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ASSOCIATION POUR LA COOPERATION ET L'AUTOGESTION RURALE EN AFRIQUE DE L'OUEST (CARA) ~Working Together with Rural Malians to Achieve a Healthier & Happier Life~



In this month’s Close Up, we are pleased to introduce the ASSOCIATION POUR LA COOPERATION ET L'AUTOGESTION RURALE EN AFRIQUE DE L'OUEST (CARA), a specified non-profit organization. CARA is active in the West African nation of the Republic of Mali, which is often referred to as one of the most impoverished countries in the world. There it engages in numerous projects that help to assist the people of farming areas, whose livelihoods are directly threatened by desertification, as well as by sickness and poverty. It was in 1989 that Ms. Kazue Murakami, CARA Director and Founder, closed her Japanese dental practice and embarked overseas alone. Since then, while crossing back and forth between Tokyo and Mali, she has continued to support those Malians who live in farming villages in order that they may lead happier lives through the obtaining of independence and the achieving of better health standards. On this occasion, we were lucky enough to catch up with Ms. Murakami during one of her periodic returns to Japan. Thus, we had the opportunity to discuss with her both CARA’s activities, and some of the results it has achieved.

Q. Why did you select Mali as the place for your operations?

A. Approximately 30 years ago, I was in practice as a dentist. At the time, I had the opportunity to travel to the Sahara Desert as a tourist. That opportunity saw me visit Mali in West Africa. However, on visiting the country, I realized that many Malians were dying from diseases that could be either easily treated or prevented in a country like Japan. It was such knowledge that made me decide to do something. What is more, while in Mali that first time, I encountered UNICEF-sponsored doctors who were driving around the country and working to immunize the population. Their efforts made me think that, “even as an individual, there was perhaps some similar form of activity that somebody like myself could do.” To comment on my background, I trained as a dentist. Nevertheless, when viewing the situation that I encountered in Mali from the perspectives of preventing illness, and improving both hygiene and nutritional standards, I felt that there was probably a way in which I could make some form of contribution. I returned to Japan and stopped practicing as a dentist in August of 1989. By the end of September, I was off again to Mali. Although such a decision represented a major life change, on a personal level I feel that having an opportunity to work in support of people living overseas has had a greater sense of meaning for me.

Q. So on getting to Mali, what sort of activities did you commence?

A. Even though I got to Mali, I couldn’t immediately start my own activities. Thus, my initial step was to participate as a volunteer in reforestation projects that were started up by a Japanese NGO in the Sahara Desert. For approximately a year, while being involved in reforestation and disease-prevention activities, I had the opportunity to both learn a great deal and think about what I wanted to do. Indeed, to speak about the Japanese mindset for a moment, I think sometimes there is quite a gap between what we plan; and what we must do upon arriving where we wish to operate. In Mali, despite the local people being so impoverished, they are nevertheless shrewd in that they have developed the knowledge and skills necessary to be recipients of aid. Once I realized that, I quit volunteering and relocated to the capital city of Bamako to find my next challenge. It was there that I unexpectedly ran into a Malian who worked for a local NGO. That person told me that their “village was looking for somebody like me to be involved in a project.” The result of that meeting was that I quickly headed to the village of Madina.


(L) Women learning how to sew at a class designed to teach them appropriate skills. (R) Women engaged in a village council.

Q. What activities did you commence upon arriving in Madina?

A. When I initially arrived, they were commencing several aid projects. One involved developing dams for agricultural purposes, another involved the rearing of livestock. Meanwhile, a third focused on nurturing individuals who could then teach literacy skills to others. However, because they were doing nothing with respect to medical care within the village, I decided to act. I started a survey process that saw me visit every household in the village. I obtained information on family structures and the circumstances under which individual people became sick. I also had villagers show me their cooking and toilet arrangements. I even went so far as to find out how many wives there were in each household, and how many miscarriages they were experiencing. On obtaining such information, I turned it into data. If I think now about what I achieved, I must say that I did a rather good job. Anyway, based on that information, we identified some of the village’s health issues from which we then started a program of health and hygiene improvements. Concurrently, I also started to teach sewing skills to the women in the village. Having them develop sewing and knitting skills, etc., made it possible to start providing them with work. What is more, by commencing health checks at schools, we could help prevent health issues such as Malaria and parasites. After doing such work as a private volunteer for two years, in 1992 I established the “Group for Supporting Health and Medical Care in the Republic of Mali.” Then in 1993, the group’s name was changed to the ASSOCIATION POUR LA COOPERATION ET L'AUTOGESTION RURALE EN AFRIQUE DE L'OUEST (CARA).

