Asked what’s on his wish list for his small clinic, Tchimaden Tafa starts pulling out a long list of items, but doesn’t get to the end, because another patient has come in to seek his help.
In Souloufeta, a village in the remote mountains of Aiir in northern Niger, health care comes in the form of a virtually empty building, run by a nurse with no equipment, medicine or even bandages.
Tafa’s facility is a two-room concrete walled structure with a barbed wire enclosure to prevent camels and goats from entering.
One room is used for examining patients, the other is the storeroom, containing perhaps half a dozen boxes of supplies.
There is no fridge or lights, because there is no electricity. Tafa has to examine patients with the door open, to let in the sunlight. There isn’t even a scale to weigh the patients.
Often, “all you can do is look at them and observe” their symptoms, the young nurse said with a sigh. “What can you do?”
– Niger’s poverty –
Niger, a huge former French colony in the heart of the arid Sahel, is the poorest country in the world, according to the Human Development Index.
Its population, the fastest growing in the world, has a GDP per capita of less than $600 a year, compared to $70,000 in the United States, according to the World Bank.
Soulefeta has about 100 inhabitants who live in about 15 brick houses.
It is about seven kilometers (four miles) from Iferouane, where there is a larger health center, but in this mountainous part of the Sahara, that distance is long and exhausting.
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The roads are bumpy and can be washed away by downpours during the rainy season, says Azori Lahou, who drives a four-wheel-drive ambulance.
Take patients to Iferouane and, if necessary, to the nearest hospitals in Arlit and Agadez.
They are five and nine hours respectively by car over desert tracks: “And that’s a good day,” commented Lahou.
In this vast empty region the size of France, there is only a single paved road. It was built years ago with the proceeds of uranium mining, but today it is almost a memory, eroded by wind, sand and truck wheels.
– Motorcycles –
Iferouane’s chief doctor, Ada Daouda, one of two doctors in the area, said one of his main concerns was getting sick patients in transportable condition so they could make the long walk to hospital.
“Someone whose vital signs are in danger and who has to wait hours to be treated, you can imagine what that (journey) is like,” he said.
“Tell them we need resources,” he added, in comments echoed by regional and other health officials to AFP.
Niger has only 0.35 doctors per 10,000 inhabitants, according to the World Health Organization. In comparison, the figure in Sweden is 70 doctors per 10,000.
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Sick people are often transported from Soulefeta to Iferouane on the back of a motorcycle, which is cheaper and sturdier than an ambulance, despite the obvious risks, Tafa said.
The village health committee proposes that local residents contribute a total of 1,000 CFA francs ($1.50) per month to buy medicine for the health hut.
Moussa Ibrahim, a gardener by profession who chairs the committee, said he knew this sum was far below what was needed.
“People are poor and not all can contribute, but they are doing their best,” he said.