RIKISKAMA, Niger, 16 June 2005 - In an isolated village in Niger's south-central district of Dakoro, Ramatou and her husband were worried about their seventeen month-old daughter, Nana. The once-active toddler had grown increasingly lethargic as her weight continued to drop. When Nana no longer had the strength to sit up on her own, her parents realized child needed medical care.
Since there is no health facility in their village, Nana's parents decided to go to the regional capital, Maradi, where Nana could be treated at CRENI (Centre de Récupération Nutritionnelle Intensive), a therapeutic feeding centre operated by Médecins sans Frontières and supported by UNICEF. They knew about this centre because other children from their village had returned home in good health after receiving treatment there. The couple and their child set off for the centre with the hope the doctors could save her.
Trekking by moonlight, Nana's parents avoided the unrelenting daytime heat of Niger's hottest season. After walking throughout the night, the family arrived at a village where they could find public transportation to continue their journey. They paid the equivalent of $7.00 for seats on an overcrowded van, and then travelled another six hours before reaching Maradi.
Seeking treatment: Maradi's Centre de Récupération Nutritionnelle Intensive, CRENI
When Nana was admitted to CRENI, she weighed only 4.3 kg. Her stomach was distended, her feet and ankles swollen. She was listless and refused to eat. The medical staff recognized the symptoms of 'kwashiorkor', a protein deficiency disorder.
Since her admission, Nana has been through almost every phase of this programme. New patients usually start out in phase one, where the children are so weak and tired they no longer want to eat. Because their fragile bodies cannot process regular food, they drink only F-100 therapeutic milk, a formula rich in nutrients and easy to digest. As the children grow stronger, their appetites return and they are ready for the next step.
In phase two, a vitamin-rich peanut paste named 'Plumpy Nut' is added to the children's diet. Children stay longer in phase two, which consists of four stages called Lions, Tigers, Rhinos and Elephants. After four weeks of treatment, Nana is now an Elephant. Her recuperation has been difficult. Like so many other patients, she has cycled through progress and setbacks. She must reach her target weight before she can be sent back home: 5.6 kg.
While this programme's main focus is treatment of malnutrition, another major component is prevention. In the afternoons, the mothers or other caregivers gather for staff-led sessions that teach them not only about nutrition, but also about health care and sanitation practices such as the importance of washing hands before meals.
Niger's malnutrition: statistics
Nana is just one of hundreds of Niger's children receiving treatment through therapeutic feeding centres this year. Admissions have grown at alarming rates in Maradi, Zinder and Tahoua, the regions most affected by last year's poor harvests. UNICEF is working in collaboration with the government, non-governmental organizations - including Médecins sans Frontières and World Vision - to treat children with severe and acute malnutrition, and to reduce the effects of household food insecurity. UNICEF has allocated $952,000 to respond to the current crisis and is urgently seeking an additional $1,095,000 to purchase therapeutic food for malnourished children and grain for women in the most affected villages.