By Paul Hahn
22/10/2012 - Niger comes second from the bottom of all the countries in the world. Living conditions are hard in this country plagued by droughts, floods and invasions of insects which struggles with a chronic food crisis. Paul Hahn reports on malnutrition and ignorance, but also on strategies to combat hunger and on resourceful women.
Ibrahim is two years old. He weighs exactly 7,200 grams. Nurse Yahanatu Manan Issa (25) puts a measuring tape round the weak little boy's arm. The measurement shows what was plain from the start: red alert, serious malnutrition. In Germany a child of Ibrahim's age weighs double this. Nurse Issa carefully pulls down one of the child’s lower eyelids. The mucous membrane is as white as snow: with a proper blood supply it would be pink. The boy is suffering from anaemia, and she has also diagnosed a hunger oedema on his foot. This is serious. Mothers with their babies stand silently with worried expressions around the table where Nurse Issa now puts a red tape round little Ibrahim's foot, a sign that he needs to be admitted immediately to the special diet programme.
A good harvest is not enough
In the health centre in Takorka in the Madaoua Department in Western Niger the young nurse has examined at least 50 children who are so dangerously underweight over the past month. Along with a second nurse, a nursing auxiliary and a pharmacist, she is responsible for 19 villages with around 42,000 people. Together they perform a heroic task in a country beset by a severe hunger crisis and where around eight million people have far too little to eat. In some areas there has been no proper harvest for years due to the continuing drought, floods and swarms of locusts. And now millet, the most important staple in Niger, is so expensive that many people can barely support themselves any longer.
Hamissou Karaou, Director of SOS Children's Villages Niger, describes the current situation as desperate: "Many people have now got into so much debt that, despite a good harvest, they cannot escape the hunger crisis." This alone is a good enough reason to continue the SOS Emergency Relief Programme which began in Niger in 2010. Aid programmes like this were also started in Mali and Chad this year. "Our food supplies have reached 7,200 people so far, with over half going to children. And we will continue to expand this aid", Hamissou Karaou stresses. But the emergency relief programme, from which the clinic in Takorka also benefits, also includes drugs, special therapeutic foods such as peanut butter and cereal bars for malnourished children and clothes.
Nurse Yahanatu cannot do much for Ibrahim in her clinic with its limited facilities. She refers the little patient on which hunger has left such deep marks to the district hospital 30 kilometres away in Madaoua. Then comes the next shock for Ibrahim's grandmother who has brought him here: "How am I going to pay the fare to get there?" "Families have almost nothing, the mothers themselves are often malnourished, have too little milk and can barely afford the fare to the clinic in Takorka", the young nurse says, explaining why children are often only brought to the health centre when they are already severely malnourished.
A lack of knowledge about proper child nutrition
"Many mothers also have no understanding of the connection between nutrition and their baby's health and tend to believe that the child is suffering from some disease or other", the nurse explains. Mothers therefore go to the marabou, an Islamic holy man, instead of to the clinic. Or they go to a traditional healer who attempts to stop the progressive weakness by reciting a charm. Aboubarkar Zenabou (25) is trying to combat this superstition. She is employed as a nutritional advisor as part of the SOS Emergency Relief Programme in the Madaoua region.
Today she is outside the small clinic in Rezi, a good hour by car from Takorka on a bumpy track. The young woman is surrounded by at least 200 mothers with their babies tied to their backs. "After breast-feeding, the mothers often give their babies the same food that the adults eat straight away because they don't know any better. Too salty, too hot and spicy and often much too greasy from the cooking oil. And they believe that the child has had a good meal. Instead of which diarrhoea sets in and the baby loses weight", explains Aboubarkar. Today she is showing the women how to cook a very nutritious vitamin-rich baby food using maize meal, peanut butter, sugar and milk. "Can you use millet meal, because we don't have any maize meal?" one woman in the crowd asks. "Yes, that works as well, but you need to roast it a bit first", Aboubarkar explains, pushing another bit of firewood under the sooty black pot. As part of this cooking class she also gives small tips on hygiene: "You can feed this porridge to your babies all day, but put a lid on the pot to keep off the flies." Then she explains that the flies might have come from a pile of excrement and would contaminate the baby food with dangerous intestinal bacteria.
