The magnitude of the humanitarian crisis in north-east Nigeria has driven 1.7 million people away from their homes to camps and host communities, where those without relatives resort to using twigs and grasses to make ad hoc shelters outside the communities or in some cases, within host communities.
The nearly decade-long crisis is characterised by massive destruction of social amenities and public structures including health centres, schools, water points, banks, and so on. About a third of 743 health facilities identified in Borno state have been completely destroyed. Of the 481 health facilities that have not been destroyed, 31% of them are not functioning, according to the World Health Organization (WHO).
“Difficult terrain, insecurity, inadequate staffing and insufficient supplies and equipment significantly hinder access to basic, lifesaving health care by IDPs and local populations in the North-east.” – Dr. Baweye, Alliance for International Medical Action (ALIMA) Coordinator.
The disruption of local economy and farming for a while now has led to massive hunger, leading to high prevalence of acute malnutrition and other related diseases such as diarrhoea. According to WHO, the overall nutrition situation in Borno state is very alarming.
“Undernutrition is one of the major threat to life of mothers and children under age 5 in IDP camps and local communities of Borno state”, he further said.
What We Are Doing
ALIMA runs an extensive health clinic in one of the largest IDP camp in Borno state, sited in Muna Garage on the outskirt of Maiduguri. The health centre provides free primary health care to children under the age of 5, with focus on undernutrition treatment, reproductive health care for pregnant women as well as outpatient treatment.
A total of 28,067 patients benefitted from at least one of these services since April 2017 with an average of 65 patients accessing the clinic per day. Dr. Baweye explained that “even though the health centre is sited in the camp to target the IDPs, more locals from far and near are accessing the facility than IDPs”.
As part of the diagnostic process, patients wash their hands with chlorinated water immediately after triage to improve hygiene and minimise contamination. In July 2017, 8,879 children under 5 years came for consultation with 1,517 of them treated for undernutrition in Muna Garage clinic with a 95% success rate. Such are the volume of cases of malnutrition ALIMA handles almost every month. “Sometimes, chances of survival of these children depend on how early they are received in the clinic. Some of these children are even brought to the clinic without eating for days as a result of hunger.” – Dr. Jeremy, ALIMA.
Aside treatment of malnutrition, children also undergo check-ups and immunization services for fatal diseases. Their accompanying parents’ – who are mostly mothers – knowledge on best hygiene practices and feeding are improved. Mothers are trained on how to screen their children for malnutrition using the MUAC bracelet. A study conducted by ALIMA in Niger Republic reveals that this approach is more effective in upscaling nutrition intervention than relying on trained health workers. A dedicated unit in the clinic also takes care of pregnant women and women and girls who have suffered medical complications from sexual abuse.
ALIMA is one of the few humanitarian organizations who significantly contributed to the efforts that halted Cholera Epidemic in Muna Garage in October 2017. More than 590 infected patients were treated in the clinic, while 257 advanced cases were referred to other treatment centres in Maiduguri with 32.7% of them being children under 5 years.
Concurrently, ALIMA is supporting a 30-bed Inpatient Therapeutic Feeding Centre (ITFC) within the University of Maiduguri Teaching Hospital (UMTH) with personnel, medical supplies and capacity building. The centre is equipped to care for children suffering from severe acute malnutrition (SAM) with complications and other child and maternal related diseases. With a plan to commence outpatient treatment in 2018, the centre hopes for more space within the institution to expand the bed space to 50.
The ITFC is the first of its kind in Sub-Saharan Africa. ALIMA provides free feeding and ambulance service throughout the treatment period of every patient in the Muna Garage’s clinic and those referred to the ITFC or any other treatment centre.
In a bid to ensure the sustainability of malnutrition treatment in Borno state, ALIMA recruited and stationed health practitioners who are mostly Nigerians in the ITFC to support and build capacities of the UMTH staff working in the centre. Intensive trainings are from time-to-time organized by UNICEF to teach staff from the state Ministry of Health on how to manage SAM in children as well as related medical complications.
According to Professor Jose Ambe, ITFC, “this centre is an example of a partnership at its best and my dream is for it to eventually become an Institute of Child and Adolescent Medicine, a leading centre in terms of research and trainings on child and adolescent related diseases”.
With widespread hunger among vulnerable families leading to alarming rates of malnutrition cases in Muna Garage and surrounding communities, more is needed to be done to combat child and maternal mortality.