The cries of children fill the intensive care unit of the Médecins Sans Frontières / Doctors Without Borders (MSF) Nilefa Kiji nutrition facility in Maiduguri, Borno state, Nigeria. Nurses move from bed to bed checking vital signs, dispensing therapeutic milk, and reassuring anxious parents. Every child here is fighting severe acute malnutrition, a condition that continues to claim young lives across northern Nigeria.
Since malnutrition weakens immunity, some children also arrive with other diseases, such as measles, diphtheria, and malaria. Treatment can last from one week to a month. Throughout that time, caregivers remain at the hospital, often far from home and burdened with worries of how their families are coping.
The stories of caregivers – often mothers of the children – rarely get told. Yet their emotional wellbeing is tested by weeks of anxiety from their child’s condition, uncertainty, separation from their families, and the fear of losing a child.
Fatima Ibrahim’s 23-month-old daughter, Aisha, was admitted to the Nilefa Kiji nutrition facility in Maiduguri after battling meningitis and repeated convulsions. The three weeks spent in hospital were filled with conflicting emotions. While grateful to see her daughter improve, Fatima could not stop thinking about the eight children she had left at home.
“I am so worried about my children. Yesterday my older daughter had fever, and her father did not have money for medication. Yesterday, I cried and had no appetite.”
Stories like Fatima’s reveal an often-overlooked consequence of malnutrition. While medical statistics capture admissions and recovery rates, they cannot measure the emotional burden people carry while trying to support their sick children.
To address these challenges, MSF integrates mental health and psychosocial support into the malnutrition programmes in Nilefa Kiji. Caregivers receive psychological first aid on arrival, followed by individual counselling and group sessions where they can share experiences, express their fears, and learn coping strategies. Children also participate in structured play activities that help restore a sense of normalcy during recovery.
Latifat Abdulkareem arrived at the nutrition facility with her seven-month-old daughter, Aisha. “My daughter started having headache, fever and a cough, and started vomiting. I felt terrible. For days I couldn’t sleep. I even thought my daughter would not make it. When I brought her here, the nurses calmed me down. The counsellors come to play with my daughter, and we also have group sessions. The counsellors are very kind.”
Seeing the immense stress that caregivers experience every day, we try to support with care beyond counselling. When caregivers become distressed after losing contact with relatives, our counsellors help them reach family members by phone. In some cases, supervised home visits are arranged so caregivers can briefly check on their families before returning to complete their child's treatment.
Another mother, Halima Mohammed, experienced a different kind of strain after spending 45 days moving between hospitals with two sick children.
“I was having good sleep before my children fell ill,” she says. “Now I barely sleep. For the past two days, I have not been feeling well myself. I pleaded for my daughter’s discharge, and I assured them that I was not running away; that my daughter is now better, but they advised against self-discharge as my daughter was not yet in a stable condition.”
Kethurah John, an MSF counsellor educator, says many caregivers gradually regain hope as they witness their children's recovery. Some even return after discharge simply to show how healthy their children have become.
"For us, those moments remind us that caring for the caregiver is also part of caring for the child,” she says.
Supporting caregivers is more than an act of compassion. Their emotional wellbeing influences their ability to remain engaged in treatment, follow medical advice, and provide the care their children need to recover.
As the fight against malnutrition continues, the needs of children and those who care for them cannot be separated. Healing is not only about restoring a child's weight. It is also about restoring hope and resilience to the person who sits at the bedside every day.
In 2025, MSF teams treated 425,634 children for acute malnutrition across northern Nigeria, a 41.8% increase compared to 2024.