Review of the effects of insurgency on public health: The case of Borno State, North-east Nigeria

Ibrahim N. Mamadu
Centre for Alternative Sustainable Livelihoods (CASELS), Nigeria

Zara W. Wudiri
Department of Community Medicine, University of Maiduguri Teaching Hospital, Nigeria

Hyelni H. Mshelia
Borno State Primary Healthcare Development Agency, Nigeria

Purpose: To analyse and highlight the effect of insurgency on healthcare outcomes in the developing world and its implications for future migratory patterns using Borno state, Nigeria as a case study.
Design/methodology/Approach: A review of available information and publications on the above subject was carried out. Information was sourced from online databases, journals, websites and reports.
Findings: Nigeria is the most populous country in Africa with a population of about 170 million. Over the last decade it has attempted to make gains in improving the healthcare of its citizens sustainably in line with its commitment to the Millennium Development Goals (MDGs). In recent times however much of the progress made has been reversed in the North-East of the country due to a home grown insurgency by Boko-Haram militants. This region had some of the worst health indices in the country prior to this insurgency. In that region since 2009 more than 13,000 civilians have been killed and as many as 1.5 million displaced, with the highest number of attacks taking place in Borno, Yobe and Adamawa States. In the State of Borno; the epicenter of the insurgency, 537 primary health centers, 38 secondary health centers and 2 tertiary centers existed of which about a half have been destroyed by insurgents also killing an unspecified number of health workers. Migration from that region has been mainly internal and across borders to Niger, Chad and Cameroun with some affected persons joining the steady flow of migrants to Europe from other conflict ridden zones in the middle-East and Africa. While Nigerian troops and a West African multinational coalition force are making large gains in retaking territory from the insurgents, the rebuilding of critical infrastructure across the region is a long way from beginning. Without a concerted international effort at stabilising this region and rebuilding the socioeconomic and healthcare infrastructure there will be a continuous  ow of displaced persons turning up in the country’s neighbours and ending up in other continents, further increasing the resources required to provide social services for these individuals and added security checks for immigrants.
Originality and Value: The results highlight the need for the international community to assist in the rebuilding of infrastructure and systems in the insurgency affected regions and stem the tide of displaced people and migrants from the source. Reports from the healthcare angle have not been highlighted internationally and will require increased attention and funding.
Keywords: insurgency; migration; Boko-Haram; healthcare; developing countries; Africa; Millennium Development Goals; MDGs; Nigeria.

Mamadu IJFNPH V8N2 2016.pdf
Mamadu IJFNPH V8N2 2016.pdf
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