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Last Updated: Friday, 13 May, 2005, 23:07 GMT 00:07 UK
Battling to keep children alive
By Jane Elliott
BBC News health reporter

Mobile clinic in the village of Maradounfa
Children get much needed food
Faroukou was two years old and weighed just 5.7 kg (12lb 5oz) when he was brought to an emergency feeding clinic in Niger, West Africa.

He had malaria and gastroenteritis and was in such a weakened state that despite all the medics efforts he died.

Now health experts are warning that another 20,000 children could die like Faroukou before the next harvest, unless action is taken immediately.

They say poor harvests have left the people of Niger without food or milk and are warning that the country is facing tragedy on a huge scale.

In the worst hit areas, harvests have been destroyed by drought or locusts.

There is no fertile land for livestock to graze and people have been selling off the land and young livestock that they do own in a desperate bid to buy food to survive.

Most of the families have already used up their food resources and there will be no new crops until October.

Thousands treated

In the last four months, Medecins Sans Frontieres (MSF), has treated more than 3,000 severely malnourished children at its therapeutic feeding centre in the region of Maradi, in Southern Niger - three times the number than in the same period in previous years.

Mobile clinic in the village of Maradounfa
Many children are malnourished
Things are so bad that they have now opened another feeding centre in the region and plan to open a third in the area of Tahoua.

In the next few weeks they will also establish 500 beds for severely malnourished patients needing intensive care and 13 consultation sites to give medical and nutritional follow-ups for children needing treatment as outpatients.

But experts say that although they are already seeing a large number of malnourished children, this is just the tip of the iceberg.

They say they only have feeding centres in two regions of the country, but the problems are widespread.

Help needed

And MSF is calling on the other charities to mobilise their resources into the region and prevent another tragedy.

A spokesman for MSF said something needs to be done immediately to prevent further children dying.

"MSF call on aid agencies to immediately mobilise additional resources to respond to an already existing nutritional crisis.

"The specific support MSF provides to malnourished children and families at risk can only have a real impact if general food support programmes are put in place for people in the affected areas."

Dr Isabelle de Fourny, who has recently returned from Niger for MSF, told the BBC News website that Unicef was already starting to mobilise as well, but that much more help is needed.

She said she had been very shocked by what she had seen in the country.

Deaths inevitable

"The severely malnourished are in a very bad medical condition and will die.

We want to be able to look after these children until the next harvest, when hopefully there will be some change in the food stocks
Dr Isabelle de Fourny
"The children have a massive loss of muscle and you could see the bones.

"Others have skin lesions and they have a real decrease in immunity. The risk of infection is high.

"They can not regulate their temperatures and the mortality risk is huge."

She said that in the next few weeks the rains will start and they will bring with them a greater risk of malaria and diarrhoea - diseases which could kill many of the already severely weakened children.

As well as the severely malnourished there are also huge numbers of moderately malnourished children, who without adequate food and milk will also become severely malnourished.

Dr de Fourny said: "If they don't get nutrition and access to health care they will die.

"We want to be able to look after these children until the next harvest, when hopefully there will be some change in the food stocks."

More arriving

Each day more and more children are staggering or being carried to the feeding stations.

Child being treated in the Maradi camp
Child being treated in the Maradi camp
Children like Djamila. She is two years old, but when she arrived at the feeding station she weighed just 4kg (8lb 8oz), the weight of a new born baby.

Her eyes look huge in her hollow face and she no longer has the strength to feel hungry.

Her mother can not afford private care so the emergency feeding station in Maradi is her last hope.

Within 24 hours after being fed eight times a day on specially enriched milk she puts on 400g.

In a few days doctors hope she will be able to eat more.

Long walk

Another girl Rashida weighed just 3.8 kg (8lb 4oz) when she and her mother made the six hour walk to the centre.

Her tiny body is bloated and swollen and her hair has a red hue.

She suffers from kwashiorkor, a particularly severe form of malnutrition that results in the retention of body fluid known as oedema, and requires extremely careful treatment.

The weakest children, those like Rashida and Djamila, are given therapeutic milk eight times a day. This phase of treatment lasts three to four days.

Each dose of milk is small enough to allow their bodies to become reaccustomed to digesting again.

Recovering children receive six meals a day. And all are vaccinated against measles when they are admitted to the centres.


There are also children being treated as outpatients. While they are also severely malnourished, they do have an appetite, and no serious medical complications.

They can be treated at home and will be given two food packets a day, including Plumpy'nut - a mixture of peanuts and sugar that is enriched with vitamins and minerals.

The families of the malnourished children are also being given food rations in a bid to stop their brothers and sisters deteriorating too.

But Dr de Fourny said the problem is growing daily.

"We see from the medical centre that the children keep coming. They need help to feed them until the next harvest."

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