Sanam, Niger - You can see the difficulty of life here in Boubacar Harouna's eyes. They are yellowed from chronic malaria and glassy from exhaustion. Still, Harouna somehow summons the energy to treat dozens of patients each day as the town's only nurse.
Clad in an improbably clean, crisp white coat, Harouna makes the rounds to check on his patients - many of whom lay outside under shade trees because of the lack of beds here. One man, so weak from malaria that he cannot sit up or even move, is sprawled out on a dingy mattress with an intravenous drip in his arm.
One of the clinic's few observation rooms holds four-year-old Ousama Mamidou, who was transported here in a donkey cart from a nearby village. Already chronically anemic and severely malnourished, Ousama arrived in convulsions from a malaria fever. Even after treatment with anti-malarial medications and rehydration solution, she's still listless in her mother's arms and fighting for survival.
"You've come on a slow day," Harouna says with no trace of irony on his care-worn face.
Last year, Harouna assisted in 112 births. He kept a busy schedule of prenatal, breastfeeding and child nutrition consultations. He filled the remainder of his days with vaccinations, curative treatments and emergency medical care.
Harouna is on call around the clock. If a patient comes in the middle of the night, he must quickly rouse from sleep and do what must be done. He's never far from his work; he lives with his wife and children in a small house that's attached to the clinic.
A difficult road
He gives me a weary smile as he begins talking about the town he serves and loves.
Sanam is on the fringe of the Sahara Desert. A town of about 28,000 people, it lies in Niger's impoverished Filingue Department. This entire region was hit hard by catastrophic drought and crop-killing insect swarms in late 2004 and again in 2005. People had hardly any millet to harvest as a result. At the height of the food crisis in 2005, more than 3.5 million Nigeriens faced the prospect of starvation.
Harouna and other residents of Sanam are hopeful that this year's millet crop will do what the previous two could not: sustain area families until the next harvest. The city must struggle to be self-sufficient; the closest market town is more than three hours away down a jagged road cratered with potholes.
It was up that road that Mercy Corps first arrived here in August 2005, after thousands of caring private donors contributed more than $335,000 to help launch a lifesaving response to Niger's hunger crisis. Within days of beginning an emergency fundraising campaign to help Nigerien families, Mercy Corps quickly deployed experienced aid workers to remote places like Sanam. The task was daunting: identify and treat malnourished children under five years old, while also training local health officials like Harouna to sustain this critical work.
That response, which is ongoing, finally gave Harouna some much-needed support.
"Besides Sanam, this health clinic is responsible for three other villages: Kololo, Magaria and Kordongo," he says. "Mercy Corps has helped us provide support for families there."
With the help of medical professionals like Harouna, Mercy Corps identified dozens of villages where hunger was endemic, including the three villages in proximity to Sanam. Local health centers in these villages began distributing nutritious food to the mothers of malnourished children: UNIMIX, a vitamin-rich porridge for moderately malnourished children and Plumpynut, a protein-packed food for those with severe malnutrition.
Keeping a promise
Within weeks, hundreds of children were "graduating" from the therapeutic feeding program, having met the target weight for their age groups. In just three months time, more than 4,000 children in Filingue Department regained their health.
Today, there are still 167 malnourished children in Sanam; all of them are moderately malnourished and being treated with UNIMIX.
"There are no longer any severely malnourished children around Sanam," Harouna proudly explains, "and that's a compliment to Mercy Corps and its donors."
Mercy Corps has kept its promise: the program is currently operating in more than 100 health centers in Niger and providing services to 33,000 children. Over the past year, hundreds of local health officials have been trained how to recognize, treat and - most importantly - prevent malnutrition and the health issues that it causes.
Life is hard in Sanam; Boubacar Harouna knows that better than most. However, some timely help from Mercy Corps is helping to lighten his load.