Displaced from their homes and left to live in squalid conditions, Internally Displaced Persons (IDPs) in Niger state are dying from malaria disease due to uncoordinated government and stakeholders’ interventions. In this report, Hamzat Ibrahim Abaga unravels how IDPs are increasingly vulnerable to chronic malaria disease and resort to self-treatment.
No one knows how to describe the double tragedy better than Lado Pada Bulus, a middle-aged man whose family has made Gwada Internally Displaced Persons (IDPs) camp their home. Sacked from his ancestral home in Kaure, due to incessant attacks by Boko Haram in 2019, Mr Bulus and his family sought temporary relief from Gwada IDP camp, in Shiroro Local Government Area, Niger State.
But soon, without notice, tragedy struck. His two daughters, Favor, 15, and Victoria, 18 months old, had malaria and, like previous infections, he thought they would survive it. They both died a week after being diagnosed with the disease.
“I took my daughters to a private hospital in Gwada because there was no presence of medical staff in our camp. After taking initial treatments, we had to come back home since I didn’t have the money to continue treatment. We left the hospital and resorted to self-treatment, and after one week, my two daughters died,” Mr Bulus told DAILY NIGERIAN.
Although it has been difficult to forget the incident, Mr Bulus, who is now the chairman of Gwada IDP camp, decries the poor access to medical facilities by IDPs in the state. He’s been chairman since 2020, and the circumstances that led to the death of his daughters are still prevalent in the camp.
“Whenever we need medical attention, we are always left stranded and at each other’s mercy. Recently, we lost an elderly woman to malaria and other health implications. We called a doctor to examine her, but unfortunately, she died. We don’t have enough money to take her to the hospital. We only did the little we could with the little money at our disposal,” he said.
Although Mr Bulus’ predicament and those of Gwada IDP points to a larger security problem bedeviling Niger state, it also signposts an often neglected problem of poor access to health care, especially in the treatment of common diseases such as malaria and typhoid in IDPs camps across the country.
Insecurity, displacement, and malaria problems in Niger state
As insecurity bites harder in Nigeria, nearly 150,380 persons have been displaced in Niger State, north central Nigeria. Of this lot, about 27,678 persons have been displaced in Shiroro Local Government Area alone. The crisis has forced many residents of the area to take refuge at various IDP camps across the LGAs of the state.
In particular, the security situation in Niger state has continued to worsen daily. People get killed, maimed, and abducted by kidnappers, bandits, and terrorists.
The IDPs camp in Gwada is one of the three officially recognised camps (Kuta and Zumba IDPs camps) in Shiroro LGA, making access to healthcare a major issue amongst IDPs in the area. Findings by this newspaper revealed that despite malaria control programmes embarked upon by the state government and other stakeholders, the burden of malaria disease and other related diseases is higher amongst women and children in IDPs camps across Shiroro LGA.
The disease: Malaria
Malaria is a life-threatening, acute febrile parasitic disease transmitted by the bite of an infected female Anopheles mosquito, the most implicated species causing human infections in sub-Saharan Africa. Nigeria has the highest number of global malaria deaths, according to the 2020 World Malaria Report, with an annual loss of over $1.1 billion (N645.7 billion) to malaria prevention and treatment.
According to the National Malaria Strategic Plan, NMSP, between 2014 and 2015, children under five years of age accounted for about 62 per cent of the burden of disease and about 72 per cent of malaria-related mortality in the country. It was recorded in 2021 that over 200,000 Nigerians died from the disease.
Malaria is rife in Nigeria’s northern states like Niger and contributes to high infant and under-five mortality rates of 85 and 106 per 1000 live births, respectively. With a year-round transmission, at least 19,000 children under five years die of malaria in the state annually, making it the state with the highest number of child deaths from malaria in Nigeria’s north central.
Niger state’s malaria diagnostic and treatment guidelines, updated in December 2017, state that any suspected case of malaria must be confirmed by a diagnostic test–either a Rapid Diagnostic Test, RDT, or microscopy–followed by treatment with an Artemisinin-based Combination Therapy, ACT. While this is laudable, however, it significantly adds to the cost of seeking healthcare, which is often unaffordable. For rural people who are poor. Due to the poor living and sanitary conditions in most IDP camps, residents of the camp are more vulnerable to mosquito bites.
