By Alex Duval Smith
GANZOURGOU PROVINCE, Burkina Faso, 17 September 2010 – Nurse Roland Nikiéma, 26, needs only to reach for a pile of dog-eared ledgers to produce evidence that his hard work is making headway.
|VIDEO: UNICEF correspondent Zenande Mfenyana reports on a European Union supported programme to provide water and sanitation to some of those hardest hit by climate change in rural Burkina Faso.|
His under-equipped rural medical dispensary is making great strides towards reaching the world's most vulnerable people – and children in particular – in an effort to achieve the United Nations Millennium Development Goals, a set of internationally recognized targets for reducing poverty worldwide by the year 2015.
“If I compare, say, January 2009 and January 2010, the evidence is clear,” said Mr. Nikiéma, fumbling through his records in the half-light of the three-room clinic in Rapadama, a village in central Burkina Faso. Here Mr. Nikiéma is single-handedly serving the health needs of some 10,000 of Burkina Faso’s poorest people.
|In Salogo, Burkina Faso, hygiene education starts early in this pre-school.|
The odds are against this landlocked country of 15.23 million people, which has been described as 'ground zero' for climate change. Wedged between the Sahara desert and Côte d’Ivoire, and with a southern neighbour emerging from civil war, Burkina Faso is also suffering the effects – especially price increases – of a food crisis in Niger, to the east.
Despite feeling tired after delivering three babies overnight, Mr. Nikiéma’s excitement grows as he peruses his ledgers.
“When it comes to children with diarrhoea, I recorded 14 cases in January 2009 and only seven in the same month this year," he said. "Let’s try intestinal parasites: we had eight of those in January 2009, and three in January 2010.”
The changes described by Mr. Nikiéma may seem microscopic in scale to many. But the data provide tangible evidence that children in this remote village are becoming healthier.
Mr. Nikiéma says that the improvements are largely thanks to two grassroots non-gvernmental organizations, the Centre Régional pour l’Eau Potable et l’Assainissement (CREPA) and the Association Chant de Femmes (ACF). Since 2007, the two groups have worked with UNICEF and about $2.2 million in funding from the European Union to change the sanitation habits of 75,000 people in the Burkina Faso provinces of Ganzourgou and Gnagna, bringing safe water to within 500 metres of many homes for the first time.
|A girl fetches water in Meguet, Burkina Faso.|
Mr. Nikiéma says has seen incredible changes in the two years he has spent at Rapadama. “When I arrived in 2008, CREPA and ACF were getting down to work," he recalled. "CREPA was helping people build latrines and ACF was informing the women about how to improve sanitary practices."
In the years since, vomiting and diarrhoea in children have decreased significantly. Mr. Nikiéma also notes that more women are giving birth at the clinic and are vaccinating their babies. Women's information groups have sprung up in the region, providing a forum for discussion on health issues that affect women.
Crucial support from women
Sociologist Ida Ouandaogo coordinates the sanitation programme in Ganzourgou for CREPA, which works in 17 West and Central African countries. In the past three years CREPA has made it possible for 8,000 homes in the pilot area to build latrines – 5,000 more than the project had envisaged. She says the success of the EU-UNICEF pilot programme lies in the fact that it has broad support.
“It is very important to gain the moral backing of customary chiefs, of the mayors and councillors," said Ms. Ouandaogo.
And the crucial element holding everything together, she added, is the mobilization of women. "It is they, after all, who not only fetch water and prepare food but who look after the children,” said Ms. Ouandaogo.
Assèta Ilboudo, a mother of four children from Salogo village, performs all of those tasks each day. She is also among the nearly 700 latrine-builders trained in bricklaying by CREPA in Ganzourgou and Gnagna. Most of the bricklayers are men, but Salogo village – which has a female mayor – was amenable to Ms. Ilboudo taking on the traditionally male job.
While innovative, UNICEF Water and Sanitation Officer Jean-Paul Ouédraogo cautioned that the Ganzourgou-Gnagna project was one small success story in a country beset with a “deeply worrying sanitary situation, high infant mortality, high childbirth and severe health challenges linked to sanitation and water.”
Burkina Faso has set for itself a goal of providing improved sanitation for 54 per cent of the population and safe water for 76 per cent of households by 2015.
“We are close to achieving the goal for water access, but on sanitation we are way behind," said Mr. Ouédraogo. "We have made strides as a country, but I doubt whether, taking into account both rural and urban sanitation, we have even reached 10 per cent access,” he said.
And much more remains to be done, said Mr. Ouédraogo. “Sensitizing people implies responsibility. If you tell people the advantages of latrines, you have to be certain these will continue to be built and maintained for years to come."
Rapadama dispensary still has no electricity. Wounds are dressed with bandages that are hand cut so as to avoid wasting a single centimetre of material. Mr. Nikiéma rarely gets a full night’s sleep between delivering babies. Yet fuelled by optimism and the encouraging figures in his ledgers, he pushes onward, dealing with a stream of malaria and pneumonia cases that would defeat some qualified doctors twice his age. He is passionate about the improvements he sees.
“Things are getting better and better," said Mr. Nikiéma. "It is exciting to be involved.”