An extremely critical health situation is unfolding in northeast Nigeria
With an estimated population of 190.6 million, Nigeria is the most populous country in Africa and the seventh most populous country in the world.
Nigeria also has one of the fastest growing economies in the world. Petroleum and oil resources play a large role in the Nigerian economy. However, the security situation deteriorated in many areas of Nigeria in 2014.
Violence and displacement took their toll on people’s health and reduced their access to medical services.
Médecins Sans Frontières/Doctors Without Borders (MSF) first worked in Nigeria in 1971. Our response to the Biafra conflict and ensuing famine was, in fact, the first official MSF mission after our founding.
For further updates on our work in Nigeria, follow @MSF_WestAfrica on Twitter.
Since May 2013, a violent insurrection by the Islamist militant group Boko Haram has forced hundreds of thousands of people to flee their homes in northeast Nigeria. As such, a humanitarian crisis is raging in the Lake Chad region.
The Nigerian Army has regained control of the main towns and villages in Borno State and the scale of this disaster is now all apparent: the health situation is critical.
“People are gathered, isolated and cut off in a half-destroyed town, and are totally dependent on external assistance, which is cruelly lacking. If we don’t manage quickly to provide them with food, water and urgent medical supplies, malnutrition and disease will continue to wreak havoc.”
Whether in the capital of the state, Maïduguri, or in hard-to-reach areas, hundreds of thousands of people are in urgent need of food and medical care, despite the efforts made to increase aid.
Even in easily accessible areas, when our teams ask what people need the answer is always the same: “We need more food.”
More than 40 percent of health facilities in Borno were destroyed in the conflict between the Nigerian Army and Boko Haram. MSF is trying to expand its medical and malnutrition activities in several areas of Borno State, overcoming the limitations linked to insecurity.
Displaced camp bombing
At least 120 people were wounded and 52 killed following a bombing in an internally displaced person’s camp in Rann, Nigeria, on 17 January 2017. The bombing was carried out by the Nigerian Army.
“This large-scale attack on vulnerable people who have already fled from extreme violence is shocking and unacceptable,” says Dr Jean-Clément Cabrol, MSF Director of Operations.
MSF’s work in Nigeria: 2016
An estimated 1.8 million* people across northeastern Nigeria have been displaced due to the conflict between Boko Haram and the Nigerian army (which began in 2009).
In 2016, the fighting resulted in a catastrophic humanitarian emergency in several areas of Borno state. This resulted in high mortality rates linked to severe malnutrition and preventable diseases. Although security within Maiduguri (the state capital) improved slightly – allowing for an increase in aid – active conflict, mass displacement and disease outbreaks continued outside the city.
*Source: International Organization for Migration’s Displacement Tracking Matrix, 15 December 2016.
vital medical assistance in Borno state
From July 2016, MSF scaled up emergency assistance in Borno state to reduce the high risk of death and disease amongst communities living in catastrophic conditions. We had been here since mid-2014.
Insecurity restricted our presence significantly – in some of the hardest hit villages, our teams could only carry out short visits with rapid interventions. This included:
- Distributing food, therapeutic nutritional products and relief items.
- Running mass vaccination campaigns against measles.
- Sesonal malaria chemoprophylaxis (SMC).
- Medical consultations.
- Water and sanitation activities.
We also scaled up our activities in displaced persons camps in Maidaguri and 10 nearby towns. We ran fixed clinics in Maidugri, Mongonu, Damboa, Benisheik, Gwoza and Pulka. Additionally, we deployed regular mobile clinics to the hard-to-reach towns of Bama, Dikwa, Banki, Ngala and Gambaru.
Over the course of the year, we:
- Admitted 20,760 children to therapeutic feeding centres.
- Carried out 290,222 outpatient consultations and 2,764 emergency consultations – from this, 3,071 patients were admitted for treatment.
- Conducted over 56,000 antenatal care consultations.
- Assisted with 5,181 deliveries.
