Samuel Lowenberg - Independent Journalist biography articles articles

Millions in Niger facing food shortages once again

This time of year is typically a comfortable one for the villagers of Niger, as food stocks are usually plentiful. But despite last year's bountiful harvest, the aftermath of earlier food shortages means 2 million people are again facing acute malnutrition. Samuel Loewenberg reports from Niger.
The Lancet  May 6, 2006

In a rudimentary medical clinic on the southern edge of the Sahara desert, a baby is taken from his mother's arms. He is placed inside a black harness attached to handheld scale. All of his ribs are visible, his limbs are emaciated. The child is 10 months old. He weighs 4 kg, down from 5 kg 2 months earlier. He should weigh twice as much.

By the harsh calculations of the feeding centre, one could say the child is lucky. He is so badly underweight he will receive a ration of therapeutic feeding: 3·5 g of enriched cornmeal and oil. Resources are so badly stretched here that out of the 200 children brought here by their mothers, only a third will receive food.

People get upset, but we only have enough supplies to help a few of them," says Ibrahim Chalaré, the field coordinator for the feeding centre, which is run by the British charity Islamic Relief. Childhood hunger is a perennial problem in this landlocked sub-Saharan country, but it is unusual to see so many malnourished children so early in the year, he says. Rates of admission are double what they were last month, Chalaré continues, and he expects it to triple by summer.

More than 2 million people in this West African country are facing acute malnutrition. Most of them are children.

Normally at this time of the year the villagers still have plenty of food left over from the harvest season. In fact, the rains were good this past year, and the harvest was bountiful. But the food shortages of last summer left many people weakened and indebted, and they have already exhausted their supplies.

A few hours to the south, in the capital city of Niamey, the outdoor markets overflow with fresh meat and vegetables. But Niger is one of the poorest nations in the world, and even in good times that bounty is beyond the reach of most of the country's rural population.

In the vicious cycle of sub-Saharan nations in chronic poverty, any disruption can quickly throw millions into a hunger crisis. Once a food shortage hits, grain prices skyrocket, as they did last year. Even with the bountiful harvest this year, grain prices are already twice the normal price in many districts, leaving them out of reach of millions of rural Nigeriens.

In a therapeutic feeding clinic for severely malnourished children, Foure Souley rests her 2-year-old child on her lap. The child's body is so wasted, at only 4·5 kg, that she cannot support the weight of her own head. She looks like a broken doll.

When Mrs Souley is asked what she will do when she leaves the feeding centre after her child is released in a few weeks, she shrugs and says “"Dabary ban." It is a new phrase in her tribe's language that has come into use since the recent hunger crises. It means that all hope is lost, there is nothing left to do.

Unlike the more high-profile food crises in Ethiopia and Sudan, the malnutrition problem here is not due to the armed conflict, natural disaster, or corruption. Simply put, the problem is chronic poverty. Malnutrition rates throughout this sub-Saharan region have exceeded the World Health Organization's crisis threshold for more than a decade.

“"Niger is such a poor country that we've gotten used to the idea that one in five children die before the age of five," says Jeremy Lester, the European Union's chief of mission for Niger. An October, 2005 study by UNICEF found that 15·3% of Niger's 6 to 59 month old children suffer from severe or moderate malnutrition.

The international community does seem to be slowly waking up to the problem of chronic hunger. Unlike last year, when the World Food Programme's pleas for emergency assistance were virtually ignored until famine conditions had set in, this year the USA and the EU have already funded half of the WFP's US$25 million aid request.

But even with these commitments, thousands are already suffering and the feeding centres are jammed. The current crisis is an example of how the wealthy countries that fund relief efforts so often miss the most crucial moment: the months before hunger becomes widespread.

“"Children are already falling into acute malnutrition. The aid money and food will arrive too late," says Johannes Sekenes, a Norwegian nurse who has headed up the Médecins Sans Frontières (MSF) operation here since 2004. She says that the MSF therapeutic feeding operation last year was the largest in her organisation's history. A striking fact, since MSF usually operates in war zones and disaster areas.

For Niger, with its paucity of resources, hunger is only one of a plethora of public-health problems that range from tropical diseases to single-digit rates of literacy. Niger sits at the bottom of the United Nation's Human Development Index, which assesses factors like poverty, education, and life expectancy.

Basic access to health care is out of reach for the vast majority of the population. Some villages have rudimentary clinics, often little more than dispensaries of the most basic medicines. Souley, like all of the mothers at the feeding centre, walked hours along desert roads to bring her child to the feeding centre.

Another of the crucial problems that must be addressed, say public health advocates, is the issue of education, especially for women. Literacy rates in Niger are among the lowest in the world. More than half of the Nigerien girls have no schooling, and overall only 9·4% of women are literate.

“If girls go to school, they will have less children, better jobs, and less disease”, says Carol Añonuevo, a senior researcher at the UNESCO Institute of Education who is conducting a study of sub-Saharan Africa.

