Action For Health : Empowering Communities in Mali

 
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Ami Tangara
Ami Tangara

June 15th is GlobalGiving bonus day! Donate to Action for Health and GlobalGiving will provide a 30% match!

With the support of our Community Health Worker team, Action for Health recently expanded to two new neighborhoods, nearly doubling program enrollment. We are excited to announce that our twelve fulltime Community Health Workers now provide in-home education and case management for nearly 800 poor children!

The newest neighborhood to be added to the program’s catchment is Bandiagara Coura, a peripheral area of Sikoroni where houses climb the base of a nearby cliff. Residents here have no access to running water or sanitation services. Over 170 of the poorest families in the neighborhood have been enrolled, allowing much needed access to health care and opening the door for residents to work together to address root causes of health problems.

Action for Health uses a peer education model, encouraging program participants to become health advocates among friends and neighbors. Community Health Workers are chosen from the neighborhoods that the program serves. This means that Health Workers’ patients are also their friends and neighbors, allowing them an invaluable insider’s perspective and ensuring that they are near the families they serve in case of urgent needs. Sanata Cissoko and Ami Tangara are two of the newest additions to our team of Community Health Workers.

Sanata and Ami exemplify the diversity across the team of Health Workers and the unique strengths that each individual brings to the group. Sanata Cissoko is a 24-year-old new mother who moved to Sikoro just four years ago. She was recently certified by the Red Cross as a nurse’s assistant after a six month training in which she learned to recognize danger signs of serious illness in children, administer dressings and bandages, giving injections, and understand pathologies of diseases like malaria and respiratory infections. Santa is especially excited to work to educate and serve other young mothers like herself, saying, “I want to do my work well.”

In contrast, Ami Tangara has been living in Sikoro for over twenty years. She has raised her own four children here, selling meat at the local market to support her family. Today she is an active leader in local women’s groups, including a savings group through which women pool their money to support each other. Upon meeting Ami, one is immediately struck by her sense of humor, as well as the wisdom and experience of an older woman who has already shepherded many children into the world. Ami is excited about serving the community as a Health Worker, saying: “We can teach families; help them understand what's important for their child's health. It's our job to make sure they get care and follow up with the child to make sure they get better." We look forward to keeping you updated on the dynamic leadership of Ami, Sanata, and the rest of our Community Health Worker team. Read more updates on Mali Health programs at www.malihealth.org, and as always don't hesitate to email us with questions at information@malihealth.org.

Bandiagara Coura Homes
Bandiagara Coura Homes
Road to Sourakabougou
Road to Sourakabougou
Sanata Cissoko
Sanata Cissoko

Links:

On March 1st, Action for Health celebrated its one-year anniversary. Over the last twelve months, our community health worker team has made over 13,000 preventive home visits and supervised nearly 800 clinic visits to treat sick children. With half a dozen health actions, families have contributed over 1,000 hours of community service to improving the health of Sikoro as a whole.

Beyond the numbers, the impact can be seen by the families themselves. Oumou Niare, a 38 year old Sikoro community member, sells condiments on the side of the road while her husband works as a carpenter. Customers are scarce, and neither job provides a reliable income for the family. Last year Oumou enrolled her two children in Action for Health because she didn’t have the financial means to take care of their health.

Since joining, Oumou has learned a lot about preventive care from the community health workers, who have worked with her one on one to cover topics ranging from vaccinations to mosquito nets that can protect her children. Thanks to these health lessons she has learned, Oumou says her children now have fewer problems with diarrhea and vomiting.

At the same time she’s thankful to know that when her children do fall ill, can get the medical care they need. In her own words “Now I don’t have to leave my sick baby at home because of lack of money. The program helps me to cure my babies and I can also give back to the community.” Knowing that the cost of care is covered, Oumou now takes her children to the clinic when they first become sick, rather than have to spend several days scraping together funds for the visit from friends and family.

