One of the most satisfying aspects of our missions is to observe nomadic women helping one another achieve better health and safer pregnancies. Each year their achievements grow along with their confidence and knowledge. In addition, it is always an enormous pleasure to reconnect with our nomad friends and colleagues despite the limitations in direct communication. Our work is hard and made even more difficult by the austere conditions – no running water or electricity and the blistering heat. The enthusiasm of the women we train and the raw need of communities requesting training keep us going. However, our long-term goal is for the nomads to continue these programs without us. I am pleased to report that this year we are taking even bigger steps towards that important goal.
Projects are the building blocks of development. Successful projects engage the target population in every step of the process – from goal-setting to implementation and finally, to handover. The ultimate goal for any development project is for it to be sustained by its beneficiaries.
Niger is one of the least developed countries in the world with vast needs. Aid that creates debt or fosters dependency is no real help. Nomad Foundation projects are sensitive to this issue and focus on schools and skills-training. When disaster has struck, relief has been provided; but the foundation’s main mission is to support the sustainability of nomadic life.
Medical projects can be tricky to hand over in that they require trained personnel and specialized supplies. Several years ago, we had planned for our RN to take over training at the methadone clinic. Last year we initiated teacher training among the nomads with the thought that establishing trainers within the community would enhance continuity. This year we discussed the reality of taking on training about the use of drugs and understanding overuse of them with two teams – one each for the two regions in which we have been working.
Multiple communities in both the Ingall and Iferouane regions have requested training. Our plan is to expand to those communities with our local trainers. They will make use of the pictorial manuals we developed and introduced last year and provide limited starter supplies. The long-term goal is for matrones to charge for their services so they can replenish their own supplies. These are critical steps towards sustainability. Our next mission will be focused less on individual training and re-supplying and more on evaluating the success of training (collecting data and administering oral exams) and the local supply chain. There will be problems! But we must start somewhere.
Handing over the Tamesna Clinic presents a different challenge. The clinic is staffed a Nigerien RN and nomads make donations for their treatment. A committee of local nomads oversees the clinic’s operation with the RN serving as the committee’s secretary (since she is the only member who can read and write). Medications can be purchased locally but we also bring a large supply of donations from Direct Relief, The Medicine Shoppe of Ojai, CA and Esterbrook Pharmacy, Reading, PA. (A very big thanks to all three!) In contrast to locally purchased drugs, the American medications are of known strength and purity. Nomads believe they are superior and most likely they are. While the clinic can operate without these medications, it is much better because of them. That is an obvious hurdle to complete handover of the clinic to the nomads and one that is not likely to come down for a long time.
Our mission was a huge success by so many metrics: from simple logistics such as flight connections made and bags safely handled to the inspiring statistic of no maternal deaths within the encampments. We are now at an important point where expansion, handover, and sustainability are more than a dream. Many thanks to our generous donors, Ventura Global Health Project, our steadfast and hardworking midwife Pat Manzon, and this year, to our interpreter Alissa Everett for making this mission an enormous success. (I have not eaten a single potato since departing Niger.)