The 2014 annual Secretary of State’s International Women of Courage Award honors was celebrated by Malian newspapers and media. This is because for the first time since its establishment, a Malian women, Fatimata Touré, president of a local NGO called GREFFA based in Gao, Mali, was among the recipients. I met Ms. Touré while I worked at the regional hospital of Gao. It was not a surprise for me to hear such news, knowing the role played by local organizations like GREFFA to improve women’s health and protect their rights.
Long before the political and military turmoil of the last two years, Fatimata has devoted her life to helping women in northern Mali, in particular those who are suffering from the consequences of fistula. A large majority of these women are young and mostly victims of early marriage. Fistula is a hole between the vagina and rectum or bladder that is caused by prolonged obstructed labor or rape, leaving a woman incontinent of urine or feces or both. Obstetric fistula the most common one, occurs among women who live in undeveloped countries, who give birth without any access to medical help. Unsupported and denied access to healthcare, ostracized from friends and family, women who have fistula are left behind doors to suffer for the rest of their lives. GREFFA, in partnership with other organizations, worked since early 2008 raising awareness about fistula at the community level, training community volunteers in identifying fistula cases, and referring them to health facilities for treatment and follow-up. In addition, the GREFFA program ensures that all expenses are covered from transportation, to surgery, drugs and inpatient hospital fees. After treatment, the program provides an ongoing support to cured women by facilitating their reintegration in the community and a return normal life. The impact of such program cannot be underestimated in the context of Gao, in Northern Mali where the scourge was raging due to lack of access to health care (socio-cultural and financial barriers) and the high rate of early marriage, the main risk factor. More than 70% of women in Mali are married early according to UNICEF and this rate is even higher in Gao where some girls are wed at the age of 10 – 12 years old.
After the coup d’état led by military junta that ousted the elected president in March 2012 and the instability in the north caused by armed rebels, the region was occupied by Islamist and separatist groups. This led the administration to flee with a complete shutdown of all health facilities and administrative services. During this period of occupation, women suffered the most due to the new “sharia law” imposed: women were forced to marry, lost their freedom, and raped, jailed or stoned for not following the “law”.
One the most tragic issue during this crisis is shut down of health centers and the withdrawal of all international organizations that were working in the region to support the government and local communities. The regional hospital remained the only health center open, with a limited number of staff. Although basic care was provided, surgery and the advanced care required for fistula were not possible due to lack of skilled workers.
If the efforts of Fatimata Touré are praised today, it is because she stood up against these violations of human rights, risking her own life. She managed to ensure a continuous care for women with fistula and other victims of sexual violence by establishing a referral system to help women to be referred to southern towns to receive adequate care.
The crisis in Northern Mali is far from being settled. Protecting women and young girls, and supporting those in need, should be one of the priorities of the Malian Government and local authorities. This crisis brought international attention to the exceptional courage of Fatimata Touré. That will encourage her to continue her work supporting the care and protection of vulnerable women and young girls in Northern Mali.
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