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Niger: Nutritional Situation Remains Worrying
December 1, 2005
Between January and November 2005, Doctors Without Borders/Médecins Sans Frontières (MSF) admitted nearly 60,000 severely malnourished children to its therapeutic feeding centers in Niger. While the severe malnutrition epidemic is slowly decreasing, the current situation and the outlook for 2006 remain troubling. Johanne Sekkenes, MSF Head of Mission in Niger, provides an update on the situation.
How do things stand as of late November?
The number of admissions to our therapeutic feeding centers has declined slowly since the end of September but still remains high. During the week of November 14, we admitted 644 additional children to our centers in the Maradi district. Several weeks after the harvest, we are still seeing high levels of malnutrition. The crisis is not over.
In southern Maradi, where we admitted unusually large numbers to our feeding centers, many families went into debt to buy food. Now they are paying off those debts with sacks of millet or with money. Regardless of the results of this harvest, access to food will impact nutrition levels. For instance, people who for whatever reason could not fill their granaries still have very limited access. The post-harvest millet price is high compared to past years, and distributions of free international food aid ended October 10.
With respect to medical treatment, free care is not available to all children under 5 years of age. The majority of health centers charge fees for medical visits and drugs, adding an extra burden. The end of the rainy season has brought with it fewer cases of malaria, but respiratory infections are on the rise. Without treatment, children can weaken quickly become malnourished.
How do you assess the severe malnutrition epidemic of in Niger in 2005?
In 2005, there was a malnutrition epidemic of unusual scale. Malnutrition is chronic in Niger, but this year the situation has been much more serious than in prior years. Between January and November, we admitted approximately 60,000 severely malnourished children to our centers in Niger. Neither MSF nor any other organization has ever treated so many children in one operation. Therapeutic food supplements proved effective, with a recovery rate above 90%. For MSF, that translates to more than 54,000 children who recovered.
But how many more lives could have been saved? The key actors had problems setting up aid operations. First, the existing monitoring system proved inadequate and the severity of malnutrition in the areas at greatest risk was under-estimated. Second, this crisis exposed the absence of effective strategies to deal with a nutritional emergency in Niger. The development strategies used until July 2005 (the sale of cereals at moderate prices, cereal banks, food-for-work programs, etc.) did not prevent tens of thousands of children from developing severe malnutrition. Free food distributions did not begin until the story received media attention. Treatment of moderate malnutrition was late and limited.
What is the outlook for 2006?
The number of admissions to our feeding centers has increased every year since 2001. I am worried about 2006 because I don't think that adequate measures are in place to prevent a new epidemic of acute malnutrition. Today, after the 2005 crisis, there are many more aid providers in Niger. The government of Niger, United Nations agencies and donors are working together, demonstrating their commitment to preventing the recurrence of such a crisis. But will that be enough? Many of the aid providers involved in the 2005 crisis are making alarming predictions for 2006. What prevention and treatment operations have they planned?
As for MSF, we are maintaining our presence in Niger. We have transferred some of our activities to others and are concentrating our operations on the treatment of acute malnutrition in the most affected areas.