In Nigeria, COVID-19 is not the only epidemic

Doctors Without Borders has been responding to disease outbreaks and emergency health needs in Nigeria for many years, focusing on maternal and paediatric healthcare throughout the country. In Borno state, where I worked, the continued violence and armed conflict has displaced more than two million people. Just like in many other places around the world, the COVID-19 pandemic has made things for difficult for everyone. 

But COVID-19 is just one of many problems plaguing Maiduguri.

Malnutrition

In Nigeria, our teams are responding to high numbers of malnutrition cases. In September, our team in Maidiguri admitted more patients for malnutrition than any other month so far this year. In the internally displaced people (IDP) camps, we see a lot of cases of malnutrition. Many people, especially children, are suffering. Many families do not even realize that malnutrition is an emergency, because it seems normal for them to have a baby with very low body measurements. They think, this baby is normal because I can see, among my neighbors, it’s like this as well.  

We are actually running a therapeutic feeding center, and a mobile clinic outreach program that provides nutritional support and comprehensive medical services to IDPs and people in the informal camps in Maiduguri.

Currently, in Borno state, Doctors Without Borders provides a comprehensive package for malnourished children. We have laboratory, our own pharmacy, a central sterilization unit. We have our own ICU plus two-bed kwashiorkor room. (Note: Kwashiorkor is a severe form of malnutrition, where babies and children do not get enough protein or other essential nutrients in their diet.)

COVID-19 and other epidemics 

Though malnutrition is our main project in Maiduguri, we cannot ignore the other emergencies. 

Before I ended my mission in August, we responded to cholera and measles outbreaks in the state. In the mobile clinics, we also saw cases of malaria, acute watery diarrhea, respiratory tract infections. In 2020, we had three deaths from Lassa fever, or viral hemorrhagic fever. And every year there are meningitis cases as well. 

In Maiduguri we have our own Cholera Treatment Center, with a 100-bed capacity. For other communicable diseases, whether it’s measles or COVID-19, we have a 15-bed isolation facility. 

Violence and armed conflict in Nigeria

While the many health emergencies in Nigeria are complicated by COVID-19, violence and insecurity bring their own complications and problems. It has been 11 years since the insurgency began in northeast Nigeria. Thousands have been killed in fighting. There are an estimated two million IDPs in the country, and approximately 1.4 million in Borno state. In Maiduguri alone, there are 15 official IDP camps, and over a hundred unofficial camps.

Many of the patients we admit in our facility are IDPs. In our outreach programs in the camps, we respond to the basic needs, especially the distribution of non-food items, and water and sanitation facilities. We catering to emergency cases, and provide mental health and sexual and reproductive health (SRH) consultations. But there are no private spaces where we can provide services.

As of mid-2021, we have provided 7,844 medical consultations to IDPs. 

Invisible psychological wounds

With all these emergencies, psychosocial support is necessary. There are huge needs for mental health in Maiduguri. The people who are affected were in insecure areas, they experienced trauma with the fighting. They are suffering economically as well, as many people live on less than $1, or 500 naira, a day.
 

Our mental health manager assessed the needs of the IDPs, and we supported their basic needs: water, non-food items (NFIs). We also provided individual counselling, psychosocial education, group discussions, children's activities, even family counselling. One of the most important things we did was TB-HIV counselling. We also conducted sexual and gender-based violence (SGBV) sensitization and training, in collaboration with the mental health manager.

Continuing and expanding our work

With everything that is happening in Maiduguri, the health needs are immense. Our facilities can support many patients, but we need to do more. This is why we started construction of a new facility, the Nilefa Keji Hospital, earlier this year. 
 

‘Nilefa Keji’ is a Kanuri word, meaning ‘life is sweet.’ Perhaps, with better nutrition and better facilities, we can do better to make life a little sweet for the people of Maiduguri.