Niger between two seasons of hunger
Around a hundred years ago, the father of Salouf Kina, 80, founded the small village of Gueza, three hours' drive east of Zinder, the former capital of Niger.
"He was taking his cows to a new grazing ground and decided to settle here with his family. There was plenty of greenery and water here at the time. I've always lived here, but this year  is the worst I've seen," he recalled with a faltering voice.
Today, Gueza, with 2,000 inhabitants, is a patchwork of mud huts built along sandy streets, where the odd tree provides some rare shade. In the surrounding area, a few scrubby fields of millet left over from the recent harvest give the hills an air of neglect.
Salouf Kina's son, Aboukar, has been one of the village wise men for more than 50 years. Aboukar, who is also a neighbourhood chief, tells of the terrible lean period that the inhabitants of Gueza experienced in 2010.
"At the end of 2009, the harvests were very bad and some families harvested nothing at all because of the drought,” he explained. “When people's stocks ran out and they could no longer borrow, they had to leave the village - young men at first, to go and work in Nigeria, then whole families.
“Between May and September, more than half of the village fled, leaving behind only women, young children and the elderly. We're a long way from everything and few people are interested in us. If MSF hadn't set up a feeding centre at the health centre, all of us would have left and the village might have died."
Gueza's Integrated Health Centre is one of the only concrete buildings in the village. It is the young Mamane Bashir, the centre manager, who greets us. During this period in late December, there were few consultations and MSF had packed up its out-patient nutrition education and rehabilitation centre for cases of severe malnutrition (CRENAS). It is hard to imagine that three months ago some 300 children were being treated by the MSF team here.
"The rains came very early this year and the malnutrition situation was exacerbated by malaria, which hit the weakest children,” explained Bashir. “Last August, we treated around 600 children, compared with just a hundred or so in August, 2009. This is also linked to MSF's presence, which ensured that the medicines and therapeutic foods didn't run out."
In Zinder and Magaria, the main towns in this region of Niger, at the end of December, there are still some 200 children in the beds of the CRENIs, the intensive hospitalisation centres set up by MSF for the most serious cases of malnutrition. However, these facilities - rows of beds under large tents - now seem relatively empty. At the height of the nutritional crisis, in August and September, more than 800 children were being treated there, the majority of them on the brink of death.
Kelima, 32, and a mother of four, took her youngest child, Djamilou, aged 15 months, to the Zinder CRENI in early December. He had lost a lot of weight. The MSF doctor diagnosed him with severe anaemia combined with malaria. After being immediately put on a drip and then fed therapeutic foods, he gradually gained weight. Two weeks later, he smiles and waves his hands when spoken to. "Soon we'll be able to go back to the village" explained Kelima, relieved. "But this year, it was really too difficult to feed the children; there were only a few handfuls of millet for the whole family...".
"Unfortunately, 2010 was the year that broke every record,” underlined Dr Moïse Moussa Gabrial, head of the Magaria CRENI. "Since January 2010, we've seen more than 6,200 children. At the end of August, we had around 500 hospitalised children. We had planned to recruit and train medical staff, but the situation was so bad that we had to hire people locally and train them on the job.
“At the height of the malnutrition crisis, 280 people were working for MSF at the CRENI. And tragically, we saw the deaths of many children - 133 in September alone - who had arrived in a desperate nutritional state and were often suffering from malaria".
However, 2010 was also the year of unprecedented mobilisation to fight famine in Niger. The government, born of a coup d'état at the beginning of the year, made food security one of its central causes and called upon international organisations to help. A number of organisations, including MSF, provided extensive support for care facilities and implemented large-scale prevention strategies, particularly based on appropriate food supplements, making it possible to limit the damage.
"We dare not imagine what would have happened if no one had rallied to help", explained Patrick Barbier, MSF's Head of Mission in Niger. "But what worries us today is that, despite some good harvests at the end of 2010, 2011 still risks being a very difficult year, in a context which remains one of extreme poverty, often combined with a lack of access to care.
“In nearly all the country's regions, families are heavily in debt and must now, after the harvest, pay back three or four measures of millet for every two borrowed. Added to which, many families’ livestock assets have been reduced from a whole herd at the start of the year to just a few goats and sheep. International organisations and aid agencies must remain extremely vigilant and prepare to intervene on a large scale again in 2011."
In Gueza, Salouf Kina's grandson and Aboukar's son has just turned 20 and already has the serious face of an old man. In a few days, he will set off for Nigeria to sell tea in the street to enable his family to survive in the village and keep the hope that a life there is still possible alive.