Mariam Mohammed, a widow, stands in front of her house in Bama, Nigeria. She holds the favorite clothes of her younger son Babagana. He died in early February from the complications of the sickle cell anemia. She had taken him to a clinic funded by the United States for treatment, but at that time, the establishment was closed due to a stop prescription issued by the Trump administration.
Lawrence Abah
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Lawrence Abah
In the testimony to the Chamber’s Foreign Affairs Committee on May 21, Secretary of State Marco Rubio said: “No one died because of USAID (Cuts)” – the threshold of billions of dollars in the United States for world health programs.
During a subsequent hearing in the congress, he said: “No child dies on my watch.”
Mariam Mohammed begs to postpone.
The widowed mother of two children says that her younger son – Babagana Bukar Mohammed, 7, died due to the disturbances of the American foreign aid.
Mohammed had lived with his two wires in a single piece of concrete blocks without running water. She says Babagana was a cheerful boy who liked to cycle in the neighborhood and at school. Their house is in the city of Bama in the northeast corner of Nigeria which has, in the past, been terrorized by Boko Haram, the militant Islamist group.
Babagana has a sickle cell and, in the middle of the night on February 2, Mohammed noticed that his son had a fever. In the morning, she precipitated it in a keke – a tricycle taxi common in Nigeria – at the local clinic at a little more than a mile where Babagana had received care in the past.
When she arrived, the security guard told her that the clinic had been closed.
The clinic was funded by USAID or the American agency for international development and was the most popular medical establishment in the region, seeing up to 400 patients per day. But, a little more than a week before the arrival of Babagana, the Trump administration sent a work prescription to the clinic – part of a massive break in foreign aid while US officials have examined the contracts and programs to determine if they should continue.
More than 80% of foreign aid contracts have been canceled But the Babagana clinic was authorized to resume operations on April 14, once the exam was completed and which funding restarted.
But it was more than two months after Mohammed’s visit this February morning. She remembers standing outside the closed clinic with Babagana. “I was shocked and I got angry,” she told NPR by phone on May 23. She spoke in Kanuri, a local language in Nigeria. “Immediately, I prayed for God to intervene.”
That night, Babagana died.
Mohammed said that Babagana’s care at the United States was free and had no money to take it to the local government clinic, which has medical care.
The doctor of Babagana at the clinic – Edifre Jacob – says he will never know exactly what happened to the young person because he did not get medical aid before dying, but Jacob feels confident that his team could have prevented his death.
“We are sure we would have done something to save the patient,” said Jacob. “We have the ease of managing these patients, and we have results – positive results – patients that we manage with sickle cell disease (disease).”
Drépanocytosis is a condition where a person’s red blood cells are distorted, making them break down faster than normal and potentially obstruct blood vessels. The condition is associated with a long list of dangerous complications, but fast medical care can make a big difference.
Even in places with many more medical resources, rapid medical care for sickle cell patients are essential. “We recommend that if a child has a fever, he is seen as soon as possible, and often within the hour,” said Dr. Natasha ArcherDirector of the Drépanocytose program at Boston Children’s Hospital.
She says there are several serious conditions that Babagana could have had. One is sepsis – a potentially fatal infection that can cause a fever. People with sickle cell anemia are vulnerable because their rats do not clean blood as well as in a healthy person. With quick access to antibiotics, sepsis can be healed, says Archer.
NPR asked the State Department to comment on the death of Babagana and the testimony of the Rubio Congress. They did not respond in time to respect our date of publication. We will update this article with their comments if they answer.
What is the number of deaths?
During the hearings where Rubio spoke, legislators underlined other individual death stories that they attributed to the aid cuts. The representative Brad Sherman (D-Calif.) Pe kha lau in Myanmar could not obtain oxygen in a local hospital after the help cuts and that Evan AnzooA 5 -year -old child in South Sudan could not obtain HIV medication previously funded by the USAID.
Senator Jeff Merkley (D-ear.) Went further, citing the work of a team from the University of Boston which aims to estimate the total human cost of the cuts to help by modeling. These estimates represent a crucial tool to understand the possible implications of political actions.
“Mortality monitoring in low and intermediate income countries is difficult, the systems are not as robust as we have done in the United States,” said Brooke NicholsAn infectious disease modeler who managed the team. Many health systems that could have collected this data were funded by the same programs that have been reduced, she said.
Nichols and his team started working in the days following the freezing of the Trump administration of Usaid to project the potential impact on human life. They started with the hypothesis that all USAID programs have been reduced, based on data accessible to the public at the time. Then, they took into account what the researchers know what is happening when people and children living, tuberculosis, malaria and other diseases cease to receive treatment.
All in all, the researchers believe that More than 96,000 adults and 200,000 infants and children have already died because of the cuts, which started on January 24.
“It is really important that they do this,” said Dr. Chris BeyrerDirector of the Duke Global Health Institute. “In general, their hypotheses are quite reasonable.”
However, Nichols is the first to recognize that these are very approximate estimates.
“The error bars are enormous, because we do not know which shortcomings are filled and by whom”, explains Nichols. National governments could intervene to compensate for the brutal withdrawal of American aid, or non -governmental organizations on the ground may find other sources of funding. Or certain clinics could still operate with volunteers or funding from other sources.
Their estimates do not represent certain deaths, such as those of Babagana, who are probably died of causes that they did not understand in their analyzes. Even with all this uncertainty, Nichols resists his estimates. “We can discuss the details and the size of the error bars, but we are not talking about dozens of (dying) people,” she said. “We are talking about tens of thousands of people.”
Rubio is disdainful of their modeling. “It’s false, it’s false,” said the Secretary of State about the figures cited by Merkley during the hearing. He underlined the fact that these estimates are based on a total cessation of funding, when he said that 85% of people rely on the PEPFAR – the US President’s emergency plan for AIDS which was funding the HIV clinics – still received care.
Rubio did not provide additional information on the source of the number of 85%. The State Department did not respond to several clarification requests.
It “seems impossible to me” that 85% of recipients always get care, says John StoverVice-president of the future Health, a global health consulting company. “USAID has been dismantled, and most of this money (PEPFAR) crossed USAID, so there is no mechanism for this money to reach the programs that need them,” he said, and much fewer people to implement these programs.
Nichols said that she would fortunately update the death model estimated with more information on still operational programs. “If there are executing programs, provide a list, we can update it.”
The wish of a mother
Mariam Mohammed and her surviving son, Umar. Like her deceased brother, Umar has a sickle cell disease and she is concerned about her health.
Edifre Jacob
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Edifre Jacob
Mariam Mohammed says she now lives in the fear of losing her eldest son – Umar, 9 years old – who also suffers from a sickle cell anemia. She says she is relieved that the clinic’s hospital has reopened, but the previous shutdown order underlines the fragility of the system for her.
She says her only wish is that USAID programs are allowed to continue.
Umar simply says that he is missing to play with his little brother.
