Each year, MSF volunteer doctors, nurses, logisticians, water-and-sanitation experts, administrators, and other medical and non-medical professionals depart on more than 3,400 aid missions. They work alongside more than 16,000 locally hired staff to provide medical care.

MSF has been active in Mali since 1992 and reports that the people of Mali are plagued with chronic health emergencies that include epidemics of meningitis, cholera, measles and yellow fever. Because exclusion from health care is a large problem, the primary focus of MSF's medical programs in Mali is to provide treatment to those who most need it.

VR photographer Mickael Therer had always admired MSF and approached them with the idea of introducing VR photography as a new medium to highlight their work. Soon after he was on his way to visit two MSF operations in Mali: Goundam, in the north, west of Tombouctou, and the circle of Kangaba in the south, near the Guinean border.

Mali, at nearly twice the size of Texas, is the largest country in West Africa and is bordered by seven other countries. With a life expectancy of 51.5 years, 2000 GDP per capita of $797 (compared to Canada at $27,840) and a probability of nearly 40% at birth of not surviving to age 40, Mali is one of the world’s poorest countries. Seventy three percent of the population earns less than $1 a day. The United Nations Development Programme ranks countries using the Human Development Index, a formula that takes into account three aspects of human development: longevity, knowledge, and a decent standard of living. Norway, Sweden and Canada top the HDI list; Mali ranks near the very bottom, 164 out of 173 countries.

Therer spent an all too short eight days in Mali and had just two days of shooting in each location but it was enough to leave a lasting impression, one of widespread poverty to a degree that is hard to comprehend. “I've seen pictures and films but being there with MSF in secluded regions is a different view than the usual clichés,” he says.

Kangaba, Doctor's Office

In Kangaba, Therer followed the MSF team involved with the malaria program, a disease that is the number one killer of children, killing some 3,000 per day in Africa. “MSF teams are now treating malaria patients with an artemisinin-based drug - the latest treatment method as old drugs (chloroquine and fansidar) have lost their effectiveness,” says Therer.

Economists estimate that $10 to $12 billion a year in productivity is lost in Africa because of malaria, and it hits children under the age of five the hardest as they have not yet developed immunity or tolerance for the disease. More than 90 percent of life-threatening cases of malaria occur in children under age five in sub-Saharan Africa. It accounts for a fifth of their deaths.

The plague of malaria on Africa’s children begins before they are born as parasites invade the placenta and sap vital nutrients, leading to low birth weight and anemia. Repeated bouts cause severe anemia, hypoglycemia and lower respiratory tract infections. At its worst, malaria infects the brain and children suffer seizures, lapse into a coma and die. If they survive they experience disabilities such as blindness, speech impediments and learning difficulties.

Obviously, the photo shoot was very different from Therer’s usual VR business, and he found the trip emotionally consuming. “What's very impressive is the will and dedication of everyone involved, expats and locals within MSF. What was even more striking is the positive attitude of the Malians who, under the worst living conditions, keep a smiling face, trusting in a better tomorrow with prodigious energy.” As a photographer who believes some degree of emptiness is a part of life and therefore integral to the moments he captures, he hopes his panoramas bring an interesting perspective to which viewers can relate.

Karan, Health Center

The people of Mali, while understandably confounded by the technology, managed to relate in a universal way: “It is not easy to explain what VR is when you are in a region with absolutely no access to technology, you just have to wait for the bursts of laughter when they see this sweating white alien shooting straight up to the sky or down to the ground. Better than long explanations, sharing laughter is of great help building relationships.”

In Goundam, which lies at the entrance of the desert in the Sahel region, acute malnutrition is a recurrent problem, but “with the terrible malnutrition now happening in Niger, MSF sent an exploration mission to monitor the area for severe malnutrition as no clear information on the situation was coming through”, Therer reports. Although Therer saw many serious cases of severe malnutrition among infants around Goundam, the situation is not as dire as that in Niger, where some 30,000 children remain under threat.

click here to view MSF website

Therer shot some 60 panos during his visit, of which he’ll keep 20 to 25, a lot, he says, under his standards. They show children waiting for Parachecks, a new quick test to detect malaria, and local MSF staff waiting to start their day. One panorama shows a girl lying on a bed, atop a colorful blanket, inside a hospital. Beside her sits an older woman and across, on another bed, three young boys stare at the camera. Rays of light pour through the open window. Therer writes of the pano: “06 Oct. 2005, 9:50 am: Kangaba, some 70 kms south of Bamako near the Guinean border, is the reference health center. I am told this is the children’s room of this hospital for a population of 96,000. I count four beds, three of them occupied by infants with bad malaria. … After the consultation, the medics leave the room; I stand here alone with the infants and their relatives. The grandmother in front of me probably stays here all day watching over her granddaughter. We have very little means of communication, but I timidly ask for a photo and she blinks her eyes in agreement. As I start shooting three visiting brothers slip silently behind me and sit on the empty bed.”

Kangaba, Children's Room

Therer set out on his trip with a new camera, received the day before leaving, because he didn’t want to risk being there with just one camera. His equipment: D2x, D100, a 10.5mm lens + a couple other lenses, tripod and monopod 303sph and nodal ninja or handheld at times; an Apple Powerbook and an external FW drive for double backup of the daily GBs of pics.

His main technical obstacle was the dynamic range. “I was never shooting at the best hours, when the light is soft,” he says. “Inside the buildings the only light sources are the window openings, so most of the inside panos were shot between 320 and 800 iso at low speed when the outside light usually was some 15 stops higher.”

Therer hopes his panoramas will make it onto MSF websites. “So far we have built two kiosks and printed some very large close-ups of the scenes for an exhibition currently in Luxembourg where the government is organizing a ‘Mali week’,” says Therer, who adds that the reaction within MSF, which has high photographic standards, has been positive. A second phase plans to distribute the panoramas to a targeted audience within the organization.

View all of Therer's MSF panos. Make a move. Donate one Euro per week.

Comments:
i read with great interest your article on the Médecins Sans Frontières in mali, but noted one factual error. you wrote "Mali, at nearly twice the size of Texas, is the largest country in West Africa", which is not quite true. the total area of mali is 1.24 million sq km, of which only 1.22 million sq km are land, while the area of angola, another west african country, is 1.25 sq km. it's a small difference, but... mali is not the largest. as you describe, the situation in mali is quite bad. it is not necessary to pretend the country is larger than it is, in order to emphasize the problems. cheers, pedro silva

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