Malnutrition woes overwhelm children in northeast Nigeria | Boko Haram

Maiduguri, Nigeria – One afternoon in August, Kaka Modu was rushed to the emergency room of the Umaru Shehu Stabilization Center in Maiduguri, the capital of Borno State in northeast Nigeria.

The three-year-old had been brought earlier in the day from Konduga, a town 25 km (15.5 miles) from Maiduguri. She had shrunk and moaned every time her mother, Yagana Modu, adjusted her sitting position.

“She started with having a bowel movement for a few days,” Modu said. “I was hoping it would stop. Then I noticed that the belly and the body were swollen.

Kaka, who suffers from severe acute malnutrition (SAM), is one of more than 1.3 million children under the age of five who are likely to be acutely malnourished in northeast Nigeria, according to analysis by acute malnutrition from the Food and Agriculture Organization of the United Nations (FAO).

Food shortages and bouts of famine have plagued the region for years as Boko Haram, which has wreaked havoc since 2009, continues to run amok. Thousands of people have been killed and millions displaced by the conflict.

Across the region, some 8.4 million people, mostly women and children, are in need of humanitarian assistance, according to the UN Office for the Coordination of Humanitarian Affairs (OCHA). Many are on the verge of death, experts say.

In 2019, Boko Haram attacked the Modu family village of Takari in Konduga, destroying Modu’s family home and livelihood. His family of eight was held captive for months until Nigerian soldiers recaptured the town and moved them to Konduga to join thousands of others displaced by the conflict.

“Health establishments… overwhelmed”

Health authorities and nonprofits say the situation is squeezing available resources.

Each week, one of three ambulances operated by the International Rescue Committee (IRC) travels to outpatient care centers in Konduga and neighboring communities in Borno to transport patients like Kaka. Since May, the admission of SAM cases, mostly children, has skyrocketed.

“This year we are experiencing what we haven’t experienced for a long time,” IRC nutrition manager Martha Budidi told Al Jazeera. “Cases of children suffering from severe acute malnutrition are beyond normal and even all health facilities around Maiduguri are overwhelmed.”

Every day, 30 to 40 such cases are admitted to IRC’s three stabilization centers in the state – and about 200 people a week, officials said.

Elsewhere, the situation is grimmer.

The NGO Médecins Sans Frontières (Doctors Without Borders, or MSF), which has been treating malnutrition cases in Maiduguri since 2017, says there have been a record number of admissions since May, when health officials say Malnutrition cases peak every year.

“Since week 30 [the last week of July], we admit an average of 330 patients per week. During the same period, the average number of weekly admissions last year was 69 patients. Htet Aung Kyi, MSF’s medical coordinator in Nigeria, told Al Jazeera.

In August, more patients were admitted in a week than in an entire month at the same time last year, Aung Kyi added.

Worsening food crisis

Two years ago, before armed groups hit Takari, life was good for Modu, a maize and millet farmer like her husband. Each year, they reaped enough profit to feed the whole family.

But his fortunes changed after the attack. “I had no access to food and healthcare in captivity, so my children died,” she told Al Jazeera.

In the garrison town of Konduga, home to internally displaced people (IDPs), food is rationed so that the family receives a daily meal from her husband’s meager income as a laborer. building.

Across the region, deteriorating food consumption patterns over the past year are aggravating malnutrition.

FAO analysis showed that 42.1% of households in BAY states – Borno, Adamawa and Yobe – had insufficient food intake, compared to 37.8% at the same time in 2021.

According to the organization, the regional armed uprising has denied 65,800 farmers access to farms and agricultural inputs, leading to soaring food prices and a food crisis.

In the metropolis of Maiduguri, displaced people who previously depended on food donations from NGOs such as Action Against Hunger and Save the Children in the camps are stuck in starving host communities.

Recovery and relapse

Since 2021, the Borno State government has resettled around 200,000 displaced people from Maiduguri relief camps. While their resettlement brings them relative peace and stability, thousands of people are reeling from hunger.

According to a November 2022 report by Human Rights Watch, government camp closures have exacerbated hunger and malnutrition in the city. Displaced people interviewed in the report said the Borno State Emergency Management Authority (SEMA) and humanitarian organizations like Action Against Hunger have stopped providing monthly food rations and cash grants that helped to buy food in the Maiduguri camps.

“Once people don’t have access to food rations, it’s [malnutrition] is expected,” said Anietie Ewang, Nigeria researcher at Human Rights Watch. “For children, it’s more concerning because it impacts them and their growth.”

In Maiduguri, for example, Hauwa Ali has struggled to feed her two children since she was relocated from Dalori I camp in July. The 25-year-old is out of work and her husband’s new life as an apprentice car mechanic has yet to take off.

In June – and again in August – she rushed her nine-month-old daughter Hadisa to Maiduguri Stabilization Center and was diagnosed with SAM with complications including oral thrush and diarrhoea.

“The first time she had a bowel movement and she was treated,” she told Al Jazeera. “This second time, I couldn’t breastfeed her, she started to lose weight. I noticed the symptoms one night when I checked her mouth and realized it was swollen.

Hadisa is a relapse case which, according to Ibrahim Mohammed, an IRC doctor in Bama, occurs when a child returns to SAM after a recovery period. “This [relapse] can be caused by poor health or poor hygiene, but most of the time it is often intense hunger,” he told Al Jazeera.

At the Bama stabilization center, cases of relapse are frequent due to food rationing and limited food choices.

Thousands of families eat only one meal a day in the region and “around 5,000 children could starve to death if there are no shared resources to save them over the next two months”, said to Al Jazeera John Mukisa, Nutrition Sector Coordinator for UNICEF. .

In the past, the Ali family depended on food provided by the World Food Program (WPF) and other donor agencies. But since moving to a host community on the outskirts of Maiduguri in July, the four-person household eats just one meal a day.

Meanwhile, Hadisa, who takes F.100, a calorie and protein formula used for rapid weight gain in acutely malnourished toddlers, is recovering.

But Ali fears another relapse. “There’s nothing (food) to go home,” she told Al Jazeera. “I can’t feed her properly and I’m afraid she’ll be admitted again.”