North-east Nigeria: Ringing the alarm bell on the malnutrition crisis

"So how far away are we from a crisis? We are in the middle of a crisis. We need to be clear on that. We are ringing the alarming bell. There are people close to or dying right now as we speak in north-east Nigeria.”

Those were the stark words of Matthias Schmale, the Humanitarian Coordinator for Nigeria, in reference to the grim projection that hangs over north-east Nigeria: 2 million children under age 5 may suffer from acute malnutrition in Borno, Adamawa and Yobe (BAY) states this year due to a lack of nutritious food. About 700,000 of these children may suffer life-threatening severe acute malnutrition (SAM). This is more than double the number of SAM cases in 2022 and the highest levels projected since the nutrition crisis in 2016.

Rising levels of complicated acute malnutrition

In Maiduguri, Borno State’s capital, there was 48 per cent increase in the number of children with complicated acute malnutrition requiring inpatient care during the first quarter of this year, compared to the same period last year.

This increase is visible at the stabilization centre, managed by the International Rescue Committee (IRC), in Gwoza General Hospital, Borno. Mothers line up with their malnourished children, and distraught mothers from nearby camps for internally displaced persons (IDPs) and host communities rush in with their malnourished children.

The heat is sweltering. Sunlight filters through the windows, casting long shadows on the children’s beds, which are covered with paediatric scales and measuring tapes.

At one end of the stabilization centre, women quietly wait and observe. Their expressions are a mix of worry and hope as they watch their children being moved from one intensive care room to another for emergency life-saving treatment.

Aisha Mohammed, 26, clasps her eight-month-old son, Ali, in her arms. Ali has sepsis – a serious infection stemming from a compromised immune system due to acute malnutrition. His small, frail body bears the tell-tale signs of poor nutrition.

"I just want my child to get better,” says Aisha. “Life has always been harsh and continues to be so. During the time when we were held captive [by a non-State armed group], our diet primarily consisted of guinea corn and various soups prepared with zobo [hibiscus] leaves. We have been unable to eat the way we used to."

Aisha is one of many people who arrived in Bama from inaccessible areas in Borno to find help.

Aisha’s son, Ali, receives treatment at the stabilization centre. Photo: UNOCHA/Adedeji Ademigbuji

There are places where people’s vulnerability has increased. In 2022 there was a huge increase in the number of patients treated by Médecins Sans Frontières (MSF) for severe malnutrition; more than 8,000 children were hospitalized for intensive nutrition care. And between January and May 2023, some 2,530 malnourished children were admitted for intensive care at the MSF stabilization centre. That’s an increase of about 120 per cent compared to the same period last year.

Since late April 2023, almost all of the stabilization centres in Maiduguri have been full, leaving many children waiting in line for an available bed.

The nutrition sector urgently needs approximately US$4 million to increase bed capacity (by about 220 beds), support the operational costs of stabilization centres and implement a harmonized nutrition response across Borno State during the lean season.

Additionally, $4 million is needed to ensure a secure pipeline of life-saving nutrition commodities.

Responding to the lean season nutrition crisis

Efforts are urgently required to prevent a food and nutrition crisis in north-east Nigeria from turning catastrophic.

Some 4.3 million people in the BAY states face the risk of severe hunger at the peak of the lean season, from June to August. More than half a million of these people may face emergency levels of food insecurity, with extremely high rates of severe acute malnutrition that could result in death.

In response, partners have developed a lean season food security and nutrition multisector crisis plan, drawn from the 2023 Humanitarian Response Plan.

Humanitarian organizations urgently need $396.1 million to scale up food, nutrition, health, protection, and water, sanitation and hygiene support in the BAY states over the next six months.

The early disbursement of funds is critical to scale up preventive services and case management, including support to stabilization centres that are either non-functional or operating at suboptimal capacity due to a lack of funding. Delayed funding will have devastating consequences for millions of children.

The World Food Programme aims to provide 2.1 million people with emergency food and nutrition. The UN Children’s Fund and partners aim to provide nutritional services to more than 1 million malnourished children and pregnant or breastfeeding women. The Food and Agriculture Organization of the UN aims to assist 2 million people with seed packages for cereal production.