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In Nigeria, COVID-19 is not the only epidemic

Between malnutrition, armed conflict, and mental health, Nigeria’s less fortunate communities are facing a lot more than the coronavirus.

Written by: Rodel Lambatin

As a nurse, I have worked in many different places. From an emergency room in Marikina City, I have worked in Libya, Qatar and Papua New Guinea. In 2017, I started working for Doctors Without Borders / Médecins Sans Frontières (MSF), and my missions took me to South Sudan, India and Ukraine. 

By 2020, I started working in Maiduguri, Nigeria, and I was there when the COVID-19 pandemic started. And I have to say, this was one of my hardest missions so far, because it was quite complicated.

Nigeria faces many problems, and the pandemic has only emphasized the need for better healthcare.
Photo: Miroslav pavicevic

Doctors Without Borders has been responding to disease outbreaks and emergency health needs in Nigeria for many years now, focusing on maternal and pediatric healthcare throughout the country. In Borno state, where I worked, the continued violence and armed conflict has displaced more than two million people. And 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 is a major concern

In Nigeria, our teams are responding to high numbers of malnutrition cases, and our team in Maidiguri admitted more patients for malnutrition in September 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.  

Doctors Without Borders visited the new Malamari camp after heavy rains in Maiduguri in May 2021. IDPs had requested food distribution. Photo: Rodel Lambatin

We run a therapeutic feeding center: 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, we have a comprehensive package for malnourished children. We have a laboratory, our own pharmacy, a central sterilization unit. We have our own ICU plus a two-bed kwashiorkor room. (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 concern in Maiduguri, other emergencies have presented themselves. 

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. 

Measles patient admitted at Fori PHC. Photo: Miroslav Pavicevic

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 the 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 ones.

IDPs gather for a mental health activity and community festival, to promote social cohesiveness. Photo: Miroslav Pavicevic

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 has become necessary. There is a huge need for mental health in Maiduguri. The people affected were in insecure areas, and experienced trauma with the fighting. They are suffering economically as well, as many people live on less than $1, or 500 naira, a day.

IDP children play at Malamari camp while Doctors Without Borders is conducting an assessment. Photo: Rodel Lambatin

Our mental health manager assessed the needs of the IDPs, and we support their basic needs. 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.

IDPs face constant threats, though the communities are being encouraged to help each other through social activities. Photo: Miroslav Pavicevic

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 on a new facility, the Nilefa Keji Hospital, earlier this year. 

The Nilefa Keji Hospital in Maiduguri. Photo: Rodel Lambatin

‘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 sweeter for the people of Maiduguri.

Doctors Without Borders provides medical assistance to people in need all over the world, from Nigeria and Sierra Leone to Pakistan and Bangladesh. In the Philippines, our projects support tuberculosis screening in Tondo, Manila, and health centers in Marawi. Learn more about our work: