Just a step away from ‘catastrophic levels of hunger’, the lives of thousands of children in Borno State hang in the balance if they do not receive urgent nutritional and medical care.

The lives of thousands of children in Borno State – suffering from malnutrition, malaria and cholera – hang in the balance if they do not receive urgent nutritional and medical care.

Médecins Sans Frontières / Doctors Without Borders (MSF) has reported an “extraordinary” increase in the number of severely malnourished children with life-threatening complications being admitted into its inpatient facilities throughout northern Nigeria.

“We’ve been warning about the worsening malnutrition crisis for the past two years; 2022 and 2023 were already critical, but an even grimmer picture is unfolding this year,” said Dr Simba Tirima, MSF’s country representative in Nigeria.

“We can’t keep repeating these catastrophic scenarios year after year. What will it take to make everyone take notice and act?”

He said in some locations in northern Nigeria, there had been double the number of admissions compared with last year.

In April, MSF’s medical team in Maiduguri admitted 1,250 severely malnourished children with complications to its inpatient therapeutic feeding centre, double the figure for the same month in 2023.

Forced to urgently scale up capacity, by the end of May the centre accommodated 350 patients, far surpassing the 200 beds initially designated for the peak malnutrition season in July and August.

The MSF-operated facility in Bauchi State’s Kafin Madaki hospital recorded a significant 188% increase in admissions of severely malnourished children during the first three months of 2024 compared with the same period last year.

In Zamfara State, in the northwest, the inpatient centres in Shinkafi and Zurmi received up to 30% more admissions in April compared with March. There was a 20% increase in the same period at Talata Mafara.

In April, MSF inpatient facilities in major cities reported “alarming surges” – 75% in Kano and 100% in Sokoto.

The therapeutic feeding centre in Kebbi State documented a rise of more than 20% in inpatient admissions from March to April this year.

In the harsh economic climate – in June this year, Nigeria’s inflation rate hit 34.19%, with food inflation exceeding 40% – along with the cost of all commodities, the price of even basic foods is out of reach for thousands of poor households.

A lactating mother needs nutritious food to produce enough breast milk to feed her newborn – but, with the exorbitant price of food, many mothers are struggling and are feeding their babies pap instead.

Displaced persons say they and their children go to bed with empty bellies at least twice a week.

The United Nations and Nigerian authorities issued an urgent appeal in May for US$306.4 million to address the pressing nutritional needs in Borno, Adamawa and Yobe states.

Tirima said a bigger response was needed to address the “catastrophic lack of nutrition”.

“We are alarmed by the reduction in aid at these critical times. Reducing nutritional support to only severely malnourished children is akin to waiting for a child to become gravely ill before providing care,” Tirima said.

“We urge donors and authorities to increase support urgently for both curative and preventive approaches, ensuring that all malnourished children receive the care they desperately need.”

The persistent malnutrition crisis in northern Nigeria stems from a variety of factors, such as inflation, food insecurity, insufficient healthcare infrastructure, ongoing security issues, and disease outbreaks that are worsened by low vaccine coverage.

The MSF said tackling acute malnutrition in northern Nigeria required preventive and curative steps. As an immediate measure it was important to establish and strengthen healthcare facilities and programmes capable of diagnosing and treating malnutrition effectively.

Additional key steps included reinforcing vaccine programmes that could help stave off preventable diseases, enhancing access to nutritious food through agricultural initiatives and food distribution programmes, improving the water and sanitation situation, and raising awareness.

The International Rescue Committee (IRC) has also called attention to the “alarming rise” in cases of children with acute malnutrition across all its treatment sites in Borno and Adamawa.

Record levels of food insecurity during the worst lean season in years had left communities unable to meet their essential needs.

“Food security in northern Nigeria is severely challenged by rising prices and attacks by non-state armed groups hindering humanitarian efforts, hampering access to basic commodities and leading in turn to increased acute malnutrition rates,” said Babatunde Ojei, the IRC’s country director.

“The situation is extremely critical. In the metropolitan areas where we are working right now, the prevalence of malnutrition has gone from 12% to 16% between 2022 and 2023. The prevalence is likely to be higher in garrison towns and worse in communities where access to humanitarian services is limited. In the areas where the IRC operates, the caseload has doubled compared with previous years.

“In May of this year, the IRC recorded a 70% increase at its nutrition treatment centre in Mashamari in the Jere Local Government Area of Borno State.

The United Nations Office for the Coordination of Humanitarian Affairs (OCHA) also reported the highest admissions rate for children with severe and moderate acute malnutrition in May.

It said the lives of more than 230,000 children under the age of five were in danger, particularly during the lean season from May to September, if they did not get urgent treatment for acute malnutrition.

They also needed access to clean water, healthcare, and hygienic living conditions to protect them from diseases such as diarrhoea which could increase the risk of death.

In Borno, Adamawa and Yobe, 4.8 million people were likely to face severe food insecurity over the lean season.

“Of these people, close to half a million are facing high levels of food insecurity, just a step away from catastrophic levels of hunger,” OCHA said.

Earlier this week, the World Health Organisation (WHO) donated medical and nutritional supplies to Borno State.

“This timely contribution is poised to reduce child mortality rates, combat malnutrition and ensure children can grow and thrive in a healthy environment,” said Dr Ann Fortin, the head of WHO Nigeria’s emergency preparedness and response cluster.

“Malaria and cholera are significant threats to young lives in Borno. This donation is a lifeline that will provide the necessary resources to combat these deadly diseases,” said Dr Walter Kazadi Mulombo, WHO country representative to Nigeria.