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Sustainability or Dependence?

In International Development, Niger, Public Health, Sustainable Development on October 21, 2008 at 4:55 pm

I’ve been following this for the last couple of weeks – Doctors Without Borders (known also by their French acronym, MSF) have been asked by the government of Niger to suspend their activities.

This is an interesting case study. MSF has provided tons and tons of medical coverage in Niger and has saved probably thousands of Nigerien childrens’ lives. Their work there has been an excellent opportunity to perfect the “Plumpy Nut” nutritional supplement as well.

But to a certain extent, I can see where the Niger government is coming from. It seems to me that President Tandja and his subordinates are a proud bunch – imagine if your country became the posterboard for famine and malnourished children. You too would be sensitive to NGO’s taking advantage of the situation to exaggerate their effectiveness or the need for their services in order to enrich themselves.

So, is this a case of MSF using Niger as a platform, overstaying their welcome?

The hard part is that it’s not like their services are not sorely needed in Niger; infant mortality is chronically high in Niger. A good year for Niger still includes 25% of children dying before their 5th birthday and life expectancy in the upper 40’s.

Perhaps if MSF reconfigured their interventions to include extensive training of local medical services, rather than flying in international staff – they could contract the locals more. I don’t personally know MSF’s practices – perhaps they are using locals more.

Help Niger help itself, basically. I think that’s all the Government of Niger wants, instead of a handout.

  1. Re local services: MSF has had to lay off 350 local workers as a result of the ban. Do you have the sense the Niger government can pick up the slack–once MSF and Action Contre Le Faim (also now banned) leave? Or is this a case, similar to what happened with HIV/AIDS in South Africa, of denying a problem that would put a huge strain on limited resources to deal with?

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  2. Thanks for your comment! I haven’t lived in Niger since 2001, so I don’t have a sense of how it is right now. I can’t imagine they would be able to meet the needs of their population (with developed-world standards of quality) without the added NGO intervention. I think that could be a good comparison with South Africa, however in this case it doesn’t seem like the Nigerien Government is denying the conventional causes and effects of their poverty. They know their situation. Tandja, the president, has been a Prefet (governor) of three different states in Niger; it’s not like he’s ignorant of the situation. I think this is more of a case of MSF not keeping the GON in the loop or behaving deferentially enough with the government. I honestly don’t know about the Action Contre Le Faim situation, so I can’t comment on that. Now that you mention it, this could also be tied to lingering anti-colonial attitudes, as Action and MSF are both French. Perhaps?

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