Over the past four years, the security situation in northeast Nigeria has steadily worsened, as the militant group Boko Haram has gained in both strength and audacity. In 2014, bombings in Maiduguri killed and wounded scores of people. Boko Haram attacked the town twice last year as well, and, on the night of January 24, 2015, they attacked again. The next day they took control of Mongono, a town 100 kilometers [about 62 miles] further north. All but one of Maiduguri’s main access roads are now closed.
An attack on the town of Baga in early January killed and displaced many people and created a spike in medical needs in the area. But since the attempt on Maiduguri last week, no humanitarian aid actor, including Doctors Without Borders/Médecins Sans Frontières (MSF), has been able to reach the Baga area due to the high level of insecurity. Instead, some 5,000 displaced people from Baga have arrived at the “Teacher Village” camp in Maiduguri, capital of Nigeria’s Borno State. Survivors’ statements describe a deserted, empty town, and satellite images have shown widespread destruction.
MSF teams have been providing assistance to survivors of the Baga attacks in Maiduguri and in neighboring Niger, where refugees continue to arrive. Additionally, with the risk of renewed violence surrounding upcoming elections, MSF teams in the south of the country are preparing an emergency response plan.
Hundreds of Thousands Displaced
According to the National Emergency Management Agency, there are now nearly one million displaced people in Nigeria, and this number is growing. Most are in the northeast of the country, including up to 500,000 in Borno State. Of these, some 400,000—primarily villagers from the surrounding areas who fled Boko Haram Attacks—have settled in Maiduguri.
The increasing number of displaced people is putting significant strain on available resources and the few existing services—especially health services, which are often dysfunctional. Those communities who have taken in the displaced also suffer from the resulting scarcity of food and medical supplies.
Fear of further attacks has also led some people to leave their home, particularly in Mongono, an isolated area with a population of some 300,000. MSF supports the hospital there with donations of medical supplies.
In Maiduguri, MSF is working in the three most-populated camps, which host 10,000 to 15,000 people per site. Nearly 10,000 medical consultations have been conducted in two months. Following the arrival of the displaced people from Baga, MSF teams carried out needs assessments at the Teacher Village site. In each of the three camps, MSF has set up a clinic, outpatient activities (treatment of malnutrition and prenatal visits), and a system for transferring the most serious cases to hospitals.
MSF has also launched hygiene activities and supports camp managers in water treatment to improve water quality in the 10 camps set up since July in the Maiduguri area. A health center with a 10-bed capacity will soon be operational in another Maiduguri neighborhood.
Crossing the Border to Diffa, Niger
Between 100,000 and 150,000 refugees who fled the violence in Nigeria have arrived in the town of Diffa, in southeastern Niger, just a few kilometers from the border with Borno State. They have crossed Lake Chad and the Komadougou River to find refuge in towns and villages on the other side of the border. Most are women, children, and elderly people from the Nigerian town of Damassak.
In December, MSF launched medical activities in response to a cholera epidemic in Diffa and Chatimari. The response included setting up cholera treatment sites and training the health center’s staff on water chlorination at rehydration stations and on disinfection of homes. More than 300 patients were treated in cooperation with Niger’s Ministry of Health.
MSF also supports the N’Garwa and Gueskerou health centers and handled the distribution of non-food items to newly arrived refugees in the Diffa region. Given the precarious nature of the refugees’ living conditions and the large number of families with children that are still arriving, MSF plans to launch a vaccination campaign in Diffa in the coming weeks.
Southern Nigeria: Preparing for Electoral Violence
MSF is setting up an emergency response plan to help treat wounded in case of electoral violence during the upcoming presidential elections. MSF teams will set up an emergency room, operating room, and a post-operative care unit at a city hospital in Rivers State, in southern Nigeria.
If violence does occur, two medical stations will be set up in other states as required. In the meantime, Ministry of Health staff and MSF team members will be trained to provide care in the event of an influx of wounded patients. A “flying” surgical team will also be on standby to set up a temporary operating room and advanced health post if needed.