Nigeria

In 2008, Nigeria enjoyed a relatively calm political environment after the 2007 presidential elections. However, towards the end of the year, there were several days of ethnic clashes in Jos, Plateau State. In the conflict-ridden Niger Delta, despite another wave of violence in Port Harcourt in July, the situation has cooled down. However, access to adequate health care remains difficult for people who cannot afford it.

Trauma care and primary healthcare in the Niger Delta
In the oil-rich Niger Delta, Doctors Without Borders/Médecins Sans Frontières (MSF) is running programs in Rivers State and Bayelsa State. In the regional capital, Port Harcourt, MSF has worked to improve the quality of care provided at its hospital for trauma victims. MSF teams have enhanced the use of internal fixation, a procedure involving the insertion of a metal component inside a bone to join broken segments. This has significant advantages over external fixations because it reduces the length of hospital stays, allowing patients to return to normal life more quickly.

Port Harcourt is prone to peaks of violence. In 2008, MSF teams treated more than 9,300 patients in its emergency room and performed more than 3,000 surgeries. MSF has also recently begun offering support to victims of sexual violence. A team of specialists treated 265 people and will continue focusing on this issue in a city where victims often have nowhere to go for care.

In October, MSF opened a health center in Oloibiri, in the south of Bayelsa state, to provide primary and mother-and-child healthcare to the population. The 10-bed center has been fully occupied. In December, more than 800 consultations were carried out, 31 percent of which concerned children under five. The main pathologies treated include malaria, respiratory infections, and diarrhea. The center where pregnant women come for antenatal care will also provide assisted deliveries.

Improving maternal healthcare and reacting to epidemics in the north
MSF has also started a maternal health project in northern Sokoto State to help address alarming maternal and infant mortality rates. While Nigeria already has the seventh highest maternal mortality in the world—claiming the lives of approximately 59,000 women per year—the rates in Sokoto are estimated to be even worse. MSF is supporting the maternal care program at the Goronyo hospital in Sokoto state.

MSF also opened a new surgical program focusing on emergency obstetrics and women suffering from fistulas in Jahun, Jigawa state. Fistulas are usually a consequence of poor obstetric care—a woman develops a fistula after being in labor for many hours, or even days. In 2008, 63 women underwent surgery to correct fistulas, and the team helped more than 530 women to deliver. In 2008, around 480 women with obstetric complications were admitted to the hospital.

MSF has responded to various medical emergencies in the northern states—dealing with cholera outbreaks in Sokoto state, vaccinating more than 71,000 for meningitis in Katsina and Kebbi State, vaccinating around 11,000 people for measles in Niger state, and a nutrition campaign in Yobe State. MSF also provided non-food items after riots in Jos and carried out an assessment of the condition of refugees from Bakassi peninsula, a disputed territory between Cameroon and Nigeria, located in the Nigerian Cross River state.

Handing over the HIV/AIDS program in Lagos
In September 2008, after five years of activity, MSF completed the handover of its HIV/AIDS programs in Lagos. When MSF started providing free, life-prolonging antiretroviral (ARV) therapy and comprehensive care for HIV-positive patients in 2003, there were no other agencies offering that medical support in Nigeria.

In 2006, a presidential decree launched a national program offering free ARV therapy to all HIV/AIDS patients in Nigeria. Over the last few years, MSF has cared for more than 1,900 HIV-positive patients. By 2008, when it was clear that the Nigerian government had made substantial progress in providing free ARV therapy, MSF handed over the program to local partners and the Lagos general hospital.

MSF has worked in Nigeria since 1996.

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