Via Science: Hunger amplifies infectious diseases for millions fleeing the violence of Boko Haram. Excerpt:
BORNO STATE, NIGERIA—Flying into Monguno, a recently "liberated" town in a forgotten corner of a forgotten state in northeastern Nigeria, all you can see is a vast expanse of nothingness. There is no horizon, just a haze of sand whipped up by the hot, harmattan winds blowing from the Sahara Desert. No green, except for the curious mossy splotches where groundwater rises to the surface. All else is dust. The only signs of farms are the faint outlines of what were once fields etched into the desiccated land. Every so often the charred remnants of a village come into view.
This is what scorched earth looks like, a legacy of more than 8 years of terror by the extremist group Boko Haram, which, until recently, held the region in a vice. The world began to wake up to the full horror of that legacy last year, as the Nigerian army started ousting the insurgents from their strongholds here in Borno and the two adjoining states of Yobe and Adamawa.
As survivors began straggling out, the few humanitarian workers already on the ground were shocked at what they saw: millions sick and near starvation, fresh graves that hinted at an untold number of dead. "We started seeing the state of the people coming out and got a sense of what the magnitude of the crisis might be," says John Agbor, UNICEF's head of health for Nigeria in Abuja.
Exact numbers are hard to pin down, but across these three states 8.5 million people are in need of humanitarian assistance. About 5.1 million are malnourished, half a million children so severely that without treatment 75,000 more will die by June, warns the U.N. Office for the Coordination of Humanitarian Affairs (OCHA). About 1.8 million people have been internally displaced and are on the move, more than half of them children. In Borno, the hardest hit state, 1.2 million have crowded into the capital city of Maiduguri alone, doubling the population in a matter of months.
The uprooted are crammed into squalid camps and towns already too destitute to deal with the influx. Food, water, and sanitation are scarce or nonexistent, leaving few options other than open defecation. The camps and slums provide a perfect breeding ground for disease. In a deadly cycle, malnutrition renders children more susceptible to infection and less able to fight it.
Epidemics of measles and malaria rage, and polio has resurfaced. Child mortality is off the charts, "two, three, four times" above the emergency threshold, says Marco Olla, a pediatric specialist with Médecins Sans Frontières (MSF) in Paris. Malaria has been the biggest killer, accounting for about half of all deaths, but acute respiratory infections and diarrhea are now vying for the top spot.
It is hard to rank human tragedies, but by all accounts this is one of the worst on the African continent today. "It is really, really, really bad for a lot of people. It is a crisis of great severity and magnitude," says Jorge Castilla of the health emergencies program at the World Health Organization (WHO) in Geneva, Switzerland.
Yet it remains remarkably unrecognized and hugely underfunded, leaving aid workers struggling with how to deliver lifesaving interventions when the needs are so great and the resources so paltry.