Grain banks help through the worst times
While outside the clinic the cookery course continues under a scorching sun, inside, in the examination room of nursing auxiliary Alou Saley (42), little Aischa Garba (8) lies with a high fever and violent shivering fits on the worn bed. "Malaria is currently the most widespread disease", the orderly explains, preparing a drip with a glucose solution for energy and a malaria drug for little Aischa. "There are far too many mosquitoes in the rainy season", he complains. Yet despite this, the people await the rains more eagerly than anything else. "Everything depends on the rains!" stresses Moussa Moudi (61), Hakimi (local chief) in Maiwatan, a village where over 3,500 people live in traditional mud houses. It is now only three weeks to the millet harvest which could turn out well again at last "if it rains in the coming weeks", the Hakimi says hopefully.
The previous year there was no harvest at all in Maiwatan. "We have gone through a bad time. We had to take our goats and cows to the cattle market. And then buy grain which is currently in short supply in the whole of West Africa and can only be had for premium prices. Without the money from villagers who work as migrant labourers in neighbouring countries such as Nigeria we would have died", the Hakimi explains. However, the village now has additional support. Mahamadou Ibrahima – who coordinates the SOS Emergency Relief Programme in Niger – and his team bring maize and millet to 100 of the worst affected families including around 400 children. "This is the time when help is most urgently needed", explains the emergency relief coordinator. "Many families' grain stores are now empty and they cannot afford to buy millet." The average family in Niger has seven children and can live for just under three weeks on a 100 kilo sack of millet which currently costs 50 Euro.
The significance of this price can be understood by a glance at the statistics. These show that Niger ranks 186, just above the Democratic Republic of Congo, as the second poorest country in the world with an annual average income per capita of only 280 Euro. In order to reduce the large fluctuations in the price of grain, with the difficulties this creates for the villagers, grain banks will be created after the harvest. As part of the SOS Emergency Relief Programme, grain will be bought at a low price straight after harvest and stored in the banks. If prices rise and famine returns, the villagers can get grain and seeds from these banks at the low purchase price.
The fate of Mamou Younouss (51) also depends on a bank. Over 600 kilometres west of Maiwatan she sits at the side of a dusty road in Bobiel, a district of Niamey, the capital of Niger. She is carefully stirring a pot with boiling oil. Hungry customers stand beside her, waiting until her fari massa, traditional fritters, slowly turn golden yellow. Mamou is one of 107 widows who have been given a small interest-free loan as part of the SOS Family Strengthening Programme (FSP) which guarantees the loan. No bank would have given a poor woman like Mamou a loan without any security. She has now received her third loan from the SOS programme. She was able to repay the two previous small loans promptly within the designated time period of six months.
Every day of the week she bakes and sells her fari massa. However, she particularly looks forward to Thursday afternoon. This is when the widows who are in receipt of small loans meet in a yellow-painted room in the FSP project building. Mamou stands in front of a large slate and starts to add up a line of numbers. "My neighbours said that I'm wasting my time when I admitted that I am now learning to read, write and do sums", Mamou relates. She has not found it easy, learning all this at her time in life. "Now I'm really happy because I'm getting the hang of it."
Aichatou Iro, one of the FSP team who looks after the business women, is also proud of Mamou. When asked what the women find hardest when trying to build up a lasting business and so become credit-worthy themselves, Aichatou replies immediately: "Having money and not spending it on food when business is not going so well. You need to be very strong in that situation!" Which these women obviously are, because out of 107 borrowers, only 28 have had problems in repaying their loan within the six months. This is actually a good number when you consider that over 20 percent of creditworthy customers who owe money to the Deutsche Bundesbank cannot pay their loans back on time.
