Water is at a premium for most Niger, located on the edge of the Sahara Desert, and waterborne diseases threaten many people, who have no option but to drink from unsafe sources such as stagnant ponds. The government of Niger invited The Carter Center to assist with efforts to combat two painful and debilitating waterborne illnesses, Guinea worm disease and, later, trachoma.
Current Status: Transmission stopped, October 2008 (Read the announcement)
Since 1986, the Carter Center's Guinea Worm Eradication Program has led a worldwide coalition to wipe out this devastating disease. In 1993, when the Center began working in five of Niger's six endemic regions — Dosso, Maradi, Tahoua, Tillaberi, and Diffa — there were approximately 33,000 cases of Guinea worm disease in 1,700 villages of the country.
In collaboration with the Ministry of Health, The Carter Center implemented health education strategies aimed at changing behavior in order to prevent Guinea worm disease and mobilized communities to improve the safety of their local water sources.
Efforts were focused on collaboration between village volunteers, who were trained to detect and quickly report cases, and medical facilities, where worms could be safely removed to avoid contaminating sources of drinking water.
Niger reported its last three indigenous cases in October 2008, and after 13 consecutive months without an indigenous case, Niger was determined to have broken Guinea worm transmission. However, neighboring Mali, which remains endemic, exported three cases to Niger in 2012.
Migratory groups (such as the Tuareg and Peule) in the tri-border area of Burkina Faso, Mali, and Niger pose a challenge to the global eradication program. Often marginalized, migrant populations must be given the necessary tools, such as portable pipe filters used for drinking water from stagnant ponds in the desert, and health education, to prevent the disease from traveling with them.
To help avoid further case importation and ensure successful regional elimination, Mali and Niger have collaborated to standardize their monetary rewards for reporting cases and guidelines for hospitalizing Guinea worm patients.
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 on trachoma control. Surveys conducted in Niger from 1997 through 1999 found the burden of trachoma to be concentrated in Zinder, Diffa, and Maradi regions. High prevalence in children and the advanced stage of the disease, trichiasis, in adults indicated that trachoma was a major public health problem in Niger.
In response to these data, the Niger Ministries of Health, Education, Water, and Social Development established a Trachoma Task Force and invited The Carter Center and other partner organizations to serve as members.
From 1999 through 2008, the Center focused exclusively on health and hygiene education and environmental sanitation activities. In late 2008, the Niger Ministry of Health and the National Prevention of Blindness Program asked partner organizations to support the full SAFE strategy nationwide. SAFE is a multipronged approach to trachoma prevention that includes: Surgery, Antibiotics, Facial cleanliness and hygiene education, and Environmental improvement. With renewed funding from the Conrad N. Hilton Foundation in 2008, The Carter Center expanded its assistance to include surgeries for those threatened with advanced trachoma and mass drug administration throughout Maradi, Diffa, and Zinder regions. Through both health center-based care and outreach strategies, The Carter Center has supported surgeries in targeted districts. In 2015, a total of 9,938 trichiasis surgeries were conducted. From 2008 to 2015, The Carter Center assisted the Niger program in performing 57,663 corrective eyelid surgeries.
The Center also has provided the Ministry of Health with topical antibiotic ointment and other needed surgical supplies and consumables with support from the John P. Hussman Foundation, the Lions Clubs International Foundation, the Conrad N. Hilton Foundation, and other donors. The mass drug administration of Zithromax was taken over by Helen Keller International in 2011 as part as an integrated Neglected Tropical Disease (NTD) program supported by the Ministry of Health. From 2008 to 2011, The Carter Center supported the distribution of 3,780,384 doses of azithromycin in Niger.
The Carter Center delivers health education through a variety of approaches, including rural radio broadcasts and listening clubs and training of religious and community leaders as advocates for change. With support from the Hilton Foundation, The Carter Center partner organization Helen Keller International has assisted national school health programs to train schoolteachers so they can then educate their students about trachoma control. Approximately 624 primary schools in Carter Center-assisted areas participate. To reach children not in the secular school systems, the program also has trained traditional Koranic schoolteachers. In 2015, 800 people were trained to provide health education and assisted ongoing health education in over 500 villages. Since 1998, The Carter Center has assisted the national program in bringing health education to more than 1,100 villages.
To broaden the reach of the program's educational campaign throughout Niger, health education messages on the SAFE strategy are produced and broadcast in local languages on community radio stations. To reach people without access to radio, artists and health educators perform theatrical dramas in large villages and weekly markets.
Household latrine promotion has been a cornerstone of the Carter Center program in Niger. As of the end of 2015, with the Center's support, more than 103,000 household latrines had been built by over 2,900 trained masons.
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Size: 1.267 million square kilometers
Population: 18,045,729 (2015 est.)
Population below poverty line: 63 percent
Life expectancy: 55 years
Ethnic groups: Hausa, Zarma/Songhai, Tuareg, Fulani (Peul), Kanuri, Gurma, Arab, Tubu, other/unavailable (2006 est.)
Religions: Muslim, other (includes indigenous beliefs and Christian)
Languages: French (official), Hausa, Djerma
Source: U.S. Central Intelligence Agency World Factbook 2016