Hunger is a constant for displaced communities in northeast Nigeria

"We ran. That was how I survived and got to this place," says Tijani Umara, a 65-year-old who fled the Islamic insurgent group Boko Haram seven years ago.

A nearby village had been attacked and “burnt into ashes”, he says. “They were coming towards us. When they approached my village we heard the gunshots, I asked my children to follow me, and we walked through the bush and hid until we found it was calm, then we sneaked and entered here.”

Umara’s wife is dead and his eight children are unemployed, except for odd jobs such as cutting grass. He pays 1,500 naira (€3.17) a month for a single room, which four of them squeeze into. They sold what remained of their animals to buy food.

When we meet, during an outreach visit by charity Christian Aid, the sexagenarian has holes in his clothes and is missing a front tooth. “Life has been so terrible, I have nothing to do. That place was home, there were a lot of things to do to save my life and give my children food. I used to rear animals, cows and farming. Before the attack that’s what I did.”

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Two of his neighbour’s sons attempted to go back to the farms they had fled from and were abducted. He says his home is a “no-go area ... So I’ve gone here and I’m going to stay here.”

His story highlights the difficult existence of northeast Nigeria's displaced people. About 2.4 million have been forced to leave their homes as the now 13-year-long war with Boko Haram escalated in the Lake Chad region. The insurgent group has now split into factions, the most powerful of which is Islamic State's West Africa Province (ISWAP).

In 2017, Nigeria’s government went from promising imminent victory against the insurgent group to instead bringing in a “garrison town” strategy, which involved gathering civilians across the northeast in towns ringed with military protection. The areas outside are effectively considered to be enemy territory, meaning it is unsafe for people to return to their homes and farms.

It is difficult to know what the real conditions are for those living beyond military-controlled areas, aid workers say, and humanitarian organisations are banned from travelling there.

Extreme poverty

The population of Maiduguri – the capital of Borno State and the city where Boko Haram was initially founded – has doubled since the conflict broke out, but even in what was once an economic centre and trade hub, displaced people suffer from malnutrition and the effects of extreme poverty.

"This is still an emergency situation," says Jeremy Ristord, a project co-ordinator for Médecins Sans Frontières (MSF), in his office at the medical charity's 120-bed inpatient therapeutic feeding centre. He says MSF hospitalised 2,475 patients suffering from malnutrition between January and October 2021. The number of outpatients was double the previous year – trends that hadn't been seen since 2016 and 2017, when the UN warned of a looming famine.

About 80 per cent of those needing treatment were displaced people. Between 5 and 10 per cent of admissions die.

When new patients arrive, they undergo an appetite test, which involves them trying to eat the peanut-based paste Plumpy’Nut. Then they can be given F-75 or F-100 therapeutic milk powders, or admitted to the intensive care unit.

Inside the ICU, a dozen mothers lay curled up with babies. There is one room for babies under six months old. A measles outbreak has exacerbated the scale of the problems, and there were separate isolated areas for the 19 patients that had measles along with malnutrition.

Maryam Mustapha (30) who lives close to the facility, was staying there after her 10-month-old daughter, Hawa, was admitted. "We used to get food but it's not sufficient. We are displaced so we only eat what we can get," says Mustapha. For the past five years, she has lived with relatives and sells traditional hats for about 2,500 naira (€5.28) a month, but it's not enough. Hawa is the youngest of seven children.

In the malnutrition facility, Mustapha says she is “very happy”. Hawa is on a drip and she gets three meals a day herself while she cares for the baby.

Two or three days

Nearby, Falmata Bulama, another 30-year-old caring for four children, says her two-year-old son has been improving after a week. He had measles and became unconscious; after arrival, he was placed on oxygen.

“There’s really a problem of food,” she says. Sometimes she goes two or three days without eating. “The neighbours will give us something but I’ll give it to my kids and go without myself.”

While she is in the treatment facility, her other three children are staying with neighbours but they have nothing to eat either. “I have to go work in the community to get food,” she says. “I used to go to houses to clean and wash plates, when I raised capital I’d buy vegetables to sell.”

She has been in Maiduguri for seven years, living in a room her husband built before he died. Now she’s also wondering when it will be safe to go home, and whether there is work there. “I will go wherever I can find something to do,” she says.

Hajja Zara Abubakar (45), who has 10 children, has spent 10 days in the facility with her two-year-old. She has been living in a camp for displaced people, after fleeing conflict in different areas seven separate times. “I’ve now stayed a year without running,” she says. “I live in a tent, we have a problem with water. I move around and do petty jobs for my children.”

Her husband used to work as a motorbike driver but he has been stopped because motorbikes are banned in the city due to the risk of attacks.

Like the others, she is grateful for the treatment, but well aware that she is going back into a situation where it could easily happen again. “When I leave I will appreciate the organisation but miss the care,” she says about her child being discharged from the facility. “We’ve been well taken care of.”