Nigeria, unprecedented number of malnourished children need life-saving treatment in therapeutic feeding centers

ROME – There is an unprecedented number of malnourished children needing life-saving care in therapeutic feeding centers run by Doctors Without Borders (MSF) in Maiduguri, the capital of Borno state in northeastern Nigeria. MSF raises the alarm of impending catastrophe if action is not taken immediately. The number of hospitalizations since the beginning of 2023 is the highest ever recorded by MSF teams in Borno state for the period preceding the annual lean period (June to August) when the dry season is accompanied by peak levels of malnutrition. “With the arrival of the dry season, therefore – says Htet Aung Kyi, MSF medical coordinator – the massive increase in malnourished children requires an immediate increase in prevention and treatment activities to avoid a catastrophic situation”

The numbers, times and geography of the crisis. From the beginning of January to 20 April 2023, 1,283 malnourished children were admitted for intensive care at the MSF feeding center – around 120% more than in the same period last year. In addition to this feeding emergency in Maiduguri, MSF teams are responding to large-scale malnutrition and health crises in other parts of northwestern Nigeria, working in 32 outpatient therapeutic feeding centers and 10 inpatient therapeutic feeding centers in the states of Kano, Katsina, Kebbi, Sokoto and Zamfara. In 2022, MSF teams treated 147,860 children suffering from severe acute malnutrition across northwestern Nigeria.

“We’ve never seen anything like it.” The team at MSF’s Nilefa Kiji Therapeutic Feeding Center in Maiduguri has reported an increase in hospitalizations for moderate and severe acute malnutrition. In January, about 75 children were hospitalized each week for severe malnutrition, three times the average for the same period over the past five years. At the beginning of April, almost 150 children were assisted, double the number in the same period of the previous year. “We have never seen anything like this since we started working in this malnourished area in 2017,” explains Dr. Htet Aung Kyi of MSF. “The number of weekly hospitalizations is two to three times higher than in the same period of the last five years and continues to grow. Last year we sounded the alarm in June when hospitalizations skyrocketed at the start of the lean season, but this year we’re already seeing alarming numbers when we are just weeks away from the start of the period between planting and the harvest. Time to act is short if we want to avoid a catastrophe”.

“Immediate action is needed.” Malnutrition is nothing new in Maiduguri, where years of conflict and insecurity have led to a critical humanitarian situation. Many people have been displaced from their homes and are now living in precarious conditions in informal sites, in host communities or in transit detention camps. The number of patients treated by MSF for severe malnutrition exploded in 2022, with over 8,000 children admitted for intensive nutritional care. One in seven came from the Hajj detention camp for former members of armed opposition groups, their families and those living under their control. Many arrived in the camp in an already precarious state of health, which then deteriorated further due to the harsh living conditions in this transit point.

Cutting humanitarian aid. At the end of 2021, the official camps for displaced people were closed and humanitarian and food aid was cut. For most people, living conditions are extremely difficult. Some people are subject to movement restrictions that prevent them from earning a living or cultivating the land. The vulnerability of people has recently increased further due to the revaluation of the Nigerian currency in late 2022, which has led to cash shortages and the recent destruction of large markets in Maiduguri. MSF teams provide inpatient and outpatient care to malnourished children and ensure adequate nutrition for moderately malnourished children to prevent their condition from worsening. MSF mobile teams also run clinics providing primary health care to people living in the Hajj camp and the informal sites of Muna and Maisandari.

“But food aid alone is not enough.” “Food aid alone is not enough – says Gabriele Santi, coordinator of MSF projects in Maiduguri – the authorities and humanitarian organizations must immediately increase activities related to malnutrition and increase the number of beds in intensive therapeutic feeding centres, but they must also improve living conditions in transit camps and expand people’s access to health care.All of this must be supported by a rapid increase in donor funding and strong coordination of these funds to ensure that food reaches the most vulnerable. At this stage, only 16% of the required funds have been secured. This is also alarming.”