Motherless in Niger
Adam stands out among the crowd. I meet him outside a crowded health clinic in the town of Maine Soroa in Niger, along the border with Nigeria.
While most children there are toddlers, carried on the backs of their mothers, Adam is four years old and stands on his own two feet, his older brother close by his side.
I find out their mother died ten months ago and it’s their elderly great aunt who has brought Adam to the clinic to be screened for malnutrition.
As Adam waits in line to be weighed, his brother Ousmane helps prepare him, taking him by the hand and leading him forward every time the line advances and more children go through the scale.
A stark picture
In some cases in Niger, I’ve asked parents what made them bring their child for screening – how did they know to be worried something was badly wrong when chronic poverty and malnutrition are everyday problems?
With Adam, I don’t need to ask. The image of Adam standing, listless and without speaking, looking off into the distance without focusing on anything – is one that will stay with me long after I leave this country.
He stands patiently, or barely seeming to notice, as Ousmane carefully helps him out of his shirt to be weighed.
As Ousmane helps lift Adam’s arms up to get the oversized shirt off, the young boy’s ribs protrude, stretching against his skin until the whole ribcage is horribly and clearly outlined.
With his arms back down again, his shoulder blades stick out from his back, creating sharp edges that only contribute to the starkness of the whole picture.
I’m not a nutrition expert but even to me it’s painfully clear, even before he is weighed. Adam is seriously, scarily malnourished.
How could it get this bad?
When it’s his turn on the scale, Adam’s long, emaciated legs almost touch the ground. Unlike many of the younger children, Adam doesn’t cry, scream or wail. He simply waits for it to be over.
At his side, his brother stands ready to help him get dressed after Adam’s weight is confirmed – he is drastically underweight, at 4.1kg less than he should be for his age and height.
For a split second, I wonder how it could have gotten this bad – but then I remember.
With his mother dead, his father absent and his grandmother suffering from mental illness, Adam has no one but his elderly great aunt and his older brother – still a boy himself at only ten years old.
A broken family
Ousmane quietly takes his brother by the hand and brings him to another area in the clinic grounds to test how Adam will react to the nutrition supplement used to treat malnutrition.
Adam lies down listlessly next to his brother and aunt, staring off into the distance, his eyes unfocused.
Ousmane sits quietly, looking down at the barren ground, listening to the questions about his brother, his mother and his father.
He doesn’t attempt to answer anything and it’s not clear how much either he or his great aunt understand, even the interpreter doesn’t speak this family’s native language.
When Adam tries the high-nutrient peanut paste, there is some relief. He eats it without any problems.
This means he and his brother can go home with a full stock of life-saving peanut paste for Adam to eat regularly every day until the following week when they come back for a check-up.
As the small, broken family walks away, I’m touched by how closely Ousmane looks after his brother.
Taking him gently by the hand, Ousmane leads Adam out from the clinic grounds and towards their village.
He’s looking after his brother with everything he has, but who is looking after him?