How Aid Agencies Avert Humanitarian Tragedy In North East

MSF staff treating a malnourished child in Borno State
MSF staff treating a malnourished child in Borno State

Interventions by international aid agencies and non governmental organisations are the reason why there is no humanitarian catastrophe in the North East

By Tajudeen Suleiman

Every hour, the gate of the Maiduguri office of the International Committee of the Red Cross, ICRC, swings open at least a dozen times to allow official vehicles conveying staff and aid materials in or out.

The compact office has about 35 workers, all busy at their desks or criss-crossing offices with files in their hands.

“The vehicles come from different places in the field,” said Umar Sadiq, the ICRC’S Communication Field Officer, adding that that there were more workers in the field than the office.

The ICRC is one of several international agencies providing humanitarian assistance to victims of the Boko Haram insurgency in Northeastern Nigeria.

It was not the first international agency to arrive the region, but its crisis response machinery was handy and effective in saving hundreds of lives that could have been lost.

Providing early life saving services

Working with the Nigerian Red Cross Society, NRCS, the ICRC prioritised urgent humanitarian needs of the people, focusing on difficult – to – reach areas where both internally displaced persons, IDPs, and residents were facing severe food shortages.

Because it is seen as impartial and neutral in all conflicts, the ICRC is able to penetrate difficult and dangerous war zones at great risk to its staff.

Before aid came, residents of many communities faced severe hunger and malnutrition and many were already dying as they were unable to engage in farming and other economic activities due to the prolonged insurgency.

In Gamboru-Ngala, Monguno, Dikwa, Damboa, Sabon Gari and Maiduguri, the ICRC built temporary shelters and distributing food items to the displaced.

A total of 1,063,050 people received life-saving food rations continuously for three months between June and August 2016 alone.

To expand the reach of relief items and care for IDPs, the ICRC trained over 95 staff of NRCS, National Emergency Management Agency, NEMA, and state emergency relief agencies in humanitarian management programme.

Working with the state governments to find out areas where urgent assistance was required, it also facilitated quick rehabilitation of primary healthcare centres close to the displaced, providing regular medical supplies and equipment and training their staff to respond to emergencies.

Two surgical teams were also stationed at the Borno State Specialist Hospital to provide emergency treatment for the weapon-wounded and the displaced persons. It also set up nine mobile clinics to provide emergency treatments for the displaced who were growing in number, moving from camp to camp and to communities government had no resources to reach.

According to ICRC record, 15, 438 children that could have died for lack of care were delivered in Red Cross supported clinics in the Adamawa, Borno and Yobe states. Not less than 12, 821 children under the age of five suffering from severe acute malnutrition were also treated in these clinics.

Those wounded by Boko Haram insurgents or during cross fire between troops and insurgents were also treated by the surgical teams. A total of 1,765 patients so wounded treated in facilities Maiduguri between January-December 2016 alone. Many have been treated since the beginning of 2017.

Too many hands spoil the broth?

There are many international aid agencies like the Red Cross and NGOs working to provide humanitarian aid to millions of people affected by the Boko Haram insurgency in Northeastern Nigeria.

However, the problem is that it is hard to get the exact number of such organisations, the total number of their staff working in the region and quantify or qualify their specific interventions in the region.

This means that their is not coordinated and the authorities can also not properly plan and harness all available resources in an organised manner.

Even then, undoubtedly, international aid agencies and NGOs are the reason the crisis triggered by six years of Boko Haram insurgency has not degenerated into a humanitarian catastrophe.

According to the governor of Borno State, Kashim Shettima, there are about 62 officially registered aid agencies and NGOs operating in the North East, especially in Borno, the state most devastated by the Boko Haram insurgency.

But Shettima also noted that there are more than a hundred NGOs operating in the region, all claiming to be helping to solve the humanitarian challenges in the area.

All the aid agencies and NGOs are expected to register with the state Emergency Management Agency, SEMA, headed by Garba Satomi, an engineer.

When icirnigeria.org asked Satomi for the list of organisations registered with the state, he asked his private secretary to furnish the reporter with the complete list.

