This weeks letter home : Médecins Sans Frontières Australia

Niger : Robin Sands in Maradi

Robin during his first mission in Liberia

Robin Sands is an Australian logistician from Eltham, Victoria, currently responsible for food supply of Médecins Sans Frontières (MSF) nutritional programs in Maradi, southern Niger. This is Robin’s second mission with MSF and in the following interview he describes the technical aspects of delivering food and some of the personal challenges and rewards of being involved in such an operation.

For more information regarding the status of the overall program please read the interview with Dr Isabelle Defourney

Could you walk us through the food supply system, how do you get it and how do you distribute it?
So we have the 11 ambulatory nutritional sites which provide a remote service for food where people come in once a week. Under the old system people stayed for a certain time under total care of MSF. But under the new system, those that have no medical problems [aside from being malnourished] come in regularly, collect their food for their malnourished children and can then go and live in their homes and happily feed their children. Most people prefer it that way.

So I supply food to 11 different sites which are spread around the two different counties of Madarounfa and Guidan Roumdji, a travelling distance of no more than 45 to 60 minutes from Maradi. In each site we have a store where we do a continuous supply of food to people who come in.

What is actually in the food and protection rations?
The main form of food distribution is for the children who are malnourished and for that we have Plumpynut which is produced by Nutriset, and is a hybrid peanut paste vitamin supplement. That is supplied with two sachets a day per child, so each week and for each child the mother gets 14 sachets of Plumpynut.

When the sickest children first arrive they receive blankets; a mat and a mosquito net to help maintain their health while they are staying in the hospital. This also aids them because they can stay in the hospital for about four weeks – they follow through the program and if the child is well and there are no complications and they can leave the program, we provide them with what we call a discharge ration which is 15 kilograms of ‘mil’ [millet], which is the local grain, 25 kilograms of Unimix, which is a standard vitamin supplement grain and then we supply them with their last ration of Plumpynut, another 14 sachets, some soap and 5 litres of oil.

How do you source the food?
The millet is a local grain so we source that locally here and for the others we source through MSF logistics and we can also source it in collaboration with groups such as the World Food Program and UNICEF - we can get supplies from them locally because they already have it here, and to save shipping it all in we can have an agreement with them and they can also help us with the supply because its such a large amount of food – it’s a lot to ship in and if we can use other sources to get food to help the population then that’s also great.

So far this year MSF has treated 45-48,000 children for malnutrition in Maradi region, what does this mean in terms of quantities of food?
We have a lot of stock in at the moment. We currently have in store about 180 tonnes of Unimix without sugar added, and we’re about to get 750 tonnes of rice, 112 tonnes of vegetables, 13 tonnes of sugar, 55 tonnes of oil and that’s actually only for a period of a month, so we will continue getting a delivery particularly during this peak period of malnutrition. We have nine stores and we have about 1,000 tonnes of food in stock, including 9,000 cartons of Plumpynut in stock [150 sachets per carton so that’s 1,350,000 sachets]. We’ve got about 150 tonnes of oil in stock, so these are the sort of quantities we’re talking about to feed a lot of people.

In your view, what do you think of the efficacy and value of MSF broadening its program and doing this sort of wider distribution?
I’ve been here for a short time, only for about three months but my impression of the country and the sort of problems they have even though this year looks like it’s not going to be as bad, but we still have a lot of people in with problems.

It’s a country that’s really living on the edge of its abilities, its like a desert and by chance it happens to rain once a year, if that rain is very patchy and it rains in spots – at the moment we’ve got some places that are really green and some places that have got nothing….the people live from year to year, they grow the grain, they store the grain, and that’s all they have for the year so if they don’t get any grain then they have nothing…and they have very large families and the ground is not fertile - its like a sandy desert I sometimes wonder how they get things to grow here.

It is really living on the edge of a liveable area where we’re trying to support a lot of people living in a very simple subsistence way so if there’s any change in the weather conditions it has a dramatic affect on the food supply. Therefore for MSF being here you can see why they have emergencies and why we’re here for emergencies - there are times when the rains don’t come and they have no way of feeding themselves so even though I know MSF has been and its slowed down its work here and then come back again, its because the emergency comes and goes – there doesn’t seem to be any likelihood of any change in the future, so our presence is probably going to be required for some time I imagine, unless there’s some other form of food supply, or another way of changing the food supply in order to help the people, it’s going to be a difficult time ahead for the rest of this year.

What’s your impression of the local population or local staff’s view of what’s happening in their country?
Yes when talking to the local staff they are just dealing with the day to day problems…but while you’re working them you ask them about their thoughts on what the problems are and what the future holds. They understand the difficulties and they know why there’s a problem but the solution is another thing. But yes they do understand especially those working with MSF - they’re very aware of what’s going on because they see it everyday, but if you don’t see it you don’t really realise what the problems…they see it everyday and they have a better understanding than most people of what’s going on and the difficulties.

How did you become involved with MSF?
I decided it was time for a change, something I’d wanted to do for a long time and an opportunity came in my life when I was able to have the freedom to go and do something like this to help others. I’ve known about MSF for a long time.

What has been the major highlight of working with MSF?
The highlight for me has been that I have been able to directly help others, that’s a highlight, since my original career was involved in engineering so it’s less involved with people, here I can actually go out in the field and help people directly and that’s a really wonderful thing for me to be able to do.

So a highlight would be to able to help sick people which as a non medical person you are not normally able to do, but this way I can actually help sick people by building clinics, providing food, or providing water and sanitation and help them in many different ways with their health.

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