Mali

MALI
Work commenced : 1979
Nature of work : Implementation and support of a comprehensive eye care system
Geographical areas concerned : Kayes, Sikasso
Partners : -Foundation : Mectizan donation program
- SightFirst (SF 1194)
2013 (in partnership with Lions Clubs of Mali/SF) : - Onchocerciasis control : activities continue effectively in all households within the framework of national control programs, where following the initial training provided by the OPC, the work of village agents allows more than 3.5 million people to continue to be protected.
- 33,000 ophthalmic consultations have taken place in three eye care centres supported by the OPC (Kayes, Sikasso, Mopti)
- 4,800 cataract and trichiasis operations
- Diabetic retinopathy control (training health personnel, awareness campaigns)
- Students for the DESSO qualification (Diploma in Superior Specialist Studies in Ophthalmology) in Conakry continue to use Kayes Hospital, refurbished by the OPC
- Two Malian ophthalmologists in training at the African Institute for Tropical Ophthalmology awarded grants to support their rural cataract surgery placements.
- In close partnership with the national blindness prevention programme, the necessary consultation equipment for the opening of four community care centres in the regions of Kayes and Bamako was provided and delivered by the OPC
Aims : - Open discussions with partners - the national blindness prevention programmes and Lions Clubs of Mali - to consider possible post-project actions, incorporating a consolidatory phase of the work carried out in the three regions of Kayes, Sikasso and Mopti and likely also including the region of Ségou.

Track Record for 4 Years of Mobilisation

The results we have obtained show the full strength of everyone’s generosity towards sustainably preserving the sight of men, women and children threatened by blindness.

(photo : treatment from Dr Kon­ate in Kayes)

Following an evaluation carried out at the beginning of 2010, the OPC decided to extend its program of comprehensive eye care for 4 years in the Kayes and Sikasso regions of Mali in order to consolidate the results obtained, as well as to spread its activities to the Mopti region. A new evaluation from earlier this year underlines the level of progress made, which often exceed the initial objectives.

Eye care :

- 109,083 ophthalmologic consultations carried out in 4 years, that being 3 times more than initially planned.
- 14,967 cataracts operated on, almost 2 times more than hoped.
- 84% of patients suffering from glaucoma operated on, almost 3 times more than the initial objective.
- 100% of new borns protected from purulent neo-natal conjunctivitis.
- 100% of congenital cataract and glaucoma cases diagnosed at birth and orientated towards a national specialist support center.
- 5,448 children with refractive errors detected and equipped with corrective glasses at the optical center created in Sikasso.

Training :

- 100% of the General Practitioners made aware of the need to refer diabetic patients to the eye clinic to undergo routine screening for diabetic retinopathy.
- 28 doctors, 320 medical leaders, 96 midwives and obstetric nurses trained in the detection of ocular diseases and referral to appropriate services.
- 9,070 community health agents trained in the detection of reduced vision.

Equipment :

- 8 Eye care units reinforced or created.
- 3 Mobile Eye care Units created : 4x4 vehicles and portable medical equipment in order to travel to operate on patients in isolated eye care centers.

Raising Awareness :

- Thousands of radio messages broadcasted in order to raise awareness about the prevention and detection of eye diseases.

Independence :

- Implementation of a cost recovery system through patient participation, which, from now on, ensures the independence and durability of the program.

Operation Yeleen in Mali (1979-1986)

Yeleen, which means “light” in Bambara, was the first programme to be conceived and executed by the OPC, and targeted eye health at the level of an entire African state, Mali. At the request of Mr Christian Monnier, visionary and founder of the OPC, an aid programme was developed in 1979 by Mr Ruy Rodriguez da Silva and Dr Marcel Chovet.

The programme offered :
- National medical and surgical cover including :

  • 1/ At a primary level : prevention, screening, primary health care and the implementation of a sanitary drainage system.
  • 2/ At a secondary level : the provision of quality eye care (cataract surgery)
  • 3/ At a tertiary level : IOTA (the African Institute of tropical ophthalmology) symbolised a great recourse regarding diagnosis, management, training and operations research.
    - Training (over a period of 4 years) : 6 Malian ophthalmologists and 12 specialist nurses.
    - Epidemiological and operational research applied to eye diseases.

Placed under the guidance of Dr A.D Négrel, the former Executive Director of the OPC, who was the soul of the Yeleen project and made it a great success, the programme - which was scheduled to last 5 years - ended in 1986. The cost of the programme amounted to over €1,676,000 of which €425,000 were investments. More than 1,250,000 consultations and 23,000 operations were carried out. The centres in Gao, Kayes, Mopti, Sikasso and Ségou were each equipped and staffed by an ophthalmologist and two specialist nurses. Progress was in full swing, and today the health care programme is busy as ever.

Yeleen was a total success and the programme has become the keystone public health ophthalmology in Mali. This success endures today to the utmost benefit of the population of Mali.

After the success of its first venture, the OPC has committed itself unreservedly, since 1991, to the fight against onchocerciasis in West Africa and later in Central Africa. This age old fight continues and the programme is now enriched by the inclusion of eye care at village level.

We are well on the way to eliminating onchocerciasis after 30 years of battle. More than 3 million people in 7,582 villages were protected in 2010 in 4 African countries, and thus will not go blind. Populations are now progressively returning to the most rich and fertile areas.