However, the list given to our reporter contained only the names of 20 organisations. They are the ICRC, Medecin Sans Frontiers, MSF, World Health Oganisation, WHO, World Food Programme, WFP, OXFAM, International Organisation for Migration, IOM, INTERSOS, Danish Refugee Council, DRC, Norwegian Refugee Council, NRC, International Medical Corps, IMC, and Medecine La Mode.

Others are Premier Urgence, Refugee International, Arewa Consultative Forum, ACF, Catholic Relief Service, CRS, FAO and United Nations agencies such as UNICEF, UNFPA, UNOCHA and UNHCR.

The sad story of displaced persons

Since 2014 when the Boko Haram insurgency got to its peak, at the time when the insurgents took control of nearly every part of Yobe, Borno and Adamawa, except for the state capitals, the country has witnessed an unprecedented rise in the number of displaced persons, including large numbers of women and children.

An International Organisation for Migration, IOM, Displacement Tracking Matrix report, indicates that 1,491,706 people from a total of 194,145 households were displaced by January 2015 in Adamawa, Bauchi, Borno, Gombe, Taraba and Yobe.

The report also showed that 57% of the total IDP population in North-east Nigeria are children, 52% are female, whilst 48% are male.

In Borno State, a large number managed to escape Boko Haram killings by trekking several kilometres through the bush paths from the hinterland to Maiduguri where they were later picked up either by the military or officials of SEMA and taking to a camp.

The situation was similar in Yobe and Adamawa states where camps were also established to take care of those fleeing insurgent ravaged communities.

But thousands were unable to escape due to the distance to Maiduguri, which was at the time and up till now, the only place that is relatively secure.

In Borno State, there were those caught up in high-density towns such as Bama, Banki, Baga, Konduga, Kaga, Mobbar and several others close to the Sambisa Forest where the insurgents hibernated before they were dislodged by the military.

Most of the displaced persons had no access to food, water, medication, and in some cases shelter, some for upwards of six months because their areas were inaccessible, and they couldn’t get out for fear of being killed.

Boko Haram

In a position paper presented to the Presidency by the Borno State government in May 2016, the insurgents destroyed nearly 953,000 residential houses, 5,335 classrooms and other school buildings across 512 primary schools, 38 secondary schools and two tertiary institutions.

Also affected were 201 healthcare centres; 726 power distribution lines and 1,630 water supply sources across the state. It led to a humanitarian emergency that was beyond what the state government alone could handle.

The world intervenes in the North East

MSF staff provide care for IDPs
MSF staff provide care for IDPs

This was the situation when aid agencies and NGOs started coming into the three most insurgency-ravaged states of Adamawa, Borno and Yobe. But it was Borno that was hardest hit where over 70 per cent of the population were displaced.

In the league of ICRC is Medecin Sans Frontiers, MSF, better known as Doctors Without Borders, which is also skilful at penetrating dangerous zones due to its known neutrality in conflict situations.

Its modus operandi is similar to that of ICRC. It also uses it local staff to disabuse the minds of hostile elements, including insurgents on their neutrality, thereby allowing them to gain access to people caught in the conflict.

MSF was the first NGO to alert the world about the scale and the urgent nature of the humanitarian crisis in the North East after it visited camps and communities in Bama, Baga and others along the Nigerian-Cameroun borders in June.

The alert was a wake-up call to United Nations humanitarian community to urgently intervene to arrest the impending tragedy.

Since April 2014, when MSF opened an office in Maiduguri, it has worked to provide medical and nutritional support to the displaced in Maiduguri, Monguno, Dikwa, Bama and Damboa. It has been most efficient in the treatment of severe acute malnutrition in children and infants, thereby saving hundreds of children that were on the brink of death due to hunger.

In June last year when MSF medical assessors visited Bama, Borno’s second largest city, they found a city destroyed and a camp of about 30,000 people, mostly women and children. Many were starving, almost to the point of death.

They also found graves of 1,233 people who had died in the camp, 480 of whom were children. More than 3,000 of the displaced persons were severely malnourished.

MSF established a 100-bed Inpatient Therapeutic Feeding Centre in Gwange, a Maiduguri district, which has treated hundreds of children suffering from severe acute malnutrition, measles, malaria and related diseases. It also established a similar facility in Cameroun where patients and residents close to the border are taken for treatment.

