STEVE INSKEEP, host:
In Subsaharan Africa, the United Nations World Food Program reports that it's struggling to feed 43 million people. That's a record and it's twice the number of just a decade ago. This week, we're examining various aspects of global public health starting with hunger and disease. Adding to the crisis in Africa are the problems created by poverty, conflict, AIDS, drought, weak governments and corrupt governments. NPR's Ofeibea Quist-Arcton reports from the West African nation of Niger, scene of a devastating hunger crisis earlier this year.
OFEIBEA QUIST-ARCTON reporting:
Madadeen(ph), Niger's second city in the south, was hard hit by this year's calamitous food crisis. Images of stick-thin malnourished children were beamed all over the world and journalists, including me, reported that many babies were dying of starvation, but correctly speaking that's not the case says Dr. Mamudu Abdu Garba(ph), chief medical officer for Madarufa district(ph) in the Madadeen region.
Dr. MAMUDU ABDU GARBA (Chief Medical Officer, Madarufa District): (Through Translator) These children don't die of hunger. Rather when a child is malnourished, the immune system is weakened, making children more vulnerable. That's why we call malnutrition the link to all other infections. It's an explosive catalyst.
QUIST-ARCTON: Almost all of the severely malnourished babies seem to have a cough at this tented intensive care unit at nutritional feeding center in Madadeen run by MSF, the medical relief agency Doctors Without Borders. Dr. Shantel Omutoni(ph) says with the oncoming colder season accompanied by desert winds, she's seen an increase in the number of admissions of starving infants compounded by chest and other infections.
Dr. SHANTEL OMUTONI: Right now we had a pick of malaria, cerebral malaria. When the children reach our center, either it is too late, they're too sick, or because of the state of malnutrition, they're so weak, they die.
QUIST-ARCTON: The mothers are breaking their fast with a syrupy orange drink at sundown during the Muslim holy month of Ramadan. It's women like these who are the real target for awareness campaigns about good nutrition and disease prevention in a poor country that's prone to drought, hunger and cyclical famine.
In Niger, one in four children under the age of five is reported to die of poverty and hunger-related causes. Madarufa regional health chief Dr. Garba again.
Dr. GARBA: (Through Translator) We've trained what we call mother educators, up to 10 per village where possible, to teach women and men how best to feed their children and, most importantly, not to wait to take children to the clinic as soon as they fall ill.
(Soundbite of grinding)
QUIST-ARCTON: Despite these efforts to improve primary health and fight hunger, poverty remains a key factor in access to health care in Niger. Women like these in Madarufa village are workhorses. They spend their day in the field farming, then when the harvest is good, pounding millet to prepare the meals to feed the family. But often these women don't have ready cash for emergencies.
Ms. SAHARA GARBA(ph): (Foreign language spoken)
QUIST-ARCTON: Sahara Garba, a 20-year-old mother of three from nearby Dantutu village(ph), explains that it's difficult enough to raise the $1 or so you need for a consultation at the clinic for your child. She says once you've trekked all the way from the village, you simply don't have the extra 20 cents to pay for a syringe for a blood test if it's needed, and that's the reason she says that some mothers in Niger just don't bring their children to the hospital even when they're hungry and sick.
Dr. OMUTONI: I think the first solution is to really improve the access to health care and then politicians must put in enough means in terms of access to afford improving agriculture and access to the food on the market and free health care.
QUIST-ARCTON: So says Dr. Shantel Omutoni, the pediatrician from Doctors Without Borders, working with malnourished children in Niger.
Dr. OMUTONI: I think if people get access to health care, the mothers just bring the children to the health centers as soon as they are sick and we can avoid a lot of death.
(Soundbite of people)
QUIST-ARCTON: There are small-scale income-generating initiatives to help women in Niger become more economically independent says Asam Azon Dusase(ph), the coordinator in Madadeen for the UN Children's Agency. One such UNICEF project benefits women and malnourished children here in Garingulbe village(ph) outside Madadeen.
Unidentified Man: (Through Translator) UNICEF has set up a goats milk project in many villages like Garingulbe. We buy the first two goats for needy mothers and then we leave them to rear the goats and to feed the milk to malnourished children.
(Soundbite of goats)
QUIST-ARCTON: Health experts here in Niger acknowledge that it'll take much more than these efforts to ensure that malnutrition and associated common diseases as well as hunger crises like this year's are deemed a menace of the past, but Dr. Mamudu Abdu Garba, the chief medical officer for Madarufa district Madadeen, says he's hopeful.
Dr. GARBA: (Through Translator) It takes time for people to change their behavior and habits when it's such a deep part of their culture, but I believe that if we continue along the course we have started, that in five to 10 years, malnutrition will seem like just a bad dream from Niger's past.
QUIST-ARCTON: Meanwhile, despite a good October harvest, hundreds of emaciated, severely malnourished infants are being treated for a variety of infections here in Madadeen and elsewhere in Niger.
Ofeibea Quist-Arcton, NPR News, Madadeen, southern Niger.
INSKEEP: And this series on global public health will continue tomorrow. We'll hear a story about fixing El Salvador's drinking water problem.
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We are continuing to follow a major story this morning. Samuel Alito is President Bush's latest nominee for a seat on the Supreme Court and he's already holding his first get-acquainted meetings with senators on Capitol Hill. He was just formally introduced to the nation a short time ago, earlier this morning, and he's already over at the Capitol. Reaction to his nomination has been swift and intense. He's a federal appeals court judge and he has a long record as a staunch conservative. Some Democrats and many liberal interest groups are very unhappy with this nomination and they are warning that Alito, if confirmed, will tip the balance of the Supreme Court to the right.
He would replace Sandra Day O'Connor, who was seen as a swing vote on many issues. She has sometimes sided with her more liberal colleagues and sometimes siding with conservatives. Now Republicans, for the same reason, are very positive about this nomination, as are many conservative interest groups. And they are citing Alito's views and past record in court cases on issues ranging from abortion to sex discrimination. And we'll continue to bring you more on this nomination as it develops through the coming days, weeks, perhaps months. It is not clear if this nomination can be voted on by the end of the year, which is what President Bush has requested of the United States Senate.
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