Health at the heart of the African development

Download this portrait in PDF

Health conditions in a country play a central role in its development, which is why Total is taking a wide range of actions to protect the health and well-being of local communities. As part of this approach, the Group participates in awareness and promotion campaigns for individual and collective health, adapted to local conditions. Furthermore, because the nature of its activities can also expose employees to diverse types of sanitary risks, Total, as a responsible company, ensures their good health as well as their families’.

HEALTH-
AN ESSENTIAL CONDITION FOR A PRODUCTIVE ECONOMY

There are serious health issues within African populations, mostly due to recurring pandemics and a lack of awareness about crucial preventive measures. The high cost of healthcare is also a major obstacle to treatment. The effect of health on local economic development is now a proven fact. The Director of the Health Committee in the French Council of Investors in Africa (CIAN), Erick Maville, is also the Managing Director of Santé en Entreprise (SEE), an association founded in 2011 and of which Total is a partner. Its core aim is to help companies implement health prevention plans.

On which areas does your association focus its work?

Erick Maville : We work on four main diseases: malaria (the main focus of our work in Africa), HIV, hepatitis and diabetes as well as cardiovascular risks. We now have over forty corporate partners, most of which are large companies, for whom we implement specific prevention plans (such as advice, testing, or activities on international days dedicated to awareness) targeted at their employees, their families, and the general public too.

What effect does health have on the economic development of a company or a country?

E. M.: Generally speaking, health problems in local populations result in workplace absences and therefore, from an economic point of view, in decreased productivity. The consequences of this can extend so far as to jeopardize a country’s economic sustainability. I have thoroughly studied the impact of malaria on the local economy. In Africa, it is the biggest cause of absenteeism in the most exposed industries such as construction or oil, where employees mostly work outside, in the most high-risk areas. It is also the biggest source of medical expenses for companies who provide their workforce with health insurance.

Is it possible to quantify this economic impact?

E. M.: In the case of a company based in an exposed region of Africa with 750 employees, the cost of inaction against malaria was estimated to be around €120 per year per worker, and this was just taking absences into consideration. On the other hand, investments in a suitable action plan – such as the distribution of mosquito nets – cost between €4 and €20 per employee. This is much lower than the disease’s economic impact, and that’s without accounting for the fact that malaria can be a deadly illness. After just one year of participating in an initiative like this, the number of new reported cases fell by half.

What about the other diseases, such as diabetes?

E. M.:  The impact is much more difficult to evaluate here because these are rampant diseases that cause numerous complications over time: hospitalization, blindness, amputation… They’re like ticking time bombs. Diabetes treatment is extremely expensive and the disease has no dedicated worldwide foundation, unlike AIDS, tuberculosis or malaria. That means this is one area where prevention is absolutely vital, and fortunately the awareness of its consequences is quickly spreading in Africa.

SUPPORTING GLOBAL RESEARCH

Recognized globally for its work on existing and emerging viruses, the International Center for Medical Research in Franceville (CIRMF) was designated a World Health Organisation (WHO) Collaborating Center in September 2016. The research institute, established in 1974 by the Gabonese government and Total Gabon, works on the characterization of viruses in domestic and wild animals that may infect humans (Ebola, Crimean-Congo virus,
Marburg virus, and many more).

A well-deserved recognition

Appointed by the Director General of the WHO, collaborating centers belong to a network that supports the Organization’s programs at different levels (regional, inter-regional and global). They back up in-country
resources to help promote national health development. Awarded to the CIRMF for four years (and, if necessary, extended for a shorter duration), this distinction is testament to the excellence of its research work. “It’s a
real blessing! This is the reward for all the hard work we have been carrying out for more than 20 years in the diagnosis of arboviroses(1) and viral haemorrhagic fevers. We are all immensely proud. This will bring us
increased visibility, new partnerships, and funding opportunities,” declared Dr Gaël Maganga, a CIRMF researcher.

Aerial view of the CIRMF in Franceville, Gabon.

Handling of the Ebola virus in a laboratory of the CIRMF.

International influence

Skilled in handling dangerous viruses, the CIRMF receives samples for analysis from neighboring countries (like the Democratic Republic of Congo, Chad and Equatorial Guinea), in order to diagnose whether a virus
is present. Its researchers were able to prove that the Ebola epidemic that struck the DRC in 2014 was separate from the one that had previously devastated West Africa. “We demonstrated that they were two different
strains, and our results were published in a scientific journal,” Dr Maganga adds. He is now working to diversify the scope of his research: “In addition to bats and meat derived from wild animals (such as bush meat) sold
in markets, I am starting to study other animal reservoirs for viruses, such as primates, rodents and arthropods, that are often in contact with humans and that could pose a threat.”