Mothers and children are daily brought in to the facility from different camps and communities in Borno State for urgent medical attention. According to Pindar Wakawa, the Medical Activity Manager of MSF, the facility used to register as many as 300 patients per month during the peak of the crisis. But now it has gone down to about 150 patients per month.

The most common ailments are diarrhoea and malnutrition, which had killed hundreds of children in remote communities and IDP camps.

In view of the overwhelming number of those requiring medical care, MSF also operated an Ambulatory Therapeutic Feeding Centre in the general hospital in Dikwa, Monguno and some other high-density camps and settlements for the displaced.

Our investigations show that among the aid agencies that also impacted significantly on saving lives are the UNICEF, the UN Refugee Agency, UNHCR, the World Food Programme, WFP, the Danish Refugee Council, DRC, and the Norwegian Refugee Council, NRC.

UNICEF was one of the earliest aid agencies to arrive the region, caring for displaced children in official and non-official camps and settlements in Maiduguri, Monguno, Bama, Dikwa and Damboa.

They treated children suffering from severe acute malnutrition, diarrhoea, malaria, measles and other childhood killer diseases before MSF and ICRC came to the scene.

UNHCR provided critical emergency assistance in the form of portable water, providing boreholes in camps and communities, building shelter, providing blankets and household items to displaced persons to keep them safe and healthy.

Whether in Adamawa, Yobe or Borno camps, tents were erected for IDPs by the UNHCR while UNICEF built make – shift clinics to provide much needed emergency medical care for children and women fleeing from insurgency.

Both UNICEF and UNHCR are part of the Borno State Humanitarian Coordination Working Group that meets regularly with the state emergency management agency, NEMA and relevant stakeholders to decide on how to address some emergency situations, especially on food security and healthcare issues.

Through its community management of acute malnutrition, CMAM, program, which is operational across 57 local government areas and 399 sites in Adamawa, Borno and Yobe states, a total of 153,936 children with severe acute malnutrition were treated for malnutrition and saved from probable death between January and November 2016 alone.

A total of 234,997 pregnant women and children less than two years old were also fed within the same period. Also within the same period, a total of 137,962 children age 6-23 months were given life-saving micronutrient powder in the three states.

Aid Agencies not doing enough

But considering the huge resources available to UNICEF and other UN agencies operating in region, and especially in Borno, the popular opinion is that they can do better.

For instance, a UNICEF fact sheet seen by icirnigeria.org indicates that the organisation spent $16 million on treatment of 153,936 children in its therapeutic feeding centres in the three states between January and November 2016 alone.

This is far less than half of the $42 million it requested for the feeding programme. So, it means that $26 was spent on implementation while only $16 went into the feeding itself.

Governor of Borno State, Kashim Shettima, who is one of the strongest critics of UNICEF and other UN agencies, once told a delegation that UNICEF and other UN agencies “will construct five toilets in Gwoza and fly in helicopters more than seven times to inspect the toilets,” thereby spending more money on inspection than on the project.

Also, in January, Shettima lambasted international agencies and NGOs, including UNICEF, for failing to justify the huge funds they claim to have expended on victims of the Boko Haram insurgency in the North east.

The governor alleged that the NGOs use most of the funds released to them for the displaced persons to service their overheads and personnel costs.

He claimed that out of the 126 NGOs that were working in Borno State, only seven or eight were actually providing humanitarian services to the displaced persons.

“Some of the United Nations agencies are doing their best in their own way of doing things; but to me I am not satisfied. The huge chunk of what they are budgeting for Borno goes to service their overheads,” Governor Shettima lamented.

There are also complaints that UN agencies are not transparent enough in their finances. For instance, according to Gusau, the state does not know how much any of the agencies has budgeted for assistance to the state. He said that such information was needed to enable the state plan better.

Local NGOs are even worse

Modupe Ozolua in an IDP camp in Borno State
Modupe Ozolua in an IDP camp in Borno State

But if the UN agencies are not transparent enough, some NGOs are worse and seem only interested in profiting from the misery of displaced persons.

Accusing fingers have been pointed at Empower 54 Project Initiatives, an NGO that belongs to Princess Modupe Ozolua, a Nigerian-American entrepreneur.

It was learnt that Ozolua went to Maiduguri in June last year and visited Bama to see displaced persons. She helped bring public attention to the plight of malnourished children in camps who were dying daily.

