The over 108,000 Internally Displaced Persons, packed into a school in the Ngala community, Borno State, are grappling with a litany of infections and hunger, reports OLALEYE ALUKO who spent two days at the camp
Amina Saidu clutched her three-month-old baby to her bosom. She tried in vain to pacify the child who cried intermittently and looked pale.
Saidu needed to see the doctor very urgently, as her first baby had died from persistent cough in November 2016. Her three-month-old had started showing the same symptoms.
She looked disturbed as she sat among other women at a clinic run by the United Nations Children’s Fund for the Ngala Internally Displaced Persons camp in the Gamboru-Ngala Local Government Area of Borno State.
“My first child died in this camp. He had fever, cough and diarrhoea,” she told our correspondent.
“This boy is my second. He is coughing too and I am waiting to see the doctor. The weather in this area may be responsible for these coughing and breathing issues,” Saidu explained in Hausa.
The worried mother and her boy are among the 108,698 IDPs at the camp who are exposed to cough, malaria, diarrhoea and acute respiratory disorders as a result of unhygienic living conditions and the harsh weather.
The camp, according to military records, is the largest in the North-East and invariably in Nigeria. One of the reasons for the size is its closeness to the border between Nigeria and Cameroonian town, Fotokol, where many people displaced by Boko Haram in Gamboru-Ngala, initially fled.
Currently, these people are returning to the Ngala IDPs’ camp almost every week, making the number of occupants to soar.
Another woman at the UNICEF clinic, who identified herself as Aisha Ahmed, in her 40s, came to seek treatment for fever and rashes. The woman, who also had a few blisters, said she had been ill for 20 days.
“I don’t know what caused the skin infections. It started 20 days ago and it pains me greatly, making me scratch my skin all the time. I don’t have the appetite to eat. I don’t have any idea what caused it,” she lamented with teary eyes.
Our correspondent was told that about 200 IDPs visited the UNICEF clinic daily for cases ranging from cough, fever to acute respiratory disorders.
Although the crowd of patients visiting the camp’s clinic may not understand the causes of their recurring conditions, a UNICEF doctor, Mark Luku, explained the origin of the infections.
He stated, “Basically, there are drugs that we give for some common conditions here. Malaria is the most common in the hospital. We also have the acute respiratory infection. At some points, they have other infections but these two are the most common. For children, it is due to the poor level of hygiene. We also have bacterial infections. There is also acute diarrhoea for children below the age of five.
“Acute respiratory infection is more at this time because of the harmattan. But during the rainy season, malaria is more common in the camp because of the waterlogged areas. You know how the camp is.
“For the children just coming into the camp, it is malnutrition. They have stayed in the bushes. They are weak and when they come, they are brought to the hospital and we give them drugs. We don’t get to keep patients for so long, because our mandate is to be a primary health care centre.
“For complicated cases, we refer them to Maiduguri. We also have voluntary community mobilisers who help us to check the IDPs’ conditions.”
Our correspondent gathered that there were three hospitals in the camp and they are owned by international agencies –UNICEF, FHI360 and the Medecins Sans Frontieres (doctors without borders).
It was learnt that as recurring as infections were in the Ngala camp, thousands of the IDPs suffered more from hunger than diseases.
SUNDAY PUNCH learnt that the IDPs in Ngala were actually from five local governments in Borno – Gamboru Ngala, Dikwa, Banki, Kala Balge, Marte and Bama.
Sleeping on empty stomachs
The worst hit by the food shortage in Ngala are the women and children, particularly those who became widows and orphans as a result of the insurgency.
It was gathered that the IDPs, most of whom were farmers prior to the Boko Haram violence, could not go to farms at present and had to depend on food sacks distributed by international agencies. The agencies included the United Nations World Food Programme and the Danish Refugee Council.
Despite these efforts, the IDPs told our correspondent that their food was insufficient.
On one of the food distribution days in the camp, more than 2,000 women were observed sitting in the sun, hoping that the food sacks would get to them.
