Access to food and water has been the major challenge of the nearly 60, 000 population of internally displaced persons (IDPs) at Pulka village camp in Gwoza local government area of Borno state, the Medicines Sans Frontiers (MSF) said.
Before Boko Haram took over Gwoza local government area and declared it as headquarters of its now defunct caliphate, Pulka had a population of about 30, 000 people.
But after the reclaim of Gwoza, the military fortified Pulka which is a nexus between the area and Sambisa forest, and it gradually became a destination for fleeing villagers.
MSF’s Head of Mission in Nigeria, Luís Eguiluz, said about 200 personnel of his organisation work on daily basis to provide medical care for the surging population of IDPs , who are mostly women and children.
Mr. Eguiluz was last week in Pulka village camp for two days when he observed how most of the displaced persons fleeing their remote communities attacked by Boko Haram were coping with the extremely difficult situation there.
He said though Pulka is relatively secured as the community is well surrounded by soldiers, humanitarian workers can only access it by air.
“Pulka is about 100 kilometres from the state capital, Maiduguri,” the MSF official said.
“Our teams must cover this distance by helicopter, on flights operated by the United Nations, because of the continuing insecurity.
“Before the conflict, 30,000 people lived in the town. Now the population has doubled with the arrival of large groups displaced by fighting in the surrounding areas”.
Mr. Eguiluz said on his recent visit to Pulka, where the personnel of MSF otherwise known as Doctors Without Borders are providing primary and secondary medical care, he met a large number of women and children in dire need of “emergency services, maternal and mental health care”.
“On one of the days when I was in a camp for displaced people, whose wood and white canvas tents have become part of the town, a woman told me that, in addition to her four children, she also takes care of four others because their mother is missing”, Mr. Eguiluz said.
“The woman explained about the hardships of this situation, as she had to share four children’s worth of food with all the children, as she did not have the distribution cards for the ones that were not hers.
He said “there are few men in the camps; some had stayed in their villages to watch over their houses and their fields. Others were afraid to flee.”
“They told me about their most basic needs: water and food. The population of Pulka, both locals and displaced people, cannot access the fields on the outskirts of the town – their only livelihood – due to the high risk of attacks.
“The Nigerian army allows them to venture only a certain distance from the town, so those living there must cultivate crops in this limited space. People also collect wood for cooking, but it is not enough to cover all their needs.
He said water is the most scarce commodity in the rocky terrain as women spend more hours on queue to access the few water points that have been created.
“Children walk around the camps and the town with nothing to do because the schools are closed, the teachers have gone to Maiduguri and there are no activities, aside from some games organised by MSF.”
Despite the presence of MSF, many women complained of difficulty in accessing medicines.
Mr. Eguiluz informed PREMIUM TIMES that chief amongst the services provided by the MSF medical team was mental health care.
“The people now in the camps have suffered numerous traumas. Many of them have seen people, including friends and family members, die violently. Many women and girls have suffered sexual violence.
“As a result, the mental health support MSF provides is crucial.”
Another major problem observed in Pulka is the tension that is gradually generating over access to accommodation.
He said the large number of IDPs have eaten up space and tents making it difficult for the returnees of Pulka not having access to their website who had earlier to their homes.
“There is no enough tents in the displaced camps”, he said.
He said the few non governmental organisations that operate in Pulka do not have adequate, trained or experienced staff and are unable to meet the needs of the population.
“The MSF hospital there employs 200 staff to cover the needs of the population.
“When displaced people reach Pulka, they often do so after having walked for days without food or water. Upon arrival, they undergo a security check by the army, and only after that can they access humanitarian services, such as registration, medical attention, emergency food distribution and vaccination.
“There are currently more than 7,000 people waiting for shelter. Of these, 6,000 are living outside, exposed to the cold nights of Pulka.”
He explained that MSF has to monitor the conditions because the risk of epidemics, such as measles and meningitis, is exacerbated by the lack of adequate shelter.
Currently there are about, 15,000 children in the camp and many of them are unaccompanied because their parents are either killed or missing.
“The humanitarian needs of the population are the result of both Borno’s structural problems and the ongoing conflict there”, he added.
“Health standards were already low before the conflict. But they have been exacerbated by the massive displacement of the population, the lack of access to basic services and the insufficient level of humanitarian assistance.”
MSF is the leading healthcare provider that operates in the most difficult terrains of Borno state where absence of medical services predates even the ongoing crisis that Boko Haram brought about nine years ago.