The light of the Nigerian sun is blinding, piercing, rendering the colours of Maiduguri hollow and indistinct. The sky is as white as the dust along the road. It is here, in this place of unforgiving flashes, of reflections that overwhelm everything in sight and force the eyes into nothing more than two tiny slits, it is here that the only shadows to speak of are those of women walking along the street as they hold tiny bodies in their arms or tied to their backs. Throngs of mothers, wrapped in hijabs or kaleidoscopic Kanuri dresses, all heading in the same direction: the Gwange quarter. They march onward, without leaving so much as a footprint in the sand, as if they were floating in their ghostly condition, pariahs of human mercy. Forward, in groups, all bearing the same countenance: gaunt faces, entranced eyes, ivory teeth, breaths taken through open mouths due to the effort and the pain. Travelling along the main road, these figures, lined up as if in a procession of innocent penitents, allow themselves to be watched as they drag their children along with them. Children twisted by ruthless hunger with exhausted visages, drained of any form of resistance to the pain, incapable of objecting to the suffering, even if only with a soothing, all-enveloping cry.

A looming silence accompanies the parade of Africa’s damned to the clinic set up by the non-governmental organisation Médecins Sans Frontières (MSF or Doctors Without Borders). Their destination is the only outpost in the city confronting the food crisis. The lack of sustenance is a scourge that holds people hostage to primary needs, stripping them of their identity, subjecting them to raw necessity, eliminating individuals and creating, in their place, a single, collective tragedy made of a slow death, one that kills at its own unhurried pace, day after day, unrelenting and without pity. This plague has a name: hunger.

Nigeria’s food crisis exploded due to the conflict between jihadist Boko Haram rebels and the federal army, a war that has inflamed the country since 2009. In that time, it has created over 2 million refugees and 500,000 displaced persons. The death toll has reached over 20,000; damages have been estimated at 9 billion dollars and, in the district of Maiduguri alone, the total of those without a roof over their heads, camping in tent cities and temporary housing, exceeds one million. The conflict has destabilised life in the northeast of the country, while in the states of Borno, Yobe and Adamawa, residents have been forced to flee, abandoning their land. Fields lay fallow while 40% of healthcare structures in the state of Borno have been destroyed. As such, without harvests and medical assistance, the nutritional crisis has exploded. Reading the estimates provided by MSF, you learn that 50% of children under five suffer from acute malnutrition and infant death rates are as much as four times that of the emergency threshold. Joanne Liu, International President of MSF, has stated: “It’s a catastrophic situation, the extent of which is unclear as many areas are still isolated. We need to immediately increase the aid provided because the lives of thousands of people are hanging on by a thread”. To truly take stock of what’s happening, it’s necessary to be there, on the front line of the fight against hunger, where the international non-profit is trying to stem the tragedy.

After crossing through the Gwange quarter and having met the mothers and their children, is the MSF inpatient therapeutic feeding centre, the structure the NGO set up to help malnourished children. Five tents act as wards containing over 110 beds. Once through the gate, where a sign declares that guns are strictly prohibited, is the centre of the hospital. In a courtyard, women wait for their months-old children to be seen by a doctor. One by one, they’re weighed and, as soon as they’ve passed the preliminary checkpoint, they cross the threshold into the “pavilions”.

Those who populate the wards try to resist, like inhabitants of a city under siege, engaged in one final, personal, rebellion against rules written by pain that impose the acceptance of suffering without question.

Sarat Suleiman is two years old, with two dark, enquiring eyes that shine intensely and move feverishly. It’s as if they’ve robbed all the life from the rest of a body that, by contrast, is immobile, powerless and cradled tightly in the arms of Anem Binta Suleiman, his mother. “I’m originally from Bama. One Saturday morning, some Boko Haram fighters showed up and I fled to Baga. I had got married and I had just had my son, but shortly after giving birth I had to flee again with my new-born child because the jihadists arrived there too. We escaped to Maiduguri, but we have nothing to eat. He’s sick, they’ve diagnosed him with tuberculosis and he has kidney problems”. In the next cot over is Mohamed Mustafà, 7 years old with a hospital chart that reads, “weight: 14 kilos”. Fatima Bukar, 45 years old, walked for 5 days from Nigeria to Cameroon to escape terrorists, only to be expelled from the neighbouring country and end up at the displaced persons camp in Maiduguri. “The soldiers control the tent city; the safety measures are quite repressive and there’s a lack of food. I’ve been here for 90 days because my son has serious nutritional problems”. A doctor with a stethoscope around his neck listens to the children’s chests, another monitors their vital signs and heartbeats. A mother thanks them with almost religious reverence while nurses replace IV drips and bring nutritional solutions. Doctor Pindar Wakawa, Medical Activity Manager of MSF, explains the situation in detail: “In the city, we have three operational sites. This is the centre opened to deal with the nutritional crisis. Each month, we admit over 300 patients. Our goal is to increase the beds we have, at least up to 150, because the growing number of displaced persons is bringing a surge in malnutrition cases. The lack of food weakens people, leaving the elderly and children more vulnerable to disease. The risk of epidemics is very real, in part because a large slice of the population hasn’t yet received even the most basic vaccines”. In conclusion, the manager commented, “An urgent humanitarian intervention is needed, in addition to the large-scale distribution of food and medicine directly to the population”.

The unspeakable anxiety caused by fear of a catastrophe, as imminent as it is ruthless, is evident in the words of the doctor and confirmed by the scene that appears once inside the ‘acute phase’ ward. Seven-year-old Umar is lying on his bed, his body devoured by hunger, prey to the spasms of malaria. His mother lovingly lays her hand on her son’s forehead, while his brother uses oil to soothe arms and legs that the fever ceaselessly torments with violent, sudden contractions. The eyes of the child follow the light, his hands tighten into fists of pain and his ears, perhaps, hear the prayers his mother whispers with inexhaustible conviction, seeking out, in an unmitigated offering to the transcendent, one last foothold against an abandonment that is about to come, far from any acceptance and extreme representation of human pain.

Photos by Marco Gualazzini