By Olarewaju Kola

MAIDUGURI, Nigeria

Six years of the Boko Haram insurgency in Nigeria has been exacerbated by a polio outbreak and malnutrition among hundreds of refugees displaced by violence in the country’s northeast region, officials said this week.

Isaac Adewole, Nigeria’s health minister, announced the discovery of two children with polio at a camp for displaced victims of the insurgency in Maiduguri, the capital of Nigeria’s northeastern Borno state, and Gwoza, a Borno community at the Nigeria-Cameroon border recently liberated by Nigerian forces.

“It is unfortunate that we have this development. It has set us back,” he said.

In its reactions to the two polio cases in Nigeria last week, the WHO said the outbreak highlighted the “need to prioritize the immunization of children,” particularly in “hard-to-reach areas” like the Lake Chad region where the military still engages Boko Haram fighters.

Tobi Lazer, UN assistant secretary general and regional humanitarian coordinator for the Sahel, said last week that the polio outbreak came amid widespread malnutrition of many displaced persons at some internally displaced persons (IDP) camps.

During a visit last week to Bama, Borno’s second-largest city, Lazer said fresh polio cases have “further worsened the increasing humanitarian challenges” in the northeast Borno State, already ravaged by six years of violence from Boko Haram.

Polio or poliomyelitis is a viral disease which can cause paralysis in one out of 200 children it infects, according to the WHO. The disease remains endemic in Pakistan and Afghanistan, where Taliban fighters have targeted polio vaccination workers.

Nigeria has carried out polio-free campaigns since July 2014, when it recorded what many hoped was the last case of the crippling disease, a hope dashed last week.

Kashim Shettima, the governor of Borno State, said the fresh cases of Wild Polio Virus (WPV) will hurt Nigeria’s expectation of a polio-free certification from the WHO by December.

“Polio was a disaster waiting to happen because some of the communities recently liberated by the military are largely inaccessible,” he said, blaming the outbreak on Boko Haram murders of health workers carrying out polio vaccinations in northern Nigeria.

In February 2013, nine women who were giving polio vaccines to children in the northwest Kano State were killed by Boko Haram. That October two polio vaccinators were also killed in the central region of Borno State by insurgents.

“Many children born in Boko Haram captivity were not immunized. Some who were born earlier, before they were kidnapped, also could not access the vaccine for two years,” Shettima said on Monday.

-Insecure areas

Nigeria President Mohammadu Buhari has deployed a national emergency response team to the area to begin “rapid-response vaccination” to halt further outbreaks. But some health workers expressed concern over insecurity in some remote communities.

“How secure are we to carry out effective vaccination in communities just liberated from Boko Haram? How safe is our movement even to some communities, or have you forgotten the recent attack [last month] on UN aid workers?” asked a medical worker, speaking on condition of anonymity due to restrictions on speaking with journalists.

But Abba Ibrahim, a local immunization coordinator, said the authorities are providing adequate security for polio vaccinators and humanitarian workers. “What we’re doing now is rapid response, a kind of emergency arrangement. Another round of vaccination is starting on Aug. 27 and government is providing security for all teams,” he stated.

Dr. Saheed Gidado of N-Stop, an independent polio vaccination assessor, identified some locals’ refusal to let their children be vaccinated as a challenge faced by vaccination campaigns.

He also said the movement of more displaced persons from communities recently liberated by the Nigerian military to the refugee camps in Maiduguri, the capital, over-stretched the plan and facilities for the immunization response.

“The distribution of food by vaccinators as incentive to people to embrace the vaccine encouraged many IDPs to leave the cities with their relatives to besiege the IDP camp for free food. The huge crowd altered our plan and resources,” Gidado explained.

Borno, worst affected by the Boko Haram violence, has experienced food shortages amid the heightened insurgency.

Abubakar Muazu, a university teacher in the capital, said locals were forced by the insurgents to abandon their farmlands, while many communities were cut off from the capital where foods would have been supplied by donors and humanitarian relief agencies. Malnutrition was therefore expected, he stated.

-Displaced and ill

UNICEF says one-quarter of the 2 million people displaced by the Boko Haram insurgency in the northeast are suffering from malnutrition.

More than 1,000 people, mostly children with severe malnourishment, have been moved to the management center in the capital, said Dr. Haruna Msheliha, Borno’s health commissioner.

Job Kamamba, a nutritionist with Doctors Without Borders (MSF), currently working in IDP camps in Borno’s central town of Bama, told Anadolu Agency that new cases of malnutrition were discovered last week.

“We have discovered a total of 152 children who are sick and severely malnourished,” he said at the refugee camp in Bama, some 71 kilometers from the capital.

He said 310 children are also suffering from moderate malnutrition, while 10 people with severe conditions have been referred to a stabilization center in Maiduguri “for further management.”