The following are excerpts written by Adam Aicha Hanne, an MPH – PharmD student who spent her summer practicum working with the Mali Health team in Bamako. She worked on the Gnaman ni Sôrô ni Kènèya project with the Community Capacity Building department.
The goals of the five-year Gnaman ni Sôrô ni Kènèya project are to improve community health by addressing environmental health hazards and creating opportunities for youth and women’s employment through waste collection, composting, recycling, and repurposing.
One of the goals of Gnaman ni Sôrô ni Kènèya project is to turn what is currently treated as waste into a useful commodity. Based on the Sustainable Community Project from GAYO in Ghana, we want to work with peri-urban communities to convert everyday trash into reusable products. But our very first step towards achieving our goal is to conduct research. Our research is composed of five analyses, three of which I am currently working on:
Waste composition analysis
Social norms analysis
Stakeholder analysis
This week we focused on the waste composition analysis as it is the most time-consuming and physically demanding one. Along with our team of investigators, we went into our target communities – Sabalibougou, Sikoro, and Kalabambougou – to physically analyze the waste generated by the homes participating in the survey. Investigators were provided with a spreadsheet that categorized the different types of waste that are typically found in waste sacs.
Teams of investigators were responsible for adequately weighing the waste sacs, identifying and segregating the types of waste, and documenting the weight of each type. The information will be used to used to identify which waste products are recyclable and the total waste per category will be quantified. Through our analyzes, we will understand the types of waste generated by the participating communities, and how their waste can potentially benefit them.
Learning from History
Last week I had an in-depth. fruitful conversation with my aunt and cousin about pre/post-colonial Mali. So, basically, our conversation was about Mali in the 1880s & 1960s. We spoke about how Mali was succeeding with the ruling of President Modibo Keïta. My aunty expressed that around the time of Modibo Keïta, Mali was functioning sustainably and the streets of Bamako were so clean. She emphasized how the community was centered around the culture, and how traditional ways were respected and followed as laws. For instance, people were frowned upon if they littered or did not contribute to community efforts to keep the country up to par. Mali was united regardless of tribalism or religious beliefs. After our conversation, she told me to take a look at Mali’s original constitution. Therefore, I focused on finding Mali’s first constitution right after gaining its independence from the French government.
However, during this research, I learned that Modibo Keïta had ruled as Mali’s leader during colonialism and post-colonialism from 1915 to 1977. But then my main question became who ruled Mali before colonialism in the 1880s? And what was the constitution or constitution-like understanding of the people of that time? I hope that my Bambara teacher who studies the history and social structures of Mali will be able to fill the gaps in the questions I have about Mali and its history. I honestly believe history is important to understand the future. My motto used to be don’t get stuck in the past but focus your energy on the future. That motto has always come in handy for me and has allowed me to advance in many ways in my life. However, as of today I now understand that it is important to look back at the past and analyze for what may have worked for people or communities and utilize those hidden gems in the future. I hope by revisiting the past I can bring to light the gems of the past to the future, and hopefully what I find can be helpful to my Malian communities.
For four years, the savings group Belle Dame, or Beautiful Lady, has met every Thursday as a part of Mali Health’s women’s health financing program. Their story begins with Mme. Koné Djénèba Ballo, the group’s founder and treasurer:
Ever since I was a little girl, I have been active and taking the lead on every activity I was a part of – whether it was organizing groups or competitions between friends in our community. One day a friend invited me to her savings group on the other side of Sikoro, but it was too far from home. So I asked if a similar group could be set up for women in our area. The animateur agreed and asked me to invite my close friends for a meeting. After 3 meetings, our group was born and we named her Belle Dame.
– Djénèba Koné
Djénèba invited other women to join the new group and soon the word spread until they grew to 25 members. Every week, they gather at their president’s home and contribute 250 FCFA (about $0.50) each – half goes to their health fund and half goes to their business fund.
