October 09

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Almost 3 weeks spent in Niger and so much going on

Many things happened since I last wrote. Believe me or not last Thursday I was in Paris for 24 hours..

Everything started on the 14th of September , I left my place at 5:30 am for an early flight to Niamey. I was in transit in Ouagadougou (Burkina) but things did not happen as expected. When I landed in Ouaga after a few hours on the plane ,a lady asked the passengers in transit to wait in an area. She then took us to a shuttle bus without giving any explanations. The driver started the bus and we asked what was going on and required to speak immediately  to a manager to explain the situation. The driver finally stopped the bus and brought the lady who was originally in charge of us back. When she arrived she said that the plane supposed to take us to Niamey broke down therefore had to wait until the evening to have a plane available ( frustrating when you know that there was less than an hour journey left). If the plane was not available, that’s fine !!  but where were they taking us ???  And the answer we got was  : To a hotel indeed… The surprising thing for me was obviously the lack of communication from the airport staff and then the fact that no one checked any of my document such as my passport or if I had a visa etc..I felt a bit illegal to be honest. The hotel was in the centre not too far from the airport and quite decent. I spent the majority of the day there and finally arrived in Niamey at 1 am the following day instead of the expected 2 pm.

This same plane came back at midnight to take us to Niamey

This same plane came back at midnight to take us to Niamey

As I said they put us in a nice hotel

As I said they took us in a nice hotel, at least 🙂

Just went for a quick drink while waiting in Ouaga to keep myself busy

Just went for a quick drink while waiting in Ouaga to keep myself busy

My first 2 days in Niamey

I went to the office in Niamey and met with a few people including the Health and Nutrition advisor to present the different tools that were created by the previous pulse Volunteer last year but due to time constraints, were not implemented. This meeting was essential as I needed her buying before going ahead with my training sessions in the other regions.

Just as a reminder and to put things into their context , the reason why I was in Niger was simply the fact that the project I am working on is for the Nigerien children under 5 years old who suffer from severe malnutrition.  The aim of my trip here was to visit health centres in several villages in 2 regions : Maradi and Zinder ( 2 regions instead of 3 as I am not allowed to travel to the 3rd one Diffa close to the border with Nigeria) to assess the situation around the management of the inventory of RUTF ( ready to use therapeutic food)  Plumpy Nut and provide a training on the stock management tools to the Save the children staff.

Stock of PPN (plumpy nut) in one of the health centre

Stock of PPN (plumpy nut) in one of the health centre

More PPN

More PPN

Each child enrolled in the malnutrition programme would be given 3 to 4 sachets per day of Plumpy Nut. They would be given their ration for the whole week and would have to come back the following week to get their new ration and be seen by a nurse in order to monitor their progress ( with a height, weight , general health check )

In an ideal world the children , if taking the treatment as per normal guidelines would be able to stabilise their weight within 4 to 5 weeks. But as I said this is in an ideal world… as a lot of ‘gaps’ are being recorded with different scenarios :

  • Parallel sales : some mothers would feed other members of the family with it or even resell the sachets to buy food to feed the rest of the family
  • Some of them sometimes even need to resell a few sachets to be able to pay for transport to go back to their villages after their visit to the health centres.
  • Some batches were found in the north of Nigeria where it seems that this product is considered as an aphrodisiac by some adults.
  • Some sachets simply disappear from the heath centre warehouses : When doing inventory checks, out of 4 health centres I recorded 2 with negative stocks
  • According to some people the factory packing the sachets in the cartons would automatically pack less as the machine would fill the cartons according to the weight and not the number of sachets.

Almost 1 in 4 children suffers from severe malnutrition in Niger

As per a recent study , 45,5 % of children under 5 years old chronically experience malnutrition in Niger . The critical threshold  fixed by the World Health Organisation (WHO) is 40 % but already exceeded in Maradi (55,9%), Zinder (48,4 %) and Diffa (42 %). This is particularly worrying for children especially those under 5 years old who are most vulnerable to the devastating health complications linked to malnutrition.

