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Niger: A mothers’ dilemma

Baraka walks through a sand storm to her village with three children
Baraka walks through a sand storm to her village with her three children

Niger is a challenging place to work at the best of times. It’s hot — the temperature rarely dips beneath 40 degrees at this time of year — and is often above 45 degrees. The distances between places are vast and the environment is harsh. For example from Niamey, the capital, to our nearest field base is 800 km. Getting from the field bases out to the communities where we work is another thing altogether.

I visited a village the other day that was a two and a half hour drive from our base in Tessaoua bumping and skidding across the desert sand, squinting through the windscreen as we drove through a sand storm. Fortunately, the driver knew where he was going and which sand track to follow.

I was lucky. I was in a semi-air-conditioned car. But no-one living in these remote villages has the luxury of a car, let alone an air-conditioned one. The main form of transport is by foot. Only the very wealthy have an ox and cart. So, if someone needs to get somewhere, there is basically no choice but to walk.

So a mother faces some tough decisions. Her child is very sick, but it takes hours, if not days, to reach the nearest clinic in some areas 70% of villages are more than 15 km from health centres.

Most mothers I’ve been speaking to at our clinics have walked at least and hour and a half to get there. In some places it can take three days to walk there and three days back.

But it’s even more difficult than this. If they decide to make the journey, what do they do with their other children? The choice is either to leave them at home or make them walk the vast distance too. In addition to this, the planting season has just started with the first light rains. Mothers are desperate to get their seeds in the ground so they’ve got something to harvest in September and finally some food for the family. Not an easy choice to make, even if your child is severely malnourished. This is the dilemma that faces so many mothers.

Children undergoing intensive feeding ideally need to be monitored weekly to ensure they’re making progress and gaining weight. Best practice dictates that we should only give a week’s supply of highly nutritious food to a child’s mother at any one time. This encourages them to come back to the clinic on a weekly basis to enable our staff to monitor the progress of their child treatment.

But what do you do if you know that mother has had to travel a day to reach the clinic, that she needs to plant her fields so she’s not in an even more desperate situation next year and she’s got other children at home who need her care? You know that the chances are slim of her returning on a weekly basis with her severely malnourished child. You know that the child’s life is at risk without the treatment.

With some cases we have given one month’s supply at a time to mothers who really cannot come weekly. We’re looking for other alternatives, but we have to do what we can to save children’s lives now.

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