According to official sources, more than 280,000 people who have been displaced by the violence linked to the Islamic State’s West Africa Province, better known as Boko Haram, are now in the region of Diffa, in southeastern Niger. Forty thousand of them were forced to flee the recent attacks that took place in Bosso. The majority of the displaced are living in extreme hardship and have settled along Route Nationale 1 (RN1) in more than 35 sites where aid organisations are working, including MSF. The RN1 crosses the region and runs along the border with Nigeria before turning north to rejoin the shoreline of Lake Chad. It comes to an abrupt end in the eastern part of the region, after the town of Nguigmi, where MSF teams are based, working in the health centre and district hospital there.

“There are many humanitarian workers and a vast number of displaced people all along the RN1,” explains Youssouf Demdelé, deputy head of mission for MSF in Niger. “But there are also several thousand displaced people who are isolated, particularly in villages to the north of Nguigmi, and it is difficult for the aid to reach them.”

Displaced people to the north of Nguigmi

There are currently around 20,000 displaced people who, since 2015, have been living in and around eight villages located up to 50 kilometres to the north of Nguigmi. They were evacuated by the authorities from the islands on Lake Chad following several attacks that took place in the area on 25 April 2015. “The people in this region are isolated and have very little access to humanitarian aid. They lack water, food supplies, shelter and healthcare,” says Youssouf Demdelé. “The original population of the area numbers around 8,000 inhabitants, who have now been joined by 20,000 displaced people.” MSF has provided emergency assistance in the area several times since 2015 and the organisation has been supporting the health centre in Bilabrim since March 2016. “It’s the largest village in the area and the only place within a 30-kilometre radius that offers any healthcare. Since the arrival of all the displaced people, the centre has found itself completely overwhelmed.” Over the last four months, 5,394 consultations have been conducted in Bilabrim, 2,832 of which have been for displaced people.

Launch of a mobile clinic

“In the next few days, we are also going to be setting up a mobile clinic that will go out to the different villages,” says Youssouf Demdelé. The clinic will be manned by three nurses. “There are mothers who come to the Bilabrim health centre with their children after walking 10 kilometres across the sand under the hot sun, which means 20 kilometres if you include the return journey. The mobile clinic will allow us to see people who are too far away to access healthcare.”

The lack of healthcare is not the only problem faced by the displaced people and the inhabitants of this remote, arid area. “The main difficulty that people face is the lack of potable water. There are only two boreholes that contain water with a high salt content, and some traditional wells with bad quality water. These isolated refugees need provisions and new tents to deal with the difficult climatic conditions. The situation is catastrophic for all displaced people in the Diffa region but we mustn’t forget those to the north of Nguigmi just because they are less visible.”