MALI: Three questions for MSF’s Ibrahim Ahmed in Mopti and Douentza
January 26, 2013
Intense fighting occurred over the last week in central Mali – particularly in the town of Konna. Médecins Sans Frontières (MSF) teams have been working throughout the area straddling the line between the north and south of the country, in Douentza and Mopti, for several months. Ibrahim Ahmed is in charge of these two medical projects. Here he describes the constraints that MSF teams face and provides an update on the situation in this pivotal region.
What is the situation in Mopti?
When we arrived a week ago, people were leaving the city ahead of the fighting. We all knew that the war had reached Konna, a small town 70 kilometers from Mopti. People were leaving to stay with relatives and friends. Mopti was nearly empty. The stores were closed and there was hardly anyone in the streets. Those who stayed clearly lacked the resources to leave – the most vulnerable people. So MSF continued to maintain a presence there, supporting two hospital units for malnourished children and an outpatient treatment center.
When we got to Mopti, our original plan was to join the medical teams working in the Douentza hospital, a town even further north than Konna, but the fighting was intense and we couldn’t travel.
How are the members of the Douentza-based MSF team?
They’re feeling a bit isolated but they’re fine. We are in regular contact with them. Since the bombing started, they have stayed in the hospital so that they don’t have to come and go. This was to ensure their own safety and also to respond to medical emergencies. The teams conducted approximately 600 medical consultations over the last week, including 200 children under 5 years of age. Fewer people are coming to the hospital and the health center we are supporting, which suggests that the town’s residents are not venturing out of doors, so we’re concerned about their health. Surprisingly, we have not received any wounded patients. There isn’t much information – the situation in Konna region is unclear. It’s unusual to actually be positioned throughout a combat zone, to be so close. However, that’s the situation we are in today! Yesterday (Monday), we learned that the French and Malian armies have arrived in Douentza. We’re waiting to obtain access so that we can travel to join our colleagues.
What is the issue regarding access to Konna?
We know that because of the ground and air fighting, this community could have significant medical and humanitarian needs. But as of now, and despite our repeated requests, we are still prohibited from entering the area, so it’s difficult to know what is going on there. Everyone – aid organizations and the media – is stuck in Sévaré, a town adjoining Mopti. Last week, we brought in two trucks loaded with medical supplies and medicine. We now have medicine on site and can organize mobile clinics quickly. We have enough medical supplies to stabilize any wounded patients and transfer them to Mopti, if necessary. Our surgeon, who is still in Bamako, is just waiting for our green light. But the more time that passes, the more bogged down the situation becomes and the less of an idea we have about what we’re going to find when we get there. Of course, the worse thing would be to get there too late. Over the last few days, our main priorities in this region have not changed – to strengthen the Mopti team and obtain access to Konna.
“This year’s rains have been much heavier than usual and people have told us the flooding is the worst they have seen in recent years. During the wet season there is always water everywhere, however steady rains in August raised the water level much higher than people’s small defences could cope with. Many people were displaced from their mud homes as they filled with water or even collapsed from steady rain. I was actually stuck at MSF’s outreach site in Wuror for some time because the rains made it impossible for our plane to land. When the rain gets really bad, even moving by air becomes difficult!
A quick visit by MSF staff found Padding county was one of the areas heavily affected by flooding. People there were in need of shelter as their houses had either flooded or collapsed and they had had to move to higher ground in neighbouring villages or to relatives’ houses. Food supply was a concern, but the host families provided support. The problem was that Padding was not accessible either by road or plane.
Helicopters are in high demand during the rainy season in South Sudan because airstrips become un-landable for planes. We were able to secure a helicopter to transport the relief items (blankets, buckets, mosquito nets and plastic sheets), but not to transport the team. Our team in Lankien prides itself on going above and beyond to reach people who need assistance. So it was decided that we would walk the 31 kilometres from Lankien to Padding to carry out the distribution.
We left Lankien at 7.30am and walked for ten hours. Most of the ground was dry and extremely hard and uneven due to recent flood waters receding. Two ‘streams’ needed to be crossed, which involved wading through water, sometimes up to our chests, for around one kilometre. I was advised to wear rubber shoes by people who had done previous distributions in another village, Majok, which was five kilometres from Lankien. This was a big mistake! The ground was dry and hard on my spoiled Canadian feet. Distance? No problem. Wading in a swamp? Been there and done that dozens of times before. But always in decent footwear!
People we met along on the trail were quite surprised to see ‘khawajas’ (foreigners) and some could not believe we were actually walking from Lankien to Padding. MSF was actually the only organisation that visited Padding since the beginning of the rainy season. On the walk we noticed the piles of drying sorghum – the staple grain here in South Sudan – grow noticeably smaller and smaller the farther from Lankien we walked. The rains had been so heavy that the crops had been damaged.
When you arrive in Padding, you don’t see much as the population is extremely spread out. Families live in the traditional mud and thatch huts called tukuls. We saw some damaged tukuls, but none that were collapsed, so we knew that Padding village was the higher ground to where people were coming. The crops were visibly suffering as very little sorghum could be purchased locally. People were living off their goats or cows. In South Sudan, this is kind of like eating money for dinner.
The location of our distribution appeared to be in the middle of nowhere. A simple mud and tin sheet building that serves as the school house and a few neighbouring tukuls are all that's to be seen in an uninterrupted field. The nearest tukuls would be at least 500 metres away and neighbouring villages easily ten kilometres or further. Many women who came to collect the relief items had to travel nearly a day and then stay in the area overnight.
We set up a camp and met with the local chiefs and administrators to work out the best way to distribute the items evenly among the ten nearby villages. We identified a landing site, cleared it of tall grass and relayed the coordinates to the helicopter. The next day we marked a large ring with flags, fixed a large MSF flag and lit a signal fire, ready to receive the helicopters carrying all the relief items. We hired 40 locals to unload the helicopters and move the materials to the distribution site. We also distributed 1000 tokens to the most affected families in the ten surrounding villages to make sure our response reached everyone who needed it. The support from the local chiefs and population really ensured things ran smoothly.
On the day of the distribution, a steady stream of people came to the site to collect their kits. In the end we distributed 775 plastic sheets, 992 buckets, 660 blankets, and 840 mosquito nets to the 1000 affected families. The following day, we made the ten hour trek back to Lankien. Along the way we were greeted with smiles and thanks from the women who were returning to their own villages with the items on top of their heads!”
Following heavy flooding in parts of Western Equatoria state in September, MSF carried out emergency relief item distributions in three affected areas – Nzara, Lui and Ibba. MSF teams responded to the most urgent needs of the population, the most affected of whom had lost their homes and household items. The teams distributed 130 kits in Nzara, 299 in Lui and 32 in Ibba, with families receiving plastic sheets, blankets, mosquito nets, jerricans, soap, buckets and cooking equipment.