Medicins Sans Frontieres (MSF), also known as Doctors without Borders, has described the humanitarian crises in the Sahel and Lake Chad regions as two of the most acute humanitarian situations in the world.
Aside the droughts affecting the semi-arid belt, the situation has also been greatly affected by the conflicts in the regions over the past decade.
The insecurity in northeast Nigeria in 2014 moved further into the Lake Chad Basin, affecting Cameroon’s Far North Region, western Chad and southeastern Niger.
The span of the crisis in the four countries has contributed to it becoming “one of the largest humanitarian crises (areas) in Africa today,” MSF said.
Social inequality, poverty, poor infrastructure, food shortages and mass displacement from the ongoing violence have all contributed towards the present humanitarian crisis the region is experiencing.
Similarly, the central Sahel region, which consists of Burkina Faso, Mali and Niger, has seen increased food insecurity, mass displacement and higher rates of poverty due to the nature of the crisis.
In some of these areas, MSF has remained the only humanitarian agency to provide healthcare to the people affected by the situations in the regions.
According to the organisation, as of November, 2020, 1,930,482 people have been forcibly displaced across Burkina Faso, Mali and Niger.
Also, 851,338 have fled neighbouring countries to their homes, MSF stated.
The United Nations High Commissioner for Refugees (UNHCR) estimates that more than three million people have been displaced across the three countries with Nigeria having more than two million of the displaced population.
“Almost 300,000 Nigerian refugees (are) seeking safety in Chad, Cameroon, and Niger. More than 18,000 people have been killed in conflicts since January 2019, including more than 7,264 in Nigeria and 1,481 in Cameroon from Jan. 1, 2020 to Dec. 5, 2020,” the Armed Conflict Location & Event Data Project (ACLED) reported.
Background on the situation
In Mali, clashes between security forces and armed groups broke out back in January 2012 in a fight for independence of the northern part of the country led by the National Movement for the Liberation of Azawad (MNLA), a Tuareg separatist group.
Following a coup d’état, Mali ended up being split in two. The direct impact of this saw 340,000 people displaced within the country, with 145,000 people, including health workers, seeking refuge in other countries by the end of the year.
In 2020, Burkina Faso and Niger saw the crisis in their territories, particularly in the border region of Liptako Gourma, which has been suffering violence by both state and non-state armed groups, increase.
“Communities are exposed to violent attacks, targeted killings, abductions, and harassment. Schools, health centres, and places of worship are frequently targeted. From January 2020 to December 2020, 5,989 people were killed in armed conflicts involving armed groups in the region,” according to ACLED.
MSF also stated that as of Oct. 15, 2020, more than 150 health centres in the region were either closed or no longer fully functional, leaving millions without any access to health care.
Supporting local hospitals with mental health care, vaccination campaigns, emergency medical response as well as mobile clinics have all been provided by the organisation, with distribution of essential items and providing access to safe water and sanitation for all those displaced.
Humanitarian aid threatened by external factors
The MSF and many other humanitarian agencies have stated how difficult it can be accessing communities in the region, making a huge challenge in providing essential care required by those requiring humanitarian assistance.
Both state and non-state actors as well as the political and security situation in the region have hampered access to the 1.2 million people in Nigeria requiring supplies, including medicines and medical requirements or for referrals to other medical centres, according to the United Nations (UN).
Terrorist groups such as ISWAP have also on several occasions targeted humanitarian workers, with some either being kidnapped and held captive, or in more grim situations, killed by the terrorists.
“On several occasions, MSF was forced to scale back outreach activities. For example, in August 2019, MSF had to suspend medical activities following a violent attack in Niger’s Diffa region,” the organisation stated.
Because of these constraints, MSF have trained community health workers on the treatment of illnesses such as malaria and also expanded services rendered at the mobile clinics due to the uncertainty of when healthcare workers would be able to return safety to the communities.
“In a shrinking humanitarian space, MSF and other actors must develop new strategies to ensure access to safe and timely care for all communities, while also ensuring the safety of our staff,” the group said.
Providing aid during a pandemic
The COVID-19 pandemic has only made the provision of assistance more difficult.
While the MSF has supported COVID-19 responses across the Sahel and the Lake Chad regions, attention to other medical conditions such as malaria, mental care and malnutrition have also remained a focal point of attention.
MSF stressed that the pandemic should not be allowed to hinder the delivery of other humanitarian assistance.
“Since the beginning of the outbreak, MSF has been concerned about the effects of COVID-19 on routine vaccination activities and campaigns because of restrictions on movements and gatherings, and a lack of PPEs. The fear of getting infected while visiting health centres also prevents people from accessing care,” the group stressed.
While the coronavirus pandemic claimed less than 1 per cent of deaths in Africa in 2020, it has remained at centre of a majority of emergency response plans, and delaying all other efforts to reduce the transmission of other fatal diseases such as measles, cholera and malaria. This is in spite of the fact that a disease, such as malaria, has shown to be 10 times more deadly than COVID-19 on the continent and accounts for 384,000 deaths, according to the World Health Organisation (WHO).
“National malaria prevention activities such as large-scale mosquito net distributions were reduced or postponed due to COVID-19 restrictions.
“In Cameroon, we have seen how allocating national health system staff and material resources towards COVID-19 has increased the risk of other outbreaks from diseases such as cholera and measles which are endemic in Cameroon.
“Continuity of care is crucial for communities and patients affected by other diseases, which means that the pandemic response has to be integrated into the regular health care system.
“COVID-19 continues to monopolize media attention around the world but MSF is committed to raising awareness about these neglected crises,” the organisation added.