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Amidst the rising insecurity, Médecins Sans Frontières still on the front-lines in Borno



Dusuman is a community outside Maiduguri, the capital of northeast Nigeria’s Borno state. Nearby is the neighbourhood of Zabarmari, where dozens of rice farmers were beheaded in November 2020 – a brutal act for which the group commonly known as Boko Haram took responsibility. The Nigerian military is struggling to retake control of the territory within Borno state as a whole, but many areas, such as Dusuman, remain very insecure. This makes it difficult, if not impossible, to provide people with humanitarian assistance and medical care. 

Despite the significant security challenges in working outside the main cities in Borno state, teams from Médecins Sans Frontières/Doctors Without Borders (MSF) have been running mobile clinics to provide basic healthcare to children under 16 in a number of locations outside Maiduguri, namely Dusuman, Musari and Ahmed Grema camp for displaced people in Shuwari.

People in these locations have very limited access to medical care, as the few local clinics that exist are desperately short of essential medications; they also charge for their services, putting them out of most people’s reach. 

Aisha, a mother of four, was displaced from her home five years ago and has been living in Dusuman ever since. When her 12-year-old son Yahaya fell ill with a fever and cough, she brought him to MSF’s mobile clinic.

“Yahaya has been sick for almost a week now,” says Aisha, “but I did not take him to the clinic in our community because drugs are often not available, or if they are, we have to pay for them, and most of us here cannot afford to do this.” 

Aisha says she would welcome having a more permanent presence of non-governmental organisations in the area to provide people with free medical care. “If possible, we would like to have a permanent presence in our community, to provide us and people in the surrounding settlements with free health services,” she says. 

Between mid-August and December 2020, MSF’s mobile team provided a total of 6,881 consultations for children living in villages outside Maiduguri. MSF staff tested 6,463 children for malaria and treated 2,260 children for the disease, referring 18 of them to hospital. The team also treated 71 children for severe acute malnutrition and 190 children for moderate acute malnutrition.

Some neighbourhoods, such as Zabarmari, are too insecure for visits by MSF’s mobile team. In this situation, MSF employs a simple yet effective method to provide children with essential healthcare. The team trains a person from the neighbourhood to carry out rapid malaria tests and malnutrition screening, and to either give appropriate medication or, if a child’s condition is serious or hard to determine, to refer them to an MSF hospital in the capital. In this way, children living in hard-to-reach villages have access to basic healthcare every day, at any time they need it.

“As we cannot directly work in Zabarmari, we have engaged members of the community and trained them in how to perform basic tasks, like test-and-treat malaria,” says Isa Ibrahim, who manages MSF’s mobile team. “They refer patients who require additional management to Gwange or Fori hospitals in Maiduguri.”

Now that peak season for malaria in Borno state is over, MSF’s mobile team has wound up its activities, but it may restart them in the coming months, depending on the security context and on people’s medical needs.

MSF has been working in Nigeria since 1996 and in Borno state since 2014. In Borno state, our medical teams provide emergency treatment, surgery, malnutrition treatment, maternity and antenatal services, vaccinations, and the prevention and treatment of malaria and other diseases.

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