Nigeria: Reducing the burden caused by disease and violence

Despite its strong efforts to receive authorization from federal authorities, MSF was not permitted to undertake a wide-scale vaccination program. Although the number of measles cases decreased, the poor nutritional status of children remained a great concern, and both measles projects were reoriented to treat those with malnutrition.

HIV/AIDS is a growing problem in Nigeria. Most of those in urgent need of treatment for AIDS or related illnesses have no way of getting it, because treatment is too expensive or otherwise unavailable. MSF is now treating more than 500 patients with life-extending antiretroviral (ARV) medicines at General Hospital Lagos Island.

The program also offers voluntary counseling and testing, support programs to encourage adherence to treatment, care for opportunistic infections, and social and psychological support. In total, more than 1,000 people are receiving HIV/AIDS care from MSF.

In the oil-rich Niger Delta region, the majority of the population has little access to basic health care because facilities are few and far between and because medicines and medical staff are in short supply. Malaria is the main cause of death for children under five living in the region's wetlands where mosquitoes thrive. In isolated and swampy parts of southern Bayelsa state, MSF teams provide basic health care and train local staff at several health centers. The team uses artemisinin-based combination therapy (ACT), the most effective treatment available for malaria.

Following a measles outbreak in Borno state in the north of the country, and in Adamawa state in the east, in March 2005, MSF conducted an emergency intervention, providing treatment to those (mainly children) who had developed complications from the disease, such as pneumonia, corneal ulcerations and diarrhea and subsequent malnutrition.

Despite its strong efforts to receive authorization from federal authorities, MSF was not permitted to undertake a wide-scale vaccination program. Although the number of measles cases decreased, the poor nutritional status of children remained a great concern, and both measles projects were reoriented to treat those with malnutrition.

In Borno, MSF opened a therapeutic feeding center in Biu Hospital, treating about 260 children by the end of July 2005. Mobile teams also traveled to remote communities in four parts of the region to let people know about the program and provide food and care to children who could not get to the therapeutic feeding center. In Adamawa state, MSF treated more than 2,000 children in outpatient clinics and cared for others in intensive care units in two hospitals.

MSF also provided therapeutic feeding and epidemiological surveillance in the towns of Numan and Mubi until August 2005. In May 2005, MSF responded to a nutritional crisis in Katsina state, near the border with Niger, where high rates of severe malnutrition were linked to a measles outbreak and an inadequate diet. More than 2,100 children were admitted to MSF's feeding center there in six weeks.

After hundreds of people were killed during violent clashes in the town of Yelwa in Plateau state, in May 2004, MSF assisted thousands of destitute, displaced people who had fled to neighboring states during the violence.

When the population started to return, MSF offered basic medical care to those living in and around Yelwa. As tremendous mental health needs were found among those who either had witnessed or were subjected to extreme violence, MSF provided mental health care services for returning civilians until May 2005. The team also developed a special school outreach program (see box) to help traumatized children.

MSF has worked in Nigeria since 1996.

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