Link to ECOSOC - Civil Society Network Best Practices
Location: Gomozo village, Maladi Region, Niger
Topic: Sustainable Development
Niger is one of the poorest nations in the world. GNI is USD 240 a person. Only 3% of Niger's land is arable. Three quarters of the workforce is engaged in livestock production and subsistence crops. According to UNDP, Niger ranked last on the United Nations Human Development Index in 2005 out of all 177 nations. Security of people (survival and health) is threatened. Niger struggles to pay off debts to foreign nations. No federal money is available to bolster desperately needed medical service or avert severe starvation. War and civil wars contribute to the tragedy.
Development of an Idea
In 1994, the first WFWP volunteer in Niger realized the country's mortality rates for infants, children under five and pregnant women were the worst in the world. According to a 2006 UNICEF report, out of 1,000 children below age five, 253 die, ranking Niger fourth worst in the world. WFWP volunteers in Niger recognized that the health and medical fields were in dire need of support and development. We discovered through research conducted by a WFWP representative in 1999 with village women that most mothers lose 2 to 3 children by disease or accident before they reach maturity. WFWP volunteers began focusing on improving healthcare.
The number one cause of death in Niger is malaria. Major risk factors of malaria in Niger include: vast numbers of mosquitoes due to inadequate environmental sanitation systems, almost non-existent prevention practices due to lack of knowledge, difficult access to medical services, and low treatment success rates due to outbreaks of drug-resistant malaria. Comprehensive malaria prevention and treatment measures are desperately needed. In 1997 WFWP volunteers began a campaign to distribute malaria prevention medicine and information on the correct usage of the medicine. The doctor-less Gomozo village of Maradi Region, in eastern Niger, where risk of malaria was highest was the pilot community. WFWP volunteers visited forty communities within three years, during this campaign. Since 2000, WFWP volunteers started a free medical exam service with a traveling medical car as a part of the medical support programs, in addition to medication distribution. Volunteers created a medicine box placement system and educated community members about health and sanitation. The traveling medical car goes to Gomozo village once a year and provides medical exams and treatment for about 3000 villagers in Gomozo and surrounding villages. A team of one doctor, two nurses and 3 helpers treat 200 people a day.
The medicine boxes were placed in public places in the villages. Medicine costs are minimal. secouriste (emergency nursing members in French) supervise and manage the supplies. A medical doctor in Niger credited the easy access to medication for the decrease in the number of sick people.
During health and sanitation education, the importance of hand washing, filtering unclean water, not playing in puddles, not going to the bathroom in the water, etc. were explained in detail and stressed. In Gomozo village, the main causes of malaria are (1) not properly disposing of waste from domestic animals, (2) lack of toilet facilities in homes, and (3) people using collected, standing water drawn from the village well. Unfortunately, guidance to the villagers alone did not improve sanitary conditions. So in 2005, WFWP volunteers began sending a doctor residing in Maradi to the Gozomo village and Kankare kochia village of Madarounfa District every two months instead of annually. The doctor started a health check-up service and educated the sechrists well. Unless the sechrist points out unhealthy, unsanitary environments and requires villagers to improve practices, nothing changes. As a result of this year long effort, the sechrists' knowledge and commitment advanced. They strengthened efforts to be responsible for the health, sanitation and welfare of the village by enforcing their knowledge and utilizing the medicine boxes. The village people's disease prevention practices improved. In order to decrease the child mortality rate, village women and mothers, as primary caregivers, received thorough instruction about malaria prevention. Doctors were very earnest in their guidance and education, so the knowledge began to penetrate among women and mothers.
Relying on doctors alone for malaria prevention is limited. The most important prevention factor is creating an environment that prevents malaria from infecting people. Since mosquitoes carry the disease, WFWP began marketing mosquito nets in 2006. The nets are sold with the medication. Pregnant women receive the highest priority and can acquire the net inexpensively. In 2007, villagers came to understand that purchasing a mosquito net had equal value in disease prevention as washing hands before a meal. We are beginning to see results of improved health among the communities we serve.
Good health is a key to sustainable development. Critical illness and premature death can devastate families emotionally and spiritually but also economically if breadwinners are taken by disease or if caring for a critically ill loved one prevents the breadwinner from working. Healthy adults can provide for their families. Healthy children can attend school. These healthcare and medical services programs have strengthened economic sustainability in the communities they served.