We need to act urgently about the health disaster in Nigeria’s Borno state

The health situation in Borno State in northeast Nigeria is critical. At least 500 000 people who are either displaced or cut off in enclaves outside state capital Maiduguri are in urgent need of food, medical care, drinking water and shelter.

“Aid agencies must deploy a massive relief operation to respond to this health disaster,” says Dr Isabelle Defourny, director of operations at Doctors Without Borders/Médecins Sans Frontières (MSF).

As the military regains control of the main towns and some villages in Borno State, the extent of the emergency is becoming all too apparent. Hundreds of thousands have been cut off from the outside world, some for as long as two years. The majority are displaced people who rely entirely on outside aid.

Recent assessments by United Nations agencies and the Nigerian authorities have shown that the situation is very serious. Teams from Borno State Emergency Management Agency, Red Cross and Unicef have distributed food and provided medical and nutritional treatment at several locations.

In June 2016, an MSF team observed extremely high levels of malnutrition and mortality in Bama, Borno State’s second largest town. Bama is now a ghost town accessible only under army escort. Its inhabitants, estimated at more than 10 000, live in a camp. While there is some food distribution and about 1 500 of the most vulnerable and sick have been evacuated by the authorities, mortality rates are significantly higher than the emergency threshold. About 15% of children are suffering from severe acute malnutrition [the deadliest form of malnutrition, a weight-for-height measurement of 70% or less below the median].

An MSF team has arrived in Bama to provide support with medical and nutritional treatment. Their objective is to rapidly reduce mortality and malnutrition among the displaced. The most critical cases will be transferred to Maiduguri. Equally urgent is improving access to water and hygiene conditions in the camp.

Monguno, a town of 150 000 inhabitants — 65 000 of whom are displaced — has been without medical assistance since January 2015. MSF plans to re-launch activities at the hospital and treat displaced and local children suffering from severe acute malnutrition.

“A massive aid effort is vital to provide assistance to people who are cut off or in remote areas,” says Defourny. “Everything suggests that the situation of people in other towns like Dikwa is just as critical, and that they also need food and medical care.”

MSF is conducting other exploratory missions when and where it can, as insecurity is a major issue. Bama and Dikwa and areas close to the frontline exposed to attacks by Boko Haram can only be reached under army escort.

Meanwhile, the displaced are continuing to seek refuge in Maiduguri. With such an influx, the town’s hospitals are overwhelmed and have been forced to turn patients away. Only recently, six children with measles who could not be admitted to hospital were sent back to the displaced persons camp where their families had just arrived. Increasing inpatient capacity in Maiduguri is therefore another of MSF’s priorities.

Since 2013 the region around Lake Chad has become an epicentre of violence and suffering linked to intensified attacks from the Islamic State West Africa Province, also known as Boko Haram. Over time, suicide bombings and raids by Boko Haram targeting civilians in villages and in cities around the Lake Chad basin have caused widespread trauma and uprooted more than 2.7 million people from their homes, with 2.2 million internally displaced people in Nigeria alone.

MSF has been working in Maiduguri since August 2014. In 2015, MSF provided more than 116 300 medical consultations, assisted with 1 330 deliveries and treated 6 000 undernourished children.

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