The women are always anxious, sitting in the sun as the food distribution holds once a month. The households in the camp are numbered and have identification cards.
One of the women, who gave her name as Safiyat Garuba, explained how she had to sell part of the food to be able to buy some other needed items.
Garuba, a mother of four children, whose husband was killed by the Boko Haram, said, “It is not easy getting food to feed my family. Coping to feed four children is very tasking. During the food distribution, I try to get some for my household. There is no other means.
“As soon as distribution is over, I share the food into two and sell a part of it so that I can buy some other day-to-day supplements and ingredients. Some of us sell part of the food as we collect it. It was the Boko Haram terrorists who sent us away from our village in Ngala. I have been living in this camp for about five months.”
One of the humanitarian workers in the camp, who did not want his name in print, said some of the women would still go home with no food after sitting in the sun from morning till sunset.
“This is how the women sit in the sun. They can sit for as long as the food is being distributed. Even if they will not get it, they will still wait in the sun, hoping that they will get it. The food distribution actually takes a lot of time.
“Since I came to this camp, for over a month, I did not see any distribution. It is just this week that we saw this distribution. The food distribution is not yet as constant as needed,” he explained.
It was learnt that like Garuba, most of the lucky women, who receive the foodstuffs, sell part of them to be able to raise money for other ingredients and supplements.
“I am hoping that this crisis will be over and I can return to my village in Gamboru. I pray that Allah brings peace back to the villages,” said another woman among the crowd.
Tani is a mother of two, whose husband fled to Fotokol, Cameroon, in the heat of the insurgency and has yet to return.
The women sat in clusters in the large dusty open fields as the humanitarian workers offloaded the sacks of food from the trucks and arranged them for sharing. There were bags of rice, millet and semolina.
There were men and children also waiting for the humanitarian workers to start the food sharing. The hunger in the camp is unmistaken.
‘My two sons are coughing, vomiting’
At the UNICEF clinic, it was observed that there were another horde of patients were waiting to be attended to.
One of the women, identified as Hadiza, brought her two sons to be treated for cough and vomiting.
She said, “My two sons – Abdul and Ali – have fever. It was the younger who first started and the elder copied him. I have been given some drugs by the attendants. The younger one is just five months old. I live with my husband in the camp.”
A health worker, who declined to give his name, said some of the IDPs usually brought their infections for treatment when there was little that could be done to save their lives.
He said, “The trend of illnesses is as a result of the weather. In the rainy season, we gave anti-malaria drugs like amoxicillin and the artemisinin combination therapy. Presently, we are giving drugs for acute respiratory infections.
“If you refer to some of the worsening health cases, the victims would not even get to Maiduguri before passing on. The most unhealthy practices among the IDPs border on hygiene. There are a few latrines in the camp, but some IDPs still engage in open defecation.”
Rate of births still high in camp
Our correspondent learnt that despite the infections in the camp, the IDPs had a high birthrate, which also constitutes a serious strain on the food and resources given to the camp.
The health worker said he and other nurses conducted up to 15 births every week in the camp.
The health worker stated, “Some IDPs are still delivered of their babies at home. It is a lack of enlightenment. But we record about 15 childbirths every week. We then go out for enlightenment campaigns where we try to discourage them from giving birth at home. We sensitise them to come to the hospitals. We also have traditional birth attendants who are on the ground to make the women comfortable while delivering the babies.”
Camp hosts about 20 per cent of widows, orphans
The Chairman of the IDPs camp, Lateef Goni, who said he was among the first batch of the IDPs in January 2016, noted that the people continually suffer from water shortage and insufficient health workers and facilities.
Goni added, “We beg the non-governmental agencies not to relent in their efforts. People are now returning from Cameroon, so that they can benefit from the relative attention that we are given in the camp. This is why we are increasing in population in the camp.
“We still have several needs; water has improved but it has not reached the whole camp. Also, we have only three hospitals and a few doctors to attend to the whole camp. We want more health facilities to take care of our people.
“It was in December 2015, by the help of the military escorts, that we were moved back to the area. But if we get to know today that our villages are accessible, we are willing to go back.”
