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Growing insecurity, combined with frequent outbreaks of disease and a weak health system, especially in the north, make access to healthcare difficult for many Nigerians

Lack of access to basic medical services is a serious problem in much of northern Nigeria. The armed group Boko Haram carried out several deadly attacks in 2011, as inter-religious tensions increased. Growing insecurity poses a potential threat to the future of Médecins Sans Frontières (MSF) programs in this part of the country, which would restrict access to healthcare even further.

In Sokoto state, MSF supports health centres in Goronyo town and the surrounding area. Staff conducted just over 70,300 consultations with children under five, and more than 28,700 antenatal consultations.

At Jahun hospital, in Jigawa state, a surgical team carried out 390 operations to repair obstetric fistulas, which are injuries to the birth canal, mainly caused by a long, obstructed labour. They result in incontinence and infertility, and can lead to stigma and social exclusion. With good obstetric care, fistulas can be prevented. MSF responded to obstetric emergencies, and assisted more than 5,800 births at Jahun hospital in 2011.

Malnutrition is endemic in Kazaure, a densely populated region at the edge of the Sahel, near the border with Niger. In 2011, MSF carried out nutritional surveillance and treated more than 16,000 children for severe malnutrition. More than 4,000 children had to be admitted to hospital.

Lead poisoning in Zamfara state

MSF was first alerted to a high number of fatalities in villages in Zamfara in March 2010 and has since treated more than 2,500 children for lead poisoning. Local, small-scale gold-mining practices using lead have contaminated the environment of several villages in Zamfara. MSF has been working with Nigerian agencies and international organizations to encourage villagers to adopt safe mining practices and clean up the environment. In 2012, MSF will host a conference, bringing together a range of experts to find sustainable solutions to the problem.

Trauma hospital in the Niger Delta

In Port Harcourt, capital of Rivers state, MSF runs an emergency trauma facility to bolster local capacity. With 75 beds, the hospital provides free emergency surgery and healthcare. Staff held more than 12,000 emergency consultations in 2011. Three-quarters were related to violence or road traffic accidents. Surgeons carried out an average of 340 operations a month. The hospital also assisted more than 750 victims of sexual violence.

Emergency response

Outbreaks of diseases are frequent, particularly in northern Nigeria, and MSF retains a dedicated emergency response team in the country. When measles broke out in northwestern Nigeria, MSF treated more than 7,900 patients. Staff also treated almost 4,800 people when cholera hit the region. After receiving reports of high numbers of children dying from malaria in two villages, staff gave antimalarial treatment to 277 people and distributed more than 1,400 mosquito nets.

MSF also treated 15,700 people in measles outbreaks in Bauchi and Katsina states between January and March. Staff assisted the Ministry of Health in a vaccination campaign, immunizing almost 190,000 children against measles in the south of the country, and more than 300,000 against polio in Plateau and Kaduna states. In addition, MSF treated more than 3,200 people during a cholera outbreak in Taraba and Jigawa states and vaccinated 260 people against diphtheria in Borno.

Concerned about potential politically motivated violence, MSF medical staff also worked in two health centres in the volatile area of Jos North during the presidential elections.

Accessing healthcare in a megacity

Providing adequate healthcare for a city the size of Lagos is challenging. The population is around 18 million, and growing. MSF has been striving to ensure that some of the most deprived inhabitants have access to medical services. The Aiyetoro health centre was set up to serve people living in the slum area of Makoko, but its location on a main road has attracted people in need of healthcare from much further afield. To cope with the extra patients, staff have introduced an appointment system and begun referring people to other facilities.

As in Makoko, the homes in Riverine have been mainly built on stilts on Lagos lagoon, by newcomers to the city who cannot afford to live elsewhere. Building has extended so far into the water that some residents have never set foot on dry land, and are therefore unable to access health facilities on shore. MSF opened a floating health clinic in Makoko in January, and a health post in Badia, near the railway line. MSF provides the only free medical services available in the area.

In October, MSF handed over the basic health services it was running in the Otto area of Lagos to the Ministry of Health, to focus activities on sexual and reproductive healthcare.

In total, more than 18,100 patients came to MSF clinics in Lagos for consultations. Staff administered more than 18,000 vaccinations, assisted some 1,200 births and admitted 900 patients for 24-hour care.

At the end of 2011, MSF had 1,051 staff in Nigeria. MSF has been working in the country since 1996.

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