"We see cases of early pregnancy from 14 years old – occasionally they are younger"

A midwife on the phone

My name is Mariame Doumbia, I am a midwife with the Association Malienne pour la Protection et la Promotion de la Famille (AMPPF), providing family planning and sexual health services to Malians in and around the capital, Bamako.

I have worked with AMPPF for almost six years in total, but there was a break two years ago when American funding stopped due to the Global Gag Rule. I was able to come back to work with Canadian funding for the project SheDecides, and they have paid my salary for the last two years.

I work at fixed and mobile clinics in Bamako. In the neighbourhood of Kalabancoro, which is on the outskirts of the capital, I receive clients at the clinic who would not be able to afford travel to somewhere farther away. It’s a poor neighbourhood.

Providing the correct information

The women come with their ideas about sex, sometimes with lots of rumours, but we go through it all with them to explain what sexual health is and how to maintain it. We clarify things for them. More and more they come with their mothers, or their boyfriends or husbands.

The youngest ones come to ask about their periods and how they can count their menstrual cycle. Then they start to ask about sex. These days the price of sanitary pads is going down, so they are using bits of fabric less often, which is what I used to see. 

Seeing the impact of our work 

We see cases of early pregnancy here in Kalabancoro, but the numbers are definitely going down. Most are from 14 years old upwards, though occasionally they are younger.

SheDecides has brought so much to this clinic, starting with the fact that before the project’s arrival there was no one here at all for a prolonged period of time. Now the community has the right to information and I try my best to answer all their questions.

Mariame Doumbia treats a client at the mobile clinic
Mariame Doumbia treats a client at the mobile clinic

They have the services on their doorstep, including family planning, treatment for sexually transmitted infections, and pap smears/smear tests. We partner with the Malian government to administer some of the vaccines children need here too. We offer them all the services when they arrive, even if they have just come for family planning. Often they have met our young volunteers in the neighbourhood.

I like helping people, especially the young ones

I also work at a mobile clinic. It’s important for accessibility, so that the women living in poorly serviced areas can access sexual and reproductive health services, and reliable information.

The women coming to the mobile clinic want family planning, and pap smears/smear tests. We have done a lot of awareness raising about cervical cancer and women are more aware now they must be tested. 

I like what I do. I like helping people, especially the young ones. They know I am always on call to help them, and even if I don’t know the answer at that moment, I will find out. I like everything about my work. Actually, it’s not just work for me, and I became a midwife for that reason. I’ve always been an educator on these issues in my community.