent. While it is known more recently as one of the most impoverished and unstable countries, thousands of years ago Mali was a cultural epicenter. The Niger and Senegal rivers that cross through the country made Mali one of the richest countries due to a flourishing trans-Saharan trade economy. With goods came literature, art, music and discovery, transforming the Malian city of Timbuktu into a vital center for scholarship. Though Timbuktu’s cultural reputation and Mali’s musical achievements have continued, the country as a whole faces many challenges. About half of Mali’s total population lives in poverty, facing exceedingly unhealthy circumstances as a result, partially due to poor sanitation. Mali’s journey toward achieving proper hygiene and sanitation is detailed in the following facts.

10 Facts About Sanitation in Mali

  1. In 2017, the WHO and UNICEF discovered 52% of Malian households nationally have access to basic hygienic facilities, just below the global average of 60%. In rural areas though, access to facilities drops down to just 39%. These averages are higher than other African countries, like Ethiopia and Burundi, that have less than 10% access to facilities in rural areas.
  2. UNICEF also found about 7% of Malians still practice open defecation, causing preventable illnesses connected to improper sanitation. Diseases like diarrhea, pneumonia and malaria unequally affect children, producing some of the highest child and infant mortality rates in the world. However, in 2018, UNICEF, USAID and its partner organization JIGI implemented Community-Led Total Sanitation models (CLTS) as a way to decrease open defecation in rural communities. CLTS helped more than 3,500 villages eradicate open defecation, improving the lives of almost three million people due to increased awareness of personal hygiene and sanitation.
  3. Thanks to humanitarian aid from various organizations, 80% of Mali’s national population has access to safe drinking water and in rural areas, 70% have access. In 2019, UNICEF and its partners provided water supply services to more than 194,500 people, including water points and latrines in 95 schools and 61 health centers.
  4. In 2018, a Global Burden of Disease (GBD) study discovered diarrheal diseases stood as the third-highest cause of death in Mali, beaten by neonatal diseases and malaria. However, it is worth noting that due to sanitation improvement measures, the rate of death from diarrheal diseases declined by almost 9% between 2008 and 2017.
  5. Currently, 52%of the population does not have access to a handwashing facility, weakening how Malians can effectively combat diseases. Since the start of the COVID-19 pandemic, UNICEF has begun distributing handwashing devices with the goal of sending up to 4,000. In a joint report with UNICEF and the WHO published in April concerning COVID-19, they specified that “frequent and correct hand hygiene is one of the most important measures to prevent infection with the COVID-19 virus”. They also recommend proper water sanitation and waste management to mitigate the spread of the virus.
  6. About 50% of schools have improved water access, though only 20% have working, gender-separated latrines. Due to the coronavirus, more than 1,000 schools have closed for the time being, cutting off access to what could be a child’s only functioning toilet.
  7. Since 2012, armed conflicts have resulted in the displacement of thousands of people in addition to violence and abuse of children. This instability has created a decrease in the successful delivery of humanitarian aid, which the country largely relies on for assistance with sanitation needs. The coronavirus pandemic has also slowed the services usually given to Mali.
  8. In April, the World Bank approved a $25.8 million grant to support Mali’s response to the coronavirus. The money contributes to health care services, screening and treatment of patients. The initial funding will focus on Mali’s response to the virus and the country’s ability to handle the health and economic impacts to come with an already fragile health system. The grant will also allow Mali to continue essential services like clean water and education.
  9. The humanitarian organization World Vision joined the Mali Integrated Water, Sanitation and Hygiene program (MIWASH) to construct 208 new water points in 2019, allowing more than 100,000 people access to sanitation facilities while increasing hygiene education. World Vision has also implemented numerous latrine stalls, handwashing kits and hygienic education services through its additional projects, reaching 15,400 children in 51 schools.
  10. In 2016, UNESCO, U.N.-Women, UNFPA and KOICA implemented the “Empowering Girls and Young Women through Education in Mali” project to help girls and young women seek better living conditions through equitable education. The project involves educating girls about feminine hygiene and their reproductive rights to decrease the rates at which young girls drop out of school, have children and marry while still children themselves. One aspect of the project involves access to clean water and sanitation facilities. One of the many achievements the project has made since its creation includes the construction and mending of 137 latrines suitable for girls in Bamako.

