Why are we there?
- Endemic/epidemic disease
- Social violence
- Healthcare exclusion
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Historical
Addressing childhood malnutrition as a public health crisis
Since 2001, MSF has been treating malnutrition in Niger. These programmes have expanded over the past decade as innovations in outpatient care have made it possible to reach more patients with both curative and preventative assistance.
Since 2010, MSF has treated more than 100,000 malnourished children in Niger annually. More than 90 percent of children admitted to these programmes recover.
MSF’s expansion of treatment and prevention programmes has coincided with the Niger government’s implementation of progressive paediatric care policies that include the increased access to nutritionally appropriate foods, vaccinations, and health care for young children.
Preventing malnutrition
Over the past few years, Niger has also worked with international partners to implement innovative strategies to prevent malnutrition peaks during the hunger gap.
Taken together, these policies, along with the presence of nongovernmental organisations, leave Niger much better prepared to deal with the seasonal peaks in malnutrition than many of its Sahelian neighbours. However, these advances remain contingent on continued investment of government and institutional donors and the NGOs supporting Niger’s fragile health system.
In 2011, the incidence of malnutrition among Nigerien children between 6 and 23 months of age was 30 percent, in the same range as previous years. This shows that childhood malnutrition cannot be considered an exceptional humanitarian emergency, but rather a persistent public health threat that cannot be addressed strictly through emergency programs.
By the end of March, MSF programmes based in the Bouza, Dakoro, Guidan Roumdji, Madarounfa, Madaoua, Magaria and Zinder regions had admitted 1,572 malnourished children to its inpatient nutrition centres and another 14,482 to outpatient nutrition centres.
Screening for malnutrition
In Guidan Roumdji region, MSF supports five government health centers—in Tibiri, Sae Saboua, Souloulou, Guidan Sory and in the town of Guidan Roumdji. These health centres also include outpatient nutrition centres where children are screened for malnutrition and other common childhood illnesses.
Like all of MSF’s nutrition programmes in Niger, malnourished children without significant medical complications are sent home and their caretakers provided with a supply of nutrient dense, ready-to-use therapeutic food (RUTF) to help the children recover.
By mid-March 2012, MSF had provided care to nearly 1,751 children in the five outpatient nutrition centres and provided almost 13,800 consultations for children under five. MSF also supports an inpatient nutrition centre where 278 children were admitted and a 70-bed paediatric ward where 1,092 children were admitted through mid-March.
In the Tahoua region, MSF manages nutritional programmes in Madaoua and Bouza districts. In Madaoua, MSF supports the district hospital, focusing its activities in the maternity and paediatric wards and the inpatient stabilisation centre where malnourished children with complications are treated. MSF also supports 11 health centres (in Madaoua, Bangui, Aoulloumatt, Sabon Guida, Ourno, Manzou, Takorka, Magaria, Arewa, Leyma and Arzerori) where malnutrition is treated on an outpatient basis.
In Bouza, MSF supports the paediatric department and stabilisation centre for malnutrition in the district hospital and is working in five health centres (in the town of Bouza, as well as in Tama, Baban Katami, Karofane and Tadoupta). MSF teams had admitted 276 children to inpatient nutrition centers and 831 to outpatient nutrition centers by the end of March.
A mother takes home a supply of ready-to-use food, Madarounfa, Maradi region. © Yann Libessart / MSF
Malian refugees
Additionally, due to the influx of approximately 1,600 Malian refugees in Tillia in northern Tahoua, MSF is supporting the Ministry of Health with a vaccination campaign and will continue to assess the needs in the area.
MSF began its activities in Dakoro in 2005. In collaboration with the Ministry of Health, MSF supports the district hospital and eight health centres (in Adjie Koria, Alforma, Goula, Kornaka, Sabon Machi, Soly, Korahane, and the town of Dakoro). MSF also conducts nutritional activities and assists with an ambulance referral system for emergencies.
Maternity and paediatric departments
At Dakoro Hospital, MSF supports the maternity and paediatric departments, sterilisation, the operating theatre, water and sanitation activities, and waste management and laboratory services.
By mid-March 2012, more than 9,460 antenatal consultations were carried out, 534 children were hospitalised, and more than 680 babies were delivered, including 64 by Caesarian section.
In the eight health centers, MSF provides medical care to children under five, and in seven of those centres, MSF also runs activities to improve antenatal and postnatal care, family planning and screening for syphilis. By mid-March 2012, MSF had carried out almost 20,000 consultations for children under five in the health centre.
A MUAC (middle upper arm circumference) bracelet is used to check a child for malnutrition, Zinder region.
© David Di Lorenzo/MSF
MSF and FORSANI
MSF and FORSANI, a Nigerien medical nongovernmental organization, have run a joint program since 2009 in Madarounfa, in Maradi region. Treatment of malnutrition, malaria and other pathologies is run in two inpatient structures, five outpatient structures, and 19 health posts that provide full health care services to children under two. This includes access to ready-to-use supplementary foods (RUSF), routine vaccination and follow-up consultations, early detection and malaria treatment. By mid-March, 1,100 children had been treated for severe acute malnutrition in 2012.
Since 2005, MSF has been running a nutrition programme in Magaria, in the Zinder region, with six outpatient nutrition centres and one inpatient centre with the capacity to treat more than 18,500 severely malnourished children over the course of a year (70 percent of whom are treated during the hunger gap). The programme also provides access to paediatric care.
In addition, MSF supports 18 small health clinics that provide paediatric care. MSF treated about 13,000 cases of malaria, 9,000 cases of respiratory infections, and about 11,000 cases of diarrhoea in 2011. By the end of March, 419 malnourished children had been admitted to inpatient nutrition centres and another 1,405 malnourished children to outpatient nutrition centres supported by MSF.
In the city of Zinder, MSF manages an inpatient nutrition center in the main hospital, in which teams have treated an average of 3,000 severely malnourished children annually.
MSF, BEFEN and ALIMA
Since 2009, MSF has been working with BEFEN, a national medical organisation, in Zinder’s Mirriah district, and ALIMA, a French organisation, to provide free quality care to around 15,000 children under five years of age annually (ALIMA supports BEFEN’s project management and fundraising efforts and works with BEFEN and MSF on malnutrition strategies in the area). By the end of March, 301 malnourished children had been admitted inpatient nutrition centres and an additional 2,994 treated on an outpatient basis.
Violence in Mali
As a result of violence in Mali, nearly 26,000 Malians have sought refuge in Niger’s Ouallam Department. MSF responded by working with the Ministry of Health and opening emergency programmes in the four locations in which refugees have been settling with their families (Abala, Chinagodar, Mangaizé and Ayorou). MSF teams in the projects provide primary health care, referrals, screening and treatment for malnutrition, vaccinations for children, and health care for pregnant women to the refugees and to another 25,000 or so Nigeriens from the local area.
In Agadez, one of the primary migration routes in the region, MSF provides access to health care for migrant populations and local communities.
At the end of 2011, MSF had 1,705 staff in Niger. MSF has worked in the country since 1985.
Patient story
Kelima, 32 and Djamilou
Kelima is a mother of four. She brought her son, Djamilou, 15 months, who had lost a lot of weight, to the MSF Intensive Nutritional Care Unit in Zinder. The doctor diagnosed both severe anaemia and malaria and immediately fed the boy intravenously.
Later, he was given therapeutic food. Day by day, he gained weight, until, two weeks later, he was smiling again.
“We will soon go back to our village," said his relieved mother. “This year, it was really too difficult to feed the children, we had only a few handfuls of millet for the whole family.”
