We all met up early at the airport in Dakar to take the flight to Niamey, the capital of Niger. The pilot announced that the ground temperature was 38 degrees Celsius (that’s 100.4 degrees Fahrenheit!) – indicating we had left the relatively cool temperatures of Nouakchott and Dakar behind. Our team in Niamey, led by HKI’s Country Director in Niger, Marily Knieriemen, met us at the airport and we had a late lunch at Marily’s house before heading off to Dogon Doutchi – a market town about 20 km (12.4 miles) from the border with Nigeria.
Rains have started recently and throughout the ride there were signs of millet having just been sown; in some cases, fresh green sprouts were pushing through the red soil. I am struck by how much of the land is cultivated. When I first began visiting Niger 20 years ago, vast stretches of land lay fallow. Now, the burgeoning population growth is putting increased pressure on farmers to cultivate all available land and they no longer have the luxury of letting fields lay fallow to recover.
We arrived in Dogon Doutchi just before dark and made a stop at the nutrition rehabilitation ward in the district medical center. The ward currently has five children in various stages of treatment for acute malnutrition and one new arrival who will start treatment tomorrow. I spoke with the mother of a one-year old girl, Mariama, who has been in treatment for three days. While her parents had noticed that she was not growing as quickly as they thought she should, it was her vomiting and diarrhea that finally compelled them to take her to the health center.
Mariama’s mother made the 35 km (22 miles) journey by paying a market vehicle to transport them. Once the malnourished baby is fully stabilized, she will be transferred to the next phase of treatment, and then sent home with rations of PlumpyNut®. This nutrient-rich paste, that tastes a bit like peanut butter, is specifically designed for the treatment of severe malnutrition and she will keep eating it until she has reached a healthy weight. Mariama’s mother reports that her daughter is already doing better than when they first arrived.
The heartbreak is that cases like this are incredibly preventable through optimal breastfeeding, complementary feeding and access to quality health care. I am awed by the dedication of the health staff – the head of the rehabilitation unit and the attending physician spent over an hour with us, visiting with patients and their parents until we left at 9pm – but no child should have to suffer like this in the first place.
Huge advances have been made in the treatment of acute malnutrition, but the real challenge lies in its prevention. Tomorrow we are leaving early in the morning to see how HKI is doing just that.