Oumou also feels the program is innovative because of the health actions. From malnutrition awareness days to community clean-ups, Oumou is proud to know that she is participating in activities that benefit the community as a whole, helping to prevent illness among other families and create a healthy environment for children across Sikoro. She hopes to see the program expand to include more families in the years to come.

As we prepare to double the number of children enrolled in Action for Health, it is heartening to move beyond the numbers and hear stories of change like Oumou’s. This coming year we look forward to not only supporting more families, but also deepening the community service impact with our new action training curriculum. We look forward to keeping you up to date as the program progresses!

Links:

Women in Sikoro sweeping the trash
Women in Sikoro sweeping the trash

With the start of the New Year fresh in our minds, MHOP hit the ground running with a trash clean-up day this past week as part of our Action for Health program. As you may recall, families enrolled in the program receive free primary care for children under the age of 5 in exchange for participating in “health actions,” or events designed to give back to the community. On January 9th, Action for Health families came together to sweep the trash that littered the roads around their homes.

Since the founding of MHOP, community members have identified sanitation as a top priority. While in the US we benefit from government-run trash services, there are no such programs in Sikoro. With the introduction of plastic and population growth fueled by immigration from rural areas, waste management has risen as a serious concern in terms of public health as well as community pride. In Sikoro, trash often accumulates very quickly because informal donkey-cart trash collectors have no place to leave it in the interim for larger trucks to come and transport it to the city dumps. Trash eventually collects in the streets, which breeds disease and other health problems in the community. This past Health Action day, three trash clean ups took place in three different Sikoro neighborhoods. Community Health Workers from each neighborhood took the lead on coordinating the event and rallied the families together around 8am. Women came out with their brooms and swept the trash off to the side of the road, while others used shovels to wade through the waste. Later, a dump truck arrived to collect the trash that was gathered together and transported it to the city dump.

It was energizing to see that Sikoro residents chose to address such a pressing challenge in the community with continued vigor and vision. As MHOP’s Community Mobilization Coordinator Dramane Diarra remarks, trash clean-up days are significant events that motivate the community to action: “[The day] shows what they should do [to address sanitation], not just for themselves, but for the community as a whole.” Last year, residents organized two trash clean-up days as Health Actions for Action for Health, and a recent clean up of a local stream has added to the impact of their work. Through the active participation of the community, the event marked the fifth Health Action since Action for Health launched last year. It was exciting to see the actions taking place and serving as a catalyst for community mobilization around health.  It looks to be a promising start for a New Year! Thanks to our supporters we are seeing Action for Health progress on all fronts and look forward to keeping you up to date with our latest news from Sikoro.

Community Health Workers Moustapha and Diba
Community Health Workers Moustapha and Diba

Links:

Sifting flour at the malnutrition training
Sifting flour at the malnutrition training

We’d like to send out a big thank you to all of you who joined in supporting MHOP during Global Giving’s matching campaign. If you missed it, you can still donate by October 31st and have your donation matched by 50% by MHOP's own private donors!

As for our work on the ground, Action for Health turns eight months old on November 1st! It’s hard to believe that it has been that long but we’ve accomplished a lot.  We’ve been enrolling a lot of new babies in the program: we are now serving 398 children and 251 mothers.  That’s even before the expansion we will begin in 2011!  As I’ve mentioned before, Action for Health is a complicated program with a lot of moving pieces. It feels like with six months of experience behind us, we have finally gotten all these different pieces into place, which is great news.

Action for Health is based on the premise that community service can be a means of payment for free care.  We hope that when families participate in community service actions, they will mobilize around their own health, while also improving living and health conditions for the neighborhood.  Our goal for the future is to engage families in at least one community service “Action Fee” per month, and so far we’ve organized four. 

Trash and sanitation is a huge problem in Sikoro, especially because there is no transit site where small donkey-cart trash collectors can leave the trash to wait for larger trucks to take it to the city dumps.  The constant presence of trash and the difficulty of getting rid of it  are issues that really attract the attention and energy of Sikoro residents.  For that reason, our first Action Fees were trash clean-up days.  We organized two in May, one at an unofficial transit site and one near the school in Sourakabougou.  People were really pleased to see (and smell!) the cleaned up areas.

