Niger: MSF Still Blocked in Maradi Despite a New Memorandum of Understanding

The French section of MSF hopes to obtain authorization to resume its activities as quickly as possible

Ten weeks after MSF's authorization to treat malnutrition in the Maradi region was suspended, the French section of Médecins Sans Frontières is no longer providing any medical-nutritional treatment on site there. A new memorandum of understanding was drafted between the Ministry of Public Health and MSF, but the authorities of Niger have yet to sign it.

"In recent weeks, many contacts raised our hopes that the suspension would be lifted soon," said Christophe Fournier, international president of Médecins Sans Frontières. "Unfortunately, these favorable indications have been slow to materialize. However, we still hope that a positive outcome is possible."

Since July 18, the date its authorization was suspended, MSF has taken a variety of steps in an effort to resume its activities. On August 7, Marie-Pierre Allié, president of the French section of MSF, went to Niamey to meet with the Minister of Public Health. Following that meeting, a joint delegation of Ministry of Health representatives and MSF operational managers went to Maradi to draw up a new memorandum of understanding between the organization and Niger's health authorities. It was submitted to the Minister of Public Health and then transmitted, officially, to the Prime Minister on August 15. In addition, in early September, MSF submitted requests to meet with Niger's president and the Health and Interior ministries.

In accordance with the Nigerien authorities' decision, MSF halted admission of new children into its program when the suspension was announced and gradually closed its 13 treatment centers in Maradi and surrounding areas. In addition, 2½ months after the suspension, given that it could not treat children in Maradi, MSF had to start the process of terminating the employment contracts of its Maradi staff.

Considerable progress has been made on nutritional issues in recent years. In 2005, Niger was the first country in the sub-region to adopt a national treatment protocol for severe malnutrition. A national malnutrition agency was created within the Ministry of Public Health. Based on surveys conducted by Niger's own Ministry of Public Health and UNICEF, the prevalence of malnutrition in the Maradi region dropped sharply between 2005 and 2008.

"Since early 2008, our program has treated more than 14,000 malnourished children in the Maradi region," stated Marie-Pierre Allié, president of Médecins Sans Frontières France. "At the time our work authorization suspension was announced, nearly 3,400 children were being treated in our centers, 180 of whom were hospitalized. It is very disturbing not to be able to treat malnutrition in the midst of the dry period, the most sensitive time of year."

Lifting the suspension quickly is more critical than ever so that Médecins Sans Frontières can resume its activities in Maradi and continue working with authorities to improve treatment of malnutrition in Niger.

Médecins Sans Frontières has been operating malnutrition treatment programs in Niger since 2001. The organization is currently working in the Zinder, Maradi and Tahoua regions. Between early 2008 and mid-September, a total of 61,051 children suffering from acute malnutrition were admitted into MSF feeding centers.  In collaboration with health authorities, Médecins Sans Frontières also provides epidemic response in Niger, treating patients and carrying out vaccination campaigns. In 2008, more than 700,000 children were vaccinated against measles and MSF was involved in responding to meningitis and cholera epidemics. The MSF teams in Niger total 1,537 staff, including 1,468 Nigeriens.