fatoumata
Fatoumata Traoré,
Prajwala
(2004 AWARD RECIPIENT)
Madame Fatoumata Traoré has spent her life in the service of women and their families, transforming their lives (and her own life) by implementing the first family planning programs in rural Mali. She grew up in Rarous, a small and isolated village in the Sahara desert northeast of Timbuctu, where her father was posted from the South of the country as a government official. She was the only girl in her class, small and dark among the light-skinned Tuareg boys, who brought their spears to school along with their books and pens, and the Songhai boys, whose sisters didn't go to school either.
Marked by her early life in what is still one of the most remote and underserved villages in West Africa, Madame Traoré chose to become a midwife in one of the poorest countries of the world with one of the world's highest rates of maternal and infant morbidity and mortality. She studied first in Guinea, at the School of Midwifery in Conakry, and later in Mali and the former USSR. Like Perdita Huston, she perceived from the outset a pattern in poor women's lives, and she chose a career in public service to help them surmount the enormous obstacles of disempowerment, poverty and ill health.
Her first appointment was in 1963 to the maternity hospital in Bandiagara, on the threshold of Mali's cliff-dwelling Dogon populations. In this context, evacuating obstetrical emergencies frequently meant securing a woman in labor to a crude stretcher which was lowered on ropes vertically down the cliff-face in a process that could take up to two hours and as many lives. It was here that Madame Traoré developed what she sometimes refers to as her "obsession" with family planning. She told her Dogon mothers about high-risk births, urged pre-natal consultations, and talked about the advantages of birth-spacing, providing them with information on prolonged breastfeeding and sexual abstinence in an era when modern contraceptives were not available.
Later transferred to Mali's largest hospital in the capital, and thence to directorship of a maternity hospital in Koulikouro region, she continued to advocate for family planning and the availability of modern methods. Eleven years after Bandiagara, and at a time when Mali still had no official population policy and less than one percent of the population was using a modern method of contraception, she joined the Director of Health in the Region of Kayes to launch one of the first government-sponsored regional family planning programs in the country (1974).
She went on to serve as Director of the maternity hospital in the heavily rural area of Katibougou (1975 - 1993), where a cluster of 2,000 students attended the polytechnical institute alongside a local population of 20,000, scattered among 20 villages. The village women were for the most part illiterate and supported their families through subsistence agriculture. The students were plagued by unwanted pregnancies and the constant fear of abortion. Madame Traoré's devotion to this extended rural community and to a concept now known as quality of care meant that she was quickly accepted and almost immediately overworked, receiving a constant stream of young women, mothers and children in desperate need of basic family planning and maternal and child health interventions. In contrast to the local students, only nine percent of the village women had attended school, and most were married by age 13 or 14. Prior to age 31, the average woman had registered 5.6 pregnancies and 5.2 live births, and had 3.3 surviving children. A quarter of the women had had 8 to 13 pregnancies.
Aware of her increasing influence within this extended and conservative rural community, Madame Traoré in 1982 sought contact with other women managers through a leadership workshop sponsored by the Center for Development and Population Activities (CEDPA) in Bamako. In 1983 she continued to explore the parameters of women's leadership through a CEDPA-organized Women in Management workshop in Washington, D.C. Returning to Mali, she immediately mobilized other CEDPA alumnae in country to launch the groundbreaking Women's Committee for Population and Development Activities (CFDAP), using her position as a government health worker to leverage its attachment to Mali's Ministry of Health and Social Services (MSP/AS). In the same year the Committee was able to propose and launch Mali's first corps of community health extension workers, engaging the students at the Polytechnique along with the rural population. Two years later, Katibougou found itself firmly embarked on an informal experiment in community-based distribution (CBD) of contraceptives, responding to tremendous unmet need among both students and rural women.
Defying the prevailing belief that community-based distribution of contraceptives could not be done in rural areas, Madame Traoré in 1987 pioneered the first pilot community based distribution project in Mali, with financial support from USAID/Mali and technical assistance from the Center for Development and Population Activities (CEDPA). Far ahead of its time, the project included literacy and income-generation components and depended heavily on male participation. It was on the basis of the unqualified success of this initiative that the Malian Government launched its first national CBD program in 1989 through the Ministry of Health.
In 1993, Madame Traoré capitalized on the experience of 30 years to enter the arena of non-governmental organizations (NGOs) and policy advocacy. Following Mali's transition to a democratic regime and the trend to support civil society initiatives, she strategically transferred her base to the capital, where she established the first and largest non-governmental organization (NGO) in Mali specializing in family planning and adolescent reproductive health care. Her focus was on communities in the first five Regions of Mali and the District of Bamako.
Celebrating its 10th anniversary this year, the Association for Development and Population Activities (ASDAP) is one of Mali's great success stories in the privatization of family planning information and service delivery and a model for sustainability. Income generation from its youth outreach center in Bamako supports a specialized reproductive health clinic for adolescents, with emphasis on adolescent girls and professional counseling, and on prevention of sexually transmitted infections and HIV/AIDS. ASDAP has likewise pioneered strategies in volunteer peer education for adolescent reproductive health and mother-child health. Its peer educator program is the oldest and largest in the country (700 volunteers between the ages of 15 and 24, 50% of whom are girls).
Through ASDAP, Madame Traoré also continues a lifelong commitment to eradicating the practice of female genital cutting (FGC) in Mali, where 96% of the women have undergone "excision", as the practice is officially designated. Her recent and courageous efforts to educate powerful coalitions on the negative health consequences of excision have been recognized by the head of the National Program to Eradicate Excision.
ORGANIZATION
Over a decade, ASDAP has been implementing health programs and projects and community development initiatives both in rural and urban areas, through its competent and highly qualified multidisciplinary team. The main strategy of ASDAP is to use an integrated approach focused on complementarities and synergy with social and health services as well as community participation.
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