Niger is a land-locked country in the Sahel. It is currently facing a food deficit – with over 1.5 million people affected by food insecurity in 2017, another 1.5 million chronically food insecure, and millions more experiencing transitory shortages – and its population is growing at 4% per year, one of the highest rates in the world.
Widespread and entrenched gender inequality across the country means that food insecurity disproportionality affects women and children. With very high levels of chronic and acute malnutrition, low access to clean water and poor sanitary conditions, a child’s early years a particularly vulnerable, and the country has the world’s eleventh highest morality rate for children under five.
Since 2017, Niger has faced a large increase in arrivals of people seeking asylum, due to its position at the crossroads of migratory paths from West and Central Africa. Agadez, the northern most city in the country connected to the road network, has seen a particularly high influx of migrants and refugees; and whilst local authorities were originally able to work in partnership with the UNHCR to deal with this increase, their capacity and willingness to do so has since decreased significantly.
Doctors of the World started working in Niger in 1998. Alongside the local population, we worked with the regional public health directorate and other NGOs to combat malnutrition by integrating therapeutic feeding centres with hospitals. We also assisted in setting up a sustainable referral system, which funds the medical evacuation of those wo need it the most to nearby health centres for care; and worked to strengthen access to contraception and safe deliveries.
In 2018, with increased numbers of people arriving into the city of Agadez, and ongoing political tensions, more than 2,000 people were moved to a new site 13km outside the city. Thanks to MERF funding by the START Network, we were able to scale up the project run by our international network to help provide for the support needs of those being moved, before, during and after the fact.
Initial activities focussed on responding to immediate needs through mobile clinics, deployed on 225 occasions and treating 2,627 patients, providing primary and specialised medical services; for example, the detection of malnutrition amongst children and pregnant women, vaccinations, and antenatal care. We also provided psychosocial care to many who had been several traumatised by their experiences. As Johannes, a member of our response in the country noted:
“Traumatised by the violence and suffering they had encountered on their trip through North Africa and scarred by their experiences in Libya, psychological issues were prevalent throughout this migrant community.”
We also set up a network of community representatives to provide guidance on the developing needs of the population, and supplied water tanks, washing stations and trucked water into the camp. Finally, as there was no formal school or community area for children, we delivered toys and colouring books to keep them busy and safe.