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MSF in Niger, 2010
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Nutritional crises are a chronic problem in Niger, but a particularly poor harvest in 2009 made the 2010 crisis far worse. Global acute malnutrition rates among children passed the emergency threshold of 15 per cent, with more than three per cent of under-fives suffering from severe acute malnutrition.
The extent of the food crisis was recognised early, and the Ministry of Health, international organisations and national associations treated 328,000 children for severe acute malnutrition. MSF cared for more than 148,000 malnourished children.
A preventive approach
Even when receiving good care in a high-quality nutrition programme, between three and five per cent of patients suffering severe acute malnutrition will die. For some years, MSF’s nutrition projects in Niger have been implementing a preventive approach. Children under two years of age who are suffering moderate malnutrition or are at risk of malnutrition are given ready-to-use supplementary food before their condition can deteriorate to the level of severe acute malnutrition.
In 2010, this innovative approach was taken up for the first time by the Niger government, the UN and their partner organisations. An ambitious target was set: to reach more than 650,000 children. MSF provided supplementary food rations to more than 202,000 children aged six months to three years, and preliminary results of a survey carried out in Zinder region during the second half of 2010 show that this strategy had a significant impact on mortality rates.
The worst-hit regions
Maradi, Tahoua and Zinder were some of the regions worst hit by the food crisis. MSF and its partner organisations worked to provide malnutrition care in as many locations as possible, so that treatment could be sought closer to home for more people.
In Maradi, up to five per cent of children were suffering from severe acute malnutrition. MSF teams screened and treated children for the illness, trained staff, provided supervision and supplied medicines to 19 health centres spread across the departments of Dakoro, Guidan Roumdji, Madarounfa, and in Maradi commune.
MSF worked with local medical organisation FORSANI (Forum Santé Niger) in Maradi town and Madarounfa, and more than 21,300 severely malnourished children were admitted to their feeding programme, almost 5,000 of whom were hospitalised in therapeutic feeding centres. More than 35,000 severely malnourished children were admitted to the feeding programmes in Guidan Roumdji and Dakoro. In Madarounfa and Guidan Roumdji, supplementary ready-to-use food was distributed as a preventive measure to 44,200 children.
In Zinder region, MSF supported 19 health centres in the departments of Mirriah and Magaria with feeding programmes, providing extra staff and essential drugs to ensure free care for children under five. A network of 250 community health workers was built up and dispatched across Magaria to screen children for signs of malnutrition and encourage parents to seek treatment for their children. MSF managed two therapeutic feeding centres. More than 34,000 malnourished children received treatment for severe and acute malnutrition. The supplementation programme in Mirriah district reached more than 106,500 moderately malnourished children or children at risk of malnutrition. MSF also provided technical support to BEFEN/ALIMA, a local association running 15 outpatient feeding centres and one therapeutic feeding centre in Mirriah department.
In Tahoua region, to the west, MSF provided free medical care and treatment for severe acute malnutrition at six health centres in Madaoua department, and treated 18,370 severely malnourished children under five. More than 2,000 of these children were admitted to intensive nutritional rehabilitation centres. In collaboration with the World Food Programme and local associations ADRA and GADED, MSF distributed more than 128,000 supplementary food rations to children aged between six and 23 months in the departments of Madaoua and Bouza.
Malnutrition and malaria create a vicious spiral: malnutrition weakens a child’s immune system, making it more difficult to fight against malaria. In turn, symptoms of malaria in children include anaemia, diarrhoea and vomiting, all of which can cause or complicate malnutrition.
In Zinder, MSF treated more than 72,500 cases of malaria. Over a quarter of the children hospitalised for malnutrition were also suffering from malaria. In total, more than 216,330 children under five received treatment for malaria in the regions of Zinder, Maradi and Tahoua.
Maternal and child health
MSF teams supported local hospitals and health centres, particularly paediatric and maternal health services, in many parts of Niger.
In Maradi, MSF supported the maternity and paediatric departments, and the sterilisation and laboratory services of Dakoro hospital. More than 2,500 births were assisted and more than 9,100 children were hospitalised. Staff also worked in health centres in Dakoro, and carried out 183,000 consultations with children under five.
In Guidan Roumdji hospital, also in Maradi, MSF provided medical supplies, medicines and staff to the paediatric department, the laboratory and the sterilisation service. A team also installed a clean water supply and sanitation system.
In Tahoua, MSF built a new paediatric ward for the Madoua district hospital.
In Agadez, MSF teams provided free gynaecological and obstetric care in five health centres. Staff assisted more than 2,600 births. Agadez is on the main migration route for people heading to Europe from west or central Africa, and MSF provided free medical care to more than 730 migrants and distributed 690 relief kits.
MSFsupported the Ministry of Health’s vaccination campaign against meningitis: in total, 490,000 people were vaccinated against various strains of the disease in Zinder, Maradi, Agadez and Madaoua (in Tahoua region).
With the support of MSF and other international organisations, the Ministry of Health carried out a second vaccination campaign in Dosso and Boboye departments in December 2010, using the new vaccine against meningitis A. The new vaccine provides four times greater protection than the one traditionally used, and this protection lasts for ten years, compared with three years for the older vaccine. Another major benefit is that the new vaccine can help stop meningitis transmission as it eliminates the bacteria even in healthy carriers of the disease so they cannot pass it on to others. Initial results indicate that more than 90 per cent of the 627,000 target population was vaccinated. If the vaccine is used widely, there is real hope of seeing a sharp drop in the number of meningitis A outbreaks.
Following a cholera outbreak in Zinder, MSF teams treated 249 patients in two treatment centres and cleaned four wells to help halt the spread of the disease.