International Activity Report 2012
MSF in Niger, 2012
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Including prevention and treatment of malnutrition as part of basic health services in Niger will allow many lives to be saved.
Food insecurity and nutrition crises are a chronic problem in Niger, but child mortality was reduced by 45 per cent between 1998 and 2009, according to a study in the Lancet. Health authorities have shown the will to make changes. They have recruited more medical personnel, and measures such as the decentralization of nutrition programs and the provision of supplementary treatment to prevent those at risk of developing severe malnutrition have brought improvements.
However, malnutrition rates remain high, with overall levels close to the World Health Organization’s emergency threshold in 2012. There are still chronic shortages of drugs and medical supplies, and the free services for children under five and pregnant women formally introduced five years ago have yet to be made available. Doctors Without Borders/Médecins Sans Frontières (MSF) activities in Niger are mainly aimed at improving healthcare for children under five and pregnant women, focusing on early treatment and prevention, particularly of malnutrition. Teams in the regions of Zinder, Maradi and Tahoua run outpatient feeding programs in some 38 health centers. Patients in need of hospitalization are cared for at inpatient feeding centres in Zinder, Magaria, Madarounfa, Dakoro, Guidan Roumdji, Madoua and Bouza hospitals. The staff in Zinder and Magaria are in the process of handing over activities to the Ministry of Health, and in 2013 expect to provide support only during the peak season for malnutrition.
MSF handed over the inpatient feeding centre it built at Dakoro hospital in Maradi to the Ministry of Health, while the feeding programme at the centre and at eight other outpatient centres have been handed over to the organisation ALIMA/BE FEN . MSF will continue to provide paediatric and maternal care – including obstetric surgery – at Dakoro hospital, where the team assisted 13,200 births in 2012. Pediatric services also continued at the other hospitals, and MSF still supports maternity services, as well as laboratory and sterilization departments
at several of them.
Alarming rise in malaria
An extremely high incidence of malaria was reported in nearly all regions in 2012.
Malnutrition and malaria peak at the same time of year (July – September) and create a vicious cycle in children: malnutrition weakens the immune system, while malaria causes anemia, diarrhea and vomiting, aggravating malnutrition.
Guidan Roumdji’s intensive care and pediatric units, in Maradi, were overwhelmed, with an occupancy rate of 200 per cent in July. Dedicated units to treat severe malaria were set up in Dan Issa and Madarounfa, Maradi region and Madoua, Tahoua region. In Madarounfa, MSF worked with local organisation FORSANI, focusing on treatment for children under five. When cholera struck Tahoua, the team set up treatment units in Galmi, Koumassa and Madoua, and treated 350 patients.
Improving health closer to home
The positive results of moving healthcare closer to people’s homes can be seen not only in the outpatient feeding centers but also in the community health programs that MSF runs in Niger. When children in remote villages catch malaria, they often arrive for treatment too late, owing to a lack of access to adequate healthcare in their villages.
In Madarounfa and Madoua, MSF implemented a new strategy to improve early diagnosis and treatment of malaria for children and pregnant women: staff now provide diagnosis and treatment in rural villages.
In Zinder region, community health workers have been recruited to promote practices that will help reduce child mortality, such as improving hygiene, carrying out vaccinations and encouraging people to visit clinics. In village ‘health huts’, health workers screen and treat children for malnutrition, and diagnose and provide treatment for the three main childhood killers: respiratory infections, diarrhea and malaria. Patients in a more serious condition are referred to a health center.
Assisting Malian refugees
Violence in Mali drove thousands of people across the border to Niger’s Tillabéri region over the course of the year. MSF provided basic and specialist healthcare for the refugees and the host population, including vaccinations, maternal care and referrals. Staff carried out more than 334,000 outpatient consultations, admitted nearly 19,000 people to hospital and vaccinated over 22,000 children against measles. When cholera broke out, teams set up treatment centers and rehydration points, and treated 2,730 patients for the disease. In August, MSF donated basic relief kits to people affected by flooding in the region’s Ouallam department.
Closure of program in Agadez
Agadez is located on one of the main migration routes from sub-Saharan Africa
to the north. MSF has been providing maternal and pediatric services in Dirkou and at eight health centres in rural areas for migrants and local communities who have difficulty accessing healthcare. The program was closed at the end of 2012
as MSF focused its activities on the wider humanitarian needs in the country.
At the end of 2012 MSF had 1,593 staff in Niger. MSF started working in the country in 1985.