Today, Belle Dame is in its fourth savings cycle, which due to COVID-19, is unlike anything they have experienced before:
The COVID-19 pandemic has profoundly affected Mali, especially us as poor women. Its arrival slowed down our activities, our children no longer go to school, our husbands are unemployed. As for our group, we could not hold our meetings. There were prohibitions related to gatherings that affected us, but because we did not have access to our small business activities, the members had trouble collecting their weekly contribution. We all sell goods and food we prepare either in the markets or on the streets, but none of that was possible for a while. In a nutshell “the country was on a answering machine” and nothing was going well.
Personally COVID-19 had a large impact on my business activity, too. Before, I could make up to 15 000 FCFA (about $30) per day. Today I find myself in the best case at 2 500 FCFA (about $6) per day.
– Djénèba Koné
But after several months, their savings meetings resumed. Now, they have regulations for distancing and handwashing with soap and water, as their animateur instructs during the health sessions with the group. To help cope with the economic consequences of COVID-19, the group has granted loans to most members to help them strengthen their small business activities, or begin new ones that are safer during COVID-19.
Women are providing each other with the support and solidarity they need to stay healthy, not only during the pandemic, but long before it.
Djénèba and her husband live in Sikoro-Sourakabougou with their six children. Before her savings group, Djénèba was afraid when a health problem arose because she didn’t know where or how to get a loan to pay for healthcare. She would ask for loans from neighbors, but didn’t want to risk gossip or getting a bad name. On one occasion, she had to use all the funds she had for her small business, forcing her to close it and losing her only source of income. She describes the stability that her savings group offers her:
Thanks to my savings in the group, I can have money to solve my family’s health problems in peace and in the utmost confidentiality. I was able to strengthen my small business, in which I was prospering a lot. As a street vendor of cosmetic products, I was able to set up a small kiosk that serves as a store for my business. Now I can provide for my little needs and that of my children.
– Djénèba Koné
In addition to having a source for loans and support for her business, her group also provides health information and help preventing illnesses:
At the end of each cycle, we buy preventive products such as soap and bleach, then we share the remaining money with all members of the group. It is a moment of joy most awaited by the members, and an opportunity for each of us to be able to achieve something like growing our businesses, take care of our children or even to have fun. There has never been a shortfall, and in our group, we are all friends. I am very happy to be part of Belle Dame and I do not intend to leave her with all the advantages that I enjoy.
– Djénèba Koné
COVID-19 continues to disrupt life in Sikoro and across Bamako, but there are no relief programs to restore what Djénèba and women like her have lost. But the networks they built to help each other stay healthy and access resources before COVID-19 continue to serve them during the pandemic. We’re committed to making sure Belle Dame and hundreds of other groups keep going strong.
The Health Promotion Department recently celebrated Global Handwashing Day, which takes place every year on October 15th. During the celebration, we promote hand washing with soap as an easy and affordable way to save lives by preventing pneumonia, diarrhea, and malnutrition, three conditions that are especially dangerous for children. Mali Health community health workers encourage families enrolled in our programs to wash their hands with soap throughout the year, but Global Handwashing Day is our opportunity to spread this important message to families we wouldn’t normally reach.
The theme for 2017 was “Our Hands, Our Future.” Mali Health recognized the occasion by hosting two public educational events: one on October 14th in Kalabambougou, where hundreds of women participate in our Savings for Health program; and the other on October 20th in Sikoro, where we engage community members in all three of our programs to improve the health of women and children. Between the two events, 1,100 people joined in the festivities.
We focused on promoting hand washing with soap at three critical times: 1) after using the restroom, 2) after changing a child’s diaper, and 3) before touching food. Two of our Quality Improvement coaches, Dr. Sogoba and Dr. Bathily, demonstrated proper hand washing techniques to the crowd, and our emcee Abdou Touré, Mali Health’s media expert, kept the crowd engaged and entertained between activities. Those attending answered trivia questions about hand washing and won hand washing kits, complete with wash basins and several bars of soap.
