Activity Report: Doctors Worldwide Turkey launches its first Health and Nutrition Project in Niger
The food crisis in Niger officially started in December 2011 but in fact the country has faced on-going food insecurity since the major crisis of 2005-2006, worsening an already alarming health situation. Indeed, Niger with one of the lowest DHI (0.295 in 2011, which gives the country a rank of 186 out of 187 countries according UNDP Human Development Report) has one of the world’s highest under-five child mortality rates. One in six children die before they reach their sixth birthday and one woman in seven dies in pregnancy or childbirth. The daily life of many households depends on a precarious balance. Poor and erratic rainfall since last year has led to widespread failure of crops and death of livestock. Shortages have started months before the traditional lean season which means that the hunger affecting thousands of families will last longer and more children will fall into acute malnutrition. According to UNICEF up to 400,000 children could be affected by the end of the year. As per July 24th 2012, 160,000 children had been admitted in therapeutic programs across the country.
Since November Doctors Worldwide Turkey (DWWT) has implemented three nutrition centre projects in Mogadishu and we have been willing to address malnutrition in Niger as well in an integrated approach combining nutrition and health care. After undertaking a need assessment in May we decided to implement our project in the region of Tillabéry which had amongst the highest rates for both acute and moderate malnutrition. Even though Tillabéry Health District has made substantial efforts to coordinate the activities of the different partners to address malnutrition, many malnourished children remain unscreened essentially because of the lack of both logistics and human resources
The main findings of our assessment were that:
1) Malnutrition cannot be isolated from health care
2) Proximity and accessibility to health and nutrition care are the keys to implement a successful project.
Starting from these two observations, instead of diluting our action on a large territory with a loose control we decided to focus on the limited area covered by the Integrated Health Centre (CSI) of Koria Haoussa which is one of the biggest villages in Tillabéry region. Located on the national road half way from Niamey and Tillabéry, this Integrated Health Centre, if functioning properly and optimized can attract many patients coming from rural areas who cannot afford to go to Niamey and who cannot receive an adequate treatment in Tillabéry district hospital, the region being the only one without a regional hospital.
Koria Haoussa Integrated Health Centre officially covers 15 villages for a total of 15,000 inhabitants, but it also welcomes many people coming from farther villages of the district and even from villages located on the other side of the river in Tera Department. Since the facility has not been maintained for 10 years it needed some renovation and we also had to purchase new medical equipment before starting our activities. Since medicines shortage is a crucial problem in the national health system, DWWT will provide medicines free of charge to children and pregnant women. We also recruited new staff to optimize the capacity of the centre and to reach as many patients as possible. A doctor, a nurse, a nutrition specialist and a midwife will join the chief nurse and the pharmacist. In addition in order to organize screening campaign our team will be backed by medical students and by 3 community health workers.
In order to incite mothers to bring their children to consultation mosquito nets and soaps will be distributed for every household. Besides, to prevent malnutrition and to accompany poor families through the lean period we will distribute food regularly.
During one year we will provide health and nutrition care with a strong focus on children and pregnant women. DWWT will also support Tillabéry Health District for specific campaign. Using three wheels motor ambulances our team will be able to reach remote areas to identify malnourished children and to deliver basic health care services. These vehicles will also be used for the evacuation of patients to Niamey or Tillabéry. At the end of the project we will undertake an evaluation and if the results prove to be satisfying DWWT will consider extending the capacities of Koria Haoussa Integrated Health Centre to turn it into a district hospital with a focus on malnutrition mother and child health care.
