MALNUTRITION: Niger: Between two seasons of hunger

PHILLIPPE LATOUR Feb 23 2011

 A woman collects water for her family’s animals in Gadabeji, Niger. Here the grass is meager after a drought killed off the past year’s crops. Aid groups warn 2011 will be another difficult year. (Sunday Alamba, AP)


Despite the large-scale response to the nutritional crisis from Médecins Sans Frontières/Doctors Without Borders (MSF) and other aid organisations, tens of thousands of children suffered from malnutrition in Niger in 2010. Despite better harvests, 2011 also looks set to be a critical year.
Around 100 years ago the father of Salouf Kina (80) founded the small village of Gueza, three hours' drive east of Zinder, the former capital of Niger. "He took his cows to a new grazing ground and decided to settle here with his family. There was plenty of greenery and water here at the time. I've always lived here, but last year [2010] was the worst I've seen", he says with a faltering voice.
Today Gueza, with 2 000 inhabitants, is a patchwork of mud huts built along sandy streets, where the odd tree provides some rare shade. In the surrounding area a few scrubby fields of millet left over from the recent harvest give the hills an air of neglect.
Kina's son, Aboukar, who is more than 50 years old, is also a neighbourhood chief and tells of the lean period that the inhabitants of Gueza experienced in 2010: "At the end of 2009 the harvests were very bad and some families harvested nothing at all because of the drought. When people's stocks ran out and they could no longer borrow, they had to leave the village -- young men at first, to go and work in Nigeria, then whole families. Between May and September more than half the village fled, leaving behind only women, young children and the elderly," he says.
"We're a long way from everything and few people are interested in us. If MSF hadn't set up a feeding centre at the health centre, all of us would have left and the village might have died completely."
Gueza's Integrated Health Centre is one of the few concrete buildings in the village. There are few consultations and MSF has packed up its outpatient nutrition education and rehabilitation centre for cases of severe malnutrition.
It is hard to imagine that three months ago some 300 children were treated by the MSF team here. It is the young Mamane Bashir, the centre manager, who greets me.

Malnutrition exacerbated by malaria
"The rains came very early this year and the malnutrition situation was exacerbated by malaria, which hit the weakest children. Last August we treated around 600 children, compared with just a hundred or so in August 2009. This is also linked to MSF's presence, which ensured that the medicines and therapeutic foods didn't run out," says Bashir.
In Zinder and Magaria, the main towns in this region of Niger, at the end of December, there were still some 200 children in the intensive hospitalisation centres set up for the serious cases of malnutrition. However, these facilities -- rows of beds under large tents -- now seem relatively empty. At the height of the nutritional crisis, in August and September, more than 800 children were treated there, the majority of them on the brink of death.
Kelima, 32 years old and a mother of four, took her youngest child, Djamilou, aged 15 months, to the Zinder centre in early December. The MSF doctor diagnosed him with severe anaemia combined with malaria. After being given a drip and then fed therapeutic foods, he gradually gained weight. Two weeks later he is smiling and waving his hands when spoken to.
"Soon we'll be able to go back to the village" says Kelima. "But this year, it was really too difficult to feed the children; there were only a few handfuls of millet for the whole family."
"Unfortunately, 2010 was the year that broke every record," says Dr Moïse Moussa Gabrial, head of the Magaria centre. "Since January 2010 we've seen more than 6 200 children. At the end of August, we had around 500 hospitalised children. We had planned to recruit and train medical staff, but the situation was so bad that we had to hire people locally and train them on the job.
"At the height of the malnutrition crisis, 280 people were working for MSF at the intensive malnutrition centre. And tragically, we saw the deaths of many children -- 133 in September alone -- who had arrived in a desperate nutritional state and were often suffering from malaria."

Fighting famine
However, 2010 was also the year of unprecedented mobilisation to fight famine in Niger. The government, born of a coup d'état at the beginning of the year, made food security one of its central causes and called upon international organisations to help.
A number of organisations provided extensive support for care facilities and implemented large-scale prevention strategies, based on appropriate food supplements, making it possible to limit the damage.
"We dare not imagine what would have happened if no one had rallied to help," says Patrick Barbier, MSF's head of missions in Niger." But what worries us today is that despite some good harvests at the end of 2010, 2011 still risks being a very difficult year, in a context that remains one of extreme poverty, often combined with a lack of access to care.
"In nearly all the country's regions, families are heavily in debt and must now, after the harvest, pay back three or four measures of millet for every two borrowed. Added to which, many families' livestock assets have been reduced from a whole herd at the start of the year to just a few goats and sheep. International organisations and aid agencies must remain extremely vigilant and prepare to intervene on a large scale again in 2011."
In Gueza Kina's grandson and Aboukar's son has just turned 20 and already has the face of an old man. In a few days he will set off for Nigeria to sell tea in the street so that his family can survive in the village and keep the hope alive that life there is still possible.
http://mg.co.za/article/2011-02-23-between-two-seasons-of-hunger/