On the 9th of September, Nigerians woke up to the devastating news of catastrophic flooding in Maiduguri, the capital of the northeastern state of Borno. The Alau Dam, in the Konduga Local Government Area (LGA), had overflown and released its water, submerging most parts of the ancient city. There are no official confirmed figures yet, but it is estimated that more than 400,000 people have been displaced, with thousands of structures destroyed, including residential buildings, roads, schools, shops, and health facilities. The pictures and videos coming out of the city are very heartbreaking. It is yet another disaster for people who have endured over a decade of agonizing insurgency from the terrorist group Boko Haram.
Life in Maiduguri was gradually returning to the peaceful pre-insurgency period. The Nigerian military had made significant gains against Boko Haram in the past few years, allowing some normalcy to return, despite periodic attacks. The Borno State government, local development partners and international non-governmental organisations (NGOs) have provided livelihood support to the impoverished population of the state. Business activities were gradually picking up, schools were being reopened and provision of essential healthcare services, including maternal and child health and immunisation coverage were improving. However, the flooding may have reversed these gains. It has disrupted and will continue to disrupt livelihoods and essential services in the foreseeable future. Healthcare is one of the most significant areas that would be impacted.
Risk of infectious disease outbreaks challenges to menstrual hygiene
The flooding in Maiduguri was so intense that buildings were submerged, gutters overflowed and waste disposal were washed away. Residents were seen moving in the flood waters in pictures and videos. Displaced residents, in their thousands, took refuge in schools, which have been serving as displaced persons camps, obviously in overcrowded, unhygienic conditions. These, in addition to a lack of clean drinking water, pose a potential risk of outbreaks of infectious diseases, particularly cholera.
Nigeria has been dealing with a cholera outbreak in many states in 2024, with 6,782 suspected cases including 197 deaths reported by the end of August 2024. The flooding in Maiduguri may worsen the outbreak. With most health facilities in the city affected and not able to operate optimally, an outbreak could be highly fatal. Additionally, displaced young girls and women will certainly struggle to access menstrual hygiene services such as sanitary pads and gender-equitable toilet facilities, creating another threat to their health.
Exacerbation of malnutrition crisis
In 2023, the United Nations raised the alarm over the rising levels of acute malnutrition among children in Maiduguri. The destruction of farmlands and businesses because of the Boko Haram insurgency triggered a malnutrition crisis in Borno State. The massive influx of people into Maiduguri at the height of the insurgency put enormous pressure on the city's internally displaced persons (IDPs) camps. Even though some camps have been closed, and some people have returned to their communities in recent years, a large number of people continue to take refuge in Maiduguri, with the majority working in menial businesses and receiving food from local and international organisations. The destruction of businesses by the flooding will worsen hunger for the already overburdened population, with reports of skyrocketing food costs. According to Chachu Tadicha, Deputy Director, Programme Operations/Humanitarian at Save the Children, the flood has "posed a serious risk to food security because crops in the field have been severely damaged, along with food in stores, the market and shops".
The situation is being further complicated by the difficulty in reaching people trapped in their homes, and in displacement camps owing to the water levels in the city. The aftermath of the floods will worsen this crisis, plunging more children in the city and throughout Borno State into deeper levels of malnutrition, and in the process, predisposing them to diarrhoea and other malnutrition-related diseases. In the interim, the Borno State government is distributing food items to habitants in the city.
Disruption to healthcare services
Healthcare facilities, especially public ones in Maiduguri were already under pressure due to the city's high population. However, support from NGOs and international organisations has enabled the provision of maternal and child health services, mostly in IDP camps and specifically designated facilities operated by the NGOs. These services have now been disrupted by the flood. The destruction of facilities means less resources for even more people in need. The few that have not been destroyed would have had their services disrupted by the lack of adequate supplies, lack of drinking water, disruptions in electricity supply, and inaccessibility due to water levels. In order to mitigate the consumption of contaminated water, chlorine tablets are being sent to Maiduguri from other states, according to the Coordinating Minister of Health and Social Welfare. Children who cannot be treated for diseases such as malaria, are at risk as a result of destroyed infrastructure, and stagnant water which is serving as a breeding ground for mosquitoes.
Immunisation services are also being impacted, since cold chain stores with vaccines are among the damaged structures, and regular immunisation services in health facilities are being impacted, if available. This might reverse the progress gained in vaccination delivery in Borno State. As stated by the Coordinating Minister of Health and Social Welfare during a TV interview, 'We lost about two million doses of vaccines that were in a cold store and exposed.' Other medical commodities that were salvaged included antimalarial treatments, Intravenous Artesunate for malaria, and rapid diagnostic kits. To address the potential increase in malaria cases, bed nets are being sent to Maiduguri."
Pregnant women are also on the receiving end of the flood damage, unable to access antenatal and delivery services, and are now at a higher risk than at any time. Their access to reproductive health services will be affected, resulting in a potential increase in unplanned pregnancies.
The University of Maiduguri Teaching Hospital (UMTH), which has stopped admitting patients due to concerns about the risk infection, also sustained significant flood damage. Medical equipment at the multimillion-dollar Radiotherapy Department was flooded, causing damage to expensive state-of-the-art equipment such as two Elekta Linear Accelerators, two Brachytherapy machines and a Canon Large Bore CT Simulator among other medical equipment. Former President Muhammadu Buhari commissioned the UMTH Cancer Centre, which equipped by JNC International Limited, in 2023.
A desperate appeal
Health care systems across Nigeria are already under significant pressure, and Borno's system may be considered to be at a disadvantage due to the destruction sustained by the Boko Haram insurgency. The flooding has wreaked havoc on an already weak health system that required strengthening. It is now even weaker. As federal and state institutions, as well as national and international organisations, race to provide support to Maiduguri and its residents in this highly tumultuous period, deliberate efforts must be made to ensure healthcare services are prioritised, especially for vulnerable groups. Basic maternal and child health services should be provided at displacement camps, and mobile health facilities should be established across the city to provide services to residents. In the midst of this disaster, we must ensure that critical services such as immunisation, antenatal and postnatal, and health worker-assisted deliveries are not entirely cut off.
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A wake-up call
Rebuilding Maiduguri will need time and resources. When it starts, priority should be given to destroyed healthcare infrastructures such as health facilities and cold chain stores. However, most critically, disasters such as the Maiduguri flooding must never be repeated anywhere in Nigeria. Federal and state governments should rise up to their responsibilities of maintaining and strengthening our weak infrastructures, including dams across the country. As much as climate change-induced excessive rainfall contributed to the Alau Dam's collapse, there are reports that show that the dam had shown signs of decay for years and had started collapsing since 2022, without any meaningful effort by the relevant authorities to repaid it. It ultimately gave way and overran Maiduguri, the city it was supposed to provide with water, with devastating consequences on every aspect of life. Many Nigerians are concerned about what dam will come next. Another dam must not fail again, and the federal and state governments must assure this.