One of the Bulamas (community heads) in the camp, who gave his name only as Salihu, told SUNDAY PUNCH that health issues among the IDPs were partly caused by overpopulation.
Salihu added, “You see, the more you have crowd, the more health issues fester; it is the multitude of people. The people mostly affected by health issues are the women and children. Naturally, if you check around, you will see that there are more women and children in the camp. The population of women and children, who are widows and orphans as a result of the insurgency in this camp, is almost 20 per cent.
“Whenever the military go out for operations in our villages, they still return with 60 or 70 people from the villages around Ngala. The people come to this camp and we receive them. Some captives of the Boko Haram may also come by themselves. Some of them are coming from Cameroon.
“So, while other IDPs camps may be decreasing, ours is increasing. The returnees from Cameroon are suffering. They did not have food distribution by international agencies like ours.”
Food scarcity amid torrential rains
The IDPs looked famished and unkempt as its inhabitants pleaded for more attention from the government and the international community.
Our correspondent met with an IDP named Sheriff Sulaiman, who also works as a volunteer teacher in the camp.
Sulaiman, like others, said hunger was the greatest challenge in the camp. He noted that during the rainy season, the roads were bad and the trucks supplying food could not get to the camp.
The teacher, who has two wives and six children, said, “Our greatest worry in this camp is hunger. The food they are providing is not enough. Nobody eats even two times a day. For example, if you have been given rice, millet or wheat, you still need pepper and tomatoes. You cannot eat without a stew. Hence we have to sell part of the food.
“The people who feed us are the UN World Food Programme and the Danish Refugee Council. We hardly see anything from the government. We also get assistance from the Red Cross, the International SOS and the IOM.
“At times, for over 40 days, we don’t see any food distribution. It was worse during the rainy season; the roads were bad; there was no way to bring food. But now, the NGOs are trying. They brought food last month and this month too. The amount of food we get in this camp is not enough. We need government’s attention.
“People die in the camp. We have a burial ground where we bury them. Children and adults are buried in the same place. Formerly, we used to have many burials in a week, but now, they are reducing thankfully.”
Our correspondent learnt that the camp was managed by the Borno State Emergency Management Agency.
When confronted with the issues raised by the IDPs, a SEMA official in the camp confirmed that there were challenges in taking care of the large population.
The official, who is SEMA camp Manager, Yusuf Gulumbo, however, denied that there was water shortage.
He said, “Yes, managing the largest IDPs camp comes with a lot of challenges. We cannot say there are no challenges. We receive new refugees from Cameroon, Chad and other neighbouring countries. When the people first arrive in camp, sometimes we don’t have the means to take care of them.
“To mobilise resources for their care is a problem. This is because most of the NGOs with us do a lot of paperwork. The paperwork takes a lot of time. The organisations have to do a lot of documentation before they attend to the IDPs. By that time, hunger has already hit a lot of people. This is the most challenging experiences we have here.
“On the shortage of water, that is a lie. The tankers on a daily basis supply 250,000 litres to our camp. They have abundant water.”
How Ngala fell to Boko Haram
Ngala town was once a thriving border area with rich farmlands and herds of cattle, camels and donkeys.
Our correspondent learnt that the displacement by the Boko Haram insurgents started precisely on the night of May 6, 2014, which many IDPs still recall as a terrible evening.
The Boko Haram terrorists struck the twin towns of Gamboru and Ngala on this night, and reportedly killed about 200 people in the 12-hour attack, burning houses and looting the residents’ property.
The insurgents had one aim – to declare the town as part of the terrorist caliphate from which they could also launch an offensive at Cameroon and expand their areas of influence.
A security official at the camp narrated to our correspondent that the Boko Haram gunmen invaded the community when the residents were asleep.
He explained, “The attack style was shooting, arson and mass killings with AK-47 rifles. The terrorists also had rocket-propelled grenades and on that night, about 200 persons were killed. The number of non-fatal injuries is unknown. They largely destroyed Ngala and forced most of the residents to flee to neighbouring Cameroon. The attack occurred when the residents were asleep. The terrorists opened fire on the people sleeping in the market square.
