Nigeria

Northeast Nigeria Response (Borno State): Health Sector Bulletin #7, 12 November 2016

Attachments

12 November 2016

3.7 MILLION
IN NEED OF HEALTH ASSISTANCE 2016
1.8 MILLION
INTERNALLY DISPLACED PERSONS
2.6 MILLION
2016 TARGET BY HEALTH SECTOR
1,799,506 *
BORNO STATE POLIO VACCINATED CHILDREN

HIGHLIGHTS

  • Suspected Measles cases continue to spur across IDPs camps spite ongoing routine immunization activities. As part of a phase I measles campaign, Borno State Ministry of Health and partners conducted reactive measles vaccination in three camps: Muna Garage, Custom House and Fariya informal camp.
    The total vaccinated children aged 6 months to 15 years was 13,537 with vaccination coverage of 98.2%. Reactive measles vaccination campaigns are ongoing targeting 16 camps in MMC and Jere LGAs.
  • Based on trends in previous years, the risk of malaria, measles and acute respiratory infection, it is expected to increase over the next three months. The Borno State Ministry of Health and the Nigerian Meteorological Agency (NMA) predicts that increase in temperature heralding the end of the rainy season could lead to increase incidence of meningitis.
  • The initial draft for the NE Nigeria HRP 2017 shows 18 health projects by 12 partners with estimated request budget of $93.8 million.

Situation Update:

According to latest International Organization of Migration (IMO) Displacement Tracking Matrix (DTM), as of 31st October there are 1,822,541 internally displaced people (IDPs), with 93% of those in Borno, Adawama and Yobe states. Borno State alone is hosting 1,468,810 IDPs. Children under 18 constitute 55% of the IDP population and 48% of those are under five years old. In Borno, over 1 million of the IDPs are residing in host communities, as opposed to camps.

The DTM found that IDPs 50% of sites have access to health facilities but not medicines, as the facilities are not equipped. However, the situation is worse for those living outside the camps; 18 Health partners are supporting 128 SMOH health facilities in Borno State. Of the 86 camps (formal and informal) in Borno, 60% are with no health partners’ support. Of the 128 partner-supported facilities, only 2 provided psychosocial support or mental health services. Coupled with the finding that the referral system is also non-functioning; these factors have no doubt led to the anecdotal reports by health partners of patients dying due to lack of medicines, poorly trained staff, or a failing referral service.

According to MSF-Switzerland Snapshot on OCG operations in Nigeria’s Borno State report (November 2016) the MoH teams working in Banki, Ngala and Gambaru LGAs in Borno State, lack the proper space and medical equipment to conduct consultations and are struggling to cope with the high number of patients. As briefly described by the report:

  • Banki IDP camp: the population is currently at 20,000 to 25,000 people with one health post attended by only six MoH community health workers.
  • Ngala IDP camp: estimated population between 50,000 to 65,000 people and only 2 nurses from the Nigerian Red Cross conducting medical consultations.
  • Gambaru town: estimated population at 70,000 to 80,000 people and the health centre is destroyed and only one nurse working from time to time.

MSF conducted three retrospective mortality surveys amongst the general population and children under 5 years of age in Banki camp, all three surveys showed an abnormally high mortality rate of children under 1 year of age; they make out 54% of all registered deaths of children under 5 in September and still represent 43% in October. The main cause of death reported in the October survey was malaria (50% of all deaths).

Already-poor host communities have been sharing resources with one of the largest IDP populations in the world for more than twelve months with little support, and are now relying on negative coping mechanisms after savings and assets have been used. The fact that routine immunization have been prevented by the conflict is compounded by the overcrowding, insufficient potable water, poor hygiene and sanitary conditions in the camps, centers and host communities, increasing the risk of disease outbreaks like measles and meningitis. The Health Sector, lead by the Ministry of Health, has identified the need for a comprehensive minimum package of health services to be delivered, including Primary Health Care (PHC) services including immunization, mental health and psycho-social services, Integrated Management of Childhood Illnesses (IMCI), emergency obstetrics, and management of severe acute malnutrition.

The security situation remains fluid and unpredictable. The number of improvised explosive device (IED) incidents have spiked during this month, the most recent of which have been perpetrated by suicide bombers within Maiduguri mainly at densely populated areas.These incidents, coupled with the additional corresponding security measures had continued to impact on the accessible footprint and tempo of humanitarian response operations.