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QUICK FACTS: MALI Size: 1.24 million square kilometers Population: 11,995,402 Population below poverty line: 64 percent Religions: Muslim 90 percent; indigenous beliefs 9 percent; Christian 1 percent Life expectancy: 49 years Ethnic groups: Mande, 50 percent; (Bambara, Malinke, Soninke); Peul 17 percent; Voltaic, 12 percent; Songhai 6 percent; Tuareg and Moor, 10 percent; other, 5 percent (Source: U.S. Central Intelligence Agency, World Factbook 2008) |
Mali
Mali, a landlocked former French colony, remains one of the least developed nations in the world with a ranking of 164 out of 173 countries on the U.N. Development Program's Human Development Index. Elections in 1992 ushered in a new era of democracy after decades of military dictatorship. Prudent economic policies have stimulated growth, but poverty remains widespread and is not decreasing quickly enough. Mali's government has embarked on one of Africa's most ambitious decentralization programs reflecting a commitment to poverty eradication and grassroots democracy. However, Mali faces many challenges in deepening its democracy and ensuring sustained human development. Read about the Center's health work in Mali > Waging Peace Encouraging Sustainable Development & International Cooperation The Carter Center and the government of Mali have a strong partnership through existing disease eradication and agriculture programs. To make these efforts sustainable, the government of Mali invited the Carter Center's Global Development Initiative to work with the government and Malian civil society to strengthen democratic institutions needed to establish realistic and coordinated development priorities; facilitate citizen input into setting those priorities; improve government management of development policies, programs, and projects; and build the government's capacity to coordinate its needs with international financial institutions and donor countries. President Touré of Mali made opening remarks at the fourth Development Cooperation Forum, "Achieving More Equitable Globalization," held Dec. 9, 2005, in Atlanta, to examine its progress and ongoing challenges to reducing poverty, fostering development and democracy, and enhancing international cooperation. Previously, Mali's president and a group of civil society representatives participated in the initiative's third Development Cooperation Forum Feb. 21-22, 2002. The forum explored Mali's participation in and ownership of its development strategies and programs with the international community. Helping To Establish a New Democracy With its 1992 constitution, Mali established the first multiparty democratic government in its history. This long-awaited political reorganization came after a legacy of colonial rule under France, a period of martial law, and considerable unrest, as citizens clamored for democracy. The first president chosen under this system, Alpha Oumar Konaré, was re-elected to a second, five-year term in 1997; still, the new government remained tense, with an electoral system only in its early stages of development. The Carter Center started its work supporting Malian democracy in 1998, when President Konaré and the Collectif des Partis Politiques de l'Opposition invited Center representatives to Mali, shortly after Konaré's re-election. COPPO is an alliance of political parties competing with the dominant Alliance pour la democratie au Mali, known as Adema, which counts Konaré as one of its prominent members. On this initial excursion, The Carter Center intended to facilitate discourse in talks regarding COPPO's involvement in future elections. At the time, COPPO would not recognize the Adema government's legitimacy, claiming, despite international elections observer reports to the contrary, that the May and July 1997 elections were fraudulent. The issue remained unresolved at the conclusion of the Center team's visit, as the disputing parties could not establish terms for joint meetings. Nevertheless, even with uncertainties about electoral integrity fueling conflict for Mali's government, the Center's separate meetings with the alliances indicated that headway could be made on several issues. All parties wanted to address concerns over the accuracy and reliability of elections, proposing measures to cultivate an environment more suited for democracy. The reforms included creating an organization to audit the expenditures of the National Electoral Commission, establishing a commission to investigate elections irregularities, and implementing plans to allow equitable access to state media. In the 2002 elections, The Carter Center continued efforts to assist and promote the country's democratic process by sending a small delegation of staff and observers to Mali. Overall, the delegation was impressed with the peaceful conduct of the elections, the high degree of competition with 24 presidential candidates, and the diversity of views expressed through civil society and the media. The delegation also