“In December 2014, they attacked again and abducted eight of our girls, aged 12 to 15, from the town. They attacked Ngala with two Armoured Personnel Carriers, which they had stolen from the Nigerian military.”
After attacking Ngala and Gamboru towns, the terrorists headed for Fotokol and also burned down the Cameroonian town on February 4, 2015.
“They shot dead 90 persons. They burnt down villages, churches and mosques. They did not allow anyone to escape with any property. All the Ngala settlers in Fotokol were further scattered into the Cameroonian hinterlands,” the official noted.
It was learnt that there was a large international school in Ngala, which was newly built by the state government and was about to be opened in May 2014 when the insurgents struck.
However, the school was officially opened as the Ngala IDPs camp in January 2016 after the military had recaptured the town from terrorists and the residents started to return.
The first batch of arrival at the camp was 11,000 residents who were received from Fotokol town by the local government officials and the military.
The Commanding Officer of the Nigerian Army, 3 Battalion, which liberated Ngala, Lt. Col. Patrick Omoke, told SUNDAY PUNCH that the troops had been on the ground since February 2016.
The battalion is under 22 Brigade of 7 Division, which has its headquarters in Maiduguri, Borno State.
Omoke said, “Our battalion was inducted into Operation Lafiya Dole on February 28, 2016, with the movement of the unit from Warri, Delta State. Our mandate is to smoke out the Boko Haram insurgents from the Gamboru-Ngala and Kala Balge Local Government Areas of the state.
“The operational tasks of our unit also include the protection of the IDPs and the peaceful conduct of humanitarian activities within the area. We are working to deny the Boko Haram terrorists access to the town and the IDPs camp. We cover the strategic Ngala IDPs camp.
“On the security situation, it is stable though unpredictable. We have been here since February 2016. Within this period, we have been able to conduct at least 35 offensive operations.”
Ngala town is now trying to get back on its feet, but our correspondent observed that the two filling stations in the area are still closed and deserted.
Two million live in hunger – United Nations
According to the humanitarian report on the North-East crisis, released in September 2017 by the United Nations Office for the Coordination of Humanitarian Affairs, 5.2 million people in the North-East live in food insecurity.
These people, including the IDPs, are said to be in Borno, Adamawa and Yobe states and are in need of food assistance.
The UN says 3.4 million persons also “live in nutrition assistance of which about 450,000 suffer from severe acute malnutrition.” The UN puts the total IDPs in the North-East at 1.7 million persons.
The UN adds that 6.9 million people are in need. There are 1.7 million IDPs and 4.2 million residents in the host communities. The UN breakdown shows that there are 1,263,909 girls, 926,867 boys, 1,053,258 women and 758,345 men. Others are 126,391 elderly women and 84,261 elderly men. The UN also notes that about 70 per cent of the IDPs in the North-East had got medical care.
In an interview with our correspondent, the UN Deputy Humanitarian Coordinator, Peter Lundberg, said two million persons in the North-East currently lived in hunger.
Lundberg said, “One thing we want to ensure is that people can feed themselves. That has been done in the distribution of food and cash. One thing that is equally important is that we have been able to distribute seeds and fertilisers to predominantly farming communities in the North-East.
“This has helped to bring a sharp decline in food insecurity. The people living with hunger have reduced from five million to about two million. But there are still lots of other people to be reached. We still know that there are many more areas that we are not able to go.
“Well, funding has improved. We launched an appeal of $1.05bn at the start of 2017 and we have received almost 70 per cent of that money from the international community. We have about $350m to go. We are happy to get assistance from the federal and state governments.”
The task ahead remains immense with 1.6 million people still displaced and people continuing to flee violence on a regular basis.
Our correspondent observed some representatives of the German and the Swedish governments arriving in Ngala last week with the UN workers to inspect the camp and to assess the humanitarian efforts.
Despite these efforts, all is not well in Nigeria’s largest IDPs camp.
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