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Trial run for malaria protection in Niger
16 December 2005
John Haskew, in Agadez
We approached the Tuareg settlement through a protective ring of acacia thorn bushes and baobab trees. Inside a house, a gleaming white mosquito net was installed proudly above a bed.

It was here, a few weeks ago, in the remote north of Niger, that the International Federation of Red Cross and Red Crescent Societies and the Niger Red Cross distributed 21,000 mosquito nets. Tchirozérine district was one of those chosen by the International Federation to trial an innovative strategy of distributing mosquito nets when children are vaccinated against polio. We have come to see how the trial distribution faired.

Lessons learned from the trial are being put into practice across the whole of Niger, where the International Federation will distribute 2,030,000 long-lasting insecticide-treated mosquito nets in a week-long campaign starting today (19 December 2005). The nets will cover every child under five, a total of 3.5 million children, and every pregnant woman. In Niger, one child in four does not reach her or his fifth birthday, often because of malaria.

Tchirozérine is a remote district in Agadez, in the north of Niger. Distances are vast. This area is inhabited by the Tuareg and Fulani, people who roam the Sahel in search of temporary sources of water and pasture for their cattle and goats.

It has taken two long days of driving from Niamey, the capital, to reach here. Considerable planning was required to pre-position more than 21,000 mosquito nets in health centres and other points throughout the district.

“We needed to use three types of distribution points,” explained Elhadj Kollo, the regional medical officer in Agadez. “We used a fixed point in the towns, one in the villages and a mobile point to reach the nomadic populations.”

Red Cross volunteers registered more than 22,000 mothers during the trial distribution, 4,000 more than expected. Such high turnout was testimony to the information campaign and the high demand for mosquito nets.

Moussa Inne Koka, secretary general of the Agadez branch of the Niger Red Cross, described the procedure by which 72 Niger Red Cross volunteers gave nets to mothers with a child under five.

“Mothers were identified by the polio vaccination teams, who made door-to-door visits.” he explained.

“An eligible mother received a mark on her thumb nail and came to a distribution point to receive a net. A mark on her other thumb nail indicated she had received a net.”

Despite the considerable logistical challenges, 92.5% of registered mothers received a net. One of the difficulties was the unexpected number of women coming to distribution points in towns. The International Federation realised that more volunteers would have to be posted in these distribution points in December’s big distribution.

We visited Tchirozérine several weeks after the distribution to see how families were using their nets. At one settlement, Amina Adimou was preparing tea outside her tent.

“The vaccination team visited to treat my children,” Amina explained.

“They told me to go to Aderbissinat to receive a mosquito net.”

In spite of a 5 km distance, Amina walked to the distribution point to receive her net. She installed it above the bed she shares with her children.
“My youngest child had malaria last year. Now I know we can sleep protected at night,” she said.

From Monday (19 December), 3,850 Red Cross volunteers will help distribute 2,030,000 mosquito nets in Niger, in what the International Federation believes is the biggest distribution ever carried out.
International Federation malaria adviser for Africa, Stefan Hoyer said campaigns like that in Niger would play a crucial role in achieving the Millennium Developmental Goal of reducing child mortality by two-thirds by 2015.

“The joining of forces between vaccination and malaria programs can solve one of the key problems of malaria control at the national level – the need to scale-up logistical and operational support - to protect vulnerable children even in the most remote households in Africa.”

The programme is funded by USD11.3 million from the Global Fund to Fight AIDS, Tuberculosis and Malaria and USD2 million from the Canadian International Development Agency through the Canadian Red Cross.
The Federation is supporting the Niger Ministry of Health, which is coordinating the project with partners such as the Niger Red Cross, World Health Organisation (WHO), UNICEF and the Centre for Medical Research in Niamey.
View of Amina Adimou's tuareg settlement, Tchirozerine district of Agadez, Niger. (p13627)
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Amina Adimou's children with their mosquito net (p13626)
Amina Adimou, outside her tent, Tchirozerine district of Agadez, Niger. (p13628)
Inside Amina Adimou's tent, with her two children and their mosquito net. (p13629)
Mariama Sidi with her two children, Tchirozerine district of Agadez, Niger. (p13630)