CAREGIVERS in Borno State are putting the health of acutely malnourished babies at risk by selling off free food supplements meant to revive them. In this investigation, Zainab Yetunde Adam unravels the illicit practice and how it affects the children.
Teema Abubakar, a three-year-old girl, was used by countless caregivers to get access to Ready to Use Therapeutic Food (RUTF) also called Tamuwa and sell for their personal gains. This is despite the fact that RUTF is a well-known free supplement for malnourished children.
This exploitation made the poor baby acutely malnourished until she was rescued by the Borno State Ministry of Women Affairs and Social Development on October 16, 2024, following the viral circulation of her pictures on the social media.
Teema is just one of many of children experiencing “inflicted” malnutrition in Northeast Nigeria in the hands of heartless caregivers who sometimes hire malnourished children below the age of five on the pretext of poverty.
These fake caregivers, with often their adopted malnourished kids that are not certified by any authority to acess the formular, are young girls and women who exploit the children to get access to the RUTF at health facilities to sell and make money.
WikkiTimes findings reveal that there are women who are usually spotted around health facilities, mostly seated, wearing hijab under trees and shades in corners and hidden places carrying out illicit RUTF transactions.
A three-year-old Zainab Ibrahim, who lost her mother at birth, is still being used to collect RUTF by her adopted mother but does not wholly benefit from it.
A source confided in WikkiTimes that other women who do not spare their own children too in this fraudulent act are usually found at Shettimari area of Maiduguri. Although little Zainab is accessing RUTF, no changes are noticed in her body. Her caregiver, Fatima Ibrahim, feels she is taking enough care of her, and nobody dares confront her about the child’s wellbeing.

Babies like Zainab abound within and outside the New GRA Primary Health Care Centre in Maiduguri. Most of them, tied to their parents’ back or carried around in their arms, are evidently emaciated as they await the distribution of these ‘not for sale’ supplements for malnourished children.
Malnutrition is one of the common ailments among children under five in Northern Nigeria. The British Broadcasting Corporation (BBC) recently reported that 4.4 million children under five are acutely malnourished, doubling last year’s figure of about 2 million. This is an exponential increase brought about by the worsening food inflation, growing poverty and security situation in the region.
As of August 2024, the Federal Ministry of Budget and Economic Planning disclosed that over 31.8 million Nigerians were suffering from acute food insecurity compounded by malnutrition among women and children in the country.
Even in the face of that, food and RUTF diversion continue to worsen, straining already limited resources and medical services.
In 2024, from January to September, Medecine Sans Frontieres (MSF), reportedly treated 18,555 malnourished children in Maiduguri, Borno State. In the same period of 2023, the number was put at 16,860. This represents an increase of 12.5 per cent. At the peak, the facility attends to 100 malnourished children daily.
How RUTF Works
Popularly called Tamuwa in Maiduguri, RUTF is a free food supplement that can only be accessed in hospitals and through NGOs. The World Food Programme (WFP), USAID, UNICEF, World Health Organisation(WHO), MSF and other development partners bring them in to treat Severe Acute Malnutrition (SAM) and Moderate Acute Malnutrition (MAM).
RUTF is made from powdered milk, peanuts, butter, vegetable oil, sugar, and a mix of vitamins and minerals. One RUTF sachet combines 500 calories and micronutrients that have high nutritional value allowing malnourished children to gain weight quickly. Children can eat it directly from the packet.
Manufactured by Mana Nutrition, United States of America (USA), Rebound RUTF locally renamed “Baby Chakwai” is produced by Ariel Foods FZE in Lagos State, Nigeria. Also, Plumpy Nut RUTF locally referred to as “Kwankwasiya” and Plumpy doz that comes in yellow and white sachet are manufactured in Kano, Northwest Nigeria.
The primary target of RUTF are children between 6-59 months with an average duration of intervention from 40-90 days.
However, despite government’s best intentions and the help of International Non-Governmental Organisations (INGOs), RUTF distribution is still marred by challenges, including illegal selling of the supplement and “renting” of malnourished babies by different people to get the food.
Boko Haram, Socioeconomic and Security Challenges
The Boko Haram insurgency in the Northeast has caused so much suffering and disruption of livelihoods to the people of Borno, Adamawa and Yobe States. Residents of the mostly agrarian states could hardly farm to take care of their own needs, let alone selling for their livelihoods.
