“Their silence is deafening,” says Dr Kadri Koda, one of over 80 Nigerien health workers being trained in the management of severe and moderate under-nutrition of children in a joint initiative conducted by the UN Children’s Fund (UNICEF) and the Ministry of Public Health of Niger.”It’s only when they start to cry that we are happy because it means they are gaining strength. It’s very heart-wrenching, but it is also good to know that we can save so many lives using the latest techniques,” he adds. “In the intensive ward, there are severely under-nourished children also suffering from malaria, bloody diarrhoea, pneumonia and anaemia.”Dr. Kadri is learning about the identification, prevention and most up-to-date treatment of under-nutrition with hands-on training at the UNICEF-supported therapeutic feeding centre in Aguie, Maradi Region, epicentre of the crisis afflicting the world’s second most impoverished country following a drought and the worst invasion of crop-devouring locusts in 15 years.”On top of the practical and theoretical aspects, the training is very enriching because we have health workers from various regions of Niger with all types of experience,” he says. “Some are doctors, others nurses, some are midwives and others are health administrators.”We’re sharing our years of experience, while also learning the latest techniques and approaches to managing severe and moderate under-nutrition. It’s important for health workers in Niger to be updated with the latest information and that was really made clear at the therapeutic feeding centre today.”In total, over 80 Nigerien health workers will be trained in Maradi in just three weeks by a Ministry medical doctor and a UNICEF-Niger nutritionist.The training is not only essential in saving the lives of children in the midst of this emergency, but it also provides a sustainable, national approach to early identification and prevention of severe and moderate under-nutrition in children throughout the country, UNICEF says.Using the “training of trainers cascade approach,” key national health workers are trained to carry life-saving techniques back to their regions. This is one of the fastest ways to create sustainable, national health networks. All participants are national health staff, working for Government, national and international non-governmental organizations (NGOs) as doctors, paediatricians, nurses, health administrators or mid-wives.It is not known how many children have so far died in Niger’s present crisis but UN Emergency Relief Coordinator Jan Egeland says it is already into the thousands in what was a largely preventable disaster had the world paid attention when the alarm was first raised in November, before a neglected emergency turned into full-blown catastrophe.