Almost a million Malians remain displaced after ethnic and jihadist violence spread across the north following last year’s coup d’état.
Despite fresh memories of conflict and atrocity, some of those displaced are seeking to return to their hometowns to vote in Sunday’s presidential election.
In a country that was home to only six psychiatrists before the war, aid agencies are seeking to raise awareness of post-traumatic stress, particularly among vulnerable children.
In an enclave of Bamako, the capital, small Christian communities that hail from Gao and Timbuktu have sought refuge from the conflict that swept their region over a year ago.
This evening one of their number, Fatima Bagayoko, a mother of six children and guardian of five more, celebrates her 39th birthday.
Under a Malian flag in the garden of her new residence, friends from home join her for a birthday picnic and a game of boules.
Sitting upright and serious in a white plastic chair next to a rusted shipping container, Fatima describes the effects of the conflict on her youngest daughter.
"It was terrible," she said. "One night there was a battle outside our door. Bullets came into the house. We thought we were going to die. A month after our escape, our eight-year-old was terrified of any unexpected noises. As a mother, it is intolerable to be so helpless."
Fatima’s husband, Mohamed Ibrahim Yattara, is the U.S.-educated Baptist pastor of one of the largest churches in Gao, a city of 65,000 that was home to around 800 Christians before the conflict. In the days after the jihadist occupation, which began in March 2012, he hoped the Christian community would be left in peace.
Soon, however, his church was vandalized, then two young daughters of a friend were raped by the jihadists.
Women in the community sought to counsel the girls, said Yattara, who himself reached out to their 19-year-old brother, who had suffered a nervous breakdown.
“It was in the afternoon. They took the girls, they raped them in a military camp, then early the next day brought them back. [The brother] saw how they brutalized his father, his sisters and mother. And he was a witness of all the gunshots in the city. I think, altogether, that is what traumatized him,” Yattara explained.
Searching for a way to escape, the priest hired the last remaining bus in Gao and filled it with 53 members of his congregation.
The Christians found room for another 76 fleeing Muslims, who crammed into, and onto, the bus. Yattara eventually led the entire group to safety in the capital, 500 miles away.
In Bamako, the non-governmental organization Plan Mali continues to operate its emergency response center. It coordinates food, health and educational aid for communities still affected by the conflict.
Dr. Sita Sidibé is the organization’s medical adviser. Before the conflict there were very few psychiatrists in Mali, he said. Today, there are perhaps two.
"With so much sexual violence and children displaced without their parents," he said, "it is fair to say that we have seen a degree of psychosis setting in among victims in those areas that were occupied, and we need to offer long-term help."
Fadimata Alainchar, Plan’s country director, hopes Sunday’s election will allow a healing process to begin for Mali.
But conservative Mali has little history of identifying or treating mental illness, let alone post-traumatic stress among vulnerable children.
“Even if everybody left, they came back," said Alainchar. "And when they did they saw all the atrocities. This guy was killed in a tree and his body was there for more than a month. The fish factory was bombed with jihadists inside and you could smell the rotting bodies two months after. If I could smell it, the children did. If I saw that body hanging there, the children did also — that kind of trauma you cannot estimate."
Alainchar takes issue with observers who argue post-traumatic stress is not an issue in Mali because most citizens fled before fighting directly affected them.
Increasingly optimistic about the future as U.N. peacekeepers deploy around Mali, Yattara says that despite the pain of the last year, there have been important benefits to his congregation’s exile.
“Our hope is the country remains a secular state," he said. "If it doesn’t, we have to stay. It is our country. If we have to die, we should die here. There is no need to flee any more.
"It was a good thing to be together in Bamako as Christian families, to learn and to teach the theology of suffering and to have a collective therapy.”
One or two of those playing boules at the picnic hope to return to vote in Timbuktu and Gao, joining the other Muslim residents reportedly returning home from exile and refugee camps. But election or not, the majority of Yattara’s congregation insist they will remain in Bamako for now, still uncertain about confronting the horrors of this last year.