Child Malnutrition In Borno Hits Unprecedented Level – MSF Records

Medicines Sans Frontier (MSF -aka Doctors Without Borders) has revealed that it has provided medical care for a total of 6,609 children who have been diagnosed of severe acute malnutrition across  Borno State, Northeast Nigeria. 

MSF said most of these children are found with parents living within the settlement or host communities for internally displaced persons. 

A statement on Thursday, Dec. 16 signed by Hussein Amri, MSF Field Communication Manager, revealed that this year’s case has so far outnumbered the cases recorded in 2020. 

MSF said children suffer nutrition deficient ailments this year as “the chronic vulnerability of the conflict-affected people was exacerbated by a major outbreak of measles.”

The charity also said the situation and other factors “have driven hospital admissions and outpatient consultations for malnutrition to climb to levels unseen in recent years.”

It said the high number of malnourished children “may signal a broader deterioration in the vulnerability of people in the region.”

“So far in 2021, we have admitted 2,465 severely malnourished children for hospitalisation in our inpatient therapeutic feeding center (ITFC) in Maiduguri, representing an increase of 13 per cent from the year before,” the statement said. 

Apart from the admitted cases, MSF said it has enrolled 4,144 outpatients for the “therapeutic feeding program” this year which is more than 50 per cent more patients than were seen in the same period in 2020. 

MSF said more than 80 per cent of cases of severe acute malnutrition recorded were children living in households displaced by the ongoing conflict in Borno State. 

“While we cannot extrapolate from hospital data a general understanding of people’s nutrition status, this year has clearly shown us that displaced people, in particular, remain extremely vulnerable to peaks of malnutrition and the numbers of malnourished children we are receiving suggest it may be getting worse,” says Shaukat Muttaqi, MSF Head of Mission in Nigeria.

“This is a concerning dynamic and needs further analysis and engagement from all concerned actors to ensure proactive and preventative action to ensure the situation does not get worse,” he added.

HumAngle learnt that MSF has 120-bed ITFC, the largest single provider of hospital care for malnutrition in Borno State, which Muttaqi said represents “a third of all beds available for malnourished patients.”

Even as MSF said it acknowledges many of the factors affecting malnutrition are complex which includes the “direct and indirect impact” of conflict on food security, access to humanitarian aid and health status, the year’s admissions data, and the increase in patients suggests ‘a concerning trend’.

Measles plaguing kids in Borno

“One important medical factor contributing to the high malnutrition admissions was an outbreak of measles, which began in February,” the top official of MSF said.  

Muttaqi revealed that the organisation had treated nearly 8,000 cases of measles from January to October 2021. 

“Our teams at the only pediatric hospital in Gwange treated 2,974 children for measles on an inpatient basis while 2,545 other children were treated at the outpatient department within the same period,” Muttaqi said.

“During outreach activities in Zabarmari village in Jere Local Government Area of Borno State between mid-February and end of July 2021, our mobile clinic team provided treatment to 2,517 children suffering from measles.”

“While the traditional hunger gap period typically occurs from June until November, we admitted 60 to 150 percent more patients per month from March to May in 2021 compared to 2020.”

More children needing medication than ever 

To tackle the worsening cases of child malnutrition and related ailments, MSF said it had to, in June, relocate its inpatient therapeutic feeding center to a new facility “to allow for increased overflow capacity but the outpatient program continues to see unprecedented levels of admission.”

The statement explained that the outpatient therapeutic feeding (ATFC) programs “provide medical care and therapeutic food to children, which reduces the risk of life-threatening medical complications if they get sick.”

Doctors Without Borders, HumAngle learnt, are currently providing ATFC care in five locations in Maiduguri, but its officials are worried that “the drastic increase in enrollment is a clear sign that more availability of care is needed.”

Possible major cause of a large number of cases

According to the MSF, the high number of malnutrition and measles cases in communities may not be unconnected with “gaps in vaccination.” 

Sadly, low vaccination rates and unavailable routine immunization have rendered this year’s mass measles vaccination campaign ineffective. 

“We are now approaching the end of the hunger gap period, however, what we saw this year is deeply concerning,” Muttaqi said.

“The same factors remain in place that could allow for further deterioration next season. Renewed focus and attention is needed from all relevant actors to prevent an even more serious deterioration during the hunger gap next year.” 

The Borno State government had last week issued a ban on the deployment of food support to relocated communities. 

These garrison settlements are largely local government headquarters still surrounded by soldiers who are keeping watch over the residents while ensuring that they don’t wander outside the communities and get attacked by marauding terrorists. 

Many concerned humanitarian experts are worried that banning food and medical relief to such restricted settlements could also worsen hunger which would lead to malnutrition in children who are usually the first casualties of a food crisis.