The use of injectable artesunate for severe malaria is now well integrated into the Burundian Ministry of Health’s malaria treatment policy.
As a consequence, the Médecins Sans Frontières (MSF) programme focusing on reducing severe malaria-related mortality is being gradually handed over to the Ministry of Health. In July 2014, the Kirundo malaria project, which was supporting 34 clinics with diagnosis and treatment, was handed over and the project in Mukenke district is due to follow suit in early 2015. Injectable artesunate is easy to administer and the treatment is shorter and more effective than quinine, with fewer side effects.
Providing fistula care
An MSF team continued to provide obstetric fistula treatment at Urumuri health centre in Gitega, alongside health promotion, staff training and case-finding activities. MSF offers reconstructive surgery, physiotherapy and psychosocial support, and runs a hotline for those seeking help. Fistulas, a consequence of birth complications, cause not only pain but incontinence, which in turn often leads to social exclusion and sometimes rejection by family and friends.
The number of new obstetric fistula cases has declined over the last few years, as much of the backlog that existed in the country when the project opened in 2010 has now been cleared. The project will be handed over to the Ministry of Health at the end of September 2015. The remaining cases will be managed by the Ministry of Health, as MSF has trained three Burundian doctors in fistula surgery.
MSF has drawn up a preparedness plan in case of emergencies, but if no major MSF intervention is needed in the next year all programmes should close before the end of 2015.
No. staff in 2014: 122 | Expenditure: €2.3 million | Year MSF first worked in the country: 1992 | msf.org/burundi