This has been further compounded by the effects of climate change. Some parts of Borno experienced low and late commencement of rainfall in 2023 in addition to the September 9, flood that submerged 80 per cent of the state capital in the last year rainy season.
The aftermath of the conflict also came with attendant food scarcity, even long after hostilities had ended. According to the International Committee of the Red Cross (ICRC), mines and explosives, remnants of war, continue to pose a threat to the safety and well-being of innocent civilians.
Explosive ordnance materials such as bombs also affect soil fertility and hinder farming activities in some areas, over stretching the safe zones. With the ongoing clearance operations by security forces and return of peace, the state government established mega farms in all liberated areas, providing grants, seedlings and capacity building to make farming sustainable in the state.
A new initiative known as sack/backyard farming has also been introduced in the state.
Despite the agricultural revolution and livelihood opportunities available, those exploiting humanitarian and health interventions given to innocent children are mostly not Internally Displaced Persons (IDPs). They are normal children from the families in the state.
WikkiTimes findings show that once a child is assessed to be malnourished at any designated centre in the state, he/she is enrolled for free treatment until full recovery.
Part of the treatment, WikkiTimes learnt, is the administering of 13 to 14 sachets of the RUTF supplement upon a single hospital visit. However, some caregivers completely sell while others keep a few pieces to give their children and show evidence of consumption whenever they return to the hospital for follow-up.
WikkiTimes gathered that a child is enrolled on the supplement for six weeks except in rare cases if it persists based on World Health Organization (WHO) standard.
To show that the babies are still sick so that they can be given more RUTF, some women and caregivers are in the habit of giving their children adulterated mixtures to upset their tummy to induce a running stomach so that they will appear seriously sick on their follow-up visit, a source farmiliar with the situation confided in WikkiTimes.
A former dealer in RUTF who spent eleven years in the ‘business’ and prefers to be anonymous, said it is lucrative, “only that at the end you will have nothing to show for it no matter how much money you make because you are denying innocent children their rights to food and medication.
“When I was still in the business, I earned up to N100,000 in five days. However, I quit the day Tamuwa became 13-14 sachets contrary to 18, 20, and 28 sachets that were being given before.”
The woman, who does not want to be named, affirmed that in some facilities Gwange, if the I-NGO staff stepped out of the facility and saw women trading the RUTF, they will pack and seize it with a warning (to the women) to desist from the act.
This claim was buttressed by Aisha Abubakar, a resident of Galtimari area in Maiduguri.
“Tamuwa is meant to help malnourished children, mostly of poor parents, to recover if taken as prescribed. The NGOs such as MSF, United Nations Children’s Fund (UNICEF), World Food Programme (WFP) Norwegian Refugee Council (NRC), Albarka Health Spring Foundation (AHSF), among other development partners, that brought it to treat malnourished children did not say healthy people and adults should sell and consume it,” Abubakar said.
Some women this reporter interviewed across Maiduguri Metropolitan Council, (MMC) said a single woman can go to different facilities with a baby, dressing the baby as male or female to collect the supplement daily. However, only few facilities unclothe the baby to ascertain the child’s sex, body weight among other indices before administering treatment.
Falmata Abba, Falmata Mohammed and Fanna Mohammed, who administered the supplement as prescribed, said their children’s health significantly improved and are now on referral at the Dalaram Primary Health Care Centre. The facility makes sure caregivers bring back empty sachets as a proof of usage on their next visit to control diversion.
How the System is Being Exploited
Zara Ibrahim was introduced to the business by her neighbours after initial hesitation in August 2024. She initially felt there was no gain until she decided to give it a trial in October 2024.
“I fled banditry from Sokoto and had to survive poverty through this business,” she said.
She claimed that she does not give her sick baby for hire, but instead, she usually gets the food supplement for him but admitted she only administers a few sachets to him and sells the rest.
Zara’s son was not diagnosed with any ailment before she was enrolled to be collecting the supplement. She got a referral card through a nurse at the Maryam Abacha facility.
“You cannot just get a referral card and start collecting the supplement without the knowledge and involvement of a health worker,” she added. Zara was given the referral card free by an undisclosed nurse on the agreement that she will give the nurse two sets of RUTF.
