CHAPTER 4 WEST AFRICA - MALI Membership: The biggest churches of the association are: The Christian produced information and awareness-raising documents in Bambara, the 8 BOTH TOP TEN CAUSES OF DEATH YEARS LIFE WHO MORTALITY SUMMARY YEAR MALES FEMALES 8 DEATHS 000 SEXES ALL AGES MALI 2002 LOST % Evangelical Church in Mali, established mainly in the East of the country, The most widely-spoken national language. APSM is currently planning to design Population (millions) 2005 6.7 6.8 13.5 All causes 242 100 Evangelical Protestant Church in Mali, ☐ The Protestant Church of the Kayes a specific programme on HIV and AIDS which could affect all the strata of the Life expectancy (years) 2004 44 47 46 Lower respiratory infections 38 18 region, The Federation of Baptist Churches, ☐ The Evangelical Lutheran country’s population. 6 Under-5 mortality (per 1000 live births) 2004 230 208 219 Diarrhoeal diseases 22 11 Churches, ☐ The Assemblies of the Church of God, ☐ The Grouping of Southern Adult mortality (per 1000) 2004 490 414 Malaria 22 11 Baptist Churches, ☐ The Union of Evangelical Churches in Mali. 6 4. COLLABORATION AND PARTNERSHIP ON HEALTH Maternal mortality (per 100000 live births) 2000 1200 Perinatal conditions 18 9 Facilities: AGEMPEM holds as an associate member the APSM (see below), HIV/AIDS 12 4 which brings member’s health activities and facilities together. It also established Collaboration with government: There appears to be little collaboration an NGO to promote social development. 6 between the few FBOs in Mali and the government, although some meetings OTHER HEALTH INFORMATION 8 YEAR % Tuberculosis 9 3 do seem to take place on topics such as HIV and AIDS. 3, 6 HIV prevalence among adults (15 - 49) Both sexes 2003 1.9 Protein-energy malnutrition 8 3 Activities: AGEMPEM functions with three departments, namely: evangelisation, Cerebrovascular disease 5 1 youth and women. In the area of HIV and AIDS, AGEMPEM works through APSM, Collaboration with civil society: FBOs do appear to collaborate with other Total expenditure on health as % of GDP 2003 4.8 Ischaemic heart disease 5 1 and otherwise plays an observer’s role by participating in the information and secular NGOs – e.g. AGEMPEM is a member of the national NGO network. Per capita expenditure on health at ave exchange rate $US 2003 16 Road traffic accidents 4 2 reflection sessions organised by the governmental structures and others. The association thus took part in 1993 in a reflection forum which brought together Interfaith collaboration appears to be rather tenuous: A 2001 study by the WCC COUNTRY INFORMATION6, 7 EXAMPLES OF FBOS WORKING IN MALI religious personalities, doctors and other stakeholders of civil society with the noted that “however deplorable this may appear, the Churches and ecumenical objective of collating the reactions of the various parties involved in addressing institutions do not yet have formal partnership relations among themselves… Geography: In the heart of West Africa, Mali covers an area of 1,240,000km², and shares its borders with 7 countries. National Faith-based Health Networks: The Protestant Health Association of Mali the HIV/AIDS problem. AGEMPEM is a member of the national NGO network. 6 the Muslims claim they are in favour of collaboration with the other religions (in Capital: Bamako (APSM). The Interfaith Network of Religious Leaders… order to halt the spread of HIV and AIDS). The Christian organisations are also Language: French (official), Bambara 80%, numerous African languages. International FBOs: Caritas, The Mission Alliance, SECAMA, Islamic Relief, World said to be prepared, but nobody is taking the initiative…Our study in Mali made e.g. APSM: THE PROTESTANT HEALTH ASSOCIATION OF MALI 6 Politics: A French colony under various forms of French rule, gained independence in 1960, and was under the rule of a Vision, Norwegian Church Aid, MAP… it possible for us to realise that the different religious and ecumenical institutions dictator until 1991. Currently a multi-party republic based on French civil lay system as well as customary law. National FBOs: The Muslim Association for the Progress of Islam (AMUPI), Groupings foster within their own system partnership relations or work in networks…” 6 Administration: 8 administrative districts outside Bamako the capital. of Protestant and Evangelical Churches of Mali (AGEMPEM), Enda Third World Mali, History: An associate member of the AGEMPEM, the APSM (Association of SDA Bamako, Union of Muslim Women Associations of Mali, Alliance Mission Stiftung Urban Rural Split: 75% of this population live in rural areas Evangelical and Protestant Groupings of Mali, Association Protestante de la Santé Local-international collaboration: Local FBOs have some collaboration and Agape… au Mali) was established in 1992 by the Health Personnel of the Protestant partnerships in place with international and regional FBOs: e.g. “the Catholic Churches and Missions in Mali. 6 Church forms part of a regional network which deals with health problems.” 