Crisis update: Borno and Yobe states, January 2019

The humanitarian context in northeast Nigeria

Nine years of conflict between the military and non-state armed groups have taken a heavy toll on the population, with serious humanitarian consequences. Thousands of people have been killed; others have been deprived of access to medical care and died of easily treatable disease such as malnutrition and malaria.

According to the United Nations Office for the Coordination of Humanitarian Affairs (OCHA), 1.9 million people are internally displaced in the northeastern states of Borno, Adamawa and Yobe, and 7.7 million people are in need of humanitarian assistance. More than 230,000 people have fled to the neighbouring countries of Niger, Chad and Cameroon.

The emergency is not over

In northeast Nigeria, services remain inadequate and there are many gaps in the humanitarian response. Security and access issues hamper the delivery of aid, and humanitarian organisations cannot provide assistance in all locations where it is needed.

Nevertheless, hundreds of thousands of people remain heavily dependent on aid for their survival. In some places, people have been stranded for nearly three years with little prospect of returning home due to the continuing conflict.

Immediate needs are not being adequately addressed

Much of the humanitarian aid is concentrated in Maiduguri, the capital of Borno state, which hosts one million internally displaced people, but services remain insufficient even there.

MSF recently scaled up its activities in the town to respond to a cholera outbreak which was declared by the Ministry of Health on 5 September 2018. MSF teams are also treating an increasing number of children suffering from severe acute malnutrition, malaria and lower respiratory tract infections.

Outside Maiduguri, the ongoing conflict restricts the movements of the population and of humanitarian organisations.

Civilians caught in a cycle of violence, fighting for survival with very little means

Most people live in towns or enclaves controlled by the military. Due to restrictions on their movements, most people are unable to farm, fish or sell their goods, leaving them dependent on humanitarian assistance.

In some locations, living conditions are catastrophic. Basic amenities are overstretched, water shortages are common, and sanitation is inadequate. Any disruption to the provision of assistance in these areas could have deadly implications.

Areas out of reach of assistance

MSF is currently providing lifesaving medical care in permanent facilities in Gwoza, Pulka, Bama, and Ngala. Mobile teams are providing medical aid in Rann and Banki, and via mobile emergency clinics in Yobe and Adamawa.

Little is known about the needs of people living outside the enclaves. OCHA estimates that around 800,000 people live in areas that are inaccessible to humanitarian organisations. The only information that MSF has about these areas is from newly displaced people who continue to arrive – not always by choice – at towns controlled by the military.

The conflict is not over in northeast Nigeria and civilians are caught in the middle. MSF patients have reported harrowing stories of extreme violence perpetrated by all sides to the conflict.