GENEVA – In Mali, despite a certain political normalization, the armed conflict that has been under way for almost two years makes access to health care difficult for people living in the north. The ICRC is helping them by maintaining its support for certain health facilities.

“Access to health care is still a critical issue for people in the north of Mali,” said Christoph Luedi, head of the ICRC delegation in Mali. “Conflict continues to have an effect on the functioning of health facilities, which struggle mightily to meet people’s needs without outside support.”

After the collapse in public services that followed the beginning of the crisis in 2012, health facilities were no longer able to perform their tasks in the normal way. Even now, the Malian civil service, particularly in the area of health, has yet to redeploy in the north of the country.

“In these circumstances, it is very hard for many Malians, especially young children and pregnant women, who are particularly vulnerable, but also war casualties, to obtain treatment,” said Kathrine Zimmermann, the ICRC’s health coordinator in Mali. “That’s why it is important that we carry on with the medical activities that we have been conducting since the beginning of the conflict.”

Gao’s regional hospital and the referral health centre in Kidal

The hospital in Gao – the main medical facility in the north of the country – has been running since May 2012 thanks to the support of the ICRC, which has been regularly supplying the medicines and medical supplies the hospital needs. As a result, inpatients receive care free of charge.

From January to October 2013, more than 19,000 patients were seen by hospital staff, including 4,000 who were admitted for inpatient treatment and 878 pregnant women who gave birth in the hospital. In addition, 435 casualties were provided with care.

Furthermore, a 150 kilovolt-ampere generator has been installed in the hospital, and with the ICRC supplying 100 litres of fuel every day the facility can meet its own energy needs and is able to provide round-the-clock service.

The hospital staff are backed up by an ICRC medical team (a project leader, two surgeons, an obstetrician-gynaecologist and two nurses) that continues to provide day-to-day care.

At the referral health centre in Kidal, an ICRC surgeon is present on a regular basis. The ICRC supports the centre by providing it with medicines and by covering the entire cost of surgical care, including caesarian sections and operations performed on wounded patients. The most serious cases are transferred for treatment to the hospital in Gao.

Weapon-wounded patients who cannot be treated either in Kidal or Gao are taken to Niamey or Bamako. Since January 2013, the ICRC has carried out 29 such transfers.

Primary health care a priority in rural areas

In order to make sure that people have access to primary health care, the ICRC provides support for seven community health centres in the Gao and Timbuktu areas: it upgrades the premises, supplies medicines and provides medical staff with training and monthly follow-up visits.

“At the hospital in Gao, we noted from the very beginning an abnormally high rate of infant and maternal mortality,” said Ms Zimmermann. “Women in labour were often arriving too late – they were already bleeding internally. It was important to provide care for them at an earlier stage, which we achieved by being present in the health centres, close to the rural communities.”

The three community health centres in the Bourem area, to the north of the city of Gao, which were given similar support by the ICRC until September 2013, are now being supported by the French Red Cross.

In the third quarter of 2013, over 6,000 people were seen by the staff in ICRC-supported health centres.

Support for physical rehabilitation of war casualties

From the beginning of the conflict, the ICRC has been working in close cooperation with the Centre Père Bernard Verspieren in Bamako. The centre receives support from the ICRC’s Special Fund for the Disabled, which provides it with materials and components to produce artificial limbs and other appliances, and backs its physical rehabilitation programme.

This support enables the centre to offer comprehensive care for patients needing prostheses or physical rehabilitation as a result of injuries or other trauma incurred in connection with the conflict.

So far, 20 injured patients at the centre have been given suitable appliances or physiotherapy with ICRC support.