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Insecurity in northern Nigeria is growing, and with it comes the likelihood of increased violence, displacement and deteriorating health services.

Health services are already inadequate in this region. The response to outbreaks of disease is insufficient, nutritional crises are frequent, and many women continue to give birth without any medical assistance.

In Jigawa state, Médecins Sans Frontières has been providing obstetric services at Jahun hospital since 2008, and close to 6,800 women gave birth there in 2012. Another 284 women underwent fistula repair surgery. Obstetric fistulas are injuries to the birth canal, and are most often a result of prolonged, obstructed labour. They cause incontinence, which can lead to stigma and social exclusion.

Further west, a team supports health centres in and around the town of Goronyo, Sokoto state. Staff offer basic healthcare, maternal care, paediatric services, vaccinations and treatment for malnutrition. They carried out more than 70,000 paediatric consultations and 28,500 antenatal consultations over the year.

The emergency team covering the northwest of the country responded to outbreaks of malaria, measles and cholera, treating tens of thousands of patients.

A team has been treating children for lead poisoning in Zamfara state since 2010. Unsafe gold mining and ore processing practices have led to the contamination of a number of villages, and an estimated 400 children have died. Médecins Sans Frontières has treated 2,500 children for poisoning so far, but patients will need long-term follow-up.

Without environmental clean-up, treatment is ineffective, because the children will only become sick again when they return home. Médecins Sans Frontières hosted a conference on the crisis in May, but six months later, none of the key action points agreed upon at the conference had been put into effect. In early 2013, following sustained advocacy by Médecins Sans Frontières and other organisations, funds were finally released to allow for remediation of one of the contaminated villages, which will mean that medical treatment can begin for affected residents. However, the crisis will not be fully resolved without a complete clean-up and the implementation of safer mining practices.

Médecins Sans Frontières first worked in Nigeria in 1971

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