ABSTRACT
This chapter describes the overall context of healthcare in Niger and the place of the National Hospital of Niamey (NHN) and the emergency service in the Nigerien Health system based on five months of participant observation conducted at the emergency service of the NHN in 1999. It explores the daily functioning of the emergency service with its erratic rhythm and routine. The chapter focuses on two characteristics of the daily governance of the service. The first is the role played by users in the functioning of the service. The patient's attendant is a crucial component of the organisation and effectiveness of the emergency service. The second characteristic is the recurrent shortages of medicine and equipment. These shortages largely result from the strategies of medical staff and affect the quality of the service delivered. The chapter also explores how medical staff deals with official, social and practical norms, juggling with legality, medical ethics, informality, legitimacy and their own feelings.