noted significant irregularities in the administrative conduct of the polling process. Mali's election law requires that the winning candidate secure a majority of votes. If no candidate secures a majority, a second round of polling must be held between the top two candidates. Although there were marked improvements from the first to second round of voting, the Center's delegation noted widespread irregularities during both rounds. These irregularities, such as voter card theft, voter identification, and a cumbersome and inaccurate tabulation process, also were noted by the Constitutional Court tasked with the announcement of official results. The court decided to invalidate a significant number of ballots following both rounds, based on its own separate tabulation of votes as well as its rulings on election petitions. Such a large number of invalidated votes is worrisome, particularly in a country with less than 40 percent voter turnout. Moreover, the Constitutional Court makes its rulings in private, even though an exchange of information among the court, political parties, elections officials, and voters is necessary for electoral practices to improve. In the end, Mali's newly elected president, Amadou Toumani Touré (popularly known as ATT), appears to enjoy legitimacy with both his constituents and the international community. Yet even with this success, building a democracy continues to pose challenges for Mali, as ATT's lack of party affiliation places pressure on the upcoming legislative elections. Its new democracy in place, Mali must face the demanding work of outlining a new republic, but it does so with the support and encouragement of The Carter Center. Fighting Disease Guinea Worm Eradication Program Current Status: Endemic Indigenous cases reported in 2008: 417 In 1991, The Carter Center began working in conjunction with the Ministry of Health to eradicate Guinea worm disease in Mali. Since then, the Mali Guinea Worm Eradication Program has reduced Guinea worm disease from 16,024 cases in 1991 to 417 indigenous reported cases in 2008. Today, Mali is the third most endemic country remaining in the world, following Sudan and Ghana.
In 2005, Mali experienced an 85 percent increase in cases compared with 2004 – a constant reminder that Guinea worm eradication efforts must be maintained. Guinea worm disease, or dracunculiasis, is a 3,000-year-old parasitic disease that rarely makes headlines but is so painful and debilitating that its effects reach far beyond a single victim. Guinea worm is contracted when humans drink water contaminated with the infected larvae of microscopic, water-flea-like organisms called copepods. One year after the larvae are ingested, a worm up to 1 meter long emerges through a blister in the victim's skin, causing fever, nausea, and other symptoms. Guinea worm disease cripples the entire community. A child suffers and is unable to attend school, work, or play. A parent suffers and is unable to harvest crops or care for younger children. Eradicating Guinea worm disease in Mali builds hope and gives people a sense of empowerment that they can tackle other diseases and problems. Guinea worm prevention activities implemented in Mali's communities include: education on proper use of and distribution of nylon filters to strain out the water fleas hosting the infected larvae; monthly ABATE ® larvicide treatments of stagnant ponds; direct advocacy with water organizations; and increased efforts to build safer hand-dug wells. Village volunteers, who are trained, supplied, and supervised by the program, carry out monthly surveillance and interventions. In 2003, in conjunction with the U.S. Peace Corps, The Carter Center and the Mali Guinea Worm Eradication Program conducted the first in what has become a series of "Worm Weeks," five days of intensive health education in the three endemic districts of Gao, Ansongo, and Gourma Rharous. In December 2005, President Toumani Toure visited the country's most endemic region, Gao, to discuss appropriate measures to further eradication efforts. As a result of his meeting with politicians and health officials, he announced the transfer of program personnel to Mopti, more central to the country's endemic areas. While the program in the south has successfully reduced Guinea worm disease, the majority of cases of the disease remain in the north where migratory communities travel. In Mali as well as in other nations, migratory people are often some of the most marginalized. It is important that these people as well as other migrant populations are given the necessary tools to prevent the disease from traveling with them. To improve surveillance of nomadic populations living in Guinea-worm-endemic areas, 32 supervisory zones were created and are covered by an equal number of supervisors who visit endemic camps by motorcycle or camel. Sociological and epidemiological studies have identified that more than 90 percent of cases reported from Mali are among Black Tauregs, a nomadic group. Such vital information