As the program moved forward, we realized that there was a serious lack of treatment and follow-up care for malnourished children.  Officially, the government has committed to provide Plumpy’Nut, a nutritional supplement, for free to all malnourished children. Many of our Community Health Workers (CHWs) were finding that they would measure children as falling in the yellow zone of their nutrition status arm-bands, but were not receiving care at local clinics for a variety of reasons. In addition to this problem, we were constantly reminded that clinical treatment for malnutrition cannot prevent the problem in the first place. The CHWs thought that the most important thing was to make sure that the mothers knew how to cook the calorie-rich, nutritious foods that keep children healthy and help malnourished children gain weight quickly.  So we held a malnutrition education day in which the CHWs trained the women to make enriched porridge (millet, bean, fine millet, wheat, rice, and corn flower) and a high calorie milk paste. Twenty mothers of malnourished children attended and each left with a kilo of porridge ingredients and a kilo of milk paste.  In November, these same women will serve as peer educators to the other women in the program, teaching them the same techniques. 

Our last action was proposed by the target families.  They reminded the CHW’s that the tree planting season in Mali is in August and September and suggested that the project put together a tree planting day.  Several families bought trees and protective fences themselves, while others who weren’t able to afford it contributed about $1 to help MHOP buy the trees.  26 trees were planted in the zones of Sikoro where the target families live. 

Thanks to our supporters we are seeing Action for Health progress on all fronts, and are particularly excited to watch the actions grow. Our goal is for the actions to serve as a catalyst for community mobilization around health that will expand beyond the scope of MHOP and our projects. The fact that the families’ and the CHWs’ are already taking initiative towards choosing and organizing the actions is really promising.  There is great potential in peer education and we’ll be sure to send you an update in the coming months on how our first peer- nutrition education session goes.

Making the malnutrition supplements
Making the malnutrition supplements
Reaping the rewards!
Reaping the rewards!

Links:

A community health worker measures a child
A community health worker measures a child's arm

As you glance around Bamako, Mali, it is easy to be struck by the numerous ways in which it is different from cities in the United States—the women selling bananas off the tops of their heads, the children running barefoot down the road, chasing tires, and the goats standing lazily in the middle of the street chewing on discarded corn. What is harder, and often much more important, is to be reminded of the ways in which it is similar. The cost of health care, for example, is an issue of similar importance in Bamako, New York, Washington, DC, and other cities throughout the world. And while my country, the United States, was fighting a political battle over health care last year, the organization, Mali Health Organizing Project (MHOP), was developing an innovative, community-based solution to children’s health care in several communities in Bamako, Mali. The program, entitled Action for Health, aims to provide free health care for children in Bamako in exchange for “community action” or days of volunteering on part of children’s parents.

As one MHOP volunteer explained, “people want to invest in their children’s health care; they just don’t have the cash.” So MHOP has given them a free alternative. By enrolling in MHOP’s health care program, children are insured against the five leading causes of children’s death in Mali including malnutrition, malaria, and measles. The organization has even gone so far as to develop a monitoring system in which community health workers conduct monthly house visits for children enrolled in the program, using innovative mobile phone technology to track the growth and health of children ages 5 and under.

By working closely with the Malian government’s health services, and collaborating directly with the local community, MHOP has developed an exciting and impactful program that already serves 385 children and 245 women! Although the organization has hopes of expansion, they are grounded in a desire for sustainability that is refreshing and important. The success that the program has experienced after just 4 ½ months of operations can only be seen as a predictor of even greater accomplishments to come!

Alexis is an In-the-Field traveler for GlobalGiving. Follow her and her fellow travelers' adventures at www.itfwa.wordpress.com!

Using mobile phone technology to monitor health
Using mobile phone technology to monitor health

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Organization

Project Leader

Kris Ansin

Executive Director
Westminster Station, VT United States

Where is this project located?

Mali   Health
Map of Action For Health : Empowering Communities in Mali