Borno State

ABUJA — Seven years of war against Boko Haram militants have left northeastern Nigeria in the grips of a humanitarian emergency. Borno state has borne the brunt of the violence and is now feeling the pain of an increasing food shortage.

More than a million Nigerians have fled to the Borno state capital, Maiduguri, to escape the raids on villages, the suicide bombings, and the military operations that have characterized the Boko Haram insurgency.

Many of them live in shanty settlements where they have little access to food and clean water.

Across the city, people are squatting in abandoned fields, uncompleted buildings and under trees.

To survive, many rely on leaves they gather from the fields. Sometimes they go two or three days without eating. It is not what they expected.

“We came here to Maiduguri because of high expectations we had that things will be better if we are here,” says Ya Falmata, an elderly woman among the displaced.

She has set up a makeshift tent made of twigs and bamboo in the middle of a field where more than 13,000 people are living, trying to survive.

Talk of famine

“They become malnourished because they do not eat and they are not adequately fed. And there’s no food,” says Rebecca Smith, a nurse with Doctors Without Borders.

She sees some of the most extreme cases of illness at a hospital that the organization has set up.

“These cases are malnourished children that come with respiratory distress that needs O2 (oxygen) therapy, that needs blood transfusion, that are very very sick. Common cases are from disease, problems like measles, whooping cough,” Smith says.

Relief agencies have warned of a possible famine in parts of Borno state, where fighting between government forces and Boko Haram has discouraged farming and cut off some areas from outside aid.

In the local markets, the price of produce has increased because of the food shortage.

The government runs displaced persons camps, but not enough for everyone who needs shelter.

And some Nigerians say food distribution in the camps is unfair. Makkah Mustafa, who lives in a warehouse with dozens of other families, is one of them.

“We don’t know the reason why, but the distributors in the camps do not distribute food to everyone. Some people will get [it]. Some people will not.”

Some help is slowly coming. A group of children are seen gathered waiting for a food delivery truck from a local charity. They sing happy songs from happier times. Their parents and guardians hope the happier times will return.

Two Nigerian children have been left paralyzed after contracting the wild poliovirus in the northeastern Borno state, in the first cases reported since 2014.

Nigeria’s Health Minister Isaac Adewole confirmed Thursday that two children from the Gwoze and Jere areas of Borno had been infected with the virus and that a national emergency response plan had been activated that would see 1 million children across Borno state immediately immunized.

Adewole added that the immunization effort would extend to the neighboring states of Yobe, Adamawa and Gombe, bringing the number of children vaccinated to around 5 million.

The West African country accounted for more than half of all polio cases worldwide in 2012, but Nigeria has made huge efforts to eliminate the virus and in July celebrated two years without a case. Only 21 cases of wild poliovirus have been reported so far in 2016, with Pakistan and Afghanistan the only other countries to report outbreaks.

Polio results in irreversible paralysis in one in every 200 infections. The disease is highly contagious and is spread through contact with an infected person, particularly through contamination with their faeces. Most people infected with the virus show no symptoms but can carry the virus and silently infect others. The World Health Organization (WHO) thus considers a single case of polio-induced paralysis to be evidence of an epidemic.

Adewole said that the two cases had been discovered as a result of “strengthened surveillance,” which had been made possible by the Nigerian military liberating local government areas in Borno. The northeastern state has been the epicenter of an insurgency waged by Boko Haram , an Islamist militant group that has killed tens of thousands of people and displaced more than 2 million since taking up arms in 2009.

Hundreds of health centers in Borno have been destroyed as a result of the violence and the state is verging on humanitarian disaster, with UNICEF warning in July that 50,000 children were at risk of starvation.

Suspected Boko Haram members have previously gunned down polio vaccinators in northern Nigeria and the extent of the damage in Borno has made some areas hard for vaccinators to reach. The WHO’s Africa director, Dr Matshidiso Moeti, said that the organization was “deeply saddened” by the outbreak but praised the Nigerian government for its efforts to eradicate the disease.

“The overriding priority now is to rapidly immunize all children around the affected area and ensure that no other children succumb to this terrible disease,” said Moeti. The cases highlight the need for vaccination programs to reach remote areas of Nigeria, including the Lake Chad region, which borders Niger, Cameroon and Chad and has been the site of multiple Boko Haram attacks.

A country is certified as polio-free after three years without active transmission, meaning that Nigeria will now have to wait until the summer of 2019, at the earliest, to achieve that status.

An estimated quarter of a million children in Borno state, North-East Nigeria, face severe malnourishment and risk death, UNICEF said today, as the scale of the humanitarian crisis caused by the Boko Haram emergency continues to unfold.

As more areas in the northeast become accessible to humanitarian assistance, the extent of the nutrition crisis affecting children is becoming even more apparent.

The UN children’s agency urges all partners to join the humanitarian response and donors to urgently provide resources.

Out of the 244,000 children suffering from severe acute malnutrition in Borno this year, an estimated 49,000 children – almost 1 in 5 – will die if they are not reached with treatment.

“Some 134 children on average will die every day from causes linked to acute malnutrition if the response is not scaled up quickly,” said Manuel Fontaine, UNICEF Regional Director for Western and Central Africa, who just returned from a visit to Borno state. “We need all partners and donors to step forward to prevent any more children from dying. No one can take on a crisis of this scale alone.”

While visiting newly accessible sites, previously under Boko Haram control, Fontaine witnessed destroyed towns accommodating displaced people, families with little access to adequate sanitation, water or food, and thousands of frail children in desperate need of help.

“There are 2 million people we are still not able to reach in Borno state, which means that the true scope of this crisis has yet to be revealed to the world,” Fontaine said. “There are organizations on the ground doing great work, but none of us are able to work at the scale and quality that we need. We must all scale up.”

UNICEF is working with partners to screen and treat children for malnutrition and improve access to water and sanitation. UNICEF’s humanitarian response also includes providing medical care, immunization, education and psychological support to the children affected by the violence.

In early 2016, UNICEF appealed for $55.5 million to respond to the humanitarian crisis in north-east Nigeria, but has so far only received $23 million – 41 percent. As the children’s agency gains access to new areas with vast humanitarian needs in the coming weeks, it expects the appeal to increase significantly.

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