Nigeria: MSF Treats Thousands of Children for Malnutrition as Conflict Surges in the Northwest

Salih Muhammad Auwal is a medical doctor and also the COVID-19 focal clinician at Shinkafi hospital, Zamfara state, northwest Nigeria.

Doctors Without Borders has launched a new program to treat malnourished children in Katsina state, in the northwest of Nigeria, as conflict and insecurity surge in the region.

We are working in collaboration with the Nigerian Ministry of Health to run a 62-bed inpatient therapeutic treatment centre (ITFC) in Katsina City, as well as five ambulatory therapeutic treatment centres (ATFCs): one in Katsina City and the other four in Jibia Local Government Area, close to the border with Niger.

Since the beginning of the activities in Jibia in August 2021, we have admitted 4513 malnourished children, 78% of whom were suffering from severe acute malnutrition. Given that these centres were only working two days a week due to security concerns, these numbers are strikingly high.

Salih Muhammad Auwal is a medical doctor and also the COVID-19 focal clinician at Shinkafi hospital, Zamfara state, northwest Nigeria.

Salih Muhammad Auwal is a medical doctor and also the COVID-19 focal clinician at Shinkafi hospital, Zamfara state, northwest Nigeria.

In Katsina city, from the beginning of our activities on 20 of September to the last week of October we have admitted 1784 severely malnourished children to the ATFC and 324 to the ITFC.

"In the summer we carried out a nutritional survey in Katsina that revealed alarmingly high levels of malnutrition," said Dr Guyguy Manangama, MSF's Deputy Emergency Cell Manager. "According to this survey, the prevalence of global acute malnutrition (GAM) was 26.1 %, and severe acute malnutrition was 7.4%."

"We also found that there were few options for parents in the area to access malnutrition care, the effect of which we see across the border in Niger: around 60% of the children admitted to our nutrition program in Madarounfa district are from Nigeria."

Doctor treating a child in Shinkafi General Hospital, Zamfara state, Nigeria.

Doctor treating a child in Shinkafi General Hospital, Zamfara state, Nigeria.

Elsewhere in northwest Nigeria, we are also running nutritional activities in Zamfara State, with three ITFCs in Anka, Shinkafi, and Zurmi Local Government Areas, and 12 ATFCs spread throughout the state.

The northwest of the country, including Katsina State, is currently witnessing a wave of violence, with kidnappings for ransom common, and frequent confrontations between various armed groups and Nigerian forces.

"The conflict is both contributing to the high levels of malnutrition and making responding to them more difficult," said Dr Manangama. "Agricultural activities are impacted, travel is more difficult, and the cost of food therefore increases. The population are also facing an economic crisis driven by several factors including the consequences of the Covid-19 pandemic."

IDP's being attended to by MSF staff at the new emir's palace IDP CAMP

IDP's being attended to by MSF staff at the new emir's palace IDP CAMP.

The provision of healthcare is also increasingly complicated: medical staff can be targeted for kidnapping, and they fear attacks on medical centres. The insecurity means that we cannot travel to all the areas where we would like to offer care DR. MANANGAMA

MoH doctor doing medical round with MSF team at MSF ITFC in Damaturu General Hospital.

MoH doctor doing medical round with MSF team at MSF ITFC in Damaturu General Hospital.

Malnutrition is endemic in northern Nigeria, with the season usually coming to an end around October. Despite this, we are still admitting patients into our ITFC in Katsina City, showing that there are still malnourished children needing treatment and that our centre is one of the very few options for treatment available in the area.

"The fact that we are not yet seeing the number of admissions drop in our centres leads us both to worry about how severe the situation is now, and how it will develop if the response is not stepped up," explained Dr Manangama. "Insecurity is a real issue in the area, but more must be done by international organisations to help the Nigerian authorities deal with this very worrying situation."

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