School of Public Health > News > News Archives > June 2004 > Ariane Alzhara Kirtley '04


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Ariane Alzhara Kirtley '04: "Three Rounds of Tuareg Tea"
From Breastfeeding Education to Hygiene Promotion in Niger: A Public Health Project

Women Attending CARE Meeting on Exclusive Breastfeeding, Village of Dibissou, Tahoua Region
Garbage Men, Konni, Tahoua region
Konni's waste department hires deaf and dumb individuals in order to give them an opportunity to make a living wage and keep them from panhandling on the streets. In this picture, men are loading garbage from the official market dump site into a truck, to then transport it to fields bordering Konni, where it is burned or left to decompose.

Notice that the garbage men are not wearing protective gear, such as gloves and boots, to shield them from harmful exposure to waste. The city does not have the funds necessary to purchase protective clothing for its employees. The city also has limited money available to create safe dump sites at locations far from inhabited spaces. This particular garbage dump is located in the middle of the produce market, and contributes to runoff and fly contamination.
Ariane and CARE Colleagues, CARE Konni Office
Yahaya, Ariane, Ramatou, Yahanatou, Nazer, Saidi
Fulani Well, Village of Satchi, Tahoua region
Notice that the well wall is built high enough to prevent floodwater from entering. There are special drinking wells for animals set at a distance, which help prevent animals from defecating near the main well. Poles are present to hang the well rope and bucket during periods when water is not being collected, which help prevent contamination from ropes and buckets sullied from having remained on the ground. The women have removed their shoes in order to minimize contamination while standing on the well rim. Finally, the area surrounding this well is swept twice daily.

Fulani wells in the Tahoua region are often more structurally sanitary than the wells of their sedentary neighbors, the Hausa. A variety of factors have contributed to this. For one, in order to help the Fulani provide water to their animals as well as their families, they have received more international aid than the Hausa to build wells with appropriate infrastructure limiting water contamination. Furthermore, a pastoral lifestyle is more conducive to proper environmental sanitation because populations are generally smaller and livestock is held in the pastures and outside of personal concessions. Since the populations are more mobile, human and animal waste does not accumulate and litter the environment. Furthermore, men and children are often held responsible for helping with household chores, thereby leaving more time to the women to tend to their personal and environmental hygiene.
Flooded Village, Village near Dogondoutchi, Tahoua region
Do not be duped by this picture, apparently depicting a serene village surrounded by a quaint lake and tranquil, quietly floating ducks. This picture in fact exemplifies the flooding dilemmas that both cities and villages encounter during the rainy seasons, because most cities and villages have poor or non-existent canalization systems. Flooding destroys homes and silos. The stagnant water attracts infectious insects and parasites such as mosquitoes, parasitic worms, amoebas, and giardia. Children can contract cutaneous infection by playing in the water, and individuals may use the contaminated flood water as an alternative drinking water source thereby possibly contributing to water-borne infections in their communities.
Traveling Medicine Stand, Konni, Tahoua Region
Over-the-counter medicine, malaria medication, and amoeba fighting "Flagyl" can be purchased from "traveling stands" carried on top of the vender's head. Medicine is sold along with delectable candy and cigarettes. Here, the vender set his stand down to sell a pack of cigarettes to the "hernia healer," lugging a wagon full of orange colored hernia curing plants.
Hausa Well, Village of Goumbi Kanno, Tahoua region
Notice that the well wall is built too low to prevent contamination from the exterior environment. Only a few days prior to the picture being taken, rain water from the "marigot" (floodwater pool) in the background flooded the well, carrying with it animal feces and other waste. Furthermore, animals are allowed to remain in near proximity of the well even though there is nothing preventing animal waste from entering the well. There is also no system in place to protect the collection ropes and buckets from contamination.

Hausa wells often suffer from poor infrastructure that contributes to well water contamination. Unlike the Fulani, the Hausa are sedentary agriculturalists and traders. A sedentary lifestyle commonly leads to higher population concentrations, thereby making it difficult to properly deal with environmental waste. Furthermore, animals tend to live in the concession with the family, and women are responsible for gathering water, tending to the fields, and all the household chores, thereby leaving little time to bother with hygiene and sanitation.
Where the Water Flows, The Ayr, Agadez Region
Grass growth indicates where underground water flows. Since water is a rare and precious commodity in the desert, the grass is a valuable indicator for the weary traveler searching for a refreshing drink.
“AIDS or Life, Choose in the Basket”, HIV/AIDS Prevention Poster, CARE Konni Office
HIV/AIDS has only recently been recognized as a pandemic in Niger, and a majority of village people do not know what HIV/AIDS is. Non-profit organizations such as CARE have initiated major HIV/AIDS prevention campaigns in order to increase awareness in both cities and villages. The known prevalence of HIV/AIDS in Niger is 2-3.3%. However, surveillance systems are poor, therefore prevalence is likely to be higher than estimated.

The Tahoua region has the highest prevalence of HIV infection, and ranges from 4.0 to 5.5 % among pregnant women. HIV/AIDS in pregnant women is a challenge for initiatives promoting exclusive breastfeeding. In countries like Niger, the World Health Organization (WHO), UNICEF (the United Nations Children's Fund), and UNAIDS (the Joint United Nations Programme on HIV/AIDS) encourage HIV infected mothers to continue breastfeeding despite the 10-15% risk of transmission. A non breast-fed child is four to six times more likely to die from a diarrheal disease acquired from contaminated water or food used in preparing alternatives to breast milk than children that are exclusively breast fed. In fact, the WHO estimates that 1.5 million infants die each year due to contaminated food or water. Improving hygiene and sanitation, thereby limiting food and waterborne disease, could help HIV positive Nigerien mothers find safe alternatives to breast feeding.

 

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