Twelve years of serving as a physician in his African homeland convinced Dr. Donald Yanogo that he needed to earn another degree—this time at FIU.
Already entrenched in the medical system of Burkina Faso, where he worked as an endocrinologist and a nutritionist, Yanogo did his homework and applied as a Fulbright scholar to Miami’s public research university, some 8,000 miles away. His country's record on communicable diseases—thousands of deaths occur annually from malaria and respiratory illnesses alone—served as a catalyst for leaving behind his young family and parents to pursue a master of public health at the Robert Stempel College of Public Health & Social Work.
“I knew that if I wanted to make a real impact in my country and this region, I needed to learn more about how to design and implement interventions that could bring about desirable changes at a large scale,” Yanogo says. At FIU he took signature courses that covered critical subjects such as community-level health needs assessment and health promotion.
Burkina Faso, with a population of roughly 21 million, is a developing country with more than 60 recognized ethnic groups. Many rural communities, which make up about 80 percent of the population, depend on river water, while luckier ones have access to communal wells. Formal education is scarce, and health education is even more inadequate.
“As a medical doctor, I was trained to treat individuals,” Yanogo says. “In my country, it is essential that we look at the whole picture, understanding how illnesses impact our communities. With very low health literacy rates, communities in the country are facing multiple health issues that we need to look at holistically and through a cultural lens.”
Yanogo cofounded and leads the community-based organization Association Burkinabé pour le Bien Etre Collectif, which has him and a team of fellow doctors and nurses traveling outside of the capital two or three times per month on market days to conduct health-education sessions. Support for the work comes from Helen Keller International, a nonprofit Yanogo connected with while serving an internship at the Bill & Melinda Gates Foundation, and topics covered range from how to prevent HIV and sexually transmitted diseases to nutrition and maternal and children’s health. These days, however, much of the instruction centers around how to stem the spread of COVID-19 through basic hygiene and social distancing.
“The markets here are a gathering place, where people purchase their food, clothes and anything that they need from the 20 to 50 vendors who come together every few days. For us, it is the ideal place to host our education sessions,” Yanogo explained. "The people here are not always aware of the health issues or how many can be prevented, but they are friendly and they are curious.”
Each of the sessions sees as many as 100 participants eager to ask questions. The medical team works with local public health officials to connect individuals to resources and continuing education and care. While the majority of the participants are women, men sometimes attend to find out what’s going on.
“We were conducting a session, about 15 miles outside the capital, about preventing HIV and sexually transmitted diseases. This was during the rainy season when most of the people are working on farms. One man came a long way from the field to the market because he heard about us,” Yanogo says. “He was married to two ladies, one who was attending the session and one who was still tending the fields. He asked if we could stay while he went back to the fields, over an hour of walking, so that he could bring his other wife and ensure that she also had the opportunity to learn what we were teaching. That made me very happy, these are the moments that you realize you are really doing something useful.”
Burkina Faso remains a highly male-dominated society where polygamy is commonplace. With men being the head of the household economically, women often do not have the option to use contraception, and the country faces one of the highest maternal mortality rates in the world with one in 22 women dying due to complications related to pregnancy and childbirth. It can be particularly difficult to access information about sexual health.
“One of our goals is to empower women, giving women and girls resources that can help them financially so that they do not need to depend on men,” says Yanogo, adding that his organization is researching viable ideas. “As soon as women can become economically dependent, then they will have more rights. We are educating them on sexual health and newborn health issues and linking them to health care options, but we are also looking for ways to subsidize women’s income and encourage their economic activities so that there can be equality.”
In a country where 40 percent of the population lives below the national poverty line and the standard way of life is harsh, many are driven by hope and a willingness to change. Yanogo gives the example of declining HIV in Burkina Faso—which has seen its prevalence rate drop from 2.3 percent 17 years ago to .08 percent today—as an example of the people’s willingness to do what it takes to improve health outcomes.
“The people here want better, healthier lives,” Yanogo says. “Many people live in rural communities without access to healthcare or running water, but they are eager to learn and quick to adapt.”
As the region moves into another rainy season, when many pathologies become of great concern, the people of Burkina Faso also continue to face the worldwide uncertainty of COVID-19. Initially it was one of Africa's hardest hit nations when the novel coronavirus began to spread in early 2020, and a high ranking official of the country's national assembly was recorded as among the first fatalties of the disease in sub-Saharan Africa. Yanogo himself got infected earlier in March, while taking care of infected patients at the emergency room of Tengandogo University Hospital, in the capital. Now, far past the COVID-19 peak, Yanogo, who is fully recovered, and fellow healthcare workers remain on high alert for a possible second wave.
Equipped with knowledge he gained half a world away, the young doctor remains a lynchpin in efforts to spare his homeland exactly that and so much more.