Nigeria: Bringing Aid Before the Rains

The rainy season is beginning in Banki, increasing the risk of a malaria outbreak.
Sylvain Cherkaoui/Cosmos for MSF
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MAIDUGURI – Teams from Doctors Without Borders/Médecins Sans Frontières (MSF) are scaling up activity in anticipation of increasing humanitarian and medical needs in hard-to-reach areas of Borno State, Nigeria.

The onset of the rainy season will render some locations impossible to reach as the countryside is inundated and roads become muddy or disappear under water. The remote town of Rann will effectively become an island, completely cut off from the outside world. Around 40,000 inhabitants and displaced people living in the area will have no assistance unless it is deployed in advance.

The rainy season coincides with a peak of malaria cases and increased malnutrition rates. In anticipation, MSF is deploying a mobile team to deliver medical and humanitarian support in the towns of Rann, Banki, and Damasak over the coming months. Team members will carry out health consultations, give preventive treatment for malaria, distribute mosquito nets and soap, and work to improve water and sanitation. They will also screen and treat children for malnutrition.

“Insecurity and logistical challenges make it difficult to provide assistance in these places, but we are working hard to step up action now before the rains come,” says Dr. Moussa Sow, MSF project coordinator for the mobile rainy season teams.

“People here have been displaced and many have been victims of violence. Our team will do our utmost to make sure they don’t suffer or die of preventable diseases.”

The mobile team has been pre-positioning medical and logistical supplies and is now starting medical activities. The team members will rotate in the three locations throughout the rainy season.

A second mobile team is distributing preventative malaria treatments in the Bama area this week, is preparing to do the same in Dikwa, and will respond to the expected increase in malaria cases in the months ahead.

Living conditions are already precarious and displaced people will depend on continuous food distribution to avoid malnutrition. More rain could also lead to outbreaks of waterborne diseases such as cholera and MSF has put an emergency preparation plan in place in parts of the state, including in Maiduguri, the capital.

A hepatitis E outbreak has already been declared in parts of Borno State, with MSF leading the medical response in the Ngala area. The risk of outbreaks will be higher if crowded camps for displaced people flood, leading to insufficient access to clean water and toilets.

When MSF started providing assistance in Rann in January, only .26 gallons (one liter) of water was available per person per day—far below the emergency standards. MSF and other organizations have worked to improve the water supply, enabling people in Rann to access between 2.6 to 4 gallons (ten to fifteen liters) of water each per day.

But MSF fears that insufficient number of latrines will lead to disease outbreaks. Teams estimate that in Rann, 279 people share each latrine. According to accepted minimum sanitation standards, one latrine should be used by a maximum of 20 people.

MSF has been working in Maiduguri, Borno State in Nigeria since August 2014. The organization currently manages 11 medical facilities in six towns in Borno (Maiduguri, Ngala, Monguno, Gwoza, Pulka and Banisheikh) and regularly visits another five towns: Bama, Banki, Dikwa, Damasak, and Rann.