MALNUTRITION: Niger Responds to Acute Malnutrition

SHAWN BAKER
September 3, 2010,
Shawn Baker is the regional director for Africa of Helen Keller International. He has spent 25 years living and working in Africa, including nine years in Niger.
Niger is facing one of the gravest food and nutrition crises of its history – massive loss of crops and livestock have contributed to 17% of children under five suffering from acute malnutrition requiring immediate treatment. The consensus is that the situation is worse than 2005, when Niger got so much media attention, and old-timers make comparisons to the devastation of the 1970s. It’s also understood that while funding gaps remain, the infrastructure in place to respond to malnutrition is much more expansive than it was in 2005.
Shawn Baker Dr. Iseybatou Seidou, deputy chief of the health district of Dogon Doutchi, explains a patient’s record to Shawn Baker.
Today I had the honor of spending time with one of the heroes on the ground who is part of this improved infrastructure. Dr. Iseybatou Seidou is in charge of the nutrition rehabilitation ward of the district hospital in Dogon Doutchi, on the border with Nigeria. She and her team are currently looking after 20 children suffering from severe acute malnutrition with complications – meaning the child has one or more infections in addition to malnutrition. Dr. Seidou worked in the same district in 2005, and according to her the situation is worse this year. However, she also thinks many medical facilities—including hers—are now better prepared. The treatment protocols are in place, health staff have been trained, supplies are available, and the ability to screen and treat children has greatly improved. On average, Dr. Seidou and her team are able to save 92% of the children who are admitted.

One of these lucky children is Tsalha Idi. With Dr. Seidou’s help I was able to speak with Idi’s mother, Aï Gado. Idi is 12 months old and weighed 10 pounds when he first came to the clinic. That is less than half of what a child his age should weigh. Aï is 25 years old and Idi is her fourth child. One of her other children has already died. She carried Idi on foot for four hours to the nearest health center when he started having severe diarrhea and vomiting. Given Idi’s condition, he was referred to the district hospital, where he has been in treatment for 16 days. Aï left her two other children with their grandmother. She says she has seen improvements in his health since he came to the hospital. He has gained one and a half pounds and has become responsive, even starting to play with a toy. Children who are so severely malnourished become listless. Providing a toy is part of the therapy to stimulate them.
Shawn Baker Tsalha Idi and his mother Tsalha Aï Gado.
Dr. Seidou patiently took me through her ward to introduce me to other mothers and their children. There are many similar stories of heroic efforts undertaken by mothers to travel to health centers to get treatment for their children. Djamila Maâzou had traveled 45 miles and spent six dollars (incomes for rural women here can be as little as $20 per year) to bring her daughter Nafissa in for treatment. Djamila is 20 years old and the biggest challenge was not the distance, nor the expense, but negotiating permission. Her husband was absent and she needed to convince her brother-in-law to authorize her to bring her daughter to the clinic.
The situation that Niger faces now and in the long term is grim. Additional assistance is needed now to scale-up treatment services. Even more important are the long-term investments to prevent malnutrition from happening in the first place. I visited the village of Bani Zoumbou Imana, 28 miles to the west of Dogon Doutchi. The community had organized a screening to identify malnourished children. Those with moderate malnutrition were getting food rations to get them back to adequate weight, and to prevent the decline into severe acute malnutrition, which requires a more expensive treatment. My most joyous encounters were with six women and their babies who have become role models in the village for practicing exclusive breastfeeding for the first six months. Their babies are vivacious and positively glowing with good health.
Shawn Baker A proud mother of an exclusively breastfed boy in Bani Zoumbou Imana.
I started off my five-day visit to Niger overwhelmed with the magnitude of the problems it faces. Heroes like Dr. Seidou and the mothers of Idi and Nafissa leave me humbled and inspired. These women do not lose hope, and their daily courage calls on the government of Niger and the international community to provide the leadership and resources necessary to break the seemingly endless cycle of famine that has haunted mothers and their children here for far too long. These women prove it can be done.
http://kristof.blogs.nytimes.com/