Aissata Touré, 16, has just had her first baby. The young mother had hoped to give birth near her home in her village of Ngouma, Mali, but a local health worker advised her to go to a hospital due to possible complications. It would be a challenging and expensive journey. Her family rented a car and she traveled in labor to the Sominé Dolo Hospital in the city of Sevare, which is 170 km from her home. “The trip was difficult and not at all comfortable,” she says. The cost: 120,000 CFA francs (about $200), an astronomical sum in her country.
People have great difficulty getting to the hospital. One family counted three days to get there, but they never arrived.
The ongoing conflict in Mali has eroded the rights of women and girls, and the crisis has contributed to one of the highest maternal mortality rates in the world. Climate shocks, particularly droughts and floods, have exacerbated vulnerability.
Fortunately, Aissata was able to reach the hospital in time to give birth under the supervision of qualified attendants. However, more help is needed so that women can access prenatal care, safe births and postnatal care. Below we cite some of the ways in which the UNFPA offers support.
The long road to the hospital
A non-governmental organization called HELP, a partner of UNFPA, is providing support to pregnant women where possible, arranging private transport from rural areas to the Sominé Dolo Hospital for women suffering from obstetric complications. But in the vast country, one of the largest in Africa, it is impossible to reach everyone everywhere. The remote village of Aissata was out of reach.
“There are no transport partners where my niece lives, and there is no support,” laments Abdoulaye Bocoum, Aissata's uncle. He knows this well, since he works with HELP. “It was terrifying. “If the family couldn’t afford to rent a car, they wouldn’t have been able to get here.”
Kadiatou Karembé, who has worked as a midwife at Sominé Dolo Hospital for seven years, has witnessed firsthand the consequences when a pregnant woman with complications does not reach the hospital in time, including death.
“People have great difficulty getting to the hospital. One family counted three days to get there, but they never arrived. “We have ambulances to look for people from rural areas, but in crisis areas, they have been taken away.” – Félix Diarra, director of the Sominé Dolo Hospital
Félix Diarra, Director of the Sominé Dolo hospital
Support for displaced people
While the Sominé Dolo Hospital team is busy saving the lives of women who can get there, UNFPA-supported mobile health teams have been established in camps for internally displaced people who cannot reach a medical center.
Hundreds of thousands of people have been forced to leave their homes due to armed attacks and raids by terrorist groups against civilians in northern and central Mali.
Fatoumata Dienta, 25, is among them. She was two months pregnant when she fled her home in Dena, on the banks of the Bani River. “One night, when we had finished eating, the terrorists came and told us to leave the place the next day,” she says. She and her family went to the Barigondaga displaced persons center in the Mopti region, 180 km from her home.
“Some came by rickshaw, others by boat,” says Fatoumata. At the center for displaced people she received support from a mobile health team, and finally gave birth at a community health center.
In the Barigondaga displaced persons center there are 149 households, with 372 women. They have all come from the fishing communities of Dena and Soye. Mobile health teams in Barigondaga and other displaced persons centers provide prenatal and postnatal care, as well as supplies for safe births. In 2023, UNFPA recruited and trained 51 midwives in the Mopti region, and renovated and equipped 12 rural maternity wards.
A promising initiative
Meanwhile, in Timbuktu, about 400 km north of the Mopti displacement center, a program to help young people learn to drive offers hope for the future.
Five hundred young people (men and women) have obtained their driving license since 2021 as part of the initiative, which is supported by UNFPA and funded by the Danish Government.
Mali has a young population, with more than 65% under 24 years of age. Growing up in a country ravaged by crisis, young people have seen their opportunities, freedom and independence restricted. The program aims to increase employment opportunities and reduce the likelihood of young people being recruited into non-state armed groups.
“Armed groups are recruiting young people everywhere, and many young people have joined them,” says Traore Safietou Abdou, 24, who learned to drive this year. “Things are a little better now, and we're slowly seeing a sense of community starting to develop. “I want to get a job, and one as a driver would be a good start.”
Djiby Kongho, 29, hopes her new driving license will lead to job opportunities. “I joined the program because life here is difficult and it opened an exit door,” she says. “I want to get a job to help my family. “I would like to get a job as a driver: women can drive as well as men.”
In addition to driving instruction, program participants receive information on gender-based violence, family planning, menstrual hygiene and maternal health, as well as available services.
A mobile health team conducts an information session in the center of Barigondaga.
Women's rights in crisis
It has been 30 years since the historic International Conference on Population and Development, where world leaders agreed to take concrete steps to put sexual and reproductive health and rights at the center of sustainable development. But in Mali and in many other humanitarian crises around the world, the rights of women and girls are being erased, stagnating or in clear decline.
In crisis situations, especially when women and girls are forced to move, there is an increase in gender-based violence, preventable maternal deaths and unwanted pregnancies. UNFPA and its partners will continue to work to realize the rights of women, girls and young people.
“Even as rockets fell, the earth shook, and climate impacts continued to bite, women and girls in humanitarian contexts continued to give birth, require sexual and reproductive health services, and seek safety from gender-based violence in their homes and communities,” said UNFPA Executive Director Dr. Natalia Kanem at the end of 2023. “But UNFPA was at their side every step of the way, providing essential services, protecting their dignity and rights, saving lives and restoring hope.” .
