The Washington Post

In Niger, a clinic is an example for the continent

Yahya Abdumalik, a 14-month-old severely malnourished child held by his mother, Zayha Arouna, at a clinic in Madarounfa, a village in Niger near the Nigerian border on June 14, 2012. (Sudarsan Raghavan /THE WASHINGTON POST)

On a recent morning, Zayha Arouna walked 35 miles to a revolutionary health and feeding center in this sleepy village. She carried her baby son, Yayha, who was smaller than most 14-month-olds and thin, with protruding ribs. Like countless other children in this region, he was suffering from malnutrition.

Inside the clinic, equally thin babies lay on beds, connected to feeding tubes. White bandages covered their small faces. On one bed was a baby with loose and wrinkled skin, his muscles wasting. On another, a skeletal baby with thinning hair and a distended abdomen.

Out of several thousand sick babies treated at the clinic this year, doctors say only 18 have died — virtually a miracle in this part of the world. Niger has one of the world’s highest rates of infant mortality, with 112 deaths per 1,000 live births last year, according to the CIA World Factbook.

“It is a success story,” said Anne Boher, a spokeswoman for UNICEF.

Aid workers say the nutritional clinic has become a textbook example of the type of health system that African governments should be creating to help their citizens. Half of the children who arrive here in Niger, one of the world’s poorest countries, are from oil-rich Nigeria, one of the continent’s wealthiest.

“I took my baby to a clinic in Nigeria, but he didn’t improve,” said Arouna, who like many of the other mothers crossed the border on foot. “That’s why I decided to bring him here.”

According to UNICEF, at least 1.1 million children younger than 5 will need life-saving treatment for severe acute malnutrition across West Africa’s Sahel region, which is in the midst of a severe drought and food crisis that spans nine countries. The next three months are particularly crucial because the region is currently in the lean growing season for crops, the driest and harshest period of the year, according to the U.N. agency, which sent out an appeal this month for $146 million to address the crisis.

In Niger, one of the hardest-hit nations in the region, health centers such as the one in Madaroufa have helped save lives. Despite numerous challenges — Niger is ranked second from the bottom on the U.N. Human Development Index of countries — the government has been trying to help its distressed population, aid workers said.

Last year, it introduced free health care for children under 5 and free prenatal care for pregnant women, rare for governments in this part of the world, said Jane Petty, an emergency field worker with the aid agency Save the Children.

The clinic is part of a network of government health and feeding centers that are integrated into the health-care system and helped by local and international aid agencies. In most parts of the continent, one typically finds a single aid agency, usually foreign, providing nutrition services.

“So often we see in countries with similar statistics that things rarely change or take a long time to change, partly because of a lack of political will and slow economic development, in rural areas particularly,” Petty said. “Here’s it’s comforting that there is a political will to make change.”

At the clinic, there are 43 staff members, including four doctors and 16 nurses, for an average of 60 babies at any given moment — a key reason child mortality rates are low here. Babies who can eat on their own often receive outpatient care to monitor their weight and health.

In less than two hours, a doctor treated Yayha. And he and his mother walked the 35 miles back to Nigeria.

Sudarsan Raghavan is The Post's Cairo bureau chief. He was previously based in Nairobi, Baghdad and Kabul for the Post.

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