Like some of the women, more worrisome is the fact that Zara appeared to be giving her child treatment without any diagnosis and prescription.
Health experts say drug doses also have to be individually calculated for every child based on their weight, age, clinical condition, and body surface area. Young children may still lack the ability to communicate and explain to parents or doctors what is wrong, which can create additional issues the longer the child goes without proper treatment.
People Have Found Other Uses for RUTF
Beyond the illegal sale of RUTF, it was also discovered that some people have found other uses for the food entirely outside what it was meant for, malnourished children. Shockingly, it was found that some men use it as an aphrodisiac.
A male health worker at a health facility in Maiduguri, who does not want to be named due to his work security, and the programme coordinator of Albarka Health Spring Foundation (AHSF), Mohammed Olatunji Bello, confirmed that people have found other uses for the supplement. They argue that was because offenders were not penalised and prosecuted for the misuse of the health supplements was the reason for repurposing it for health adults.
“Women bring it for their husbands to take, believing it makes them perform better in bed,” Olatunji said.
Another new entrant to the business, who spoke to our reporter anonymously, said that some people consume it with bread, porridge and gruel to be filled all day long to avert hunger.
Babies for Hire?
Investigations show that babies are being hired at the rate of between N200 to N1,000 by fake parents. This reporter enquired about how to access a child to get the formula and was offered one instantly by a woman who also came to hire a baby she met for the very first time near New GRA PHC. The reporter did not carry the baby and agreed to come back for it the next day without negotiating the amount to pay for the baby.
Efforts to Checkmate Fake Parents/Caregivers
WikkiTimes discovered that few hospital staff that dispense the malnourished babies’ supplements have tried to put some measures in place to checkmate fraudulent or fake parents and caregivers and eliminate their attempts to get the nutrients to sell. Some identify parents who visit frequently with their child as opposed to their scheduled visiting days. On every hand card given, there are dates for follow-ups. If a visit is not scheduled and the child is not in any emergency, the parent is turned away.
Also, in the course of examining the child’s health and asking the child’s condition, some fake caregivers are being detected, especially those using several illegal referral cards. Other means include asking caregivers to provide the empty sachets of the previous sumplement given.
WikkiTimes learnt that a caregive (name withheld) was identified in one of the facilities in the state and she was blacklisted by almost all the health centres because of her alleged involvement in the business. “Now they refuse to enroll her on the treatment any further to avert its diversion, a source said.
Malnutrition as Child’s Right Violation
According to UNICEF, Malnutrition is a violation of children’s right to good health. The Borno State Child Protection Law also frowns at child starvation.
In a WhatsApp interview with the Dean, Faculty of Law, North-Eastern University Gombe, Umar Alkali, cautioned that parents must not prioritise money over the health of their children, noting that without good health, there will be threat to children’s life.
“Several measures can be taken to address the way we nurture our children in a healthy society. Aside addressing poverty, public enlightenment, sanctioning, and government policies should also be targeted towards better protection of children so that people change their approach to health issues,” Alkali pointed out.
Meeting Points for Business
The entrance of Primary Health Care Centres that provide the RUTF have become the meeting points for the caregivers and RUTF buyers to transact, mostly codedly.
Most clinics have specific days in the week that RUTF sellers and buyers use for their transaction. At Fori in Jere LGA, community members told this reporter that every Monday from 10:00am at the Primary Health Care centre the supplements are sold at a cheaper rate.
WikkiTimes learnt that some caregivers usually dispose of it outside the PHC and within the community once it is given to them. Primary sellers who directly get the supplement from the facility sell it at the rate of N180, N200, N230 and N250 while secondary sellers sell it between the rate of N300, N350, and N400.

Transit Points
The diversion of RUTF supplements does not only take place in Borno state. The same way cases of malnutrition are being recorded in other states in Northern Nigeria, the illegal transaction of the formula also takes place elsewhere. Illegal sellers from Borno, Adamawa and Yobe reportedly transport them to other states across the country.
In 2017, Nigeria Security and Civil Defense Corps (NSCDC), state command arrested two persons with 4,000 sachets at the Borno Express Motor Park and prosecuted them. The suspects were illegally buying and packing out foreign RUTF to a biscuit factory in Kano.
