Mali, “if the war ends, we'll look for another village [...] ours has been turned into a tomb”. 

“We fled to come here to Koro. We didn't bring anything, we don't have any food, we pay the rent,” she continues. We can't stand it! Of course, we get help, but it’s not enough to pay the rent.” ​ 

“We can't go back to our village,” continues Aminata. “If the war ends, we'll try to move to another village. Where we were is now decimated, we can't go back. Our village has been turned into a tomb; we can't live there again.” ​ ​ 

The town of Koro, in central Mali, is facing an influx of refugees fleeing the violence in the Sahel’s three borders zone, around the borders of Mali, Niger and Burkina Faso. The first refugees began arriving in May 2023. This wave intensified during the first half of this year. ​ In July, teams from Médecins Sans Frontières (MSF) counted some 82,000 refugees in the town of Koro. The National Commission in Charge of Refugees (CNCR) was able to register 46,128 refugees in September and noted that there are still more than 11,000 people waiting to be registered. The local authorities, for their part, are talking about a total of more than 100,000 people seeking refuge throughout the Koro area. All these figures show that today, the number of refugees far exceeds the size of the host community, making this Malian town a crossroads where people fleeing the violence in the region find shelter. 

A shortage of water and shelter 

Before the current crisis, Koro already had a recurring problem with insufficient supply of drinking water. The arrival of refugees has increased the demand for water, further exacerbating the shortage. There is also a shortage of available housing. 

“This is the first time that the town of Koro has received more refugees than the local population,” explained a local authority. “For those who know Koro and its water problems, the arrival of the refugees makes access to water even more difficult for the whole town and also creates issues of providing shelter. Among the 6.3000 families of refugees, only 1,200 households have received two months’ worth of food aid, and only 1,000 people have received cash from the other organisations present. ​ 

“The need for water,” he adds, “has largely been solved by MSF, which has installed water points in the town to facilitate free access for all refugees.” 

Health structures overwhelmed by an inadequate response. 

In response to this crisis, MSF sent a team to support the central community health centre in Koro to provide free medical care to refugees, install water points in the town, and build latrines. 

“Our activities far from cover all the needs”, says Jonathan Tumbwe, MSF coordinator in Koro. “The number of patients consulted at the central health centre where we provide care has risen from 300 to more than 1,000 per month, the number of births from 10 to 37, and more than 15 children suffer from severe acute malnutrition out of the total number of children screened each month.” ​ 

Some refugees are living with host families, while others are in accommodation for which they pay the monthly rent for which they have no money because they can’t make a living. There are also many refugees who have no shelter and are exposed to the elements. They have no food and lack essential household items. 

In the Bandiagara region, where Koro is located, MSF has set up projects to provide emergency medical and humanitarian assistance to people affected by armed conflict, by supporting the hospitals in Koro, Bankass, and Bandiagara to deal with influxes of wounded people. MSF teams also provide protection and mental health treatment. At community level, MSF teams are working in the health centres of Diankabou, Dioungani, Mory and Baye, as well as in 14 essential community care sites to provide basic curative and preventive care to the community and refer patients to care facilities. 

MSF teams are currently re-evaluating the intervention strategy to see how to increase the level of response in the face of growing demand. As more refugees arrive in Koro, the needs increase. ​ 

“We are asking for food assistance for all the refugees to prevent malnutrition and to build shelters for them,” says Tumbwe. “It is not right that people who are already vulnerable and in need of help should have to pay rent.” ​ ​ ​ 

The National Commission in Charge of Refugees (CNCR) has also appealed for an appropriate response to this crisis: “In view of the many needs that have been identified and our limited resources, we reiterate our appeal for the mobilisation of all humanitarian actors, contributors and donors to provide assistance that will relieve the suffering of the people who have found refuge on Malian territory, as well as the host populations who are the first to receive refugees”.