Mali, a landlocked country in Northern Africa, has a centuries-old pastoralist culture. While the number of herders has declined, more than 85 percent of Mali’s citizens still own livestock. As such, zoonotic disease outbreaks – and the loss of life and economic instability they cause – are a real danger.

But as the COVID-19 pandemic made plain, no one is safe until everyone is safe.

People with disabilities experience significant barriers to accessing information about prevention and treatment of key diseases. Those who are blind, for example, can’t read the posters, billboards and flyers used by community health workers to help raise awareness of urgent health risks.

Since 2020, the Johns Hopkins Center for Communication Programs-led Breakthrough ACTION project has worked with government and civil society organizations in Mali to conduct risk communication and community engagement (RCCE) activities before and during disease outbreaks and public health emergencies.

And from the start, Breakthrough ACTION partnered with organizations like the Malian Federation of People with Disabilities, which has a nationwide network of disability advocacy groups, to make sure emergency efforts are more responsive to the unique challenges faced by people with disabilities.

Together, they have developed inclusive communication plans to address risks from zoonotic diseases (e.g., anthrax, avian influenza, brucellosis, rabies), viral hemorrhagic fevers (such as Ebola) and COVID-19 – and have planned and implemented community dialogues to address them.

Since 2022, Breakthrough ACTION and partners have reached more than 26,000 Malians, training and supporting advocates and providing communication materials created to be more accessible to people with disabilities. This included video spots about different zoonotic diseases with sign language for people with hearing impairments and providing written materials, such as vaccine factsheets, in braille for people with low or no vision.

For the first time in Mali’s history, people with visual and hearing impairments have equal access to lifesaving health information about these diseases, says Drissa Diarra, the vice-president of the Malian Union of the Blind and a trainer.

“The first time I heard about zoonotic diseases, I had so many questions,” Diarra says. “I didn’t understand. Thanks to this effort, visually impaired people can become familiar with these risks.”

Children with disabilities are especially vulnerable during outbreaks and are at high risk for specific zoonotic diseases like rabies. Breakthrough ACTION trained 86 teachers from six schools for children with disabilities on key facts about zoonotic diseases.

With their help, Breakthrough ACTION later launched a curriculum to raise awareness and encourage healthy behaviors to prevent these threats. Trained teachers have since implemented 428 lessons reaching 887 students. The students will go on to educate their peers and families and advocate for themselves, they hope.

During a public emergency, people with disabilities are too easily forgotten. “To ensure a truly inclusive RCCE response, having partnerships with local leaders and networks in place is half the battle won,” says CCP’s Aoua Konare, the chief of party for Breakthrough ACTION in Mali.

Breakthrough ACTION’s work, she says, has already helped set in motion a wider conversation about social inclusion among partners fighting all kinds of outbreaks. The Government of Mali is increasingly integrating disability considerations in the design of communication materials. It invites all partners to consider the needs of people with disabilities.

“During the dengue fever epidemic, partners have expressed an interest in supporting increased production of braille materials,” Konare says. “Others have drawn inspiration from the project to transcribe their spots or integrate inclusive, dignity-oriented language into their materials. This effort has been a much-needed catalyst and is only just beginning.”

In the Democratic Republic of the Congo (DRC), where 10.5 million people live with disabilities, access to health information has also been a persistent challenge – especially for hearing-impaired and non-verbal communities. Breakthrough ACTION, teaming up with health officials and the National Community-Based Rehabilitation Programme, conducted workshops and pledged to make health communication materials accessible to all. Sign language interpretation is now included in the project’s popular “Qui Dit Vrai?” – Who’s telling the truth? – series and other videos including a catchy song and dance about how to prevent cholera.