SPECIAL REPORT: How conflict is driving child malnutrition in Benue

Florence Ajaba strolled past rows of identical make-shift tents branded with the logos of the International Organisation for Migration (IOM) towards a familiar one where Aba Aondasee waited with his son, Alia, whom he held delicately in his arms.

After exchanging pleasantries with Mr Aondasee, Ms Ajaba squatted beside Alia and inserted his hand into a circle formed by a multi-coloured 26-centimetre-long tape, then fastened it like a belt to fit the two-year-old’s upper arm.

“This is how we check for nutritional risk in children,” Ms Ajaba told PREMIUM TIMES in June, explaining what she had learnt from Red Cross officials at the Mega Internally Displaced Persons (IDP) Camp in Benue State.

The tool, a Mid-Upper Arm Circumference (MUAC) tape, is graded in centimetres (cm) and colour-coded green for health, yellow for at-risk, and red for severe acute malnutrition in children aged between six and 59 months.

A child’s arm circumference above 12.5 cm is coded green and considered favourable, and anything below 11.5 cm is coded red, signifying severe malnutrition.

A silent malnutrition crisis

Alia’s arm measured 11.5 cm, just on the threshold of being considered severely malnourished.

“He has always been sick since birth,” said Alia’s father, Mr Aondasee. He has cared for the boy since the mother died on 16 January 2024, when he was only four months old.

Alia is one of the 313 malnourished children at the Mega IDP Camp, according to figures obtained from a camp official.

The official, who did not want to be named, said a MUAC test conducted on the children between December 2024 and January this year revealed that 180 of them were acutely malnourished.

Of the 13,617 people at the IDP camp as of May, 2,096 are children under five years – the age range of the children being tested for malnutrition.

Across Benue State, over 336,000 children are stunted due to malnutrition, the United Nations Children’s Fund (UNICEF) said in January, up from 283,727 recorded the year before. Most of the cases are at the displaced persons camps scattered across the state.

According to data from the Benue State Emergency Management Agency (BSEMA), 316 children were diagnosed with malnutrition during a screening of 1,174 children conducted between 17 June and 9 July.

The data, obtained from the spokesperson for BSEMA, Tema Ager, showed that 133 were severely malnourished while 183 were moderately malnourished.

“It’s still increasing as we speak this minute,” said Israel Wasem, a medical doctor who has worked in several IDP camps in Benue. “With the increasing number of IDPs, there has been a big challenge in increasing these malnutrition rates.”

The doctor said he diagnosed numerous cases of malnutrition within various camps in Benue State, including Daudu IDP Camp, Ortese IDP Camp and Ichwa IDP Camp, where he had worked.

The conflict behind Benue’s malnutrition crisis

Before his wife’s passing, Mr Aondasee recalled how they struggled to feed and how her hospital bills were paid by strangers.

However, he wasn’t always financially helpless. This new reality began in 2014 after he survived a deadly attack at Tyohemba, a village in Guma Local Government Area (LGA) where he lived and had a farm.

One early morning, gunmen emerged from the bush, shooting a woman going to the stream to fetch water. The gunmen unleashed mayhem on the community, as only a few residents survived the attack. Since the attack, Mr Aondasee has returned to the village only a few times to observe the environment.

“If you go to my village now, there is nothing like a house. Everything has collapsed,” he said. “You wouldn’t even know where your house was located.”

After fleeing the village, Mr Aondasee lived in the Baka IDP Camp in Makurdi until 2018, before he moved to the Ichwa camp because it promised better welfare.

Two years ago, while at the Ichwa camp, his wife, Mary, gave birth to Alia through a difficult pregnancy. Mother and child were in and out of the hospital before the mother succumbed to some health complications four months later.

Since then, Mr Aondasee has cared for the boy with the help of other displaced family members.

When PREMIUM TIMES met him in June, he was one of the over 10,000 occupants of the sprawling Mega IDP camp where the state government resettled displaced persons from Ichwa camp, NEPA Quarters, and Baka IDP camps.