has allowed the program to better direct their health education messages and prevention measures. Living in difficult conditions in Mali's vast desert, the Taureg groups must migrate seasonally for their livelihood. Nomadic people like the Taureg do not consistently gather their water from a permanent water source but move in search of fertile pasture for their animals to graze. Young men and boys who tend to their camels and goats, and women and children who harvest wild grains away from the camps bear additional risks because they are often out in the field drinking from numerous water sources. The program is encouraging the use of pipe filters and developing alternative ways to provide health education to reach these groups. Guinea worm pipe filters – hard plastic straws with a stainless steel mesh inserted at one end – are used to filter out the microscopic water fleas from the water, thus preventing people from contracting Guinea worm disease. So far, Mali has made vast improvements in surveillance and is currently implementing strategies to contain cases within 24 hours of detection at health centers. All regions, endemic or nonendemic, must report cases immediately to stop spread of the disease. It is vital for Mali to continue this kind of detail, as well as it is critical for the nation to further invigorate efforts to prevent Guinea worm disease. The goal is to regionally eradicate Guinea worm disease from West Africa in the next few years. Until Mali completely eliminates the disease, it will continue to put neighboring Mauritania, Cote d'Ivoire, Burkina Faso, and Niger at risk for importing the disease. Mali has the resources, skill, and necessary support to eliminate this disease. The dedication of village volunteers must be paired with the political will of the national program to make Guinea worm eradication a priority at every level. Guinea worm eradication is a national issue. Updated July 2009 Controlling Trachoma Since 1999, The Carter Center has supported the National Prevention of Blindness Program of the Malian Ministry of Health to control trachoma. As the second leading cause of blindness in Mali, trachoma has been a major public health problem for many years. The Carter Center's support to the National Prevention of Blindness Program historically focused on facial cleanliness and environmental sanitation interventions in the Segou and Mopti regions. In late 2008, the Malian National Prevention of Blindness Program engaged its partners to create a plan to reach national trachoma elimination by 2015. In response, The Carter Center expanded its support to implement SAFE strategy interventions in Segou, Mopti, and Sikasso regions with generous support from the Conrad N. Hilton Foundation. The International Trachoma Initiative, Helen Keller International, and the Malian Lions Club as well as other local partners, also support trachoma elimination in Mali.
Since November 2008, The Carter Center has supported the training of 25 new trichiasis surgeons and facilitated more than 5,000 surgeries to prevent future vision loss and relieve pain from this advanced stage of this disease. The Carter Center has coordinated surgical outreach campaigns and village-based surgery delivery to help reduce the backlog of cases. The Carter Center also has supported the distribution of antibiotics for trachoma elimination where gaps were identified by the national program. The Center purchased more than 160,000 doses of tetracycline eye ointment to support annual mass distribution of antibiotics throughout the country in 2009. With a strong focus on health education, The Carter Center has supported the training of community health agents, local leaders, women's groups and community radio station DJs. More than 16,000 people have been trained in trachoma control education since 2001. The Center has also funded more than 3,000 trachoma prevention radio broadcasts in target districts. Ongoing health education currently benefits more than 1,600 villages. The Carter Center has supported the construction of household latrines in Mali since 1999. In Mopti and Segou regions, more than 59,000 household latrines have been built to improve environmental sanitation. In addition, almost 3,500 community masons have been trained to construct latrines. Health education messages promote community-wide adoption of latrines and routine use to ensure trachoma and other diseases are prevented. In order to assist national planning and target setting, The Carter Center also supports the Malian trachoma elimination program with prevalence survey training and implementation. Surveys have been conducted in Kidal, Koulikoro and Kayes regions, with plans to continue in additional regions in late 2009 and 2010. Efforts like these continue to help many people in Mali live healthier lives. By preventing blindness from trachoma, more adults can work, more children can go to school, and Mali's development goals can be more quickly achieved.
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