Malian refugees in vulnerable situation

A political crisis has divided Mali since the end of January. People are leaving the regions in the north of Mali; refugees and displaced people have been hiding in the bush or fleeing en masse to Burkina Faso, Niger and Mauritania. Often they settle in places where people are living already – places that already have been weakened by food insecurity in the region. Médecins Sans Frontières (MSF) is responding to the growing humanitarian need in the region, providing assistance to refugees as well as to local people

Fear of being caught in the cross-fire, insecurity and the food crisis have driven more than 300,000 Malians to flee the country for neighboring nations. “Many are terrified and ready to leave everything behind to escape violence,” says Marie-Christine FERIR, MSF emergency coordinator.

The refugees, who are coming mostly from Timbuktu, Gao, Ségou and Mopti are taking refuge in communities and camps where there is only very limited assistance in terms of water, shelter and food.

Providing primary healthcare
In order to respond to the needs of vulnerable people. MSF is supporting health centres in Burkina Faso (Gandafabou, Férrerio), in Mauritania (Fassala, Mbéra, Bassikounou), and in Niger (Chinagodar, Bani Bangou, Yassan). Every week, MSF’s mobile clinics are treating people in camps in Burkina Faso (Dibissi, Ngatoutou-Niénié, Déou) and in Niger (Ayorou, Maigaïzé, Bani Bangou, Abala, Gaoudel, Nbeidou). Since February, MSF medical teams carried out more than 23,000 consultations in the border regions of Mali. “We are mainly seeing respiratory infections, malaria, and diarrhoea. These problems are often due to the very bad conditions that the refugees are living in ” says Férir. MSF teams are also treating a large number of women in need of obstetric care. Thus, a hundred women have given birth in the MSF health post in Mbera camp in Mauritania.

Water, a rare and precious commodity
Refugees do not have sufficient access to potable water, notably in the desert areas of Mauritania. Water is essential to avoid diseases and other health problems related to hygiene. In Bani Bangou camp, MSF trucks are servicing some reservoirs of water, constituting 200 metres cubed of chlorinated water each week. “With temperatures around 50 degrees, we have to make sure that the refugees and especially the young children and the elderly get enough to drink,” says Férir. Migration like this is even more alarming given that the region already suffers from drought and food insecurity.

Treating and preventing malnutrition
The refugees are totally dependent on humanitarian aid for essential goods like the distribution of food supplies. Mothers receive neither milk nor appropriate food to feed their children. "The rice can relieve hunger but can not replace the nutrients children need. The distribution of elements such as proteins, fats, vitamins, carbohydrates and minerals are essential for growth and development of the child " says Férir. In Mauritania, refugees have told MSF that they had fled Mali because of lack of food. Since the beginning of the emergency response, MSF has treated almost 1,000 severely malnourished children in those three countries.

Facing epidemics
Protecting children from measles is another health priority in the camps where MSF is working. In these places, where people live in disorder and children suffer from chronic malnutrition, a measles epidemic could be devastating. MSF has vaccinated more than 10,000 children since March with the support of the health authorities. Cholera cases have been documented in Namarigoungou and Bonfeba, in Niger. MSF and the Ministry of Health have treated some 600 cholera patients since the beginning of May. Another MSF team is putting the finishing touches on two 60-bed cholera treatment centres.

The vulnerability of the refugees and the coming rainy season will increase the risk of epidemics like malaria and cholera. What’s more, the “hunger gap” that begins in the month of July always corresponds with a peak in malnutrition. In treating these vulnerable people, refugees will have to face the double burden of malnutrition and malaria.

In the Sikasso region of Mali, MSF teams are also running paediatric and nutrition activities in five health centres and the Koutiala hospital. In addition to curative activities, MSF is working on prevention of major childhood diseases. In the north, MSF is working in Timbuktu hospital and provides care in villages in the Timbuktu, Kidal and Mopti regions.