At Work Around the World

Niger

In the desert of Niger, The Carter Center is working to combat two painful and debilitating diseases, Guinea worm disease and trachoma.


Building Hope

Located on the border of the Sahara Desert, water is at a premium for most people in Niger. For this reason, waterborne diseases are particularly threatening for those who may have no other option than to consume water from unsafe sources such as stagnant ponds. Because a healthy population is vital to promoting national development, the government of Niger invited The Carter Center to assist with efforts to combat two painful and debilitating diseases, Guinea worm disease and trachoma.


Fighting Disease

Eradicating Guinea Worm Disease

Current status: Endemic
Indigenous cases reported in 2007: 11

Since 1986, the Carter Center's Guinea Worm Eradication Program has led a world coalition fighting to eradicate this devastating disease. In Niger, The Carter Center has been working with the national program to eliminate Guinea worm disease since 1993. When the program began, five of Niger's six regions - Dosso, Maradi, Tahoua, Tillabery, and Diffa -were endemic, hosting approximately 33,000 cases of Guinea worm disease in 1,700 villages.

In collaboration with the federal Ministry of Health, The Carter Center implemented several strategies for eradication, primarily driven by health education. The goal of the Guinea Worm Eradication Program is to change behavior to prevent Guinea worm disease and mobilize communities to improve the safety of their local water sources.

The hard work of Nigerian volunteers and program staff has been paying off. In 2007, 14 cases were reported, more than a 99 percent reduction since eradication efforts began in Niger. Efforts have focused attention on training volunteers from each family unit in the most endemic villages and bringing cases to medical facilities where worms can be quickly and safely removed before wounds become infected. The collaboration between medical facilities and family volunteers to detect, report, and treat Guinea worm cases has helped reduce chances of a case contaminating a source of drinking water.

During 2007, indigenous cases occurred only in the Tillaberi region, which adjoins Mali and Burkina Faso, whose nomadic populations, including Tuareg and Peule, often move among the three countries. The tri-border area between Burkina Faso, Mali, and Niger poses a unique challenge to the eradication program because of the migratory nature of the populations in this area. In Niger as well as in other nations, migratory peoples are often some of the most marginalized. It is important that migrant populations are given the necessary tools, such as pipe filters and health education, to prevent the disease from traveling with them.

Niger's Guinea worm disease epidemic must be stopped. For every day that Guinea worm continues to thrive in Niger, the people of Niger as well as other nations will be in jeopardy of further suffering.

UPDATED MAY 2008


Learn more about the Carter Center's Guinea Worm Eradication Program.



Controlling Trachoma

Beginning in late 1998, The Carter Center capitalized on its experience and knowledge gained from the Guinea Worm Eradication Program to work with the government of Niger and partner organizations to target trachoma control. Trachoma is a bacterial conjunctivitis that leads to the permanent scarring of the inner eyelid, deforming the lid and causing the lashes to turn inward and press against the sensitive eye. Severe trachoma is disabling and debilitating and eventually leads to blindness, if the unfortunate sufferer lives long enough. It is the leading cause of preventable blindness in the world and is endemic in poorer rural communities in developing countries such as Niger.

National surveys conducted in Niger in 1997-1999 found that, on average, 44 percent of children younger than 10 years old in Niger had trachoma. The regions of Zinder, Diffa, and Maradi were found to be the most endemic. Recognizing the significant obstacles these children will face as they grow older, the Niger ministries of health, education, water, and social development established a Trachoma Task Force in 1999, inviting The Carter Center and other partner organizations to serve as members of a committee charged with combating this painful infection.

The Carter Center's assistance focuses on health education and environmental sanitation in endemic villages. The health education promotes clean faces among children 1 to 9 years old, better personal hygiene for everyone, clean villages, and household latrine-building and use. In 2002, these efforts were enhanced through Pfizer Inc.'s donation of the antibiotic azithromycin (Zithromax®). Mass distribution of this antibiotic reached 95,000 people that year and has since  expanded to more than 5.9 million people in 2007. In conjunction with these activities, sight-saving surgery is performed by other partner organizations and the Ministry of Health.

Health education materials for trachoma prevention were developed, 453 trachoma volunteers were trained and provided with materials to conduct community health education activities in 4,512 villages in three target regions. To broaden the reach of the program's educational campaign throughout Niger, health education messages are produced and broadcast in local languages on local radio stations.

National school health programs, initiated with the support of Helen Keller International, have contributed to the disease prevention effort by training schoolteachers about trachoma control. Today, approximately 293 schools in Niger possess at least one teacher trained in trachoma prevention. To reach children not in the secular school systems, the program also trains traditional Koranic teachers in trachoma control education.

From 1999 through 2007, there has been a steady increase in the number of villages receiving health education by the program, with 547 currently being reached.

To broaden the reach of the program's educational campaign, health education messages on trachoma have been created and broadcast using public and private radio stations to inform people at risk for the disease throughout Niger. Other outreach activities, such as dramas, are performed in villages and markets to reach those who might not have access to radio. The Carter Center has joined forces with Helen Keller International to try and ensure the sustainability of the rural radio stations as well as maintain the quality of messages broadcast.

The program also facilitates household latrine promotion for trachoma-endemic communities. The program has so far built more than 23,000 household latrines. In addition, 771 rural women have been trained in traditional soap preparation to promote better family hygiene. Soap made locally is affordable in the poorest of villages and can even be used to generate income.

Read more about soap making in Niger (Eye of the Eagle July 2007)