Magaria, Niger
Security rules continue to be extremely tight in Niger, as al-Qaida continues to kidnap westerners in this region of the world.
Most NGOs have pulled all foreigners out of Niger, and those of us who remain are no longer able to move around by foot.
It is extremely restrictive, incredibly stressful and I am happy to say that, these days, I feel like the luckiest person in the world.
In life there are things one loves, and things one inherently knows is not right for them.
I was never at ease working in the malnutrition hospital in Zinder, Niger. I felt I was not able to provide everything the position needed and, in return, I didn’t feel completely satisfied with my role.
The deaths of children in vehicles en route to the centre continuously haunted me.
The entire concept of the inpatient malnutrition centre is reactionary, and in no way prevents children from becoming malnourished and horribly ill in the community.
Fortunately, a position opened up with another Medecins Sans Frontiers project 200 kilometres away - right on the edge of the Niger/Nigeria border.
I happily migrated south to supervise a community pilot project aimed at reducing the mortality and malnutrition rates of children under five.
Due to project’s dependence on community collaboration, I have been granted the freedom to go into the remote villages to work.
While all other excursions outside of the village are entirely forbidden, the truth is that there is little risk in heading into the bush - it is almost 100 per cent certain that al-Qaida is not going to search out a tiny white woman working off a sandy unpaved road somewhere on the Niger/Nigeria border.
Working with Medecins Sans Frontiers has provided me with the opportunity to see some of the most desolate and dire areas of the world.
Today, as I headed out to one of the project’s health posts, dire and desolate were redefined before my very eyes.
Niger is one of the poorest countries in the world, and this is the poorest region of the country.
Formal education is rare.
Famine is endemic.
The harvest, collected only two months ago, has run out.
The cows we passed on the “road” were as emaciated as the children in the malnutrition centre.
Children under five die at abominable rates here, usually from one of the three “known killers”- malaria, diarrhea or respiratory infections.
The pilot project aims to make treatment for these known killers free of charge and available at tiny pre-existing health posts within small villages.
This means training minimally educated people how to diagnose and treat these basic illnesses.
When I arrived at the health post today, about 30 women with traditionally carved faces were waiting outside the health post with their children.
Inside the health post, I met Boubacar.
Boubacar is a community health worker, and, as is the case in all of the other health posts, he works completely alone.
His only education, besides primary school, is six months of “health training.”
The health post is smaller than most western kitchens, has no running water or electricity and it is there that he does more than 30 consultations a day and about five deliveries a month.
His salary is enough to pay for his food, as he works seven days a week and has no time to tend fields.
Last year, before Medecins Sans Frontiers started giving medication to the health post, he was closed most days.
He said it was too hard to consult dying children and have no medication to give them.
Now he is able to treat basic illnesses, and mothers don’t have to walk 30 kilometres to have their child treated at a “health centre,” where they have to pay for medication.
I asked, naively as always, what happens if a child is extremely sick or if a delivery has complications.
Boubacar explained that he refers the patient to the health centre, 30 kilometres away - but to get there the community needs to find a donkey and cart to provide the transport through the sandy desert.
Apparently the community knows better than to try and organize this, and they usually just take the person home and call the Marabou - the traditional leader who welcomes someone into death.
The Pilot Project has instigated a large health promotion “campaign,” where villagers learn to go the health post at the first sign of illness so that the donkey does not have to be called or contemplated.
Standing in this tiny, horribly dirty health post, I was feeling overwhelmed for Boubacar in terms of the amount of work and responsibility he has, particularly considering his level of training.
I asked him if he feels overloaded with all of the work, and he replied in typical Nigerien fashion that no, he just feels lucky.
Lucky to be able to stop children from dying, and from them having to go to the malnutrition centre.
He said he is lucky to be able to start a change for his village that has needed to happen for a long time.
And, so, if he is lucky, then I am, without doubt, the luckiest person in the world right now.
Trish Newport is a Whitehorse nurse who works for Medecins Sans Frontiers/ Doctors Without Borders. The article was written between November 2010 and May 2011, during a mission in Niger.