Mali

Axes of intervention

Care and surgery
Building and equipping hospitals
Prevention and screening
Training and skills transfer

Start of mission: 1994

At a time when the country is facing a difficult humanitarian situation, La Chaîne de l'Espoir is organizing humanitarian missions to Mali to save the lives of Malian children affected by heart or esophageal diseases and facial malformations.

Background

The humanitarian emergency in Mali

8.8 million

people need humanitarian assistance.

184ᵉ out of 189 :

is Mali’s Human Development Index (HDI) ranking in 2022.

+ over 2,000 children

are awaiting heart surgery.

Sources: OCHA (2022), UNDP (2022), La Chaîne de l’Espoir (2020 figures)

Weakened by the conflict that has pitted armed forces against radical armed groups in northern and central Mali since 2012, the country is facing multiple crises: security, political, food… This situation and the lack of public funding, accentuated by the suspension of funds from the French government at the end of 2022, have weakened Mali’s healthcare system. Ongoing insecurity exacerbates the vulnerability of populations in distress and the difficulties of humanitarian access. In rural areas, Malians are struggling to cover their basic medical needs, due to poor access to basic healthcare services.

Our humanitarian aid action in Mali

Pediatric heart surgery: essential help for children with heart disease in Mali

Every year in Mali, 800 to 1,000 new cases of pediatric cardiac pathologies are detected but not treated due to a lack of dedicated medical equipment.

To meet the needs of these hitherto often doomed children, between 2016 and 2018 La Chaîne de l’Espoir built and equipped the André Festoc Center within the Hôpital Mère-Enfant Le Luxembourg (HMEL) in Bamako. The country’s first pediatric heart operation is performed there in 2018. Since then, 500 children have benefited from life-saving surgery. Today, the Centre André Festoc is recognized as one of the two paediatric cardio reference centers in West Africa, along with the Cuomo Center in Dakar, Senegal.

Operation carried out by a Malian surgeon and a Chaîne de l'Espoir volunteer

Training Mali’s first cardiac surgeons

We runhumanitarian missions in Mali , training Malian medical teams with La Chaîne de l’Espoir doctors who are among the best French and European specialists. The first three Malian cardiac surgeons were trained under this scheme. To date, more than 30 doctors and healthcare professionals have been trained. After numerous operations carried out with the support of foreign colleagues, Malian doctors now independently manage over 70% of heart pathologies and operations. The country’s first aorto-coronary bypass operation was performed by the local medical team in 2020. Through our echoes® telemedicine program, volunteer specialists also help their Malian colleagues with ultrasound diagnosis, and participate in the ongoing training of doctors and midwives.

Facial deformities: reconstructive surgery to help children

Mali is one of the countries hardest hit in sub-Saharan Africa by pathologies such as noma, which cause facial deformities in newborns and young children. This devastating bacterial disease, which can be fatal if left untreated, devours the face and disfigures young children. That’s why, since 2014, La Chaîne de l’Espoir has been deploying a global strategy to detect, treat and operate on children in several countries in Africa. In Mali, since 2019, we have been supporting the development of a reconstructive surgery department at the Hôpital Mère-Enfant Le Luxembourg in Bamako, as well as the training of medical staff. Through our humanitarian missions in Mali, we are also raising awareness of how to prevent and detect noma and maxillofacial pathologies.

In partnership with the local New Face association, we are involved in prevention, training and facial reconstructive surgery. We provide surgery for children affected by malformations or the after-effects of facial burns. Several missions are organized in Mali each year to enable French and European doctors to share their knowledge of reconstructive surgery techniques with local doctors and students, thereby empowering Mali’s healthcare professionals in this specialty.

We also educate traditional practitioners in noma identification, enabling them to recognize the signs of the disease at an early stage, and thus promote rapid medical and surgical care for children. In fact, rural populations turn first to traditional healers in the event of childhood illness. Without training, the latter may perform the wrong gestures (such as fumigation) and aggravate the disease.

A solidarity fund to save children in life-threatening emergencies

In Mali, the poorest families are unable to access essential healthcare for their children’s survival. Very young Malians are dying from illnesses that can be cured with surgery. To save these children, La Chaîne de l’Espoir launched a solidarity fund in 2022, financed by both the association and Malian civil society (local companies and sponsors, etc.). A network of 15 Malian surgeons identifies the most critical cases so that these vital operations can be financed by the fund, with families paying 1% of the cost of the operation.

We also educate traditional practitioners in noma identification, enabling them to recognize the signs of the disease at an early stage, and thus promote rapid medical and surgical care for children. In fact, rural populations turn first to traditional healers in the event of childhood illness. Without training, the latter may practice incorrect gestures (such as fumigation) and aggravate the disease.

Combating accidental ingestions of caustic soda

Every year, the accidental ingestion of corrosive products (caustic soda, potash, etc.) causes severe burns of the esophagus, known as caustic stenosis, in children. These lesions prevent them from eating properly, and can prove fatal if not treated promptly.

“In three years, over 1,000 caustic soda users and retailers have been trained. They, in turn, will be able to spread the awareness message and prevent the many tragic accidents that befall young Malian children.”

Patrick Senia, head of La Chaîne de l’Espoir’s Mali mission

To respond to this humanitarian and medical emergency and guarantee the effectiveness and sustainability of our actions, we are developing a three-pronged approach:

awareness and prevention: public awareness campaigns, communication with local authorities, training for caustic soda users and retailers, provision of protection/prevention kits,
surgical and medical management,
capacity-building for local medical staff: training for doctors and health professionals at Mali Hospital in Bamako and Ségou Hospital in south-west Mali

Training inlocoregional anesthesia

In Mali, the ratio of anesthetists per 100,000 inhabitants is 0.3, compared with 15 in France. This shortfall has multiple consequences. Patients may be cared for by practitioners who lack the experience and skills needed to ensure their safety. To meet this critical need, in 2021 La Chaîne de l’Espoir launched a training program in loco-regional anesthesia (LRA) with ultrasound in hospitals across the country. This medical technique enables only the area to be operated on to be put to sleep. Safer and faster than general anaesthesia, locoregional anaesthesia is also less costly, making this type of medical procedure more widely available. Trained anaesthetists in turn become trainers, ensuring a lasting transfer of skills.

To find out more about our work with local anesthesia, read our article on the subject.

Read the article

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