Epilepsy is a major public health problem for Niger and there are many obstacles to the well-being of people with the disease. The population is poorly informed about epilepsy and there are strong negative attitudes to both the condition and those who have it. There is also a lack of trained staff, inadequate facilities, and no epilepsy policies.

Fear, lack of sympathy, stigma, and social discrimination, push the people with epilepsy to be ‘hidden in the shadows’. In Niger epilepsy is associated with weakness, possession by a bad spirit, and to a belief that epilepsy is contagious. Children have difficulties with schooling because of rejection by their classmates and even by some teachers. Deaths from epilepsy do occur in Niger although it is difficult to know the extent of the problem. Following WHO advice, a National League Against Epilepsy has been created in Niger. The League works in partnership with other Niger health organisations and is coordinating a pilot project for travelling medical visits to fight epilepsy.

Travelling medical teams visit communities, sending word ahead using town criers. The teams include a psychiatrist, a neurologist, a psychologist, a nurse, and a welfare officer. The team provides public information about epilepsy, the effect of the condition on life, the risks of injury and death, crisis management, treatment, diagnosis and treatment of newly presenting cases and cases identified earlier by local health workers, training of doctors, nurses and social workers from the intervention area, phenobarbitone medication, and treatment guidelines for the local community. The results have been so good that the league hopes to generalise this experience to a wider area with the assistance of international organisations and funding bodies.

D. Douma Maiga, Psychiatre assistant: Centre
psychothérapeutique “les oliviers” Route de Noisy, France
President, National League Against Epilepsy of Niger

A. Alzouma, Psychologue at National Hospital of Niamey-Niger General Secretary, National League Against Epilepsy of Niger.

Reprinted with the permission of Epilepsy Australia-the national coalition of Australia epilepsy associations and Epilepsy Bereaved UK.