Tackling malnutrition is very challenging for all the NGOs present in Niger. But when I was in the field I could see how beneficial their aid was and prefer not to imagine how critical the situation would be without their presence. Any type of action even the smallest is necessary and more than essential.

The evening before my trip to Zinder to visit different health centres, I went for dinner with one of the Save employee, Deo originally from India based in Niamey. And I cannot hide how much I respect these people leaving their home country,  spending the majority of their time on their own , sometimes away for a year or more to help with the development and also help their own family back home. He shared with me some of his experiences in Africa working for several NGOs in the past and was telling me that his favourite place to live so far was Niamey, which was more peaceful than South Sudan for example.

My trip to Zinder and Tessaoua ( Maradi region )

In order to get there I had to get on a World food programme (WFP) plane as no regular airlines get to those remote areas. That was an experience trust me and I was not really prepared for these small planes 🙂 (which can fit less than 20 passengers, you are almost sitting in the cockpit, noisy, and not sure when was the last check done or how old the planes are) I know I am a bit exaggerating , but those who know me well are aware of my love story with planes :-). When we took off I wondered what the h### I was doing there , believe me , my only thought was that next time I would come by car even if it takes me 24h and for sure no more planes! But surprisingly when I landed I thought that is was not that bad ( and 2 weeks later on my way back to Niamey with the same plane I was almost fine).

United Nations Humanitarian Air Services (UNHAS) managed by the World Food Programme provides passenger and cargo air services to the entire humanitarian community especially to remote locations

United Nations Humanitarian Air Services (UNHAS) managed by the World Food Programme provides passenger and cargo air services to the entire humanitarian community especially to remote locations

I could even see a plane for the US force , a bit more fancy than the WFP one

On my way to Zinder I could even see a plane for the US force , a bit more fancy than the WFP one 🙂

I finally arrived in Zinder which is the second largest city in Niger. I met with the pharmacist Danbaba who is working on the same project as me, only difference is that his scope is wider with the stock management of medicines too and not only RUTF (Ready to use therapeutic food).

Save office in Zinder

Save office in Zinder

Danbaba invited me to share some water melon in his new house

Danbaba invited me to share some watermelon in his new house

From there we travelled to different villages 4 in total. 2 in the district of Tessaoua and 2 in the district of Zinder. The roads in Zinder where really bad which shows the reality that some areas sometimes become impracticable and really hard to access during the rainy season for the deliveries of medicines, food etc..

Capture

The road was so bad that the driver changed the wheel

On our way back from the field the tyre burst

Not the first lorry accident that I have seen there, this one was carrying soap which left a pleasant smell

Not the first lorry accident that I have seen there, this one was carrying soap which I have to say left a pleasant smell

My first visit to a health centre was in the Village Maidamoussa which was such an experience with mixed feelings. It was great, impressive, inspiring and frustrating at the same time.

Great to see things that I won’t see anywhere else. Great to see that Help exists through the support offered by Save and even other NGOs and that these needy mothers and children are not alone.

Frustrating to see that a lot is still missing in these villages , especially very basic things. For instance clear water is seen as a luxury in certain villages.

Inspiring to see people dedicated to their work and willing to improve lives.

And Impressive to see how people remain happy with what they have ( which would be seen as nothing from us from the Westernised countries)

This experience helped me to put things into perspective and made me realise how lucky but also spoilt we are in developed countries

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First health centre (CSI) visited Maidamoussa

First health centre (CSI) visited in Maidamoussa

waiting 'room' for the mothers and children before the new admissions

Waiting ‘room’ for the mothers and children before the new admissions of the children in the Programme

The first step of the consultation is to weight the child

Then to measure the height

Second step : the Height measurement

Then measure the MUAC ( their Mid-Upper Arm Circumference)

Last step:  Measure of the MUAC ( Mid-Upper Arm Circumference)

*see link http://ec.europa.eu/echo/field-blogs/photos/malnutrition-niger-mothers-understand-and-can-do-it_en

You would wonder what that is.. It is a maternity , shocking..