It was learnt that NSCDC, apart from that prosecution, also made three more cases of Tamuwa with one of them still under investigation in Borno. In March 2016, the command arrested a man with 10 cartons of Tamuwa and prosecuted him with the offence of theft at the Magistrate court. The man was convicted with payment of fines and three months imprisonment.
In 2024, NSCDC also arrested one Mallam Baana around Shokari area running a syndicate staging malnourished children with a woman to get the RUTF and sell it out. The woman reportedly disappeared while investigation wass still ongoing. Similar arrest was also made in Damboa Local Government Area of the state the same year by the command’s officers.
However, people engaging in this illicit business are aware that it is illegal to sell the formula. For that, they are often concealing it in other commodity, package and hide it in sacks. However, few arrests have been recorded.
On October 14th, 2024, National Agency for the Prohibition of Trafficking in Persons (NAPTIP), Borno state command arrested a woman for using a child as bait and denying her the right to the supplement. This followed intelligence sharing from the arrested woman’s community, in Gwange ward. The plight of the affected child which was shared on social media had the response of the World Health Organization (WHO) and Borno State Ministry of Women Affairs.
Although the child has recovered from her inflicted Severe Acute Malnutrition (SAM) condition under the custody of Borno state government, more children’s health risk being denied recovery from malnutrition.
The Police Public Relations Officer of Borno command, ASP Nahum Kenneth Daso, in an interview said the command had not made any arrests in this regard as there were no reported incidents of people in possession of the supplement.
The PPRO described the act as a criminal offence because it is well inscribed on the sachet “Not for sale.”
In 2022, it was reported that the illegal diversion of RUTF using different modalities by caregivers which make their children forcefully malnourished.
Some sources in the report from Katsina, Kano, Jigawa and Sokoto revealed that “most of their supplies were from either Borno, Yobe, Adamawa with only a few coming from Cameroon, Chad and Niger.”
Government Agencies, Donors, Experts Respond to the Diversion
Borno State Ministry of Women Affairs and Social Development has been training women on livelihood skills acquisition, providing them with start packs and grants to help them survive aftermath of insurgency in the state. This is to enable them to become self-empowered to easily cater for themselves and their children.
Asabe Muhammad, a Social Welfare Worker at the ministry, lamented that women are into the business of selling Tamuwa due to their selfish interest and not because of poverty. Most of the women are married and being catered for by their husbands, she said, noting that, “some of their husbands are not aware that their wives engage in such businesses.”
According to Asabe, if the ministry discovers such women, they counsel them on the use of RUTF and caution them not to sell, but if the cases persist, they hand them over to the NSCDC to take it up.
She said that the ministry has been coming to the aid of motherless babies, orphans and malnourished children who are not cared for properly. Some of them are the motherless babies rescued from fake caregivers who use them to make money through trading of RUTF business.
AHSF’s Programme Coordinator, Bello, said there have been few cases of diversion and they have been doing a lot of “education and re-education to mothers and caregivers on the proper use of RUTF.”
According to him, there have always been engagement between the people and the government for them to know what is needed and provide it in due course.
Whenever they bring it, some sell it out claiming they need something else which is one of the leading causes of the malnutrition we are experiencing.”
Also, Nutrition Project Coordinator of MSF Belgium, Alvaro Sicilia, reiterated that there are different reasons for the surge in malnutrition, including the flood that recently hit the state and affected crops, economic hardship among other factors.
“MSF is aware that the RUTF supplements have value in the market, and it is becoming a commodity, but we put some measures such as health promotion and follow-ups with patients’ family to make sure the medicine is used properly as intended to treat patients,” Sicilia said.
He, however, noted that MSF does not criminalise the caregivers and patients who are already in hardship, but they make sure patients have the right medicine available and opportunities to take care of their kids.
However, UNICEF believes that governments have primary responsibility for upholding children’s right to nutrition. But the path to nutritious diets, essential nutrition services and positive nutrition practices for all children, adolescents and women demands a shared purpose, with commitments and investments required from governments, public, and private partners.
WikkiTimes request to get the response of the State Ministry of Health and Human Resources on their strategy to tackle the diversion of RUTF but the commissioner, Professor Baba Mallam Gana did not materialise. Despite several reminders including scheduled interview, the efforts were futile.
This investigation is supported by the John D. and Catherine T. MacArthur Foundation and the International Centre for Investigative Reporting