There is no simple fix to any of these problems. Many development experts note that Africa has received billions of dollars in aid during the past 50 years, but has little to show for it.

The new trend seems to be directed towards programmes that treat specific symptoms of poverty, rather than vast grants of dollars to ineffectual governments. In one example, the Red Cross gave small cash grants to 5000 households in 88 villages. The results were promising, says the Red Cross' Emmanuelle Osmond. The women, to whom the money was given, used it to buy food, pay off debts, and buy livestock and clothes. In one village, the women pooled their money to buy a donkey cart they could use as an ambulance to get to the health centre in the next village.

At the macro level, many development specialists say that the only way to break the cycle of hunger is to provide agricultural assistance so Nigeriens can feed themselves. Africa has never received the kind of long-term agricultural development assistance - such as fertiliser and high-yield seeds - that successfully helped reduce hunger in Asia and Latin America in the 1960s and 1970s, said Peter Timmer, a former development economist at Harvard University. “"Neither the donors nor the countries themselves have tried that kind of massive investment in rural economies," he says.



Delivering health care in Niger

Alassane Seydou is used to working in conditions that many physicians would find intolerable. The young doctor does not practice in a desert field station. He is a specialist in internal medicine and rheumatology at the National Hospital of Niamey.

It is hard to imagine a medical centre in a capital city that is more strapped for resources. Basics like saline solution and adrenaline are in short supply. In the malnutrition and malaria wards, which consist of little more than beds jammed into a room, flies land on the infant patients.

Outside the infants' ward there is a small garden. Chickens walk amongst the flowers, a stark reminder that Niger is ill equipped to deal with its recent spate of avian influenza. The 850-bed hospital is not free. Patients must pay, no matter how poor. Resources are so sparse here that families must provide their own food, even in the malnourished ward.

This is the only major hospital in Niger, and patients come from all over the country as we from the neighbouring nations of Burkina Faso and Nigeria.

The most widespread ailments are AIDS, malaria, and tuberculosis, says Seydou. Around 10% of their patients also suffer from acute malnutrition.

One of the biggest frustrations, says Seydou, is that lack the resources for basic preventive care. Liver cancer due to hepatitis B is one of the most common illnesses he has to treat. The neighbouring countries of Burkina Faso and Benin have programmes for childhood hepatitis vaccinations, but these are out of reach in Niger, a nation that is the poorest of the poor in sub-Saharan Africa.

As Seydou roams the hospital grounds, where families are camped out among the buildings waiting for their relatives to heal, he is approached by a woman begging for money. There is nothing he can do for her.



The politics of food aid

As with most things in the twisted world of international famine relief, the term “food aid” itself is duplicitous. The USA, for instance, gives by far the most food aid of any country. But that's not quite what it seems. While most of the world gives aid agencies cash which they use to buy food locally, 99% of the food aid provided by the USA is purchased from American farmers at market prices and is then shipped overseas on US registered vessels (the vast majority of container ships are registered in countries like Liberia and Panama; the US registered container ships used in the feeding programme are almost an anachronism, kept alive in part because of this aid programme).

By general consensus, US food aid is inefficient, overpriced, and can be damaging to the African economy. The Financial Times called the American type of assistance “a subsidy programme for rich world farmers”, such as American agro-giants Cargill and Archer-Daniels Midland. According to the Paris-based Organisation for Economic Cooperation and Development, this kind of direct food aid can take 5 months or more to arrive and costs 50% more than if the assistance had been given as cash used to buy food locally. Also, it tends to undercut local markets. If the assistance had been provided as cash, it would have added US$750 million to the approximately $4 billion in food aid already donated by rich countries.

Under increasing pressure to reform its food-only aid approach, last year the Bush Administration tried to get Congress to pass legislation allowing for one quarter of American emergency assistance to be delivered in cash instead of as processed crop purchases. Administration aid officials argued that the USA would be able to provide twice as much food for the same money because of the savings on transportation alone.

But even with the Bush Administration behind it, the proposal went nowhere. It was killed by agro-business, the shipping industry, and the farm-state congressmen that control food aid. Ironically, they had lobbying assistance not only from agro-business giants and shipping companies, but also from charity aid agencies such as Catholic Relief Services and Care. Why? Because the aid agencies sell much of the food they receive to pay for other programmes such as health care and development assistance that they provide to impoverished nations.

Despite the EU's supposed interest in long-term development, only a small percentage of the money it gives to Niger is directed towards sustainable agricultural projects like directed donations of fertiliser and high-potency seed.

The USA, the world's largest donor, spent $1·4 billion in emergency aid in Africa last year, but only one tenth that much in long-term development. “"The system of foreign aid is very political. Does it makes sense? No," says Andrew Natsios, the former chief of overseas assistance in the Bush Administration.


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