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QUICK FACTS: NIGER Size: 1,267,000 square kilometers - almost twice the size of the U.S. state of Texas Population: 12,894,865 Religions: Muslim, 80 percent; indigenous beliefs; Christian Population below poverty line: 63 percent Languages: French (official), Hausa, Djerma Ethnic groups: Hausa, 56 percent; Djerma; Fula; Tuareg; Beri Beri (Kanouri); Arab Toubou; Gourmantche; about 1,200 French expatriates Average annual income: $260 USD Life expectancy: 44 years (Source: U.S. Central Intelligence Agency, World Factbook 2008; The World Bank 2006) |
Niger
In the desert of Niger, The Carter Center is working to combat two painful and debilitating diseases, Guinea worm disease and trachoma. Building Hope Located on the border of the Sahara Desert, water is at a premium for most people in Niger. For this reason, waterborne diseases are particularly threatening for those who may have no other option than to consume water from unsafe sources such as stagnant ponds. Because a healthy population is vital to promoting national development, the government of Niger invited The Carter Center to assist with efforts to combat two painful and debilitating diseases, Guinea worm disease and trachoma. Fighting Disease Eradicating Guinea Worm Disease Current Status: Transmission stopped, October 2008 Certification of Dracunculiasis Eradication: Pending Since 1986, the Carter Center's Guinea Worm Eradication Program has led a world coalition fighting to eradicate this devastating disease. In Niger, The Carter Center has been working with the national program to eliminate Guinea worm disease since 1993. When the program began, five of Niger's six regions – Dosso, Maradi, Tahoua, Tillaberi, and Diffa – were endemic, hosting approximately 33,000 cases of Guinea worm disease in 1,700 villages.
In collaboration with the federal Ministry of Health, The Carter Center implemented several strategies for elimination, primarily driven by health education. The goal of the Guinea Worm Eradication Program was to change behavior to prevent Guinea worm disease and mobilize communities to improve the safety of their local water sources.
Efforts focused attention on training volunteers from each family unit in the most endemic villages and bringing cases to medical facilities where worms can be quickly and safely removed before wounds become infected. The collaboration between medical facilities and family volunteers to detect, report, and treat Guinea worm cases helped reduce chances of a case contaminating a source of drinking water.
After years of hard work and vigilance, Niger reported its last three indigenous cases in October 2008. After 12 consecutive months without a single indigenous case, Niger was determined to have once and for all broken Guinea worm transmission. However, the nation must continue its partnership with neighboring Mali, which remains endemic and exported three cases to Niger in 2009. An additional exported case in 2009 was imported to Niger from Ghana.
The tri-border area between Burkina Faso (which stopped Guinea worm transmission in 2006), Mali, and Niger poses a unique challenge to the global eradication program because of the migratory nature of the populations in this area. In Niger, as well as in other nations, migratory peoples (such as the Taureg and Peule) often are some of the most marginalized. It is important that migrant populations are given the necessary tools, such as pipe filters and health education, to prevent the disease from traveling with them.
To avoid further case importation and ensure successful regional elimination, Mali and Niger have collaborated to standardize their case reporting rewards and their guidelines for hospitalizing Guinea worm patients.
Niger's success at eliminating Guinea worm inspires other nations struggling with the disease as well as the Nigerien people. Now that Guinea worm has been defeated, perhaps other problems, such as trachoma, may be addressed. The Carter Center hopes Guinea worm's elimination will represent empowerment and achievement for the Nigerien people.
Learn more about the Carter Center's Guinea Worm Eradication Program.
Updated December 2009 Controlling Trachoma In late 1998, The Carter Center capitalized on its experience and knowledge gained from the Guinea Worm Eradication Program to work with the government of Niger and partner organizations to implement trachoma control. National trachoma prevalence surveys conducted in Niger from 1997-1999 found the burden of trachoma to be concentrated in the regions of Zinder, Diffa, and Maradi. High prevalence of trachoma in children and trichiasis in adults indicated that trachoma was indeed a public health problem in Niger.
In response to these data, the Nigerien ministries of health, education, water, and social development established a Trachoma Task Force, inviting The Carter Center and other partner organizations to serve as members.
From 1999-2008, the Center focused exclusively on health education and environmental sanitation activities. In late 2008, the Nigerien Ministry of Health and the National Prevention of Blindness Program requested partner organizations support national trachoma elimination, with a target date of 2015. With support from the Conrad N. Hilton Foundation, The Carter Center expanded its support to cover additional SAFE strategy activities throughout Maradi, Diffa and Zinder regions.
The Carter Center supports trachoma control in six African countries in partnership with trachoma-endemic communities, ministries of health, the Lions Clubs International Foundation, Pfizer Inc., and the Conrad N. Hilton Foundation. The leading cause of preventable blindness in the world, trachoma is an excruciating bacterial disease endemic to the poorest countries of the world. Over time and through repeated infections, trachoma leads to the permanent scarring of the inner eyelid, deforming the lid and causing the lashes to turn inward and press painfully against the sensitive eye. Although not typically a fatal disease, severe trachoma is disabling, debilitating, and eventually leads to blindness. The World Health Organizations recommends the implementation of the SAFE strategy for trachoma control: Surgery to correct scarring from advanced trachoma, Antibiotics to treat early trachoma infections, Facial cleanliness to prevent disease transmission, and Environmental changes to improve hygiene and sanitation. To achieve national elimination of trachoma and reduce the backlog of existing trichiasis cases, The Carter Center has provided support to the national program to deliver surgery to targeted districts. In 2009, a total of 3,110 trichiasis surgeries have been conducted and the Center has provided the Ministry of Health with much needed surgical supplies and consumables with support from the John P. Hussman Foundation. In 2009, The Center also distributed 612,965 doses of antibiotics to fill a treatment gap identified by the national program.
The Carter Center delivers health education through a variety of approaches including: rural radio broadcasts and listening clubs, soap-making, and training of religious and community leaders. National school health programs, initiated with the support of Helen Keller International, have contributed to disease prevention efforts by training school teachers about trachoma control so they can then educate their students.
Today, approximately 374 schools in Carter Center areas participate in trachoma control education. To reach children not in the secular school systems, the program also trains traditional Koranic school teachers. Through 2009, a total of 571 villages currently benefit from ongoing health education. Overall, a cumulative total of 5,144 people have been trained to conduct health education.
To broaden the reach of the program's educational campaign, health education messages on trachoma have been created and broadcast using public and private radio stations to inform people at risk for the disease throughout Niger. DJs from community-based radio stations have been trained in collaboration with Helen Keller International. Other outreach activities, such as dramas, are performed in villages and markets to reach those who might not have access to radio.
And to promote better family hygiene, 1,428 rural women have been trained in traditional soap preparation. Soap made locally is affordable in the poorest of villages and can even be used to generate income.
Household latrine promotion has been a cornerstone of The Carter Center Niger program. Since 1999, more than 40,000 household latrines have been built in Diffa, Maradi and Zinder regions. The Center has also supported the training of nearly 1,300 community masons to encourage adoption of latrines at the community level.
Despite this progress, major obstacles persist in trachoma prevention and treatment efforts. Lack of access to health facilities and health personnel, poor water quality in rural areas, food insecurity due to environmental problems from locusts and poor rains, and internal migration all continue to challenge program efforts.
The Carter Center is committed to working with the Niger Ministry of Health to control trachoma until this disease is no longer a public health problem for the nation.
UPDATED SEPTEMBER 2009 |
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