Why did MSF decide to start working in Benue in 2018?  

In Benue state, intercommunal violence resulting from disputes over land for grazing and farming has been happening for years, but the situation has worsened in the past two years.

The scarcity of land, due to environmental changes, has increased the levels of violence, which has forced thousands of people to flee their villages.
MSF’s team in Benue is focused on the needs of the thousands of people who has been displaced from their homes since January 2018 in the most recent wave of violence between herdsmen and farmers.

The displaced people often give us accounts of harrowing violence and destruction. Many have lost family members and everything they owned and are now too scared to return to their villages.

Where have the displaced people settled, and how many need aid?

The exact number of displaced people across the state and the wider region is unknown. Most are living outside the six official camps for internally displaced people.

Thousands have found refuge with relatives or other people in communities so-far unaffected by the conflict. Many are surviving thanks only to the host communities, who share their houses, food and other resources. In exchange, the displaced people often work with and for them.

We can’t be sure how many people are in need of aid. The displaced people who are not registered have received no support so far. They can only get healthcare if their families are able to pay for it and most have no money.

What is MSF doing to help?

Near the state capital, Makurdi, we are working in two camps called Mbawa and Abagana. We also work in Ugba and Anyiin in the Logo area (some 100 kilometres east of Makurdi).

In all four places, we provide primary healthcare for free to around 8,000 displaced people as well as to people from the surrounding communities who come for help, and we refer patients in critical condition to hospital for specialist treatment.

Last week, for example, our team diagnosed a patient with a strangulated hernia, and then transported the patient for emergency surgery to Benue State University Teaching Hospital. MSF paid for the procedure and all the necessary medicines, because public health is not free and many of the most vulnerable (including the population MSF is supporting) can’t afford the costs.

From May 2018 until September this year, our teams provided 37,143 outpatient consultations.

We also supply clean drinking water by trucking water to the camps, fixing existing boreholes and drilling new ones. In addition, we distribute essential relief items such as hygiene kits, and we build latrines and showers. In one camp we have constructed hundreds of shelters to protect people from the rain and wind.

What are people’s main medical needs?

In the four camps where we work, we see a number of recurring health problems related to people’s living conditions and lack of water and sanitation. In places without proper shelters, our patients suffer from respiratory tract infections.

The most common disease we treat is malaria, which increases even further during the rainy season. We see cases of acute watery diarrhoea and skin infections such as scabies. We also see patients with gastritis, which we suspect is often connected to the psychological hardships they have suffered.

The environment of the camps and informal settlements has a negative impact on people’s health. We see problems like improper waste management, overcrowding and stagnant water in which mosquitoes can breed.

For those living outside the camps, in abandoned buildings, the situation is even worse. Many do not have enough food or access to even the most basic services, such as primary healthcare, clean drinking water, latrines and washing facilities.

But the biggest challenge for all the displaced people is uncertainty about the future. Some return to their farmlands periodically to take care of crops, but they do this at a high personal risk.

The same people who forced them to flee may attack them again. No one knows when they will feel safe enough to return home with their families.

What would improve the situation for the thousands of displaced people?

The most important thing is for people to be safe. Patients tell us that they desperately want to go home – if only it was safe enough. For people to return to their villages, it needs to be a safe, dignified and, above all, voluntary return.

There have been fewer reports of violent incidents in recent weeks. From what our patients tell us, the opposing groups have become better at avoiding each other, while people now flee their homes before any violence can break out.

It will take careful dialogue, supported by the Nigerian authorities, between all the groups involved to ensure that people can coexist in safety and peace in the long term. But until then, the people who are currently displaced, and who don’t yet feel safe enough to return home, need more and better shelters and access to free healthcare.

The people who don’t live in official camps are in especially urgent need of aid.