With the help of the state government and the military, the children and their families were safely evacuated to Maiduguri for treatment.

She subsequently wrote a letter to Govenor Shettima after her Bama experience, informing the governor that she intended to raise funds to support IDPs in the state. The governor gave his support.

She subsequently organised the fund-raising in Atlanta, the United States of America, in August last year. She also posted pictures she took with malnourished children in Borno on her Facebook page and solicited financial support to “Save a malnourished child, feed a hungry family, sponsor a life-changing surgery, send a child to school and empower women…”

But since August last year when she had a successful fund-raising in Atlanta and other cities, she did not return to Borno or communicate to the Borno State Government.

A top Government House official confided in this website that Ozolua has neither written to Governor Shettima to disclose how much was raised for the state nor call to announce when she would come back to the state to help out.

But on February 5, she returned to Maiduguri with a container of relief items, which include drugs and clothes for distribution to displaced persons in the state. She said the relief items were worth $3 million, adding that the goal of her organisation was to distribute six more of such containers worth $18 million in other African countries.

The question many people in Borno State are asking is how much has she raised for the state? And how much has she spent on the IDPs?

All efforts to get Ozolua to provide answers to these questions proved futile as she did not respond to emails sent to her over three weeks ago. When contacted through her Facebook page, she asked that the questionnaire be sent again to another email address.

The questionnaire was sent again. But she still failed to respond two weeks after it was sent to her.

There are many other NGOs that just come with relief materials to the IDPs camps. One of these, it was gathered, is Oxfam, an international confederation of 18 NGOs based in Oxford, United Kingdom. The NGO is not as visible as expected, considering the resources available to it.

Oxfam’s humanitarian emergency response includes provision of clean water, food, sanitation and protection. While it has no doubt intervened in the North East, its impact is minimal and limited to a few IDPs camps.

One of the aid agencies that could have done more for insurgency – ridden North East is the United States Agency for International Development, USAID. With an annual budget of over $27.2 billion, intervening in a more impactful way could have reduced significantly the slide towards humanitarian tragedy in the region.

Although its mandate in foreign countries include helping societies prevent and recover from conflicts and providing humanitarian assistance, it has fallen far short of these in the North East.

USAID has concentrated more on building capacities for the region than on helping to arrest humanitarian crisis brought upon the region by six years of Boko Haram insurgency. It has spent huge resources organising capacity building conferences and workshops for government institutions, civil societies, political parties and faith-based organisations in Abuja than on providing assistance to the people in dire need of it.

For instance in May it organised a capacity-building workshop on de-radicalisation in the North East at Transcorp Hilton where it hired 200 rooms to accommodate participants. Minimum room rate at Transcorp is N85, 000 per night. And this at a time international medical charities warned of grave humanitarian crisis in the North East if urgent assistance do not reach the people. Why building capacities is a good thing, saving lives is better.

However, USAID must be commended for getting the Nigerian government to take urgent action in the zone following outcry about looming humanitarian disaster.

Government officials who spoke off-the-record said USAID has been working behind the scene to push the federal government, which had shown remarkable laxity about the humanitarian crisis, into action.

In the words of Gusau, the state does not see what most of the aid agencies and NGOs are doing, except the seven that the governor identified. These are ICRC, MSF, UNHCR, WFP, DRC, NRC and the IOM. He said the others were just “using the name of Borno to make money and enrich themselves.”

As recently as last October, the United Nations Office for the Coordination of Humanitarian Affairs, UNOCHA, said about 9.2 million people, including women and children, were in critical conditions and in dire need of food and medical assistance in the Lake Chad Basin – Nigeria, Chad, Cameroon and Niger – as a result of the Boko Haram insurgency.

The UN agency said about $739 million will be needed to “increase lifesaving support to the millions of people affected by the crisis” across the region, “of which $197 million has already been received.” The UN urged donor agencies and philanthropists to redeem their pledges of assistance in order to save the lives of the people living in this highly vulnerable area.

Just Last week, UNICEF issued a statement warning that about 1.4 million children are at risk of death in Nigeria, Somalia, South Sudan and Yemen from severe acute malnutrition this year. According to the statement, the number of children with severe acute malnutrition in North East Nigeria is expected to hit 450,000 this year.