Ms Teni now resides in Gwada’s IDPs camp. She said she has lost two children due to malaria infections in the community.
“Government should come to our aid. No money to buy medication or to take sick people to the hospital. Not only that, there are no medical personnel in the camp to render assistance.
“We are displaced here because of the continued issue of banditry and Boko Haram that has ravaged our ancestral homes.”
Squalid living conditions and other disheartening stories from the IDPs
It’s been three years since Mr Bulus and the like came to Gwada IDPs camp, but they continue to decry the squalid living conditions they have found themselves in.
Asking for quick resettlement of displaced persons in their villages, Mr Bulus said: “Government should please allow us to go back to our various homes. We are suffering here. We don’t have enough food to eat and we can’t farm. The government should allow us to go back to our villages. It has been about three years now since coming to this IDPs camp. We only receive food from the government, sometimes once every three months, so let the government restock our store with enough food and other items. We thank God, non-governmental organizations also come to our aid.”
Habibu Musa is the desk officer, Gwada IDPs camp. He recalled how a cholera outbreak in the camp, occasioned by poor hygiene and access to quality water, killed three people in December, 2021.
According to the United Nations, an adequate toilet facility is a solution to prevent infections and diseases caused by poor hygiene and sanitation. These toilets block flies and cockroaches as carriers involved in the transmission of diseases to living houses.
A displaced person in the camp, Maryam Kabiru, who spoke in Hausa language, said: “Our people have started going back to our villages, but there was no way to get into the village. Even yesterday, some of our husbands and their younger ones who went to the farm have been missing. We don’t know their whereabouts. We are all confused about what to do with our lives.
“We need the government to help us with food, health and non-food items. Before now, our children were in school, but since we have been displaced, they don’t have access to education anymore, so let the government come to our aid,” Mr Kabiru said.
Experts, Niger state government react
The director of Public Health, Niger State Ministry of Health, Dr. Ibrahim Idris, told DAILY NIGERIAN on the phone that the IDPs who are already tired of staying in the IDPs are gradually returning to their respective homes where they may have access to affordable health care.
He stressed that the state government, through the Niger State Emergency Management Agency (NSEMA) has been providing essential materials to victims of banditry in different IDPs camps across the state.
“In terms of their (IDPs) healthcare needs, the government has directed IDP camps to always seek medical attention at any nearby medical centre, or PHC close to them as the government cannot for their displacement, which is to temporarily establish PHC centres. When they eventually return to their respective home, it (PHC) becomes useless and abandoned,” Mr Idris said.
He also added that the state government through the Association for Reproductive and Family Health, ARFH, a sub-recipient of National Malaria Control Programme (NMCP) in Niger State, was saddled with the responsibilities such as malaria case management through supply and tracking Rapid Diagnostic Tests, RDTs and artemisinin combination therapies, ACTs, advocacy communication, and social mobilization and health system strengthening through capacity building, monitoring and evaluation.
According to the Head of Information Unit, NSEMA, Ibrahim Hussain, the agency with support from stakeholders has been helping IDPs to settle in and cushion the impact of the banditry on them.
“So looking at the number of the people at the various IDP camps across the state, it is not easy for the government to cater for all of their needs. The common ailment among children in IDPs camp is malaria, but the government has provided treated mosquito nets, and provided medical intervention to the affected persons,” he said.
Reacting to findings from this report, Haruna Sani, a health worker, advised that vulnerable groups particularly, women, children and the elderly should be more cautious and adhere to the use of preventive measures including the use of insecticide treated nets and insecticides.
Mohammed Al-amin, a medical expert from Lapai stressed the need for IDPs to adhere to personal hygiene to prevent epidemics.
Mr Al-amin, who deplored the poor living standards of the camp, enjoined IDPs to make use of preventative measures, including the use of insecticide-treated nets and environmental sanitation.
NOTE: This investigation was first published by Daily Nigerian.