Niger: Keeping Malaria and preventable diseases at bay
Madarounfa, Niger, April 2008 - Bassira is 31 days old and doesn’t yet sleep through the night. She often wakes up at around one am.
Her mother, Aliya Saadou, then breastfeeds her before going back to sleep.
If she is lucky, the baby will let her sleep until the muezzin calls the faithful to prayer at 5:30 am. Bassira and her two small brothers sleep under the same bed net.
Once it has been treated with insecticide, a mosquito net is the best protection against malaria, which is endemic in their village, Safo Tchikadji, 15 kilometres south of Maradi, Niger’s second biggest city.
Aliya Saadou received the bed net from the local health center after her first antenatal checkup. She will obtain a second net once her daughter Bassira has had all her vaccines (diphtheria, tetanus, whooping cough, measles, polio and tuberculosis).
Hassan Laouali, a health center nurse, is not surprised that this “gift” is helping to spread immunization coverage as well as contributing to the fight against malaria. “If a mother knows she will get a reward, she will run here all the way!” he remarks.
Although she does not know this, Aliya Saadou is a beneficiary of an Accelerated Child Survival and Development (ACSD) strategy, an intervention that aims to reduce Niger's under-five mortality rate, one of the highest in the world.
Under this scheme, young children and mothers in Madarounfa District – one of the first two districts to benefit from this initiative – were among the first in Niger to receive free mosquito nets (and to achieve a significant improvement in vaccine coverage by the same token).
According to a survey conducted in 2006 (MICS), 69% of households now have a mosquito net.
Predictably, there are not enough mosquito nets to go round, and they are not used widely enough. Usually, only the very youngest children benefit from proper sleeping conditions. Even though the number of malaria cases is falling, it remains the most common ailment among children brought to the health center in Safo (before acute respiratory infections and diarrhea).
Aliya Saadou is only too aware of the threat posed by malaria: one of her sons died from the disease when he was only 18 months old. The death was all the harder to bear because she had previously lost a daughter, a girl who died at the ge of 17 days, due to severe diarrhea. A small piece of pottery marks the spot near the house where the newborn was buried. Aliya Saadou believes that her son's death was avoidable. “If he had slept under a mosquito net, he would not have caught malaria,” she says.
Once the mosquito nets have been distributed, it is important to make sure that they are used properly. In the early days, the nets often turned up in their original packaging at local markets. Mothers would try to sell them to earn a few extra francs. Nowadays, the packaging is removed and the nets are marked with ink before being handed out.
Sometimes, husbands take the nets away from their wives and children and keep them for themselves. However, Aliya Saadou’s husband, a farmer who grows millet, sorghum and niebe beans, knows that the net is not for him. “He understands," says Aliya Saadou. "He is kind.” She adds that she chose her husband herself, instead of being forced to marry a husband who had been chosen for her.
These days, Aliya Saadou is taking things easy. As she gave birth to Bassira 31 days ago, she is still in “quarantine,” the traditional 40-day period during which Niger mothers who have just given birth have their workload reduced.
Bassira still spends all day sleeping, until her big brother Loukmanou comes home from school and starts making noise. She then wakes up and looks out from under the mosquito net. Under this delicate shield, her face still seems inexpressive. But her eyes are full of life.