In Borno State, in northeast Nigeria, nearly two million people are either displaced or cut off in enclaves outside the state capital of Maiduguri and are in urgent need of food, medical care, drinking water and shelter.

The conflict in north-eastern Nigeria has engulfed the region and millions of people have been uprooted. Farmers can’t work their land, trade routes have shut down and markets emptied.

Dr Laura Heavey is treating malnourished children in Borno State.

At the height of this crisis late last year, MSF emergency medical teams witnessed entire villages where the mortality rate was over five times what is considered an emergency. Nutritional screenings carried out in several locations in Borno State revealed that up to 50% of children under five were acutely malnourished.

Malnutrition wipes out a person’s resistance to common diseases, particularly among the very young and very old. The result is that a portion of this population in many parts of Borno State has been largely wiped out. 

The humanitarian emergency reached catastrophic levels. A massive relief effort is still needed.

What is MSF doing to respond?

Across Borno state, MSF is running 12 permanent health facilities. In our clinics we provide life-saving treatment for malnutrition, primary and secondary healthcare, maternal healthcare, vaccinations and malaria prevention.

It is difficult to deploy emergency medical teams in rural areas. Many are isolated and fighting still rages around settlements already burned to the ground. Travel by road is out of the question because of insecurity.

Yet our teams assume the risks because another planting season has come and gone, markets remain empty, health staff have fled and medical facilities have closed.

Hunger gap

The need for food assistance is likely to increase even further from May, when last year’s harvest runs out. With this lack of food, peoples’ immunity falls, nutrients in their diet decrease and the number of infections rise.

The hunger gap is coming, the situation could be even worse this year as millions remain displaced by the conflict.

our doctors: responding to the crisis

Laura Heavey, MSF Paediatrician in Borno State

"One of the hardest things about malnutrition is that these kids are so prone to infection. A normal infection that a well-nourished child can fight off, can often be fatal to a malnourished child. 

"You never get used to seeing children die from preventable illnesses, but you have to focus on the positives. To keep perspective, I always remind myself that we have more children walking out of the hospital than dying here."

Dr Laura heaveymsf paediatrician, in borno state nigeria

If we weren't here, mortality rates would be so much higher. Every day the paediatric unit is full, we treat over 60 patients per day and we have hospitals and treatment centres wherever we can reach across Borno State. 

Now we are worried. The ‘hunger gap’ is coming - the season between harvests when there isn’t enough food - maybe as soon as the end of April, with the rainy season following. Amidst the violence and the insecurity in this region, we’re doing everything we can but it feels like a race against time.

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