Location: Mopti region

Situation:
Despite a reform programme put forward by the head of state, Amadou Toumani Touré, to strengthen Mali’s economy and to promote the private sector, this country is one of the poorest in the world. Poor access to healthcare is a major problem and the maternal mortality rate remains very high, particularly due to the consequences of vesico-vaginal fistulas.

Activities:
Doctors of the World (DOW) is continuing with its prevention and treatment programme for vesico-vaginal fistulas. The activities undertaken include:

• providing surgical treatment for women;
• training three local surgeons, as well as a theatre team;
• dissemination of prevention messages (local radio, theatre);
• literacy sessions for patients who want them.

From November 1993 to December 2007, 927 patients were operated on. More than half came from the Mopti region.

In 2006, in agreement with the health authorities and the hospital of Mopti, DOW decided to progressively withdraw from this project, judging that local surgeons had mastered the necessary skills to take care of the patients with festiluas themselves.

In 2007, a unit was set up to take care of patients with fistulas having experienced psychological trauma.

In 2009, the project will enter its final phase, preparing for DOW's complete withdrawal within the next three years. It is in this context that the need for a new permanent coordinator is essential.

Outlook:
At the end of this project, Mopti hospital will be able to take care of patients. Integrated in this way into Mali’s national treatment plan for obstetric fistulas, the hospital can also supervise the training of surgeons who want to begin treating this condition.

Project Start date: November 1993

Project End date: End of 2009