The following is the first in a series of articles written by between November 2010 and May 2011, during a mission in Niger with Medecins Sans Frontiers/ Doctors Without Borders.
Niger, beyond being an extremely impoverished country, also has the lowest human development index in the world. I am in Zinder, which is the second-largest city in the country. It is a dusty brown town which cannot manage to hide its disparity. While, as always, some people are definitely better off than others, affluence is incredibly relative.
Since the great famine of 2005, Doctors without Borders (MSF) has operated a large malnutrition centre in Zinder. In the past few years, inpatient malnutrition centres have been set up in the periphery villages of Zinder, theoretically reducing the admissions into Zinder’s MSF malnutrition centre.
The food security situation in 2010 rivalled that of 2005, and malnutrition rates skyrocketed to record highs, despite early warning systems that were in place. I arrived in November 2010, knowing that the peak of the malnutrition season had passed. So on my first tour of the centre I was not expecting to see 280 severely malnourished children, with 75 of them in intensive care. Apparently during the peak this year, the centre which is meant to house 340 children at the most, was bulging at 450.
In Djibouti, and in the DRC, I had seen malnutrition - but I have never been witness to malnutrition of this magnitude, or seen children in such emaciated states.
And the peak is said to be over.
This is just everyday life that I am witnessing. But everyday does not mean OK, or normal.
It is not OK, or normal regardless of the context, for children to weigh 900 grams (less than two pounds) at two months of life.
I share a position with a very experienced nurse from Niger who worked during the peak of 2005. She recounted stories to me of MSF taking over a college to use as a malnutrition centre, and how five large lecture rooms and an entire
hallway were the intensive care units - housing hundreds of extremely emaciated children at once, and still that wasn’t large enough.
She cried as she told me that trucks would pull up to the college and drop off 20 children at a time.
Often all of them needed emergency treatment.
Nurses would stand at the doorway of the college in order to run to mothers in the distance who were at the point of collapsing after having carried their children for so many days to get to treatment - she told stories of the mothers needing to be resuscitated due to extreme dehydration from the journey.
That was the year of the “great famine,” however; since then levels of malnutrition have stayed high. MSF has improved its treatment of malnutrition and local staff have become more experienced - but the causes of malnutrition have not disappeared.
As always, these causes have little to do with food, and much to do with politics, economics and extremely non-progressive policies by the World Bank, the International Monetary Fund, and other global actors.
I hope for myself, and for the people of this region, that none of us ever have to see a famine again - but knowing that 280 severely malnourished children are being treated as inpatients during the off season, and that there are thousands more in ambulatory programs - I know that it will take a lot more than hope to make the difference.
On Wednesday, the United Nations has declared a state of famine in two areas of southern Somalia. Ethiopia, Djibouti, Kenya and Somalia are all facing severe food shortages and are experiencing alarming levels of malnutrition and related deaths. The Yukon has joined in the international aid effort. There is a bank account set up at Whitehorse’s Bank of Montreal. To make a donation simply tell a teller you’d like to donate to the “Africa Fund” and giving them your address if you want a tax receipt.