Hawa Coulibaly. Photo: Toby Madden for Action Against Hunger.
Meet Hawa Coulibaly, a 30-year-old community health worker trained by Action Against Hunger. She lives and works in the remote village of Kourougue in rural Mali. Along with being a health worker, Hawa is also a mother. From the home where she raises her three children, she operates a clinic for the malnourished children in her community.
Closing the distance to healthcare
In Mali, a child will die every five minutes. Half of these deaths are due to malnutrition. Unfortunately, in rural areas, long distances between remote villages and health centres can make healthcare inaccessible. Parents may have to walk up to 40 kilometres every week if they wish to treat their children at the nearest clinic. Because of this, malnourished children from remote communities may receive treatment only when their condition becomes critical. Some children receive no treatment at all.
Action Against Hunger is changing this harsh reality. In an innovative and life-saving approach, Action Against Hunger trains community health workers to diagnose and treat malnourished children directly in their villages. This means not only that parents are spared the long-distance trek to find treatment for their children, but also that malnutrition is spotted sooner.
Saving the lives of malnourished children
Recently, Hawa was walking through her village when she noticed that a 2-year-old boy named Simbo looked underweight and lethargic. As soon as she had spotted these familiar signs, Hawa asked Simbo’s mother to bring him to her clinic. There, she used a mid-upper arm circumference tape (MUAC) to diagnose Simbo with Severe Acute Malnutrition. She prescribed him a four-week course of ready-to-use therapeutic food. With Hawa’s support, Simbo’s mother was able to treat her child at home.
In a similar way, Hawa saved the life of another 2-year-old named Fatumata. Fatumata’s family did not need to travel to the nearest health centre, and the little girl got well at home. This was a stark contrast to Fatumata’s eldest brother Musa, who almost died from Severe Acute Malnutrition before Hawa came to Kourougue village. At the time, Fatumata and Musa’s mother, Many, had no knowledge of what to do. As her son grew weaker, Many tried traditional medicine and bathed him in a mixture of water, leaves and bark from the local tereninfu tree. Still, Musa’s condition grew worse, and Many grew desperate. Borrowing money for a motorbike taxi, she travelled 204 kilometres to an Action Against Hunger inpatient facility in Kita. This ordeal was both expensive and time-consuming for the family, and it could have been prevented with the right support.
“Before Hawa, we were living in darkness,” says Many. “Since she has come here, children are healthier, and mothers are happier.”
Hawa weighing a child. Photo: Toby Madden for Action Against Hunger.
Shedding light on malnutrition
Education and awareness of malnutrition are low in rural Mali. Before Hawa’s arrival, many villagers like Many didn’t know how to prevent a child getting sick or how to recognise the signs of malnutrition. Families often thought of malnutrition as a sign of the devil and would use traditional remedies that did not solve the problem.
Part of Hawa’s role is teaching parents how to prevent malnutrition and other illnesses. “We talk about family planning, malaria and other diseases, hygiene and the importance of vaccinations,” says Hawa. “Before I came here, there was not much knowledge about health or nutrition.”
Action Against Hunger’s ground-breaking project is increasing the proportion of malnourished children who receive treatment. By transforming access to treatment through community health workers like Hawa, the project ensures that more children get the help they need. Compared to far-away health clinics, community health workers can reach more than twice as many children at almost half the cost, all while delivering the same quality of care.
“Since Hawa has been in the village, I’ve noticed a change” says Simbo’s mother, Mamissa. “There were a lot of sick children before, but now there are few.”
To meet the needs of her village as well as neighbouring villages, Hawa must keep a busy schedule.
A day in the life of Hawa
6:30 am: Hawa wakes up and cleans the house. She cooks a breakfast of porridge, bread, tea and coffee for her family.
8:00 am: Hawa starts work. She either sees patients in her house or walks to nearby villages to treat patients there.
12:00 pm: Hawa stops for lunch, which is normally rice or couscous.
Afternoon: Hawa carries on working. She sees patients and conducts training sessions with families.
Evening: After work, Hawa helps her children with their homework, cooks supper and goes to bed.
At any time of day or night, Hawa must be ready to see emergency cases. Being a community health worker comes with a heavy workload, but Hawa knows that what she does is worthwhile:
“I could do another job, but not like this,” she says. “Why would I want to? I love this so much.”
Hawa helping her children with homework. Photo: Toby Madden for Action Against Hunger.