- Delivered over 1,099 tons of food to displaced people and families with malnourished children.
- Vaccinated approximately 130,000 children against measles.
- Vaccinated 10,052 children against pneumoccocal pneumonia.
- Treated 18,754 children with seasonal malaria chemoprophylaxis (SMC).
- Set up latrines, taps, and provided petrol to power water pumps to improve hygiene in the camps.
Maternal and child healthcare
In Yobe state, we:
- Offered reproductive and obstetric care, routine vaccinations, emergency assistance, and ran a 24-hour observation room at the Kukareta village health centre.
- Complicated cases were referred to Damaturu hospital (in the state capital).
- Operated a nutrition programme for children under five at Damaturu hospital.
- Treated 3,717 children with SMC across Kukareta and five other villages.
In Jakusko LGA (in the western part of the state), we:
- Responded to a measles outbreak – treating over 2,500 children and vaccinating 143,800 more between the ages of six months and 15 years.
- Worked in four therapeutic feeeding centres in the area, referring complicated cases to the MSF-supported stabilisation centre in Jakusko general hospital.
In Zamfara state, we:
- Worked in five outreach clinics in Abare, Bagega, Dareta, Yargalma and Sumke – providing care for children under five.
- Worked in the paediatric inpatient department at Anka general hospital.
- Carried out a total of 4,303 consultations.
In the Kebbe local government area of Sokoto state, we:
- Supported the Kuchi primary healthcare centre to treat pregnant women and children under five – this project was closed in May 2016 due to insecurity.
- Conducted 5,868 outpatient consultations, including screenings for malnutrition.
- Admitted 179 children to the inpatient feeding centre.
- Carried out antenatal and maternity consultations/admissions for pregnant women.
Responding to lead poisoning in Niger state
Following an outbreak of lead poisoning in Niger state, we:
- Initiated an remediation phase.
- Began screening and treatment activities in August.
- Opened the Safer Mining pilot project in November – working with miners to reduce exposure to lead and off-site contamination in the communities following remeditation.
- Screened 218 people and enrolled 168 for treatment and follow-up.
- Treated and discharged 160 patients since the start of the programme.
Reconstructive surgery for children
Our project in Sokoto continued to support specialised surgical care for patients with conditions such as noma, involving a team of international specialists.
A total of 388 patients underwent surgery – 121 of them for noma (a gangrenous infection of the mouth and face).
Sexual and reproductive healthcare
In Port Harcourt (Rivers state), our teams delivered a sexual and gender-based violence (SGBV) awareness campaign – reaching schools, health clinics, police stations and the media. As a result, attendace at our programme for SGBV survivors increased doubled from 35 to 70 people.
The comprehensive healthcare package we provide includes:
- Prophylaxis for HIV and other sexually-transmitted infections.
- Vaccinations for tetanus and hepatitis B.
- Emergency contraception.
- Counselling and psychosocial support for survivors of rape and sexual abuse.
In Jahun general hospital (Jigawa state), we continued to run out vesico-vaginal fistula and emergency obstetric programme.
This year, we:
- Admitted 10,531 women to the maternity unit – 70 percent had complicated pregnancies and deliveries.
- Performed 2,660 obstetrics-related surgical procedures.
- Treated 400 women with fistulas.
- Assisted 7,365 births.
- Admitted 1,293 babies and 1,141 women for intensive care.
- Donated 8,228 units of blood.
In September, we set up basic emergency obstetric services in Aujara and Miga health centres to bring antenatal and obstetric care closer to patients and avoid pregnancy complications.
Responding to emergencies
MSF’s Nigeria Emergency Response Unit operates in the northern states of Sokoto, Kebbi, Zamfara and Niger.
In Sokoto (in collaboration with the Ministry of Health and the World Health Organization), our team responded to a meningitis outbreak. We treated 203 patients and vaccinated 113,030 – an administrative coverage of 90 percent.
We also supported a measles intervention, treating 9,983 patients.
Find out more in our International Activity Report