In-depth: Food and nutrition crisis in Niger and the Western Sahel
CHAD: Stranded in the shallow end
FITINÉ, 23 June 2010 (IRIN) - Water levels in Lake Chad have been steadily dropping for decades, causing propellers to snag vegetation and sputter in the shallows, and making it harder for people who live on the islands to reach life-saving healthcare.
"If I cannot make it off the island on market day, there is little chance I could afford to rent a motorboat the rest of the week," said Moussa Ibrahim, 54, who farms on the island of Fitiné.
If he does not get a ride on boat in the vendor traffic to and from the island's weekly market he has to rent a private motorboat, which can cost more than US$150 per trip to the regional hospital in Bol.
Ibrahim was one of the 24 people diagnosed with HIV out of the 160 people tested on Fitiné - a 15-percent prevalence rate - in the island's first testing campaign
, according to regional health authorities. The national HIV infection rate is 3.3 percent, based on the most recent government survey in 2005.
Ibrahim paid $40 to go to the hospital in Bol for further testing, where he learned he needed antiretroviral (ARV) treatment. "I wish there was some way they would give me medication for longer than 28 days - I do not know when I will get enough money to come back to the mainland," he told IRIN.
The regional health director, Raoul Ngarhounoum, told IRIN he had instructed health workers to give long-term patients from the islands two to three months of medicine at the onset of the rainy season. "It takes time for the lake basin to fill up after the rains - it is not until November or December that it will become easier to get off the islands."
When the water level rises after the rainy season, what is usually a five-hour trip can take less than two, he said. "It is incredibly difficult now to reach the islands with any health campaigns, such as mass vaccinations. We move slowly, going by rowboat or foot sometimes."
The National AIDS Control Committee supports non-profit associations working in HIV education on or near the islands, but there is no money for patient transport, said Mahamat Taher Adoum, Chad's HIV focal point for the multi-country Lake Chad Basin Commission.
"If health workers from the regional hospital are having a harder time reaching islanders," then islanders were finding it even more difficult, and the situation could worsen if the rains were not good this year and the basin remained shallow, Adoum told IRIN.
A drought in 2009 killed one-third of Chad's cattle
and shrinking harvests have pushed two million people deeper into hunger