Escalating violence in Nigeria’s Zamfara state is fueling a humanitarian crisis

Zamfara: IDP - MSF Mobile Clinic

Nigeria 2019 © Benedicte Kurzen/NOOR

Doctors Without Borders/Médecins Sans Frontières (MSF) teams in northwestern Nigeria’s Zamfara state are witnessing an alarming rise in the incidence of sexual violence and illnesses related to a lack of food, safe water, and vaccinations as attacks by armed groups force people to flee their homes or cut them off from lifesaving medical care and other essential services.

Zamfara: Paediatric Ward
An MSF doctor speaks with the mother of a patient inside the pediatric malaria ward in Anka General Hospital.
Nigeria 2019 © Benedicte Kurzen/NOOR

They’ve left their towns, farms and grazing lands, and their livelihoods to escape widespread violence. Many are too afraid to travel or are staying in camps without proper shelter, adequate access to clean water and sanitation facilities, or regular food distributions.

MSF provides medical and mental health care in Zamfara’s larger towns, where people have gathered seeking protection. In Anka, where we manage a 150-bed pediatric ward in the town’s hospital and run outpatient malnutrition clinics in the area, MSF teams are seeing an overwhelming number of malnourished children whose weak immune systems have made them more susceptible to malaria, measles, and other comorbidities. MSF also provides essential health care in the town’s largest camp for displaced people.

In Shinkafi, we manage a 39-bed malnutrition ward, an isolation tent for other diseases, and a clinic for survivors of sexual violence, and provide surge capacity for treating malaria. And In Zurmi, MSF supports a 30-bed pediatric malnutrition center and a clinic for survivors of sexual violence. Our teams also provide mental health support and health promotion activities in all of these locations. MSF is also concerned about people who have stayed in their villages, who are often too afraid to travel on unsafe roads and have put off seeking medical care or fulfilling other basic needs.  

Reports of kidnappings, armed robbery, sexual violence, and killings have also multiplied. From January to April this year, MSF teams in Zamfara cared for more than 100 survivors of sexual violence. Women and sometimes men are abducted by armed men and subjected to abuse, often for weeks, before being returned to their communities.

Travel is dangerous for survivors of sexual violence, and as a result many seek medical and mental health care late, or not at all. They often arrive at our clinics too late to prevent sexually transmitted infections, suffering from serious psychological trauma and in need of protection. They tell us that there are more survivors who are too afraid to travel to our facilities.

Here, three people treated by MSF in Zamfara describe their experiences.

A survivor of sexual violence at MSF’s clinic in Shinkafi

I was going home after sunset; I was done selling food for the day.

Three men took me. They had guns. They took me to a house in a village. They raped me and they did not bring me back until dawn.

Then it happened again two to three months later. It was about 8:00 p.m. I finished selling food and was on my way to bring the plates back home when they took me again.

They shut my mouth and dragged me into the bush with their guns. There were three men; each one raped me. They said that they would not bring me back. I was crying, but they told me that if I didn’t cooperate, they would shoot me. They did not bring me back until the next afternoon, when everyone was looking for me.

I was crying when I came back, but I didn’t tell anyone apart from my grandmother. She said I should keep quiet and ignore what happened. Then our father decided to take me to the hospital in Zurmi.

This thing happened to me that makes me cry. And my greatest concern is that I got pregnant because of what they did to me. What am I going to do with [the baby]?

In Nigeria, abortion is only legal when it is performed to save the woman’s life. However, unsafe abortions are common and are a major contributor to maternal mortality in the country.

An imam at a camp for displaced people in Anka

My name is Malan Danbube, and I used to be an imam in our village. I lived happily with my family until this calamity befell us.

We heard from time to time about gunmen who raided villages and killed people. One day, it happened to us. I will never forget that Wednesday. These criminals arrived with their guns to steal the grain we were grinding and killed 26 people in my village. After they left, we buried our dead in a state of shock. I could barely think of what to say for the prayers during their funerals.

After that, many of us left the village. We had to. But we did not know where to go to find safety. We could not afford a car, so we walked and walked until we reached a larger town. I had no money to rent a house for my family, so the emir [leader] of Anka gave us refuge in this camp. This was two years ago. We have been living here ever since.

We are farmers, so we know no other trade. I used to rent a motorbike to go fetch water and firewood; I also worked at a farm to get some food for my family. Now those places are no-go areas. People who try to take the roads are killed, one after the other. I have no money and nowhere to go. 

People keep arriving in Anka, but there is no more space for them in this camp. My brother recently arrived and I’m trying to find a room for him and his family. The other day, one boy arrived with his grandfather. They are trying to find a place in the camp too. They told us that seven people were killed in their village.

I don’t know when things will get better and we will be able to go back to our village and farm again.

Thank God we receive help sometimes. I’m grateful, but I want to be in my own house. I used to have a private toilet, now I share one with 100 other people. And you are lucky if you get a meal every day.

The leader of a group of herders at an informal camp on the edge of Anka

My name is Muhammadu Babuga. For many years we had been living in the country, rearing our animals and farming near our villages, not in the city.

Our problems began when the thieves started attacking. They beat and kidnap people, steal cattle, and even murder people. We decided to leave and move close to a town.

We built our home in an informal camp close to the city as a shelter for people coming from different places. So far, people have come here from nine different villages.

I came with more than 100 goats, but I lost some of them and sold others to build a home. I needed money to rent a farm and get some food.

Now we’re even afraid to rear our cattle because the thieves followed us here and attack us. Two months ago, they even attacked us in this camp. They stole some cows, one person was injured, and three people were kidnapped and taken to the bush. We tried to find help for our injured friend but weren’t able to before he died.

After his death we came back to the camp, but we can’t live here anymore. We’re trying to sell the cows of kidnapped people to pay for their ransoms. We only stay here during the day to rear the cattle and then go back to the city in the evenings and sleep there. Then we come back in the morning. We are getting tired.

MSF has been working in Zamfara state since 2010.