Q. And you have managed to extend CARA’s activities to many more villages and further expand the range of domains in which you are involved?

A. Speaking personally, my primary motivation was to initially help improve what was happening with respect to health and medical care. However, just achieving that requires a broad knowledge that includes an understanding of matters such as education, foodstuffs themselves, and nutrition, etc. The need to have such knowledge has meant that over time CARA’s activities have broadened to encompass a wide variety of different domains. We are now involved in literacy education and the building of schools. We also establish wells so that communities can gain access to water sources. There is the work that we do to help prevent the spread of malaria and AIDS, etc. We are also involved in nurturing women who can become midwifes. We have also built maternity and general medical clinics, along with teaching women suitable skills that can improve the quality of their lives such as dyeing, sewing, soap-making, and embroidery. We have even supported horticulture projects and the issuing of small loans. All such activities are necessary for improving the quality of life. For all of them, at the village level we have developed voluntary committees so that residents can manage things for themselves. What is more, we have got to the point where many of the committees have been successful in generating income for their villages to the point of becoming profitable. I know some people resist the idea of offering support to individuals alone so that their lives might improve, however, my response to that is if everybody in a village is not able to obtain some form of financial reward, then the entity itself shall not develop. My way of doing things is to provide the minimum level of assistance that they require, and ask the villagers to then get on with things for themselves.


By establishing wells, a range of different projects have become possible.
The well on the left is a deep one bored by machine. Meanwhile, the one on the right is a shallow hand-dug well.

Q. And I know that you have put some effort into spreading education. In doing so, have there been changes in the attitudes of villagers?

A. In the past, there were more than a few villagers who believed that schools were not necessary for their communities. Simply put, their attitude was that the children who ended up going to school left their villages and headed to the big cities. However, in that bit by bit the idea as to the importance of literacy education has penetrated society, we are seeing more and more parents who would like to have their children receive some form of education. Up until now, we have been involved in the construction of twenty or more elementary schools. Moreover, we have been so successful that there are now villages who would like us to build them junior high schools. Of course, in impoverished nations, it is rather obvious that many people want to engage in activities that will immediately result in them obtaining some form of financial reward. However, it is not the case that becoming literate immediately results in wealth. Accordingly, what we have achieved thus far has taken some time.


(L) A 1st and 2nd grade class at a village school.
(R) A village literacy class. In both photographs, the seriousness of the students can be witnessed.

Q. Looking back on your many years of work, is there anything that sticks out in terms of providing you with a deep sense of achievement?

A. Concerning those areas of the country where the mortality rates among pregnant women and during childbirth were once very high, I get very emotional when I realize that, due to the work that we did for more than 10 years, we could nurture the development of our first midwife. As to why we could achieve such a result, previous practice had been to not allow girls to go to school and receive an education. However, our nurturing of a midwife became possible because the villages began to produce literate women who we could train. As to our first midwife, while she undertook training away from her village, we built somewhere she could work by establishing a maternity clinic. Moreover, I believe that she offered much hope for the other women in her village. She allowed others to realize that women like themselves could lead such productive lives. Such a positive image also resulted in an increase in the percentage of girls who now receive an education. There are some villages that now have their own midwives on hand, and at the maternity clinics, there are also study meetings that share information regarding the prevention of disease and better hygiene practices. The women in charge of these meetings are drawn from their villages and they are selected to act as promoters of healthy lifestyle practices.


In acting as promoters of healthy lifestyle practices,
women who have undergone training hold meetings where they disseminate information to their fellow villagers and help to enlighten them.

Q. And finally, could you tell me about your plans for the future.


A. Despite a recent decline in public safety preventing my return to Mali, in that over many years we have been able to nurture a local female staff member who has a clear understanding of what needs to happen, I am fully confident that she will continue to carry on with her tasks even in my absence. Furthermore, concerning the activities that CARA engages in, for each we have successfully developed leaders who are attached to the voluntary committees. Thus, it is no longer necessary for CARA to control everything. Looking to the future, I would like to focus on health and hygiene issues because like education, they are difficult to promote in that they do not lead immediately to positive monetary gain. I would also like to see the establishment of women’s centers which would give them more opportunities to be active in society. I believe that if we can change their consciousness, such a change would have a significant impact on traditional Malian society and its preference to men. Concerning the Malian people, they possess a toughness and they are not timid. Accordingly, I feel that it is our job to help them draw out their own hidden talents.