Médicins Sans Frontières/Doctors Without Borders (MSF) is preparing to respond to potential violence in northern Nigeria in the lead up to the presidential elections next month.
An attack earlier this year by Boko Haram in Baga, Borno State, caused 5,000 people to flee and seek refuge in a camp in the state capital, Maiduguri, where MSF is working.
The security situation in northeast Nigeria has worsened over the last four years. In 2014, several bomb attacks in Maiduguri killed and injured many people. Boko Haram attacked the town twice during 2014 and most recently on 24th January 2015. This continued threat of violence has meant that all but one of Maiduguri’s main access roads are closed.
Concern over electoral violence
MSF is building its surgical capacity and developing an emergency response plan in the event of a sudden influx of patients seeking treatment for trauma injuries at its hospitals.
In addition to this, MSF will set up an emergency room, operating room and a post-operative care unit at a city hospital in Rivers State, in southern Nigeria.
If violence does occur, two further medical stations will be set up in other states, if necessary. Until then, Ministry of Health staff and members of MSF teams will be trained to provide care in the event of this feared inflow of wounded patients. Lastly, a 'flying' surgical team will be prepared to set up a temporary operating room and advanced health post if needed.
Resources being stretched as the displaced seek assistance
Since the attack on 3rd January, humanitarian aid organisations, including MSF, have been prevented from travelling to the region. However, satellite images of destruction there show the extensive scope of the attack. Survivors’ statements corroborate these images, describing a deserted, empty town.
The growing number of displaced people is placing significant pressure on the limited available resources and the few existing services – particularly health services, which are often dysfunctional.
Communities that have taken in the displaced are also suffering, as the need for food and medical care is acute within both populations.
Almost one million fleeing threat of Boko Haram
There are now nearly one million displaced people throughout Nigeria. They are mostly concentrated in the northeast of the country, with an estimated 500,000 people in Borno State; 400,000 of whom are in the town of Maiduguri.
This second group is primarily composed of villagers who fled Boko Haram’s attacks in the surrounding area.
Fear of attacks has also led to 'preventative' displacements, particularly from the town of Mongono, with a population of 300,000 located approximately 100 kilometres from Maiduguri. MSF is supporting the hospital in Mongono with donations and medical supplies.
These movements of people away from Mongono happened before Boko Haram attacked and claimed control of the town on 25th January.
MSF's operations in Maiduguri
In Maiduguri, MSF has been working in the most populated camps with between 10,000 to 15,000 people per site. Here, we have conducted nearly 10,000 medical consultations in two months.
Following the arrival of the displaced people from Baga, our teams carried out needs assessments at the ‘Teacher Village’ site. As in the other two camps, we set up a clinic, outpatient activities and a system for transferring the most serious cases to hospitals.
We also launched hygiene activities and built water supply systems in the 10 camps set up since July. A health centre with 10 hospital beds will soon be operational in another Maiduguri neighborhood.
Providing care across borders
The people seeking refuge across the border in Niger are composed primarily of women, children and the elderly. Most are originally from the neighbouring Nigerian town of Damassak. They have crossed Lake Chad and the Komadougou River to take refuge in towns and villages on the other side of the border in south east Niger.
During the peak of their arrivals in Diffa, Niger, an estimated 100,000 and 150,000 people were making this journey. In December, MSF launched medical activities in this town, a few kilometres from the border with Nigeria’s Borno State, in response to a cholera epidemic in Diffa and Chatimari.
MSF also began supporting the N’Garwa and Gueskerou health centres and handled the distribution of non-food items to those recently arrived in the Diffa region. Given the precarious nature of the refugees’ living conditions and the large number of families with children that continue to arrive, we will also launch a vaccination campaign in Diffa in the coming weeks.