You would wonder what that is.. It is a maternity , shocking..

Doing an inventory check of Pumply nut

Doing an inventory check of Plumpy nut sachets with the Nurse and Pharmacist Danbaba 

Me, recounting after a gap of 12 sachets

Me, re-counting after a gap of 12 sachets

And finally the medical team running the health centre

And finally the medical team running the health centre Maidamoussa

A village on our way to the field

A village on our way back from the field

Another village

Another village

Training in Tessaoua on the stock management tools

Training in Tessaoua on the stock management tools

In Tessaoua, I managed to organise my first training session on the stock management tools. The team of supervisors and health nutrition officer attending the session were really happy to receive this training and for them the fact that someone ‘external’ from London came showed the importance that we give to their jobs.

Tabaski or Eid Al Adha : The muslim festival of sacrifice

Good timing or not, I was the only one left in the guest house , I was in Zinder during that celebration which is the biggest one of the year for Muslim people. It lasted 2 days.

My colleague Danbaba invited me to spend the day with his family which was very kind of him and enabled me to live the experience authentically as I was in the middle of the locals.

We started the day by going to the morning prayer where it seems that the 200,000 people populating this city were out 🙂 I have never seen such a crowded place of happy people in my entire life.

We then went to visit his parents and finally had lunch (chicken and chips) at his place. (it was an early one : 10 am surely because of the early start of the day:-) While having lunch the sheep would be sacrificed and then cooked/ grilled to finally be shared among the needy families.

This is a typical image in Niger :-)

This is a typical image in Zinder 🙂

The 2 sheeps of my Colleague Danbaba

The 2 sheep of my colleague Danbaba

The crowded morning prayer , you see I was not exaggerating

The crowded morning prayer , you see I was not exaggerating

Visit of Danbaba's family

Visit of Danbaba’s family

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Time to cook the head of the mutton

The families collectively grill their muttons

The families collectively grill their muttons

The day before my departure to Niamey

I checked my emails and could see that a communication was sent from the regional office listing Burkina Faso (due to the coup that happened after my transit in Ouagadougou), CAR and Ivory Coast , the countries where the Save staff were not allowed to travel for security reason. Only issue for me was that my initial flight was transiting in Ouagadougou in Burkina, and then was given an alternative flight via Togo and Ivory Coast

Everyone here would agree that it is very difficult and challenging to travel in Africa, the transit times are very long, the airlines not always reliable or on schedule. In that situation for sure French people would have pulled all their hair already 🙂

Looking at my options I realised that the only way for me to ensure my return to Dakar on time to attend an important meeting without spending 24 hours in several countries and or hotels was to transit in Paris. Luckily the timing was perfect to catch a direct flight from Niamey , in 5 hours only I would be breathing the European air..

Last dinner in Niamey before getting my flight to Paris the same night

Last dinner in Niamey before getting my flight to Paris the same night

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Back in Dakar

I am now back in Dakar and to be honest I really start to appreciate this city where I feel free, safe and don’t need a driver for all my travels. I can go out, exercise and cook with a wide choice of fruits and vegetables 🙂

The last big step for me was last Wednesday where my manager ( still in a business trip in Africa) asked me to present in front of the European commission,  the humanitarian Aid and Civil Protection (ECHO) who was meeting in Dakar this year with a bunch of NGOs. The presentation was about what I am currently working on , the improvement of the stock management of therapeutic food. That was maybe the time when my stress reached its pick as the audience easily reached 120 people.

Huge audience

OMG the audience!!

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My level of stress during the past weeks was with no doubt well above what I have ever experienced in my life. It could not be what I would live in a year in London.

My next trip in Niger will be in November.. To be continued..