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PARTNERSHIP 37 WINTER 2015 N° 36 Changing social dynamics The ageing population is central to many of West Africa’s societal issues. “Ageing is a physiological process experienced within an environmental and social context,” says Enguerran Macia, a member of the unit based in Dakar (Senegal). “It was first studied in western societies in the 1960s, but the phenomenon is more recent in Africa, and much of the research groundwork is still underway.” While better healthcare can explain this demographic shift, urbanization and modernization have also contributed to higher obesity rates, which can be related to a more sedentary lifestyle and non-traditional diets rich in complex sugars. This has led to an increase in cardio-vascular diseases such as hypertension in older age groups. “We are watching the epidemiological transition unfold before our eyes,” adds Macia, referring to the shift from infectious to chronic, non-contagious diseases as the primary cause of mortality. “Much work remains to be done, as only half of those suffering from hypertension are aware of their condition, and only 6.7% undergo regular treatment.” Rapid urbanization As part of West Africa’s ongoing rural exodus, people are leaving the countryside for cities, settling in shantytowns. As a result, a number of essentially rural infectious diseases have cropped up in large cities like Bamako, the capital of Mali, where a team of researchers1,4 is busy tracking how urbanization affects the frequency and distribution of these diseases. “Newcomers from areas of the country with endemic parasitic conditions settle along the Niger River and near its tributaries in the city’s outskirts,” explains team member Abdoulaye Dabo. “As a result of this rapid urban expansion, people live in unfinished homes near open sources of polluted water, were they run an increased risk of infection from malaria-carrying mosquitoes, as well as insects responsible for the cutaneous disease leishmaniasis, or freshwater mollusks that cause schistosomiasis, also known as snail fever.” To contain the spread of such infections, researchers used satellite imagery to generate specialized maps, each focusing on a separate component of the urban landscape such as waterways, vegetation, and buildings. They combined the data collected on vectors and parasites to identify hot spots for transmission. The mapping of these zones subsequently makes it possible to combat—more effectively and at lower cost—both the vectors and parasites in the district of Bamako. Delivering health A final challenge is to deliver healthcare, especially to pregnant women and infants. Nearly 320,000 women worldwide fall victim to maternal mortality each year, 200,000 of whom in sub-Saharan Africa. Many of those deaths occur in hospitals and are due to eclampsia, infection, or hemorrhage. Improving hospital care is thus a priority, notably through qualitative studies of maternal deaths, analysis of interactions between patients and hospital staff, and on-site training. “Yet maternal mortality also occurs outside the hospital, during secret abortions,” says France-based ESS anthropologist Yannick Jaffré. “Further social initiatives are needed to prevent unwanted pregnancies, by educating local women about their bodies and the use of contraceptives.” Jaffré also studies child health, and recently took part in a study where children in eight West African countries were asked about their illnesses and hospital treatment. “We used the results to draft policy manuals for pediatricians to improve the quality of child care. Combining the fundamental with the practical is an important aspect of our research, and it has been made possible by financial support from the AFD7 and UNICEF,” he concludes. ii gilles.boetsch@gmail.com © A. DUCOURNEAU/CNRS PHOTOTHÈQUE ESS research also focuses on improving the quality of child care in the region. A team of microbiologists collect soil samples on a parcel of land allocated for the Great Green Wall project. © S. CHERKAOUI POUR JEUNE AFRIQUE


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