In Mali, we have seen firsthand how USAID cuts have hit healthcare

Anna Taft is founding director of The Tandana Foundation, a non-profit organisation that supports initiatives that achieve community goals through caring intercultural relationships in highland Ecuador and Mali's Dogon Country.

In Bandiagara, a remote city in central Mali where thousands of men, women and children have sought shelter from jihadist violence, we witnessed firsthand the damaging effects of the U.S. government’s cuts to foreign aid.

The city’s hospital had to lay off its specialists in gynaecology and nutrition. Five non-governmental organisations closed programmes supporting internally displaced people, women’s livelihoods and conservation.

They fired staff, with 35 local residents losing  their jobs at just one of these five groups. A former watchman for another organisation began visiting our office to ask for food because he could suddenly no longer provide for his family.

All 33 rural health centers lost a USAID-funded programme that had been providing free consultations and medications to pregnant mothers and children under-five. Many of them lost staff members whose salaries came from U.S. funds.

Promises made by NGOs who had been counting on aid funds from the U.S. to provide equipment, improve infrastructure, and train community health management committees were broken.

Ramata Pamateck, a 23-year-old woman from the village of Sal Ogol, told us what these changes meant to her when her one-year-old daughter, Fatouma, fell ill.

Her community and four others had worked with our U.S.-based organisation to build a health centre near her village of Sal Ogol, saving her a 10-mile walk to access medical care at the health centre in Kani.

But after her daughter was diagnosed with malaria, Ramata found that the free medication once provided at the health centre was no longer available.

The Alliance for International Medical Action (ALIMA), the NGO that had been sponsoring the treatment, lost their funding when the majority of USAID programs were cut this year.

Ramata’s hopes of accessing the treatment her daughter needed were crushed. She did not have the money to pay for the prescription.

The upheaval caused by the U.S. funding cuts in this remote Malian city shows how urgent the work of privately funded NGOs has become.

There are many small organisations actively supporting community improvements all over the world, and they need help to expand their impact. 

Individuals, foundations, and groups who care about our global neighbours can donate to these organisations to support community-led initiatives that can weather the uncertainties of changing global aid policies.

Responding to community priorities and equipping local leaders to sustain initiatives long-term have always been important factors in effective development programmes, but they are even more critical today.

When our organisation helped Ramata’s village and its neighbours to build the health centre, we were responding to a request from the communities.

We facilitated many discussions until agreement was reached about the precise location for the centre and the contributions of each party involved in the process. We also provided training to the members of a community health committee, which oversees the centre, to make sure they were equipped to manage a tight budget, care for the infrastructure sustainably, and keep the centre staffed and supplied. 

Because of that emphasis on long-lasting local leadership, this centre has the best results of all those in the region for rates of vaccination, attendance of prenatal consultations, child births occurring at the centre instead of at home, effective care for malnutrition, and use of the centre by residents in its zone.

With the loss of USAID-funded programmes that provided free medications and consultations for pregnant mothers and children, we are also designing a system of local health insurance groups, that would be able to manage and maintain funds for long-term healthcare benefits.

In such a volatile global environment, it is vital that such initiatives can survive without outside funding.

There are many small non-profit organisations doing outstanding work all over the world that truly respond to community priorities with initiatives that can provide sustainable benefits. By supporting and strengthening local leadership and designing programmes for ongoing success, these organisations set communities up to weather the risks of changing foreign aid policies.

After taking her daughter home without any medication, Ramata turned to traditional methods of treating Fatouma’s illness. Fortunately, she says that Fatouma is recovering. 

Without sustainable programmes, the health and well-being of millions of people is in jeopardy. The important work of small NGOs can ensure that Ramata and so many others like her will be able to provide for their families for generations to come.