By DONALD G. McNEIL Jr.
Starvation in northern Nigeria’s Borno State is so bad that a whole slice of the population — children under 5 — appears to have died, aid agencies say.
As the Nigerian army has driven the terrorist group Boko Haram out of the area, about two million people have been displaced. Many are living in more than 100 refugee camps.
Doctors Without Borders, which has been in Borno State since 2014, reported in November that it was seeing hardly any children under age 5 at its clinics, hospitals and feeding centers.
“There are almost always small children buzzing around the camps,” Dr. Joanne Liu, the agency’s president, and Dr. Natalie Roberts, an emergency operations manager, wrote then.
“We saw only older brothers and sisters. No toddlers straddling their big sisters’ hips, no babies strapped to their mothers’ backs.”
Measles, diarrhea, pneumonia and malaria — all of which are worsened when starvation weakens immune systems — were taking a huge toll on infants and toddlers, they said.
Because the world’s attention has been focused on refugees in Syria and North Africa, less light has been shone on Nigeria’s humanitarian crisis.
While more food has begun to arrive, Dr. Roberts said in a recent interview, the flow was seriously slowed for months by a struggle between the Nigerian government and aid agencies.
In December, President Muhammadu Buhari accused United Nations agencies of exaggerating his country’s crisis in their appeal to donors for $1 billion. Two weeks ago, Borno’s governor, Kashim Shettima, said some aid groups were using his state as a “cash cow” and should leave.
Doctors Without Borders — widely known by its French name, Médecins Sans Frontières, or M.S.F. — normally provides only medical care, Dr. Roberts said. But the organization had been forced to distribute millet and palm oil, along with packets of peanut paste, because so many of the people it served were starving.
“Bureaucratic obstruction” by the government kept agencies like the World Food Program out for months, she said. “It’s an embarrassment to a big state like Nigeria to admit it has malnutrition,” Dr. Roberts added. “They don’t particularly enjoy outside interference.”
The situation grew so bad that M.S.F. had to change some of its protocols, she said. Instead of measuring the height and weight of malnourished children before admitting them to feeding centers, doctors started using just arm-circumference measurements to speed up the process.
And in remote villages where M.S.F. delivers food, staff members had to leave more than normal, she said. Usually, only a few days’ worth is given to families, because of the risk that large amounts will be stolen by any armed group nearby.
But because some roads are so dangerous that food can only move with army escorts or by helicopter, and because Boko Haram may send suicide bombers into any large gathering, M.S.F. does more unannounced “one shot” deliveries for safety’s sake, hoping the food will remain in the intended hands.
