Conflict in the north of Mali is still causing mass movements of people across the Sahel region of Africa and the conditions in the camps where they are living are unacceptable, leading to disease and suffering. According to UNHCR, approximately 150,000 refugees are living in refugee camps located in Burkina Faso (Ferrerio, Dibissi, Ngatourou-niénié and Gandafabou camps), Mauritania (Mbera camp) and Niger (Abala, Mangaize, and Ayorou camps). Médecins Sans Frontières (MSF) has been working in these eight camps since March 2012, providing primary and maternal healthcare for and treating malnutrition in these vulnerable people.  MSF is also providing primary care and measles vaccinations to children between six months and 15 years old. Nearly 12,000 consultations and 5,000 vaccinations have been carried out since the beginning of the year.


Mali 2013 © MSF
An MSF obstetrician treats a young mother at the Sossokoira Community Health Centre in Gao, Mali.

Nearly 67,000 refugees – mainly women and children – have arrived in the border town of Fassala, Mauritania since January 2012.  Many have travelled in trucks or with donkeys.  “At the border crossing at Fassala, Mauritania, people are arriving thirsty and showing signs of fatigue,” says Karl Nawezi, MSF project manager in Mauritania. After being registered by the authorities, refugees wait in a transit camp before being transferred to Mbera, a small, isolated village in the Mauritanian desert, just 30 kilometres from the Mali border.
Poor living conditions in the camps In Mbera, the refugees are totally dependent on humanitarian aid. To date, the number of tents that have been distributed has been insufficient. Families have been assembled under large tents called ‘meeting points,’ which leave them exposed to the elements. Fed up with waiting, some have taken it upon themselves to construct makeshift shelters out of straw mats and pieces of fabric in order to protect themselves from sand and dust storms. “People are suffering from diarrhea, respiratory infections and skin infections because of the poor conditions in the camps,” says Nawezi. Families fleeing in panic Last year people were moving across the border in an organized way, but following the recent increase in military activity in Mali about 14,000 refugees have fled in panic from Timbuktu, Léré, Goundam, Larnab and Nianfuke. Many have arrived with almost nothing after journeys of several days. “Recent developments in the conflict have caused panic. People have just fled, fearful of getting caught in the crossfire,” says Nawezi.   Malnutrition a constant concern In November 2012, a nutritional survey taken in Mbera revealed that nearly one in five children (17 per cent) was malnourished and that 4.6 per cent of children were suffering from the most severe form of malnutrition upon arriving at the camp. The MSF medical teams have expanded their activities to prevent and treat cases of severe malnutrition. “The main challenges are to ensure that children are vaccinated against disease, protected from malaria and have access to food that’s appropriate to their needs,” says Nawezi. MSF has set up therapeutic feeding centres to care for the most malnourished children. These facilities have already admitted 1000 children across the three bordering countries. Once admitted, patients are given special milk and nutrient-rich therapeutic food. As malnourished children are more susceptible to illnesses like measles, malaria, and diarrhea, their health must be monitored closely. MSF has been working in Mali since 1992. Staff run medical projects in Timbuktu, Gao, Ansongo, Douentza, Konna and Mopti. MSF has also been managing a 350-bed pediatric hospital in Koutiala, southern Mali, since 2009. MSF does not receive any government funding for its activities in Mali, which are financed entirely by private donations.