September 21, 2005; Matameye, Niger
These mothers wait with their children in the urgent care area of the Doctors Without Borders (MSF) weekly Matameye Crenas (an ambulatory clinic for severely and moderately malnourished children). These children are under observation to determine whether they are so severely malnourished they must be admitted to one of MSF’s 24 hour emergency clinics.

Today MSF found 96 new cases and reviewed 225 old cases of severe and moderate malnutrition in the village. Hundreds of women wait in line to see if their children fit the severely or moderately malnourished criteria while others return for the weekly check-up. The MSF staff quickly examine each child, ask their age, and measure their upper left arm. If the arm is small enough to fall into the red or orange zone on the measuring tape, the child is severely or moderately malnourished and is admitted into the MSF Crenas. In the Crenas, the children are weighed, measured and officially admitted into the Crenas program. Their temperature is taken and they are tested for malaria. Afterwards an MSF doctor holds a consultation with each child and mother. If the child will not eat or drink on their own, they are pulled aside to undergo observation, and then taken to one of MSF's two permanent clinics (Creni) in Zinder. If not, the mother is given a ration of plumpy nut (a highly nutritious food given twice a day) for the child, and rations of grain, oil and soap for the rest of the family. They are supposed to return weekly to the Crenas for MSF to follow the child’s condition.

September 21, 2005; Matameye, Niger
Nurse Nasirou Rouma Natou (L) conducts a weekly checkup of Aicha Moutari, held by mother Selouba.

September 21, 2005; Matameye, Niger
Doctor Ousmane (L) examines the child Baharia Rabe, held by mother Harira. Baharia Rabe is severely malnourished. Idi Moussa Waziri (R) is deaf and mute. He is part of a team of deaf and mute men that are helping to manage the crowd at the clinic.

September 20, 2005; Takieta, Niger
Dominique Proteau (R), head of the Doctors Without Borders (MSF) ambulatory clinic program in Zinder, speaks with nurse Fatima Goussman (L) about the condition of the child Habibou Kailou. Habibou is held by his mother Ousseina. He is severely malnourished and is having trouble breathing. Because his condition is so severe, he will be taken to MSF’s permanent clinic in Zinder for 24 hour treatment.

MSF has been in the Zinder region since July 15, 2005. They expect to continue their program for at least a year.

September 20, 2005; Takieta, Niger
Nurse Halima Alassane (L) examines a young patient.

September 21, 2005; Matameye, Niger
These mothers wait with their children in the urgent care area of the Doctors Without Borders (MSF) weekly Matameye Crenas (an ambulatory clinic for severely and moderately malnourished children). These children are under observation to determine whether they are so severely malnourished they must be admitted to one of MSF’s 24 hour emergency clinics.

September 21, 2005; Matameye, Niger
This mother and child wait in the urgent care area of the Doctors Without Borders (MSF) weekly Matameye Crenas (an ambulatory clinic for severely and moderately malnourished children). These children are under observation to determine whether they are so severely malnourished they must be admitted to one of MSF’s 24 hour emergency clinics.

September 21, 2005; Matameye, Niger
Nutritional assistants Bassirou Maman Bachir (L) and Oumarou Haroukou Moussa (R) measure the height of a child to determine the severity of his malnutrition.

 

September 21, 2005; Matameye, Niger
Ibrahim (L) and his blind mother, Aicha, wait to receive their ration of plumpy nut, oil, soap and grain after the baby’s, (Abdou Malan Illiya) weekly check-up. Abdou Malan Illiya is severely malnourished.

September 21, 2005; Matameye, Niger
The young boy, Ibrahim, helps his blind mother, Aicha, wrap his younger brother, Abdou Malan Illiya, onto his mother’s back. Abdou Malan Illiya is severely malnourished. His mother has brought him to the Doctors Without Borders clinic for his weekly check-up.

September 18, 2005; Dounnkoukaneye, Niger
World Vision program monitor Daniel Maizama registers Habsu Amadou (L) for the World Vision and the World Food Program’s free food distribution.

The food is being distributed to the families of five villages. The women receive grain, beans, soap and two mosquito nets. Every household receives a distribution regardless of need.
The women are first called up individually by name, their thumb-print is stamped onto the roster and they are given a card specifying how many rations they should receive (depending on the size of their family). They then wait in line and are called up in small groups to receive their ration.

September 18, 2005; Dounnkoukaneye, Niger
Hundreds of women wait for their group to be called so they can receive their ration of grain, beans, soap and mosquito nets at the World Vision and World food program's free food distribution.

September 18, 2005; Dounnkoukaneye, Niger
Hundreds of women wait for their group to be called so they can receive their ration of grain, beans, soap and mosquito nets at the World Vision and World food program's free food distribution.

September 17, 2005; the Tarka Valley, Niger
Near the village of Altine, in an area cleared as a fire-break, is mound of dead cattle. When their cattle began to die from lack of forage, Fulani and Tamashek herders brought the animals to the Tarka valley to sell. An animal which might normally sell for 350-400,000 CFA was bought at 2,000-15,000 CFA. The cattle were bought by Hausa butchers and their flesh cured and dried on the spot.

Oxfam's food for work program hired people to burn and bury the carcasses lying throughout the valley. (These bones were not burned)

September 17, 2005; the Tarka Valley, Niger
Near the village of Altine, in an area cleared as a fire-break, is mound of dead cattle. When their cattle began to die from lack of forage, Fulani and Tamashek herders brought the animals to the Tarka valley to sell. An animal which might normally sell for 350-400,000 CFA was bought at 2,000-15,000 CFA. The cattle were bought by Hausa butchers and their flesh cured and dried on the spot.

Oxfam's food for work program hired people to burn and bury the carcasses lying throughout the valley. (These bones were not burned)

September 21, 2005; Matameye, Niger
Nurse Maman Moussa (R) conducts a weekly checkup of Harissa Amadou, held by her blind mother Sakina. The older girl by their side is her sister Balki.

In the summer and fall of 2005, Niger, a landlocked country in sub-Saharan West Africa, suffered from a famine. A poor harvest the year before, caused by low rainfall and locust damage, had diminished the nation’s food supply. But, the famine was also exacerbated by a cycle of poverty and debt that plagues Niger year after year.

In September 2005, I traveled throughout Niger, photographing the work of famine relief by foreign non-governmental organizations (NGOs) – primarily Doctors Without Borders and World Vision.

The relief work I observed was both generous and necessary, but it quickly became clear to me that the year’s famine was only a symptom of chronic malnutrition, infant mortality and crippling personal debt – endemic problems that can only be lessened with difficult and controversial long-term solutions like locally-run grain banks, reforestation, and female empowerment.

I hope my photographs show dignity and strength as well as pain and resignation in the face of adversity.