Focus on Mali:  The Impact of Eliminating Trachoma 

Imagine being blinded in the prime of your life.  In much of the developed world, it’s often possible to move on—strong social services and community networks allow you to adjust and learn how to get around and continue your work.   

In a rural village in Mali, in Western Africa, to be suddenly and needlessly blinded means you’ve lost the ability to provide for yourself and your family.  It means you’ve become a burden to others—your spouse may leave you, community members may look down upon you, and your children leave school to take care of you and the family.   

In Mali, where primary school attendance is low, and secondary school attendance even lower; where the literacy rate is less than half the total population, it takes great strides to rise out of a cycle of poverty.  Here, blindness due to trachoma not only keeps individuals shackled to poverty, but it shackles their family members, too.  And most often, women and girls feel the brunt of this self-reinforcing cycle because they are expected to be caretakers for the family and give up any opportunity to continue their education.  

Trachoma in Mali

Most of Mali lies in the southern Sahara desert and the landscape is flat, arid and dusty.  Access to clean water and suitable latrines is spotty:  an estimated 45% of the population of Mali has access to adequate sanitation facilities.  Health care coverage is limited to those who require it most—the poor—and coverage is less in rural areas.  About 80% of Malians live in rural areas, and about 10% of the population lives a completely nomadic existence.  As a result of these conditions, trachoma and other neglected tropical diseases thrive here. 

Mali has been recognized by the WHO as a priority country for trachoma intervention.  Over 6.6 million Malians are at risk of being infected by trachoma and over 65,000 people face imminent blindness as a result of trachomatous trichiasis (TT)—the painful condition caused by multiple trachoma infections, when the eyelashes have turned inward and are scratching the eye—and are in need of eyelid surgery.   

Despite these gloomy statistics, progress toward eliminating the disease is being made by the government of Mali and several non-governmental partners.  Since 2000, ITI has supported the government’s trachoma control efforts in tandem with the Malian National Blindness Prevention Program.  The trachoma control program is committed to implementing the full SAFE strategy to eliminate trachoma in endemic districts and the government has demonstrated a strong commitment to eliminating the disease by 2015, five years ahead of the GET 2020 goal.     

The impact of this collaborative work is huge.  Men and women describe getting their lives back after TT surgery, or note the changes in children’s health because of new latrines or because kids are washing their faces more frequently.  School teachers note seeing more kids in the school, because a child—usually a daughter—does not have to drop out and care for the family due to a mother blinded by trachoma.

An Impact Story from Banamba District

The Banamba district sits within the Koulikoro region, which surrounds Bamako, the capital of Mali.  According to recent surveys, about 220,000 people live in various villages in Banamba, and in character with much of the rest of Koulikoro region, village life and subsistence are grounded in farming and agriculture.   

Recently, ITI representatives spoke to villagers in Banamba district about how the national trachoma control program has positively affected their lives, their families and their communities.  The following story highlights the impact of trachoma control on the life of Bako Traoré, a mother of six who runs her own groundnut business.   

For more stories about the impact of trachoma control in Mali, visit the Mali country page of the ITI website at http://www.trachoma.org/country/mali.htm.

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Bako Traoré lives in the village of Bougouba.  Usually she enjoys sitting in her chair outside her traditional home made of solid laterite mud, where she can conduct her business and talk with village members and friends.  She is a 55-year old mother of six children and she operates her own business of preparing and trading bambara groundnuts, which are similar to a peanut.  The groundnuts can be eaten fresh, dried, or used to create oil for cooking. 

Bako’s livelihood was on hold, though, when she suffered from TT caused by repeated trachoma infections.  Her eyesight had already deteriorated to the point where she could not cook, and she was starting to have to rely on others to help her with her business and care for her children.  She feared this situation would worsen exponentially as her eyesight slipped away.   

Then Bako found an opportunity to change things.  A family member informed her of the arrival of a team of health workers performing eyelid surgeries on people suffering from TT, so she traveled four kilometers by cart to the nearby health center to have the procedure.     

“I was impatient to meet the team when the day came because I was beginning to see poorly,” Bako recalled.  “I was not able to distinguish things.  I was almost blind and I was scared of this because I had already had enormous difficulties. It was necessary for me to have a maid come help me cook.   I had even stopped my business.” 

“The operation has truly changed the course of my life,” Bako continued.  “I am doing well. I am beginning to resume little by little my business.  I have very good visibility now. You see that I can sort the groundnuts all by myself. I see that which I am going to eat with my family. I even watch the television now.” 
 

Related Links: 

• Mali country page:  http://www.trachoma.org/country/mali.htm
• Trachoma in Mali Fact heet: http://www.trachoma.org/Fact%20Sheets/Mali%20Fact%20Sheet.doc