A group of children walk to a river to fill containers with water. They drink thirstily. Elsewhere, children bathe in a pond of stagnant water, while animals drink close by. Women lean in to pull up heavy buckets from a well that is more than 20 meters deep. These are daily images from Niger.
"Although people have a basic awareness about hygiene and they usually boil water before drinking it, when they are in the bush, they still drink water directly from puddles," says Eduardo Casetta, a water and sanitation expert deployed by the International Federation of Red Cross and Red Crescent Societies in Niger.
"Sanitation is secondary to people in Niger, as their first priorities are food and the availability of water, whatever the quality is," Casetta adds.
The International Federation has begun the post-emergency phase of its Sahel food emergency operation, which was launched in response to widespread hunger and malnutrition. Although people's nutritional needs have largely been met, access to water and sanitation is still very precarious in all parts of Niger.
This year's food shortage in the Sahel region is not an occasional emergency. It is the result of the extreme poverty in which the poorest country in the world (according to the United Nations' Human Development Index) finds itself.
Malnutrition affects children under five first and foremost. They are the ones who often die of diarrhoea and other preventable diseases.
According to Ministry of Health sources, 80 percent of children's deaths in rural areas are due to a simple lack of sanitation.
Water and sanitation is closely related to malnutrition, says Dr Oleg Blinikov, the Federation's health coordinator for the Sahel operation.
"If you don't have access to clean water, you get intestinal infections that end up in diarrhoea. Children with diarrhoea can't absorb nutrition."
"So they lose weight and get weaker, which makes them more likely to get diarrhoea. It's a vicious circle."
Poor water and sanitation contributes to poverty too. Diarrhoea and other diseases weaken breadwinners so they are less able to support their families.
Dr Blinikov says water-related diseases are common in Niger. They include malaria, diarrhoea, cholera, guinea worm and trachoma.
"Though water and sanitation projects are often considered too expensive, they are nevertheless the first alternative, together with hygiene awareness programmes, to reduce poverty and malnutrition on a sustainable and long term basis."
According to official data, 40 per cent of people have access to safe water in Niger, and only five percent of the total population has access to some sanitation facilities, such as latrines.
International Federation head of operations for Sahel, Steven Loyst, says the Federation wants to have some mid-term and long-term water and sanitation projects in the Sahel region, especially in Niger, to support national Red Cross or Red Crescent Societies in their efforts to reduce and mitigate deaths due to waterborne diseases.
"We are looking into promoting water and sanitation actions that complement our activities in the health sector, either directly or at locations where we have already been working during the food-crisis, such as Tahoua, Maradi or Zinder," he says.
The Federation's approach is to do sustainable rehabilitation work, such as restoring or extending existing systems and water points, such as wells.
The operation wants to put an emphasis on environmental health measures like protecting wells and surrounding structures. And it would be integrated into existing community groups that maintain wells and keep animals away from them to prevent their contamination or destruction.
This approach would also take into account women's needs, since they are the ones fetching and dealing with water.
In Niamey, the capital, the Niger Red Cross has already finished building latrines in a school, with funding from the Spanish Red Cross. North of the capital, in Tahoua, the Niger Red Cross has launched a project to train volunteers in how to build and promote latrine use in three areas of the city. The volunteers will educate people on building latrines and do hygiene promotion.
But many other projects depend on funding. An additional two water and sanitation projects in schools are waiting for funds. At least three schools in Niamey with a total of more than 10,000 pupils have no sanitation facilities, posing a health risk to children and the wider population.