After receiving help from Samaritan's Purse, community members in Ayorou are taking their health into their own hands to stop the spread of cholera
by Brittany Breedlove, program development officer in the Samaritan’s Purse Niger office
Cholera causes a constant threat to the lives and health of the people of Niger. According to a United Nations report, Niger has been in an endemic/epidemic state since 1971 with 9,284 cases of cholera and 2,333 deaths.
The region of Tillabery, and especially the department of Ayourou located along the Niger River, is consistently the worst affected area in Niger. A report by OCHA states that this year alone there have been 475 cases of cholera and 11 deaths in the region as of mid-September.
In response, Samaritan’s Purse launched an emergency cholera response in Ayorou. Our strategy is largely based on prevention awareness through community relays coupled with the distribution of water filtration kits. The relays are community members that have been selected, trained, and equipped by Samaritan’s Purse to educate their neighbors on cholera prevention.
PUR packets make contaminated water drinkable. Marie and her family are using it, and it is improving their health.
During a recent trip to Ayorou, I was able to visit some of the community relays and project beneficiaries.
There have been no cases of cholera reported in Ayorou since mid-August due to the work of several entities and partners including Samaritan’s Purse. However, the lingering question remains. What can we do to prevent a cholera outbreak next year and in following years?
As with most humanitarian projects, a sustainable impact is dependent on change in behavior, which is difficult and slow to come by in an African context. Bonkano, one of the community relays, revealed that one of the most difficult challenges to behavior change concerning cholera prevention in Ayorou is the beneficiaries’ attitudes.
“People do not understand that what they are doing (such as sweeping the streets to get rid of rubbish and filth) is for their own benefit,” she said. “They still think that they are doing it for an organization or for a person who will reward them in the future.”
This common attitude in Niger makes it very hard for beneficiaries to continue program activities independently after the conclusion of a project. They are always waiting for something in return. If they do not receive it, they quit the activity.
A Change from Within the Community
Bankano and other community relays have started making changes in the lives of their families to stop the spread of disease.
Yet, despite the accuracy of Bonkano’s observation, I was pleasantly surprised by the initiative that certain beneficiaries have already taken to make changes on their own.
With the second year of Samaritan’s Purse cholera project and increasing awareness, people are starting to realize that they have the power to reverse the negative trend of cholera in Ayorou. Year after year, Ayorou has been the worst affected area by cholera. Community members are starting to feel shame in having this reputation and have voiced their desire for change.
In visiting Ayorou, I saw tangible glimpses of this change. For example, Samaritan’s Purse distributed water treatment kits containing PUR sachets for water treatment. The dirty and turbid water from the Niger River is the main source of water for inhabitants of Ayorou. They can use the water treatment packets to purify the river water for drinking.
According to past trends and attitudes, once the packets that were distributed were finished, beneficiaries would go back to drinking the untreated river water. They were willing to treat the water while being given supplies but not yet ready to make their own investment in the activity. However, this year several different women have told me that they have been purchasing Aquatab tablets with their own money to supplement the sachets that were distributed. (Aquatab is another form of water treatment that is available locally.) Their willingness to contribute their own money shows that they now see the value in treating the water before drinking.
Additionally, when I visited the household of Marie Sadou, another community relay, I was intrigued to learn that her family had found their own solutions for keeping their latrine clean.
Samaritan’s Purse has provided several latrines for households in the Ayorou area, and some of these households have complained that with recent heavy rains they are starting to smell and contain worms. Most of these households are looking to Samaritan’s Purse to do something about the problem. Marie and her family decided to take the issue into their own hands. Marie’s older brother had the idea of starting a fire in the latrine pits with stalks and gasoline to kill the worms and then using ashes to absorb the odor. Once neighbors saw that this method worked, they came to Marie asking for advice and help with their own latrines.
The majority of the neighborhoods and islands that Samaritan’s Purse has worked in this year have reported much fewer cases of cholera. Last year there were five cases of cholera reported in Marie’s neighborhood. This year, there were none.
Bonkano demonstrates proper hand washing to help stop the spread of cholera.
“I think that the main reason why we did not have any cases of cholera this year is because people have started to understand what we are teaching them,” Marie said.
Change is coming for the communities of Ayorou. It may take several more years, but I have faith that it is on its way and one day the people of Ayorou will be cholera free.
The question that sticks with me, however, is what more can we do to help make this change possible?
Increasing awareness and providing materials and resources is good and necessary and can save lives in the short-term. However, it still takes a long time to change attitudes and behavior. People are grounded in their traditions and beliefs and are hard to convince to try something new. My hope is that over time, community members will adopt the practices that are being taught and implement them on their own initiative simply because they know it is what is best for their family and community.
But, what does it take to make that happen?
One thing that I realized is that a change of heart is truly needed to see a change in lifestyles, attitudes, and behaviors. The heart-changing power of Jesus is the ultimate solution for creating a lasting impact in the people of Ayorou. Only He can open their eyes to the truth and compel them to live out their lives in a way that is glorifying to God. In return He will bless them for their faithfulness and give them the wisdom and desire needed to love and properly care for their families.
“And when they come there, they will remove from it all its detestable things and all its abominations. And I will give them one heart, and a new spirit I will put within them. I will remove the heart of stone from their flesh and give them a heart of flesh, that they may walk in my statutes and keep my rules and obey them. And they shall be my people, and I will be their God” (Ezekiel 11:18-20, ESV).
Please pray together with us for the people of Ayorou.
