In the West African nation of Mali, villagers are cutting firewood to pay their medical bills. But in an ironic twist that is making their environment more unhealthy.
In the village of Kabe, about 50 kilometers from Mali's capital, Bamako, a community health worker looks over Aseitu Sacko. She looks in her eyes and palpates her stomach. The clinic is just a small room with a bed and boxes of medicine stacked in the corner.
Sacko brings her toddler over. The health worker asks whether he has ever seen a doctor. Sacko says no. The boy has kwashiorkor, which means he does not get enough protein in his diet. The doctor bill is almost $14, while most Malians live on a little over $1.00 a day.
Sacko more often visits a traditional healer who costs a fraction of the price and prescribes herbs.
Walking back home, Sacko says she does not have money to buy good food for herself or her son, so she certainly can not afford to go to the Western-style clinic.
In the neighboring village of Sikoro, Mam Samake also avoids the doctor. Samake says when her family gets sick, they do not get any medicine because they do not have any money. She says they just go out and farm like usual. But one day Samake got so sick with malaria she had to go to a clinic.
She says because she did not have any money to pay the doctor, she walked around her village, going house to house asking other people to lend her money. Eventually she got what she needed. Then, Samake says, she had to cut firewood and sell it to pay back the money she borrowed.
Samake says people in Sikoro did not go to school and do not have anything to sell, so to make money they cut firewood.
Fourteen-year-old Siraje Sacko takes a long log of wood from a pile towering over her head and whacks into smaller pieces.
Walking around the village, every household has sticks in large stacks in the yard waiting to be cut or in small tidy bundles tied with bark.
Mali consumes six million tons of wood a year. Villagers say the more wood they cut, the farther they have to walk to find it.
Mam Samake says they used to walk three or four kilometers to find firewood. Now they have to walk seven kilometers there and back everyday.
The Malian Ministry of the Environment estimates each year the country loses 4,000 square kilometers of forest cover to fuelwood and timber harvesting.
Sahel Eco is a Malian aid group combatting deforestation. Its executive director, Mary Allen, says the situation could be different. "They could be cutting those trees and earning a good living if there was proper management of those trees and proper management of the fuel wood supply," she said.
In other parts of Mali, Sahel Eco has helped farmers realize that they can make more money by taking care of the trees and selling their fruit and leaves instead of chopping them for fuelwood.
There are also efforts in Sikoro to provide villagers with another way to make money and provide food.
The villagers use big metal watering cans to care for crops at a community garden recently funded by the University of Southern California. They will use the money they get from selling the vegetables to pay their bills, including doctors' bills.