The conflict that displaced Alia’s father and the other occupants of this IDP camp is a common crisis in Nigeria’s North-central region.

The clashes often occur between indigenous farmers and nomadic herders, primarily of Fulani descent. Moving from the north of the country to the lush green north-central region to graze their herds, the pastoralists are routinely accused of encroaching on farmlands and grazing on crops. This has become a major conflict that locals in Benue State view as a ‘genocidal attack’ on them by the Fulani. It has left close to 7,000 people dead and over 500,000 displaced, who have taken refuge in the dozens of IDP camps scattered around the state.

Nigeria’s conflict-driven malnutrition crisis

At these IDP camps, residents struggle to feed as a result of a lack of jobs and diminishing support from donor-funded organisations and philanthropists. This dire situation is silently driving a malnutrition crisis, especially among young children displaced by the conflict.

According to UNICEF, Nigeria has the second-highest burden of stunted children in the world, resulting from malnutrition. The UN agency estimated that two million Nigerian children suffer from severe acute malnutrition (SAM), with only 20 per cent currently reached with treatment.

Between 2018 and 2023, child malnutrition worsened in Nigeria, with stunting increasing from 37 per cent to 40 per cent among children aged six to 59 months, according to the National Demographic and Health Survey.

Nigeria’s malnutrition burden

The malnutrition crisis is worse in the North-west, where banditry is rife, and in the North-east, which is battling a decade-long insurgency, according to the Integrated Food Security Phase Classification (IPC), a multi-stakeholder global initiative aimed at enhancing food security and nutrition analysis.

In the North-central, the farmers-herders clashes are driving the malnutrition crisis.

“The increasing number of IDPs is increasing the malnutrition rates,” said Mr Wasem, a medical doctor and ad hoc medical officer with UNICEF at the IDP camps.

Government’s Response to the Crisis

At the Mega IDP camp, Ms Ajaba serves as a volunteer for a mother’s club project of the Red Cross, with mothers of 50 malnourished children.

She helps coordinate the women in learning how to make Tom Brown, a nutritious, locally made food powder used to combat malnutrition in children. The meal, prepared like pap, is usually made from a blend of grains such as soybeans, groundnuts, guinea corn, maize, millet and fish powder.

The Benue State Government stated that it is also stepping in to address the challenge through a Memorandum of Understanding (MoU) signed with the Benue State University Teaching Hospital, where it will refer cases of severe acute malnutrition (SAM) for treatment.

According to Mr Ager, the BSEMA spokesperson, moderately malnourished children will also be provided with enriched flours (Tom Brown meal) for feeding.

“We signed a Memorandum of Understanding with them so that when they are referred, they will treat them before they come and pay them back so that there will be no delay,” he said in a telephone interview.

Diminishing aids

Although the government said the MoU was signed last year, it contrasts with the realities of some displaced persons with malnourished children.

At the Ichwa IDP Camp in Makurdi, Margaret Kparmegh’s 17-month-old daughter, Nguevese, is always strapped to her mother’s back, too frail to play with other children at the displacement camp.

The worried mother said the girl was constantly sick, losing weight and not growing like her mates. When humanitarian workers visited them to distribute relief materials and counselled them on healthy practices, she consulted one of them about her daughter’s condition. But she was told to see a doctor.

As the UNICEF-administered clinic in the camp had been shut at the time, one humanitarian worker accompanied her to the Primary Healthcare Centre (PHC) in Asese, a few kilometres from the IDP camp. There, the daughter was diagnosed with malnutrition, and some drugs were administered. She said the drugs had since finished, but she has yet to get more.

“She was six months old when she started purging and getting sick. I’ll manage with her, but it has continued,” she said.

The medical doctor at the PHC Asase, Adikpo Matthew, later told PREMIUM TIMES that the health centre used to receive supplements like Ready-to-use therapeutic food (RUTF) from UNICEF, but the intervention had since stopped.

“There are no nutritional drugs to give them now,” he said.

