Teams from Médecins Sans Frontières (MSF) are scaling up assistance in anticipation of increasing humanitarian and medical needs in hard-to-reach areas of Borno state, Nigeria.
The onset of the rainy season will render some locations impossible to reach, as the countryside transforms into muddy swamps and roads disappear under water. The remote town of Rann will turn into an island, completely cut off from the outside world. Around 40,000 inhabitants and displaced people living in the area will have no assistance unless it is deployed in advance.
The rainy season coincides with the peak of malaria and increased malnutrition rates. In anticipation, MSF is deploying a mobile team to deliver medical and humanitarian support in Rann, Banki and Damasak over the coming months. Team members will carry out health consultations, give preventive treatment for malaria, distribute mosquito nets and soap, and work to improve water and sanitation. They will also screen and treat children for malnutrition.
"Insecurity and logistical challenges make it difficult to provide assistance in these places, but we are working hard to step up action now before the rains come," says Dr Moussa Sow, MSF project coordinator for the mobile rainy season teams.
"People here have been displaced and many have been victims of violence. Our team will do our utmost to make sure they don't suffer or die of preventable diseases."
The mobile team has been pre-positioning medical and logistical supplies and is now starting medical activities. The team members will rotate in the three locations throughout the rainy season.
A second mobile team is distributing preventative malaria treatments in Bama this week, is preparing to do the same in Dikwa, and will respond to the expected increase in malaria cases in the months ahead.
Living conditions are already precarious and displaced people will depend on the continuity of food distribution to avoid malnutrition. More rain could also lead to outbreaks of waterborne diseases such as cholera and MSF has put an emergency preparation plan in place in parts of the state, including in the capital Maiduguri.
A hepatitis E outbreak has already been declared in parts of Borno state, with MSF leading the medical response in Ngala. The risk of outbreaks will be higher if crowded camps for displaced people flood, and there is insufficient access to clean water and toilets
When MSF started providing assistance in Rann in January, only one litre of water was available per person per day – far below the emergency standards. MSF and other organisations have worked to improve the water supply, enabling people in Rann to access between ten and fifteen litres of water each per day.
But MSF fears the insufficient number of latrines will lead to disease outbreaks. Teams estimate that in Rann, 279 people share each latrine. According to accepted minimum sanitation standards, one latrine should be used by a maximum of 20 people.