The 400,000 children at risk in Niger's worst hit area
Aid begins to trickle through, but agency says it is three months too late
Christian Allen Purefoy in Maradi
Tuesday July 26 2005
The Guardian
Reduced to the weight of a newborn baby, six-month-old Rabe was carried by her mother over 100km across Niger's hot and dusty terrain, to the shade of an intensive care tent in the middle of a barren football field.
"I didn't have enough money to buy her milk," said Rabe's mother, who didn't want to give her name. She had just been accepted into Médecins Sans Frontières' (MSF) hospitalisation camp in Maradi.
MSF, the major aid agency underpinning Niger's current relief effort, is calling the problem a "severe nutritional crisis" with an estimated 400,000 children at risk in the Maradi region alone.
"It could be double but, of course, we are not able to reach them," explained Mego Terzain, MSF's field emergency coordinator.
MSF has been working in Niger for about 15 years, but as soon as this year's malnutrition crisis became apparent it set up 10 mobile clinics and five malnutrition centres across the country. Its second hospital opened on June 27 with 150 beds, though this has been increased to 250.
One doctor explained how 30 to 40 people arrive every day, and 25 or 30 people leave. Outside the clinic, women are sleeping overnight to wait for their children to be screened, in the hope that they will be admitted.
The scale of the crisis has prompted what Mr Terzain believes is "the biggest nutritional operation in MSF history".
Last year, 10,000 children suffering severe malnutrition were admitted to MSF field hospitals and clinics in Niger.
This year, from June 21 to July 17, MSF admitted 12,838 children.
The first relief planes from France and aid agencies have just begun to arrive - the UK government has pledged an extra £1m for the World Food Programme's emergency operation in Niger, bringing the UK's total contribution to £3m.
But as early as October 2004 the Niger government announced there would be an acute problem from June this year.
"I'm afraid it's too late. The international community should have responded three months ago," said Mr Terzain.
Pinned to the wall behind him is a small graph with a thin line indicating a three- to four-fold rise in the number of admissions, and he warns the worst is yet to come. "In August there are traditionally three times more admissions."
Strangely, the area surrounding Maradi is now green with fresh crops such as millet, and puddles of muddy water from recent rain. But the people will continue to go hungry, waiting for the soudure to end - the period between planting and reaping the harvest.
This year, the soudure has been particularly arduous because last year's bad harvest has meant any food stocks have already been exhausted.
Though the UN estimates that about 800,000 children are suffering from hunger in Niger, aid agencies are concentrating on those under the age of five - the worst affected of this number are between the ages of six months and two years old.
"They are more fragile and not ready to fight against disease," explained Mr Terzain.
Niger is the second poorest country in the world, and although healthcare is not expensive, many mothers cannot afford to take their children to hospital.
Last year's drought was exacerbated, especially in the north, by an invasion of locusts. As it is, four-fifths of northern Niger is desert, with very little agriculture, and the country relies heavily on the savannah areas in the south, which are suitable for livestock and crops.
"People of the north come south, and if the food is not there then the whole village comes, so there is less food here," said Chief Abdou Bellas Marafa, the 381st chief of Canton Kyibir - an hour's drive from Maradi.
The Niger government gives Chief Marafa food to distribute and he helps with "some cereal that I have", but he insists the most serious problem is the lack of rain. "It rained half the normal amount last year," he said. There were other problems. "As the Sahara comes, the farms get smaller."
The issue of desertification - the expansion of the Sahara desert southwards - means Niger's agriculture will come under increasing stress as smaller yields are used to feed a growing population. There are 11 million people in the country but that figure is growing at 3.3%.
Over-grazing, soil erosion and deforestation - people will walk over 100km for wood - has meant desertification is a problem that will only get worse across the whole northern area of west Africa.
"The problem is not just in Niger but Mali, Nigeria and others," said Chief Marafa. "But in these countries food is not a problem as their government pays."
Unlike countries such as Nigeria that uses its massive oil revenues to import food, Niger's economy of only $9bn (£5.15bn) depends on its main export, uranium, whose value has decreased dramatically since the nuclear arms race in the 1980s.
Niger's economic situation is further complicated because it is landlocked deep in western Africa. Supplies must be transported by road through unstable countries such as Ivory Coast or Togo. The country relies on its much wealthier neighbour, Nigeria.
Nigeria's Jigawa state government last week sent trucks of aid. But because of Niger's size and its lack of infrastructure, Nigerian border controls suspect the aid did not penetrate deep inside the country.
People from Niger have begun to cross into Nigeria for food supplies in such numbers that Nigeria's border control is now supposed to refuse entry to anyone without the correct papers.
However, one immigration official - wishing to remain anonymous - said: "They are our brothers - we can't let them suffer. They come in [to collect food] - maybe even as far as Kano - and go again."
Two hours drive from the border, fans cool the inside of Maradi's intensive care unit. With essential equipment and two doctors available day and night, the mortality rate - in a country where infant mortality is as high as 12% - has been kept to 5%.
The two children dying on average each day often simply arrive too late to be helped. Rabe's mother has had 11 children, of whom five have died in similar circumstances.
The last one died two years ago aged 10 months. Rabe's mother is no stranger to Niger's problems. However, with her husband ill, she has planted this year's crop by herself, hoping that with the rains it will be a good harvest. But the present problems threaten her future and the future of many others.
"My child was about to die so I am worried about the field. No one is looking after it."
'I've seen some very, very thin children'
Nick Abrahams, emergency response team leader for Save the Children UK, Maradi region, Niger.
We've been in Niger for 10 days. At the moment we're working with the authorities here to try to work out exactly where our distribution centres should be. We want to establish them so that each village is a couple of miles walk away, so that every mother will be able to bring her children.
"In the Maradi region there are three feeding centres, which are all being run by [aid agency] MSF.
"What the agencies coming in now are doing is working with the children who don't need hospitalisation, but need to be stopped from going into hospital.
"We're expecting our plane to arrive on Wednesday, so lorries should be down here on Friday. The plane, paid for by [the UK ministry] DfID, is carrying about 50 tonnes of food, I think. It's got high protein biscuits and Unimix, a high protein porridge.
"Going into the villages, we've seen small children who are not getting enough calories. I've seen some very, very thin children.
"The people here are working hard to make what they've got last. They know it's going to be two months until the harvest comes in.
"Save the Children is planning to be here for nine months. We want to make sure people get back on their feet, and can get through the next hunger season. That's something which happens every year in this region. This year it's so much bigger because of the locusts, droughts, and localised flooding.
"I've seen food shortages before, in Congo, but not on this scale and not with so many children affected."
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