Each year in northeast Nigeria, MSF provides thousands of children under five with seasonal malaria chemoprevention (SMC). The goal of SMC is to prevent patients from ever getting malaria.

In Borno state, From July to December this year, MSF has treated 85,000 children under five with SMC. In Bama alone, MSF provided SMC for more than 12,000 children under the age of five, and admitted more than 1,000 for malaria treatment on an inpatient basis.

MSF’s malaria response was carried out in tandem with northeast Nigeria’s rainy season, which brings a huge uptick in rates of malaria. However, despite the predictable nature of seasonal malaria, few preventive measures have been put in place, and it remains challenging for rural populations to access preventive care or treatment. Even in the state capital, Maiduguri, thousands of children come to MSF clinics in need of treatment for malaria with complications.

Bama is a so-called ‘garrison town’ in eastern Borno state, where MSF provided treatment for malnutrition in 2018, and where, from July-December this year, MSF has run SMC activities and a 28-bed clinic for children with severe malaria. Being a ‘garrison town’ ostensibly means that Bama is inhabited and guarded by the Nigerian military, against armed opposition groups. There is also a substantial, state-owned hospital here, with specialised facilities and equipment. However, due to the lack of human resources, medicine and the cost of healthcare here, the hospital remains largely dormant. This situation is not limited to Bama however, significant investment in Borno state has led to an increased number of state-owned health facilities, but not all are functional and fewer still provide much needed secondary level healthcare.

The absence of affordable, accessible secondary healthcare in Borno is an extremely pressing issue for the general population, particularly against the backdrop of a decade-long conflict, which has displaced hundreds of thousands of people. Despite the gaps in healthcare – the physical infrastructure is present in many locations, and with appropriate human resources and medicines state hospitals in places like Bama could offer a much-needed lifeline to the local population.

However, outside government controlled areas the living conditions and needs of the population are uncertain, and without being able to access ‘garisson towns’ the population has no access to healthcare whatsoever.