Burkina Faso: Providing Healthcare in a Region Ravaged By Violence

“We fled the violence in our hometown and we have nothing, we don’t even have the money to treat ourselves”, tells Zallé Ramata during her visit to MSF’s mobile clinic in Sirfou, a village in Burkina Faso’s North region. Zallé brought two of her children to the clinic to receive treatment, after they’ve fallen sick last night. “We are grateful for this service; not only it’s free, but it is being delivered in our village. I neither have to worry about the consultations fees nor the transportation fees”, she adds.

Burkina Faso's North region hosts more than 100,000 internally displaced people who have fled recurring violence in this part of the country.

Since January 2021, Médecins Sans Frontières (MSF) has sent mobile teams offering healthcare to displaced people in the villages of Sirfou, Todiame, Rounga and Ouindigui, where access to healthcare and other basic services is severely limited.

"We have nothing left, since we fled the conflict," says Zallé Ramata, a displaced woman living in the village of Sirfou. "We don't even have money to pay for treatment."

Zallé brought two of her children to receive free medical assistance from MSF teams who have been regularly visiting Sirfou since January 2021.

"They weren't feeling well," says Zallé. "They spent last night throwing up until the morning."

These mobile clinics complement MSF's medical services in the town of Titao, to provide free healthcare in an area where thousands of displaced people have settled, fleeing a cycle of violence that for years has pitted armed groups against the military, as well as intercommunal clashes.

Out of 23 health centres in the district of Titao, 15 are not operating at full capacity and another three have shut down due to the conflict. Added to the difficulty in movement due to long distances, the insecurity and the lack of means of transportation, the situation makes access to basic health services in Titao's district almost impossible. Our mobile teams also regularly visit Sirfou's neighbouring villages of Todiame, Rounga and Ouindigui.

"These villages are located several kilometres from the nearest health centre," says Monique Diarra, an MSF nurse. "In Sirfou for example, where we are today, the nearest health centre is seven kilometres away. The majority of the displaced people have neither the means of transportation nor the money to get there."

These villages are located several kilometres from the nearest health centre... The majority of the displaced people have neither the means of transportation nor the money to get there. Monique Diarra, MSF Nurse

"Our main objective is to provide healthcare services to both displaced people and host communities that have no access to them and already suffered a lot because of the widespread violence," she adds.

Every week, an MSF team of five travels several dozen kilometres to reach these villages, often on very poor roads. The journey is relatively easier in the dry season but becomes longer and more difficult when the rains start falling. The region's chronic insecurity adds to the difficulties in the team's movements; it took months for the conditions to allow our teams to leave the town of Titao and reach these villages on the outskirts.

"We provide primary healthcare services that include treatment for common diseases such as malaria, diarrhoea and respiratory infections," says Diarra. "Recently, we started providing treatment for chronic diseases and mental health support."

Between January and March 2021, MSF provided more than 1,600 medical consultations to host and displaced communities in an area where around 15,000 people live.

By the end of 2020, many displaced people who had settled in Titao decided to come back to their area of origin, but the local health centres are still closed.

With the rainy season approaching, and thus the peak of malaria cases, our teams are concerned about the likely increase in people's needs in a remote area with few services available. The risk of malaria is higher because mosquitoes reproduce in stagnant water.

"Our medical work base in Titao is a short-term solution we launched this year to respond to the needs of people who were recently displaced," says Dr Diallo Alpha Amadou, MSF's medical coordinator in Burkina Faso.

MSF teams also support five health facilities in the district of Titao to help them regain their full working capacity, as a more long-term solution.

"When these health centres are ready to admit patients again, we will move our mobile clinics towards other villages," says Dr Alpha.

MSF medical teams also support local health authorities with mass vaccination campaigns against diseases common among the displaced people.

Our logistics teams rehabilitate old boreholes or build new ones to increase access to clean water. With the waves of displaced people, poor living conditions, and the lack of clean water, diseases can easily spread.

"We receive many patients suffering from diseases they caught by drinking polluted or dirty water. In many areas in the North region, just like in other areas of the country where displaced people settled, access to clean water remains a challenge for thousands," says Dr Alpha. "The lack of water access points and their bad quality are reasons behind different parasitic infections and other water-borne diseases such as cholera and diarrhoea."

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