Accessing healthcare in insecure context of Zamfara
Communities in Zamfara, northwest Nigeria, face high levels of violence and insecurity. This has led to displacement, difficulties in accessing basic healthcare including vaccinations for preventable diseases and disruption in agriculture contributing to high levels of malnutrition. This state, like much of the northwest region, has traditionally been left out of wider humanitarian responses in Nigeria and there are therefore very few other humanitarian organisations working in this area.
In Zamfara, MSF works across four local government areas, Zurmi, Shinkafi, Gurmi and Talata Mafara. Our teams offer a wide range of healthcare responses including trauma care, surgical services, paediatrics, mental health support and reproductive healthcare and emergency referrals to Gusau federal medical centre and other specialised care hospitals in Sokoto. As Zamfara has high levels of malnutrition in all four areas, MSF offers malnutrition care for children. MSF operates four inpatient and 17 outpatient facilities for children suffering from malnutrition in Zamfara. Across these facilities, MSF teams treated 65,000 children for malnutrition in 2024. Overall, MSF medical teams responding in seven states spanning northern Nigeria have treated 354,000 children for malnutrition between January – November 2024.
MSF supports the State Ministry of Health at Shinkafi General Hospital and Zurmi General Hospital by offering reproductive healthcare services to women. Across these two locations, MSF teams gave 47,245 consultations to pregnant women and assisted 6568 deliveries in 2024. Across the whole of Nigeria, MSF teams supported 26,119 deliveries in 2024. These areas of Zamfara see a lot of violence and insecurity making it difficult for women to access maternal healthcare services. Nigeria has one of the highest maternal mortality rates in the world; thus, continuous sexual and reproductive healthcare services are crucial to reduce maternal mortality number
Maryam Usman* name has been changed
“My name is Maryam Usman*. I am 20 years old. I am from a village in Shinkafi in Zamfara state. This is my first childbirth, and I lost the baby. When I was pregnant, I did not go for check-ups because we don’t have any healthcare facilities in our village, and I couldn’t go to other facilities in neighbouring villages because of the fear of being attacked. On the roads, armed people attack people and rob them of their valuables. They also abduct people, asking for ransom to be paid before they release the victims.
When my labour started, I was taken to a health care facility in a nearby village. After assessment, I was referred to the General Hospital Shinkafi. When I was rushed here, I was not conscious. Eventually, I regained consciousness, but the baby was born dead. It was a boy.”
Ramatu Adamu*name has been changed
“My name is Ramatu Adamu, I am 35 years old. When I was one month pregnant, I started urinating frequently. A doctor examined me and gave me tablets and injections. Afterwards, I was often sick. When I was three months pregnant, I started going for antenatal care. I felt a bit better at first, but I continued falling ill and recovering, until I gave birth.
We usually walk very far to reach the clinic for antenatal care. One day, my family and I were attacked by armed people on our way to the hospital. They robbed us of all our belongings including our bras.
We have healthcare facilities close to our villages, but the workers have all fled because of the insecurity.
I have given birth before, but I have never bled like I did this time around. I gave birth at home. I couldn’t come to the hospital because my labour started late in the evening, and you can’t travel on the roads at night because of the armed people.”
Habiba Saleh*name has been changed
“My name is Habiba Saleh. My family and I were displaced from our home and have been here in this camp in Zurmi for seven months now. Armed people chased us trying to kill us, so we fled here for safety.
My husband and five children are here with me. Life here is not easy but we are managing. We have healthcare services here, but it doesn’t cover everything.
We are very hungry here. We generally only eat once a day, usually in the evening.
Back at home, my children used to go to school, but here, they don’t.
We hope to go back home to our farms in peace.
Rukkaya Mohammed*name has been changed
“My name is Rukkaya Mohammed*. Me, my husband and seven children ended up in this camp after we had to flee our village because armed people had been terrorising us. They kill, abduct and take people’s belongings. Right now, eight people from our village have been abducted and the abductors are asking for five million. They won’t allow us to farm. They took all that we have.
Here, life is not easy. When we can get menial jobs, we eat. But it is difficult when we don’t have any job to do, and it is not easy to find jobs here. Many times, we are only able to eat just once a day.
We pray for peace so we can return to our villages. We also hope to have food to feed our children. Back at home, our children attended schools but here they don’t.”
Rabi Suleiman*name has been changed
“My name is Rabi Suleiman. I now live in this camp with my husband and four children. We had to flee from our village suddenly because we heard about the armed men plan to attack. We couldn’t take anything with us. We long to go back home.”
Amina Yakubu*name has been changed
“My name is Amina Yakubu. This is a very a difficult situation for me and my family. We fled our homes because of violence. They’ve taken all our food and belongings.”