This morning, we leave the green and fertile region of Sikasso in southern Mali, to visit communities and report on the exemplary experience of Yorosso – a district which has reduced rates of chronic malnutrition by nearly half in just two years.
UNICEF Nutrition Specialist Bienfait M’Mbakwa Eca talks to me in the car about the people whose influence is invaluable in fighting malnutrition. Traditional healers, also called ‘tradipractitioners’ here, use traditional African medicine that is mainly based on plants and mineral or animal substances. “We renewed their role to become modern health advisors,” he explains.
“We also work with religious leaders,” he adds. Their wisdom is recognized and their voices are heard. Their power of influence is considerable. Going through them means creating an essential climate of trust. I look forward to meeting them. Arriving at the Karangana community health centre, a man with a frail appearance Seriba Berta, a tradipractioner comes to welcome us and tells me with a big smile: “Did you have a pleasant journey?” His calm tone wins my sympathy and inspires respect. Seriba offers me a chair in the shade of a tree. This is the sign that a long conversation will soon begin in a soothing atmosphere.
“We are the first reference for the villagers. When they have a problem, they come to me first,” he starts, well aware of the importance of his role. In many parts of Mali, traditional medicine remains a primary recourse and tradipractitioners enjoy a high social status.
“I learned to recognize the symptoms of malnutrition to better exercise my profession,” says Seriba, who was trained on infant and young child feeding at the community level as part of the Africa Nutrition Security Partnership (ANSP) project, a joint European Union-UNICEF undertaking.
The tradipractitioner now knows how to prevent malnutrition. “I always advise mothers to prepare enriched porridge. A pregnant woman should be well fed, otherwise the baby in her womb will inherit her bad condition.”
He continues his story: “I abandoned a practice. I use to prepare herbal concoctions to drink and to wash.” Seriba’s life and way of thinking have changed since he was welcomed with open arms by local authorities to help coordinate nutrition activities. With many other actors, he actively contributes to the so-called “multisectoral nutrition platform”.
“Since I was trained, I can see signs of malnutrition, I send the child to the health centre where the agents can detect the disease and treat the child if necessary. This is the best thing to do for children. People in the village trust me,” he told me.
I am very surprised by this person who represents a very old tradition and yet turns towards modern medicine with so much determination. Is this a sudden break? I misunderstand traditional practices: I think they are harmful, something to abolish. “I heard that traditional healers believed malnutrition was a bewitchment,” I said, without fully understanding the impact of my words. There is a silence.
He calmly speaks up again. “Our ancestors treated malnutrition in their own way. Cases of witchcraft were not so common here.” As I think about many other questions to ask, my UNICEF colleague Bienfait interrupts me. “Cindy,” he calls, “he wants to let you know that people here don’t want to disrespect their ancestors.”
So, it isn’t a sudden break: it’s more of an evolution, an improvement, an adaptation to the modern world with respect for traditions. Tradipractitioners have a long life ahead of them.
Other voices have a persuasive power. Religious leaders have always shown the way to follow. After meeting around the table of local authorities to discuss current affairs, three chiefs – Baba Madou Koné, Muslim; Adama Emmanuel Koné, Protestant and Alphonse Goïta, Catholic – came to meet me in the courtyard.
Their words mix into each other. They answer and complement each other in harmony: they are together. They are all going back to the sacred texts, echoing their voices: “It is in the Qur’an and it is in the Bible. It is a duty for all men and women to care and feed well their children.”
Baba Madou Koné recommends the consumption of vegetables and guinea fowl eggs to the faithful who attend the Friday prayer at the mosque. Adama Emmanuel Koné raises awareness on the basis of the biblical verses at the Sunday mass. The Catholic Alphonse Goïta talks to me about the collaboration with Nutrition and Water, Hygiene and Sanitation specialists. “We meet them every year so that we can educate our communities. They inform us about bad eating habits that we need to change. They tell us about the menu we must give at each stage of life: exclusive breastfeeding for up to six months and then we have to introduce complementary foods like enriched porridge or, fish soup.”
What struck me most was the frank and sincere cooperation between all: religious leaders, big farmers and land owners, women’s group representatives, tradipractitioners. In Yorosso, they are all united by a common and meaningful goal: to address the malnutrition that makes their children suffer.
There is a reason why we often hear talking about Yorosso as a “highlight” in the Malian nutrition landscape. Beyond the impressive figures – stunting rates have decreased from 27.8 percent in 2014 to 15.4 percent in 2016 – Yorosso’s success is to avoid breaking with existing entities and leverage influence relationships. This is a basis to build sustainable and autonomous mechanisms for fighting malnutrition.
Cindy Cao is a Communication Specialist at UNICEF Mali.