Since returning from Niger, I have shared photos and stories from the trip with many people. These encounters have helped me appreciate the importance of the mission while at the same time alerting me to questions in the minds of people unfamiliar with Niger and nomadic peoples.
The Project: I have had the good fortune to inherit an important, popular, and well-executed program in support of traditional birth attendants (“matrones”) among the Tuaregs and Wodaabes in the Ingall region of Niger. Over multiple missions since 2011, Dr. Robert Skankey developed excellent rapport with the matrones and tailored a program to meet their needs. The principal goal was to help the matrones acquire culturally and technologically appropriate skills to reduce maternal and infant mortality. Although the matrones lack formal education, they are clever and observant women who have learned from experience and each other. They were eager and quick learners for Dr. Bob in the past and continued to be during this mission. They are confident that their training with Dr. Bob and the supplies provided have made an enormous difference in the health of their mothers and babies. Their outcomes support that impression: since the inception of the matrone program, there have been no maternal deaths within the encampments.
The Questions: Few people recognize how austere conditions are for nomads – they live without permanent shelter, running water, electricity, toilets, or food security. Most people I speak with cannot understand how nomads could be happy and are puzzled that they don’t aspire to western life (they do not). Others question why I would travel so far to help people I don’t know and whose language I don’t speak. Why not work among the poor in my own country? Still others query why a civilization that has thrived for millennia needs any help at all. Is it possible that helping more mothers and babies survive might actually upset the delicate balance by preserving too many mouths to feed? Could what we volunteers offer as aid actually be an obstacle to the nomads?
My Position: I view the opportunity to survive childbirth as a human right. I believe preserving ancient tradition is a cultural and historic imperative. I am a world citizen with the good fortune to have the skills and economic means to assist my fellow citizens to our mutual benefit.
- Since 1948, the UN has supported special care in childbirth for women and children as a basic human right. I consider it both a privilege and duty to provide maternity care at home in the US to impoverished, wealthy, and middle-class women as well as in international settings. I am particularly drawn to communities in great need, where healthcare is scarce and small interventions can result in life-altering outcomes. Nowhere is this more apparent than in Niger, where for approximately $10 per birth, a matrone can be provided materials and medications that may save a laboring woman’s life and that of her newborn.
- The Berber people, which includes Tuaregs and Wodaabes, have lived in Africa for greater than 10,000 years. Their cultures have succeeded where countless others have failed and disappeared. To live among them is to glimpse ancient times. The modern world threatens their existence in many ways: e.g. changes in climate have brought both epic drought and flooding, resulting in the loss of herds and homes; infectious diseases, spread via wider contact with outside communities, threaten tribes and their animals; and regional political instability has resulted in the presence of refugees filling camps and attempting to cross the desert. The Foundation partners with nomads to protect the health of people, their animals, and to sustain their traditional lifestyle.
- Since 9/11, men and women of color wearing head coverings (scarves or turbans) within the US have often been treated with suspicion by Americans. A common cultural stereotype is that Muslims are terrorists. Likewise, in many Muslim cultures, Westerners are stereotyped as immoral, arrogant, and uncaring about those less well off than themselves. Working together challenges these stereotypes for all of us. Sharing my experiences paired with photos of Muslim men and women mitigates the negative American stereotypes. In parallel, the nomads were able to see us as genuinely caring people who share their values and sense of humor.
The Risk and the Future: An important principle guiding foundation work is sustainability: we strive to develop programs that the nomads themselves can continue without foundation support. Among the matrones, we have identified a few outstanding trainees whom we expect will become trainers. Whenever possible, we use locally available medications and materials. However, no medical project ever fails to require continued educational and material support.
While we were in Niger, the first ever kidnapping of an American in Niger took place. We knew it to be a dangerous destination prior to departure, but that event has increased its riskiness. The Nomad Foundation remains committed to working with nomads and has many representatives in Niger. However, it is my deepest hope that we can continue to work in person with these inspiring people.