Increasing provision of aid and the end of the harvest have brought some relief to the humanitarian situation in more accessible areas of Borno state, Nigeria but the emergency is not over. Hundreds of thousands of people remain almost entirely dependent on aid for their survival. 

There are still people with insufficient access to enough food, water, shelter and medical care.  In Maiduguri, the capital of Borno state, a massive deployment of aid has generally stabilised the nutritional situation, but there are still vulnerable pockets within the city.

The nutritional situation can be more precarious in isolated enclaves such as Pulka, Banki, Bama, Dikwa and Rann. These towns are tightly controlled by the military and people have very limited, or even no freedom to leave, making them heavily dependent on external assistance and extremely vulnerable to any disruption in the provision of aid.

In recent weeks, thousands of refugees have moved by force or by choice to some of these already overstretched enclaves from camps in neighbouring Cameroon.

Need to scale up for difficult months ahead

The rainy season (July to September) is likely to increase the need for assistance across Borno. The needs will be particularly acute in isolated areas that become less accessible. MSF is particularly concerned about Rann, which will become an island, cut off with no road access for months at a time.  In anticipation of this, MSF has pre-positioned medical supplies in Rann, where around 55,000 people currently live, with the population doubling since April as people have fled military activity in the surrounding areas.

Two teams, including the Borno Emergency Support Team (see below) will fly between four locations during the rainy season.

Borno is already witnessing a hepatitis E outbreak, to which MSF is leading the response in Ngala. The rainy season also brings a high risk of cholera, and the annual malaria peak (August to October), which causes high rates of mortality in children under five every year and contributes to malnutrition. MSF teams are preparing to prevent, identify and manage cases of hepatitis E, malaria and cholera.

Inaccessible areas out of reach of assistance

MSF remains deeply concerned that there may be people in parts of Borno State to which it has not managed to negotiate access who may be in need of lifesaving assistance. Patients who have recently left these locations report that no advanced medical care is available there.

The Borno Emergency Support Team

MSF’s dedicated Borno Emergency Support Team (BEST) monitors and responds to needs across Borno state, including via mass vaccination campaigns, nutritional screening and distribution of therapeutic and non-therapeutic food, seasonal malaria chemoprevention (SMC), medical consultations, outbreak response and water and sanitation interventions. The BEST team manages interventions in  camps for displaced people in Bama and Dikwa, within camps and settlements and at screening points in Maiduguri, and regularly assesses other parts of the state, intervening as necessary.
MSF teams are working in Maiduguri, Pulka, Banki, Bama, Dikwa, Rann, Monguno, Ngala, Damasak Benisheikh and Dala.  Teams are also running projects in Kukerita and Jakusko in neighbouring Yobe state.

Key data relating to the work of MSF teams across Borno state (January - May 2017)

• Admissions to therapeutic feeding centres: 20,760
• Admissions to inpatient departments: 3,071
• Emergency room consultations: 2,764
• Births assisted: 5,181
• Antenatal consultations: 56,160
• Latrines built: 282
• Water tanks provided: 38
• Water taps provided: 887
• Tonnes of food distributed: 1,099