In the early morning, the door of my apartment closes behind me for six months.
In front of me, through the cold winter air, lies the beginning of my first assignment with MSF, as a paediatrician in Magaria, in the south of Niger.
Since Switzerland is “the country of the clocks”, the train arrives on time, like most of the punctual trains, and takes me to Geneva, where two days of briefing prepare me for the assignment. Later, leaving the plane in Niamey, the capital of Niger, the day flickers in the heat.
Two flights are cancelled due to sandstorms, so we set off in the morning in a jeep to cross the country, through a yellow and red landscape full of sand, mud huts and women in colourful clothes, many with children on their backs.
Julia and the team in Magaria. Photo: MSF.
After a night in Maradi, we reach Magaria, a town with 100,000 inhabitants in the southern part of the country, right on the border with Nigeria. Still dazed by the trip, I am surprised by a warm welcome from my new colleagues. With an aperitif on our terrace we enjoy the cooler air of the evening.
The next morning, Patricia, the paediatrician who is my predecessor, shows me our workplace. At the public hospital, through a small gate you reach a large square with a few tents. At present about 160 beds are occupied, in the months of July / August the number can rise to 600 - this is the time when malnutrition coincides with a high rate of malaria - the so-called "peak".
The children weigh half as much as their peers back in Switzerland
Each tent has its own ward: one for newborns, four for the care of the under-nourished children with medical complications, one for minor surgery, one for pure paediatrics, two intensive care units in a large solid building. There's also an emergency tent set up for triage and initial supply. The Nigerien doctors greet me warmly and laugh as they see my big, impressed eyes: "That's nothing, you'll see in the peak everything is full here, all full of tents!"
At 7:30 am our everyday life begins. After the morning meeting, the team spreads out over the various tents and goes through the patients. The mothers, who stay patiently with their sick children in the tents, impress me every day. They often arrived here only after a long walk from more rural areas.
Many of the young patients are much better after four days
In the tents for malnourished children, the naked reality of poverty meets me: the children weigh half as much as their peers back in Switzerland. They seem apathetic, with thin hair and thin limbs. They lie in the mottled clothes of their mothers, while the big sister carries the youngest sibling on their backs. Others look at us through eyelids that are difficult to open due to water retention. On my first visit there, their gaze cuts me to the quick. But with their seemingly imperturbable joy of life, my Nigerien colleagues still make me smile.
In the following days, I was able to see the difference that regular meals and the simple treatment of the medical complications makes: many of the young patients are much better after four days. The edema - swelling typical in malnourished patients - disappear slowly, and under the antibiotic therapy the bacterial infections start to improve. Better hygiene helps against skin lesions.
At present, however, anything we can do is too late for about one child every day. But still, many can be helped: with simple but effective paediatrics.
Vive la pédiatrie!