5 Mali RELIGION IN MALI 5 is heavily dependent on donor aid. Some large international FBOs have become Activities: APSM’s objectives are to encourage its members to provide quality heavily involved, e.g. MAP has provided major funding since 2005 towards HIV/ Predominantly Muslim (90%) with small proportions of other faith groups. Christians of all denominations account for less health care to the Malian population, and facilitate the coordination of the AIDS.3 Norwegian Church Aid and World Vision are also present. than 5%. The country is a secular State. medical activities of the churches and missions. The APSM designs, amongst others, literacy and health education programmes for women and children. 1. FAITHBASED ORGANISATIONS AND NETWORKS IN NATIONAL HEALTH ■ Until 1991, the Malian dictatorship did not encourage the In the area of HIV and AIDS, APSM undertakes prevention exercises, and has SYSTEMS development of civil society organisations – allowing only one On independence Mali inherited a state-controlled national health service with minimal Muslim organisation. Only after 1991 did other associations 5. KEY RESOURCES involvement by other providers such as the private sector or faith community.See 3, 7 There is come about. 3 1. Afronews/IRIN. 2007. Mali finds no good way to boost health services. 5. CIA. 2007. [online]. CIA – the 2008 world factbook. [Accessed 03/01/2008]. only a small tradition of Christian health service providers, nor does Islam tend to intervene ■ Because of low resources, local communities are currently not directly in health.3 “In the Sahel (regions), where most people are Muslim, Islamic primary commonly in a position to provide for health service delivery. 3 [online]. [Accessed 09/11/2007]. <http://www.afrol.com/articles/25054> <https://www.cia.gov/library/publications/the-world-factbook/index. care or hospital services do not really exist (and) Islam does not tend towards associative html> 2. Castle S. 1992. Intra-household variation in child care and illness forms in Mali.”3 Very little is known about the few facility-based health providing FBOs that Nevertheless, religious leaders have played a central role exist, although those that do exist tend to be from Christian backgrounds.3 It is said that: the in the Malian religious-health landscape, both positive (e.g. management in rural Mali. Doctoral thesis. Centre for Population Studies, 6. Josephine SK, Agapit AY and Tatagan-Agbi K. 2001. Churches and the Association of Evangelical and Protestant Groupings of Mali coordinates “some health facilities communicating health messages 3, 6), and negative (e.g. London School of Hygiene and Tropical Medicine. HIV/AIDS pandemic: analysis of the situation in ten West African countries. belonging to a number of members.”6; that there are “a few” clinics run by the Catholic Church discrimination of woman or FGM 3). Extremely low education Geneva: (WCC) World Council of Churches, World Alliance of YMCAs. – “22 centres were going to be involved in an AIDS program”6 Furthermore, in all regions of levels in Mali have also been ascribed to conflicting Islamic 3. Castle S. 2007. The contribution of faith-based organisations: networks Mali, there are traditional religions which persist or syncretically adapt to mainstream faiths educational practices and beliefs.3 The Islamic practice of Zakat, and traditions to health in Africa: a literature review. Bamako, Mali: 7. One World. 2007. [online] One World Mali country guide. [Accessed such as Christianity or Islam. Traditional healers and health systems therefore are part of the giving resources to the poor, is a strong practice in Mali, but little ARHAP FBO-landscaping for the Bill and Melinda Gates Foundation. 24/11/2007]. <http://uk.oneworld.net/guides/mali/development> Malian health system, as plural health-seeking behaviour shows, e.g. mothers in Mali’s Dogon is known how this directly relates to the health of communities, country will seek out traditional amulets from Islamic teachers; give their babies a traditional individuals or FBOs in Mali. 3 4. Castle S and Diarra A. 2003. The international migration of young 8. WHO Afro. 2006. Country health system fact sheets 2006. Brazzaville: enema every day to prevent illness; and simultaneously use ante-natal and immunisation Malians: tradition, necessity or rite of passage? Bamako, Mali: (WHO) World Health Organization, Regional Office for Africa. services if there is a health clinic nearby.2 There is also a widespread use of Islamic medicines 3. PROFILING KEY FAITHBASED ORGANISATIONS AND Report to Save the Children USA. or cures by the majority of the population of Mali. 3 NETWORKS e.g. AGEMPEM: PROTESTANT AND EVANGELICAL CHURCHES OF This profile page is a working document that seeks to summarize current available information about the faith-health sector in this country – 2. HISTORY OF FAITH AND HEALTH MALI with an inadvertent focus on facility-based religious entities, for which there is more readily available data.