The Century of Africa
January 2005
Banner photo: ©SEKAI BUNKA PHOTO
MDG Success in Rural Mali
Zégoua, 485 kilometers south of the capital of Mali, Bamako, is the last frontier post before the border with Côte d'Ivoire. In this town with a population of 22,000, the women have successfully united in the struggle against poverty and maternal mortality--a rare accomplishment in a country often listed among the poorest in the world.
Since January 2002, there has been not a single case of maternal or neonatal mortality registered in Zégoua or the nearby villages, declares Yaya Coulibaly joyfully, chief doctor at the community health center in Zégoua, which covers nine villages.
Taking Responsibility
Dr. Yaya Coulibaly
According to Coulibaly, this incredible result is the fruit of the combined will of the women of Zégoua, who formed groups in order to take responsibility for their own health. "In spite of their meager financial resources, these women pay for postnatal consultations or for vaccinations or family planning services," explains Dr. Coulibaly, who is fiercely proud of these "brave women."
According to UNICEF, every day in Mali an average of 1,530 women become pregnant, of whom 230 will suffer complications and 20 will die. And each day 100 newborn babies also die. Some of the women who survive suffer from fistulas, infections, sterility or descent of the uterus.
"We didn't give serious thought to our health problems before," says Mariam Ouatara, from the village of Katélé, adding that scarce funds were sometimes spent on community celebrations. "After these big festivities, some of us couldn't even afford to pay the 100 francs CFA (about 18 cents) it costs for a simple vaccination card."
But, conscious of the scourge of maternal and neonatal mortality, which accounted for 15 percent of deaths in 2002, the women got together in groups of 20 to 40 to plant cotton, peanuts and rice. Rather than be paid by the task for working for men, the women demanded, and got, their own fields, so they could benefit from the fruits of their own labor. They have now taken responsibility for household management and the men seem happy with the positive results.
Some of the proceeds from the sale of these crops are deposited in a local savings bank to create a fund in order to reimburse the members' health costs, notably costs of vaccinations, neonatal and postnatal consultations, family planning and buying drugs for treating malaria. In the event of severe problems during a pregnancy, the coordinator of the village team must ensure that the woman is transferred to a clinic equipped to deal with such emergencies.
For instance, Katélé, 18 kilometers from Zégoua, is the site of a health post staffed by a village activist who comments, "Here we distribute medicines and hold discussions to raise the awareness of women about maternal and neonatal mortality." Deliveries also take place at the health post, and if necessary, women can be taken by motorized ambulance to Zégoua.
At present, despite economic difficulties, bad rains and the effects of the crisis in neighboring Côte d'Ivoire, the women of Zégoua are fighting even harder against misery and poverty.
Women of Zégoua
It is Dr. Coulibaly whose unflagging efforts since 1992 have inspired the formation of the women's groups and ensured their continued existence. Now he is pushing for such groups to be formed throughout a wider area, the local commune, and he has nearly achieved his goal.
However, at the time of my visit in late November 2004, because of the conflict in Côte d'Ivoire, Zégoua had no electricity or telephone services. Since 1996 the town has been dependent on the neighboring country for power, as it is only three kilometers from the first town inside Côte d'Ivoire. It is the lack of electricity which makes Dr. Coulibaly's situation untenable. "Without light we cannot work properly."
Combined with the insecurity, the lack of power is causing a drop in the attendance of women at the center during the night. Dr. Coulibaly is concerned that this could lead women to have deliveries at home and increase risk.
Scourge of Maternal Mortality
According to the World Health Organization (WHO) and UNICEF, nearly 600,000 African women die each year as a result of complications resulting from pregnancy or childbirth.
In recognition of the extent of obstetric problems, Mali's government joined UNICEF, the UN Population Fund, WHO and other NGO and UN organizations to hold the "Vision 2010" conference in Bamako in 2001, on neonatal and maternal mortality.
The problem of maternal mortality is also addressed by the UN's eight Millennium Development Goals (MDGs), a series of targets that were agreed on by global leaders at the UN Millennium Summit held in 2000.
One of the MDGs stipulates that maternal mortality should be reduced by three-quarters by 2015-a goal that Zégoua has already surpassed.
Almahady Cisse is an independent journalist in Mali. He is editor of "Eco Perspectives" and Mali correspondent for the IRIN, IPS and www.afrika.com news services.
