Around the world, COVID-19 has hit the most vulnerable the hardest. Persistent inequalities and barriers to health care access mean that people living in poverty are at a higher risk of contracting the virus and other diseases, such as malaria.
These inequalities are apparent in Mali, where thousands do not receive adequate treatment because of creeping health care costs, infrastructure inefficiencies, and delays in access to care.
Seba Samake, a Muso CHW and Amadou Komina, a CHW Supervisor, speak to a group on the street in Samake's neighborhood of Bamako, Mali in between visits to local homes to raise awareness about COVID-19 and precautions that can be taken to protect residents.
That's why Muso, a Malian non-profit organization, is addressing the issue by helping communities get all the resources they need, including masks, to fight the COVID-19 pandemic through a local approach.
Founded in 2005, Muso quickly realized that health crises required a local and proactive approach — so they crafted a unique health care model designed to save lives in one of the world’s poorest countries.
Thanks to its community health workers (CHWs) — most of whom are local Malian women working on the frontlines of health — the organization identifies patients by taking part in coordinated door-to-door search efforts. CHWs also deliver door-step care and provide a range of health care services to adults and children across the country — including family planning, newborn screening, and treatment for children with malaria, diarrhea, and malnutrition.
As the COVID-19 pandemic gained ground in Mali, however, CHWs were forced to revise their approach to ensure that they were still able to reach and care for their patients in person amid the pandemic.
Community health worker Adele Coulibaly follows up with Mariame Coulibaly who was recently treated for an illness, during rounds to speak with families in her area of Yirimadio about malaria prevention on July 2, 2020 in Bamako, Mali.
This was not an easy process, according to Muso Mali Country Director Djoumé Diakité.
It was only once the nonprofit had secured enough personal protective equipment (PPE) for its CHWs that community members felt more at ease.
"The community was somewhat reluctant to receive care from CHWs, given that they travel frequently and are in contact with everyone else in the city," Diakité told Global Citizen. "These concerns were quite justified, so we had to devise a new protocol. We approached potential donors to secure funding for a large amount of PPE so the work of CHWs could continue. The community felt comforted and reassured."
Muso in Mali
Aissata Soumare, a nurse who has been working at the Yirimadio CSCOM in Bamako, Mali since 2016, poses for a portrait on April 28, 2020.
Muso in Mali
Fatoumata Dabo, 30, a pediatric nurse at the Yirimadio CSCOM in Bamako, Mali, poses for a portrait at the vaccination center.
Muso in Mali
Elhadj Diallo, a nurse who has been working at the Yirimadio CSCOM in Bamako, Mali since 2013, poses for a portrait on April 28, 2020.
Muso in Mali
Dr. Ibrahim Cisse, the director of the Yirimadio CSCOM, in the isolation ward where suspected COVID-19 cases will be able to stay separate from the rest of the clinic.
And while part of the population initially expressed concern over the wearing of masks, CHWs — aided by the Muso team — worked tirelessly to raise awareness about their effectiveness and ability to stop the spread of the virus, Diakité said.
"People felt suffocated, which was causing some resistance," he said. "There were also fears that the mask might carry the virus — but thanks to effective communication and awareness-raising efforts from the team, these doubts were addressed."
CHWs are now equipped with the tools they need to carry on their heroic work and have been able to resume their services.
Seba Samake, a Muso CHW, takes the temperature of Koniba Coulibaly, who was recently a patient at the Yirimadio CSCOM, as part of a follow up visit.
The Muso team is also currently acting as a advisor for the Ministry of Health and devising a national COVID-19 curriculum so that all frontline workers can be equipped with the knowledge and skills they need to keep tackling the pandemic within their communities.