We were grateful to be joined by representatives from Mali’s Ministry of Women, Children, and Family Affairs and the Ministry of Social Development, Humanitarian Action, and Economic Solidarity; their participation both strengthens Mali Health’s relationship with important actors in maternal and child health in Mali and provides an opportunity for community members to meet and share their thoughts with their government.
While reflecting on progress, accomplishments, and goals yet to be achieved after her 15 years of community health and development work, Aïssata Touré, Mali Health’s SHARE project manager, tentatively says, “we’re doing the maximum, but we can still do more.” SHARE is a component of our savings group program aimed specifically at bolstering perinatal care and assisted births among pregnant women.
As a lifelong resident of Sikoro, the community where Mali Health was born, Aïssata has been an intimate witness to, and a driver of social transformation within her community. While growing up, her mother founded L’Association Muso Kalanso, The Association of Women’s Education. It was a grassroots community savings and education group in Sikoro, and simultaneously ran a nearby kindergarten. So working directly with pregnant women as Mali Health’s SHARE project manager, Aïssata feels right at home.
At only 26-years old, experience and ambition don’t fully describe the path Aïssata has blazed thus far. “Since I was the first child in my family,” she explains, “I had to believe that I could do anything boys could do.” Aïssata’s parents frequently tasked her with chores and errands usually associated with boys, so she quickly developed a thick skin and personal resolve with which she navigates complicated gender norms today. “The worst,” she laughs, “was carrying huge batteries across Sikoro to get recharged for nighttime electricity. I think those experiences pushed me to do more, to expect more,” she says.
Mali ranks among the countries with the highest gender discrimination in the world. Aïssata consciously lives her life as a positive example for other young girls in Sikoro, especially her own 9-year old daughter. She was the first in her family to attend university, receiving a degree in Economics from the University of Bamako. “Women can do anything. We just have to be brave.”
Since I was the first child in my family, I had to believe that I could do anything boys could do…Women can do anything. We just have to be brave.
– Aïssata Touré
At 13 years old, Aïssata volunteered as a peer-educator throughout her district’s school system to perform theater skits about about HIV prevention and treatment. “Oh yeah! I was terrified before my first performance,” she remembers. Within a few years she was running health advocacy radio programs throughout Bamako as assistant director.
By 2013, Aïssata was already on a list of community surveyors that Mali Health contracted to conduct various impact evaluations of our programs in Sikoro. At the time, she was working on her radio program, women’s savings groups, and maternal health volunteer work with the Red Cross. When she saw a job posting for Mali Health’s Assistant to the Advocacy and Radio Program, she took the opportunity. From then on, “every year I wanted more. In my performance reviews I would push for more responsibility.” The following year Aïssata transitioned to Communications and Public Relations Assistant, and the year after to become project manager for SHARE, her current position.
What’s the connection between her mother’s lifelong work with women’s groups and Aïssata’s own career choices? “Just a coincidence.” And between Aïssata and her own daughter: “I’m not sure, we’re very different—she’s super ambitious!”
The theme for 2017 was “Our Hands, Our Future.” Mali Health recognized the occasion by hosting two public educational events: one on October 14th in Kalabambougou, where hundreds of women participate in our Savings for Health program; and the other on October 20th in Sikoro, where we engage community members in all three of our programs to improve the health of women and children. Between the two events, 1,100 people joined in the festivities.
We focused on promoting hand washing with soap at three critical times: 1) after using the restroom, 2) after changing a child’s diaper, and 3) before touching food. Two of our Quality Improvement coaches, Dr. Sogoba and Dr. Bathily, demonstrated proper hand washing techniques to the crowd, and our emcee Abdou Touré, Mali Health’s media expert, kept the crowd engaged and entertained between activities. Those attending answered trivia questions about hand washing and won hand washing kits, complete with wash basins and several bars of soap.