Mr Matthew said the health centre had been receiving IDPs seeking healthcare for close to two years, but noted that the children are usually presented to the clinic late after the malnutrition cases had become severe.

Within the last month, he said, two children from the IDP camp were diagnosed with malnutrition at the health centre, but the condition of one was so severe that he referred them to the General Hospital.

“Inadequate food makes the children malnourished. Even the mothers are not feeding well,” he said.

Diminishing aid, particularly due to funding cuts by the United States government through USAID, has affected healthcare projects in the state, Mr Ager admitted.

To remedy the situation, he said the state government was partnering with other organisations, including the Federal Ministry of Humanitarian Affairs, which recently committed 7,670 cartons of blended enriched flour for malnourished children, targeting over 30,000 IDPs.

Increasing Food Insecurity

Meanwhile, the World Food Programme (WFP) has warned that conflict and insecurity are major drivers of rising food insecurity in Nigeria, as 30.6 million people face acute hunger in the country.

“Armed banditry and kidnappings in the North-west and farmer-herder conflict in the North-central states, including Zamfara, Katsina, Sokoto, Kaduna, Benue, Plateau and Niger, exacerbate the prevailing economic struggles,” it said.

“The northwest and parts of the north-central regions now exhibit critical levels of severe food insecurity and malnutrition, marking them as major hunger hotspots that demand attention from decision makers.”

Since 2018, Juliana Ternengen and her husband have lived at the Daudu IDP Camp, where she said feeding has been a challenge.

Last year, they began returning to their community in Tse-gbanor, in Guma LGA, to cultivate yams and guinea corn to supplement feeding at the camp.

However, the heightened fear of attacks in the community forced them to stay away this year.

Mr Wasem, the medical officer, described the displacement in Benue as the major driver of malnutrition in the state. He said feeding was not a problem before the displacements, as the residents are mostly farmers who had enough to eat.

“Even though they might not have liquid cash, they were living very well in those villages. They didn’t have any issues with malnutrition,” he said.

UNICEF’s Country Representative, Cristian Munduate, also raised concerns about the plight of children in the crisis, emphasising the importance of upholding the right of children to adequate food and nutrition.

“Children are at the centre of the food insecurity crisis and face irreversible consequences –both physical and cognitive, and potentially even death,” Ms Munduate said.

The BSEMA spokesperson, Mr Ager, said the state government and the federal government were working to restore security in the troubled communities and ensure the resettlement of the displaced persons, where they will not be dependent on aid.

He explained that the state governor, Hyacinth Alia, presented a plan to the federal government.

“So the target now is to provide security in those areas because you cannot return them without security. When security is on the ground, that is when the houses will be rebuilt, the communities –the schools, hospitals and churches that were burnt down will be constructed and taken back. And then other facilities and social amenities will be provided for them,” he said.

Rays of hope, but affliction persists

Last year, Hembafan Ushahemba’s daughter, Peace, had diarrhoea and fever around the same time a group of missionaries arrived at the Dauda IDP Camp for a medical outreach.

As part of the outreach, they asked mothers to present their young children for malnutrition screening. After the exercise, they separated the underweight children, including Peace, who was then six months old.

The missionaries took the underweight children and their mothers to a church in Makurdi, where they received drugs and nutritional meals for their children.

“They brought a bus and took us to the church,” Mrs Ushahemba said, noting there were more than 40 children that day.

Another beneficiary of the initiative, Mrs Ternengen, said the missionaries gave them some ready-to-use therapeutic foods (RUTF).

“They gave us one food powder that we prepare with water, like pap, and the other one is like a paste to feed the children,” she said.

Unlike those whose children got help, Mrs Kparmegh still struggles to get her daughter treated.

She tried to feed her daughter, Nguevese, but the 17-month-old baby purged almost everything she ate.

At the PHC Asase, where her daughter was diagnosed with malnutrition, she was given a list of drugs, but she did not have enough money to buy them.

“Whenever I get any money, I manage to buy her some drugs, but it’s not working,” she said.

This reporting was completed with the support of the Centre for Journalism Innovation and Development (CJID)