Abstract
BackgroundFor almost a decade now, Mali has been facing a security crisis that led to the displacement of thousands of people within the country. Since March 2020, a health crisis linked to the COVID-19 pandemic also surfaced. To overcome this health crisis, the government implemented some physical distancing measures but their adoption proved difficult, particularly among internally displaced people (IDPs). The objective of this study is to identify the challenges relating to the implementation and adoption of physical distancing measures and to determine the main mitigation measures taken by IDPs to adjust to these new policies.MethodsAn exploratory qualitative research was conducted in Bamako and Ségou, two of the ten regions of Mali. The study counted 68 participants including 50 IDPs, seven administrative and health authorities, and 11 humanitarian actors. Sampling was guided by the principle of saturation and diversification, and data was collected through semi-structured individual interviews (n = 36) and focus groups (n = eight). Analysis was based on thematic content analysis through NVivo software.ResultsThe main challenges identified concerning the implementation and adoption of physical distancing measures include the proximity in which IDPs live, their beliefs and values, the lack of toilets and safe water on sites, IDPs habits and economic situation, humanitarian actors’ lack of financial resources and authority, and social pressure from religious leaders. Implemented mitigation measures include the building of new shelters or their compartmentalization, the creation of income-generating activities and food banks, psychosocial support, promoting awareness of IDPs, and nightly police patrols and surveillance to discourage IDPs from going out. Finally, a call for action is suggested for the actors involved in IDPs support and management.ConclusionsThe study demonstrates the difficulty for IDPs to follow most of the physical distancing measures and informs about the risk of disease spreading among IDPs with its potential consequences. It also shows the inability of mitigation measures to control the outbreak and suggests actions to be considered.
Highlights
For almost a decade Mali has been facing a security crisis that led to the displacement of thousands of people within the country
The public health measures implemented to prevent COVID-19 were difficult for the entire population to comply with, they were easier to implement in the general population than among Internally displaced persons (IDPs) because of their specific constraints [5]
Transcriptions were often crossed with our field notes and all divergences were discussed and clarified. This exploratory qualitative study helped demonstrate that implementation of the physical distancing measures targeting the transmission of COVID-19 is not feasible by IDPs
Summary
For almost a decade Mali has been facing a security crisis that led to the displacement of thousands of people within the country. Since March 2020, a health crisis linked to the COVID-19 pandemic surfaced. To overcome this health crisis, the government implemented some physical distancing measures but their adoption proved difficult, among internally displaced people (IDPs). Displaced persons (IDPs) are generally overlooked in global health discussions [1]. Their status is more precarious and they benefit from even weaker protection than that of refugees [2]. They are more vulnerable than the general population because they are poorer and more affected by health problems [3, 4]. Over one-fourth of IDPs reside in low- and middle-income countries
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