Poor sanitation is not the only problem plaguing Mali but it does create a tidal wave of other preventable issues that Malians have to struggle with. Disease, higher mortality rates and malnutrition result from improper sanitation of water and toilet facilities. However, continued investments by the Malian government along with support from international players will help with country to improve sanitation in Mali for its citizens going forward. 

Maria Marabito
Photo: Flickr

Agricultural Development in Mali
Mali is a subsistence farming-based economy in West Africa. Approximately 80 percent of the population works in the agriculture industry, yet low productivity, natural disasters and poor crop yields prevent many Malians from rising out of poverty. The 40 percent poverty rate includes farmers that rely on outdated farming techniques for their livelihoods while also depending on favorable crop prices that fluctuate based on Mali’s fragile economy. Since agriculture is the main industry, USAID and the World Bank are working towards agricultural development in Mali.

Importance of Crops

The main crops in Mali are cotton, corn, cereal, peanuts and tobacco. It exports cotton to neighboring countries like Senegal on the Ivory Coast, and various types of cereal remain important due to their ability to withstand droughts. Since the Sahara Desert covers the northern portion of Mali, it is difficult to find suitable land for farming and livestock. Most farmers rely on the Niger River and its surrounding area for fertile land, as about 65 percent of the country is desert or semi-desert.

Mali cultivates less than 5 percent of its land, yet almost half of its GDP is from agriculture. Most of the cultivated land involves various types of cereals, such as sorghum and millet. One issue that affects the agriculture sector in Mali is desertification, which overgrazing livestock, droughts and deforestation can cause. Farmers rely on rainfall, yet rainfall in Mali is rare and droughts are common. Since the agriculture sector in Mali remains the most important industry for the majority of Malians with more than 40 percent of its GDP comprising of the agriculture sector, further agricultural development in Mali could benefit its people and economy by increasing income and reducing poverty.

USAID Projects

As part of its strategy to end world hunger, the U.S. Government’s Feed the Future initiative in Mali focuses on cereal for food security and poverty reduction, as well as rice production to improve income and livestock for food security and another source of income. To date, the Feed the Future initiative has benefitted approximately 500,000 Malians. In 2019, USAID used two methods as part of its Fertilizer Deep-Placement Micro-Dosing. This project aims to improve crop production through fertilizer deep placement and micro-dosing technology. More than 453 jobs emerged in rural areas due to the success of the two productivity methods.

Another project in the Mopti region helped increase farming productivity by 60 percent. The goal of the Large Scale Diffusion of Technologies for Sorghum and Millet Systems project was to increase sorghum and millet income. Seed treatment, hybrids of sorghum and millet and soil fertility improvement were among the reasons for the high productivity. Sorghum and millet were the focus crops due to their climate resilience and drought tolerance.

Nah Drame benefitted from the project in the Mopti region after receiving training on fertilizer, irrigation, sowing, land preparation and harvesting. She replicated what she learned on her own five-acre farm. Production and income increased so much that she expanded her farm to 12 acres and hired three employees to help with her expansion. Drame used some of the money she earned to buy clothes and school kits for her grandchildren. She also used the money to help her daughter start a business of her own, and it was all thanks to USAID’s involvement in the agriculture sector in Mali.

The World Bank’s Involvement

The World Bank’s $150 million Fostering Agricultural Productivity Project for Mali began in 2010 with the goal of improving productivity and crop yields. The project proved successful as crop yields increased from 27 million pounds in 2016 to 34 million pounds in 2018. The project also benefitted 668 farms and 4,300 producers in Sabalibougou, and it developed more than 6,600 acres of land for agriculture in M’Bewani and Sabalibougou.

USAID, the World Bank and various other organizations are continually working towards agricultural development in Mali. Economic development is slow, yet improving income for millions of farmers in Mali could help reduce poverty and develop the economy. If more Malians like Nah Drame obtained training on improved farming techniques, an even greater impact could take place, as increased income would help millions afford better education, health care, necessities and many other things that those in developed countries often take for granted.

– Lucas Schmidt
Photo: Wikipedia