(1) Viral diseases caused by arboviruses, meaning viruses borne by blood-sucking insects, such as mosquitoes or ticks.

TAKING ACTION AT A NATIONAL LEVEL : THE EXAMPLE OF SENEGAL

Non-transmissible diseases (cancer, diabetes, cardiovascular disease to name a few) have become the new scourge of Africa. Whilst these are responsible for two thirds of deaths worldwide, the proportion reaches 40%
in African countries(2). Aware of the need to act, the Ministry of Health and Social Action in Senegal has launched an expansive STEPS survey(3) in partnership with Total, who is funding the project.

“In Africa, and Senegal in particular, we have long believed that the debate about health issues has been limited to transmissible diseases, such as tuberculosis and HIV. A number of effective programs have been developed
to tackle these,” notes Awa Marie Coll Seck, the Senegalese health minister. “However, as the number of cancer, diabetes, cardiovascular disease and hypertension cases rose, we realized we needed a reliable
statistical basis. This is the only way a public health policy can be guided effectively.”

Field work

A nationwide STEPS survey was thus carried out in 2015 across a sample of over 6,300 people with the help of several funding contributors, such as Total. Published in 2016, the survey employed hundreds of investigators
throughout the country. In addition to the main measurements (blood sugar, blood pressure, etc.), the survey also included questions about the different causes of non-transmissible diseases. For example, the study
revealed that salt consumption by respondents is much higher than the norm, which may explain why one in four adults suffers from high blood pressure. “The survey also highlighted problems with oral hygiene, which
can lead to a number of health conditions,” explains the minister. “There is also no discernible difference between cities and rural areas.”

Advocating national and international awareness

The results were presented nationally to a large panel of stakeholders including partners and regional/district chief medical officers, after which medical personnel were provided with training and awareness in
non-transmissible diseases, diabetes and hypertension especially. “2017 is the year for implementing a real public health program based on these results. We need widespread awareness, and there is an urgent need to
act against this scourge that has no dedicated international foundation” argues Awa Marie Coll Seck.

2) Source : WHO.
(3) A STEPS survey is a standardized approach for gathering information about primary risk factors using standardized methods, and offers a simple monitoring system.

"Having a reliable statistical basis is the only way a public health policy can be guided effectively."

TOTAL COMMITTED TO IMPROVE THE HEALTH OF ITS EMPLOYEES AND THEIR FAMILIES

Because the nature and extent of its business can expose its employees to a range of health risks, Total, as a responsible company, looks after their health on a daily basis and provides them with high-quality healthcare.
Moreover, their families have access to this healthcare too.

Emergency Medical Centers, onshore occupational medicine and UMIMO*: the three pillars of local healthcare

Company employees and their families benefit from comprehensive medical care, administered either in external establishments or in emergency medical centers (EMCs) at subsidiaries with a larger workforce. This is the case for
Total Gabon, Total EP Angola, Total Nigeria and Total Congo, whose EMCs provide a range of healthcare services for their employees: emergency services, in-patient treatment, surgery, maternity units and intensive care wards. “In
Angola, we have capacity for 5,000 eligible patients (employees and their families),” specifies Jacky Castello, the chief medical officer of the Total EP Angola EMC. “We have an in-patient ward, a laboratory and a pharmacy, without
forgetting the UMIMO, which is specific to this country.” The mobile offshore medical intervention unit (UMIMO) was created to ensure the safety of staff working in the oil industry. Consisting of an emergency physician and
nurse anaesthetist, the UMIMO can be deployed to save significant precious time in emergency situations. It was called out 46,260 times in 2016 and has saved countless lives. In fact, none of its patients have died since its creation
3 years ago.

* Mobile Offshore Medical Intervention Unit.

The HELPER drone

An innovation for health

Imagined by Fabien Farge, an emergency doctor for Total in Angola, the HELPER (Human Environment and Life Protection Emergency Response) drone is a “Swiss army knife that offers safety, security and environmental
protection”, according to its inventor. Small, automatically guided by a tablet and with a battery life of 30 minutes, the drone can identify people who have fallen into the sea thanks to its thermal camera. It can then
drop a self-inflating buoy with a beacon. It detects accidental leakage of industrial product, and measures its surface area and drift. If boat intrusions close to oil rigs were to happen, the device can drop a radio to facilitate
communication with the sailors and avoid any contact with Total employees. In 2016, this system detected 36 boats that had entered the protected zone around the Angolan oil rig.