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MSF working with Mali MoH in treating COVID-19 patients in Bamako

MSF nurse Nathalie Kornfein in the MSF consultation room set up in the hemato-oncology wards of Point G University Hospital in Bamako. Mali, September 2019. © Mohammad Ghannam/MSF
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Since 22 March, Médecins Sans Frontières (MSF) has been assisting health workers in a centre specialised in treating epidemic-prone diseases, in Bamako, the capital of Mali. Part of Bamako’s Centre Hospitalier Universitaire du Point G, the centre is now being used to provide medical care to patients infected with COVID-19. Fifteen patients have been treated so far, three of them in the intensive care unit. Six patients have since recovered from the disease and have been discharged.

    On 25 March, Mali registered its first two people who tested positive for the new coronavirus. Since then day, 116 cases have been confirmed and 10 people have died.

    A dedicated treatment centre

    The authorities have set up a referral facility in Centre Hospitalier Universitaire du Point G in Bamako where patients with COVID-19 can be isolated and treated.

    Maintaining cancer care is one of our priorities... but it’s going to be a problem if we don't have sufficient supplies of masks and equipment to ensure the protection of these particularly vulnerable patients.
    Dr Idrissa Ouédraogo, MSF medical coordinator in Mali

    “MSF has sent a doctor, nurse and hygienist to help in the triage zone at the entrance to Centre Hospitalier Universitaire du Point G,” explains Foura Sassou Madi, MSF’s head of mission in Mali.

    Teams from the National Institute of Public Health take samples in the hospital that they then transport to the laboratory for testing.

    “While waiting for the results, patients are isolated and put under observation in a zone that has two beds,” says Madi. “We want to increase this number to seven.”

    Patients showing signs of the virus and who need medical care are immediately transferred to the treatment unit.

    Seven MSF nurses and three doctors have been integrated into the Ministry of Health's health team to work in the treatment unit, and we are recruiting 10 hygienists to join them. For the time being, the unit has eight beds, but a building with capacity for up to 100 beds is being constructed close by.

    Patients who have coronavirus are also admitted to Hôpital du Mali and Hôpital Dermatologique. We have provided technical support to both hospitals, establishing patient flow, and implementing infection prevention and control measures.

    Administering oxygen to patients

    Patients with severe coronavirus symptoms generally have hypoxia (low oxygen levels in body tissue) and need oxygen, which, according to how much the patient requires and the available infrastructure, is delivered by different devices, such as oxygen concentrators.

    “Point G hospital has an oxygen production unit,” says Dr Idrissa Ouédraogo, MSF’s medical coordinator in Mali. “We are working with the hospital management on improving the flow of oxygen from the production unit and installing a wall-mounted supply system so that, in the new building, oxygen can be delivered directly to the patient’s bed.”

    Treatment is provided free of charge to patients with COVID-19 admitted to Point G hospital —from oxygen, drugs and pain management through to check-ups and medical examinations.

    Protecting health workers and those most at risk

    Protecting medical staff and those most at risk of developing severe forms of the disease, such as the elderly and those with chronic conditions – like diabetes, cancer, high blood pressure or other cardiovascular problems – is a real challenge as the world faces mounting pressure on the manufacture of personal protective equipment, including masks.

    Protecting medical teams from the risk of contracting coronavirus is absolutely crucial to be able to continue to provide care. And, in Bamako, this is an issue that affects more than just the COVID-19 treatment unit. We have been supporting the hospital’s haematology-oncology department since the end of 2018.

    “Maintaining this activity is one of our priorities, so that patients who have cancer can continue their treatment and those who need it can be put on it,” says Dr Ouédraogo.

    “But it’s going to be a problem if we don't have sufficient supplies of masks and equipment to ensure the protection of these particularly vulnerable patients and the staff following them.”

    Taking action to prevent the spread of the virus

    The battle against the COVID-19 virus is being fought beyond hospitals. MSF teams are supporting Ministry of Health teams who go to Bamako neighbourhoods to inform people about what they should do to protect themselves from the virus and avoid spreading it to those around them. MSF has set up water points — around 30 so far — to facilitate hand washing in the most crowded places; we are planning to extend these initiatives.

    MSF is deployed in places other than Bamako...

    ... to assist people with urgent needs but little access to healthcare, particularly in conflict zones in central and northern Mali. The organisation has programmes in Douentza, Ansongo, Koutiala, Ségou, Ténenkou, Niono and Koro. The teams are enhancing prevention, hygiene and infection control measures and setting up spaces for isolating potential COVID-19 patients in all the medical facilities where they work. And, as part of the response to COVID-19, MSF is also helping the Ministry of Health with activities such as staff training and raising public awareness in regions where the organisation is already working. Hospitals in Gao and Sévaré have also received technical support.