Illness and health among the Kel Tamasheq in Northern Mali

Verantwortliche Dr. Anna Münch
Trägerschaft Institut für Islamwissenschaft und Neuere Orientalische Phililogie
Betreuung Prof. Dr. Reinhard Schulze 
Kooperation Prof. Dr. med. vet. Jakob Zinstag (U Basel)
Finanzierung KFPE (Kommission für Forschungspartnerschaften mit Entwicklungsländern) / cogito foundation

At the mercy of the ecological and economic dictates of their arid environment, nomadic societies are repeatedly forced to migrate and relocate. Geographic, cultural and political factors have kept them largely marginalized. Their mobility, their proximity to their livestock, a dairy-rich diet and an arid habitat leave pastoral societies exposed to a variety of health risks, as reflected in one of the highest infant mortality rates in the world: up to 50% of children in the Sahel region die before their fifth birthday. Mali’s healthcare services are not geared to the nomads’ mobile lifestyle, and the socio-cultural barriers in place mean that women and children in particular have virtually no access to external healthcare facilities. Very little research has been done into their internal networks, their perception of illness, the perceived causes and their ensuing behaviour. It is, however, practically impossible to control diseases without knowing their context. Collating key data on nomad women’s general understanding of health issues as well as on diseases and their epidemiology not only serves to fill a knowledge gap, it is also fundamental to building up a socio-cultural awareness and defining local health strategies which could help regional authorities and organisations to develop a reliable medical care system. The arid regions of the Sahel zone can only be economically exploited by nomadic cattle breeders. Once pastoral nomads are better familiarized with the essentials of healthcare concepts and strategies, appropriately tailored health interventions will improve their living conditions and ensure that arid grazing land can be preserved for nomadic use. A society’s needs and the indigenous risks its faces cannot be identified by biomedical rationality alone, nor simply by taking a socio-cultural approach. Fundamental research on the diseases of a specific society require the interdisciplinary coupling of medical epidemiological studies with cultural anthropological methodology to obtain the complete picture. For this reason, local health determinants in the nomadic milieu of the Tamasheq are ascertained and interpreted with the aid of the theories and methods of cultural epidemiology and clinical and/or biological studies. Possible connections with diseases transmitted by animals (zoonoses) are also shown. The results of the present case study (socio-cultural and medical dissertations and publications) are assessed in close collaboration with the Mali health authorities. Specifically evaluated indicators are discussed a priori with partners from the Mali healthcare system, and current information on the health status and options for culturally adapted healthcare systems investigated. At the same time, disease-controlling intervention is made possible for a population group hitherto unreached.