DORI, Burkina Faso — It’s been a year since jihadists stormed Zenabo Kondaba’s village in Burkina Faso’s Sahel region, killing seven of her relatives and forcing her family to flee. Now sitting in the town of Dori, one of the last safe havens in the Sahel, where she fled with her nine children, the 43-year-old is less worried about being attacked and more concerned that her family has nothing to eat.
“There isn’t any food here,” Kondaba said, hanging her head.
Food aid from the government and humanitarians is sporadic — she hasn’t received anything in three months, she said. Even though Kondaba works overtime washing clothes to buy food, it’s not enough. Earlier this year she sent her 16- and 19-year-old sons to work in gold mines in neighboring Ghana in hopes they will send money home for food.
Five years of attacks linked to al-Qaeda and the Islamic State in Burkina Faso are now pushing people to starvation, particularly in the Sahel, the epicenter of the violence. Near weekly attacks in the region have emptied villages, cut people off from their farms and made it hard for aid groups to reach those left behind.
The number of people in need of emergency food aid in the country has tripled to more than 3 million people —11,000 of whom are facing starvation in the Sahel, according to the latest food security report by the U.N. and the government. This is the first time the country has faced famine-like conditions in more than a decade.
On a trip to Dori in September, Harouna Sawadogo, acting head of pediatrics at the main hospital, told Devex there has been a 200% increase in malnourished children being admitted to the hospital than the previous year and called the situation “alarming.” Out of 167 malnourished children brought to the hospital in September, 15 died, he said.
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Sawadogo attributes the spike to the increasing number of displaced people streaming into Dori and the challenges they face in accessing food. Violence has internally displaced more than 1 million people in the West African nation — approximately 45,000 of whom are seeking shelter in Dori, according to the government.
An overwhelmed health system
As well as restricting access to food, violence has shuttered health clinics across the country, impacting some 1.7 million people, according to the United Nations. In the Sahel, 42% of health centers have closed, the highest number in the country.
Families in villages have to bring sick children to hospitals in larger towns like Dori, but the influx is overwhelming the weak infrastructure and clinics are unable to cope. At the main hospital in Dori, three to four patients share one bed, and mothers sit on the ground, cradling sick children waiting for care.
Many families seek help for their children when it’s too late. Half of the malnourished children who die at the hospital do so within the first few hours of arriving, Sawadogo said.
UNICEF, which is coordinating the emergency nutrition response, is working with the health ministry to increase staff and beds at hospitals like the one in Dori and reach people in villages in the Sahel, by creating mobile health clinics to screen children and give nutritional supplements.
It’s also giving more responsibility to community health workers in towns without operational health centers, by teaching them to screen and treat malnourished children, whereas before they would only refer people to clinics, said Mediatrice Kiburente, nutrition manager with UNICEF.
“There isn’t any food here.”— Zenabo Kondaba, Burkinabe civilian in Dori
But agencies need more access to hard-to-reach villages to better understand what the needs are, she said.
Markets and food distribution
Compounding the problem of overrun health centers is the closure of markets around Dori and other towns in the Sahel.
Approximately two months ago, the government closed some of the markets because they had information that armed groups were using them to buy food and fuel, humanitarians operating in the area have said. But the closures have also impacted civilians’ ability to access food and generate income.
Organizations distributing food worry they are missing people. The International Committee of the Red Cross hands out food every few months in the nearby town of Djibo, one of the most cut off areas in the country.
The group has reached nearly 82,000 people this year, but estimates that up to 20% of people are unable to receive food because they’re afraid of traveling from their villages to Djibo due to insecurity, said Philippe Mbonyingingo, field coordinator for ICRC in Burkina Faso.
It’s too dangerous for aid groups to go into the villages themselves, even as populations in towns such as Tin-Akoff and Markoy, not far from Djibo, are facing starvation. Earlier this month 14 soldiers were killed by jihadists when their military convoy was ambushed in the area of Tin-Akoff, the government said.
ICRC is trying to gain access to remote towns by negotiating with armed groups, but it’s a long process, Mbonyingingo said. Shifting front lines and in-fighting between jihadist groups makes it difficult to know who to negotiate with.
In November, for the first time in Burkina Faso, the U.N. began operating internal humanitarian flights. This should make it safer and faster to reach vulnerable populations, as humanitarians can avoid illegal checkpoints manned by armed groups and explosive devices planted on roads.
Last week, Mark Lowcock, U.N. humanitarian chief, announced that the organization has set aside $100 million to support countries that are in danger of sliding into famine. Burkina Faso and five other countries will each receive a share of $80 million, distributed through cash and voucher programs. The remaining $20 million will be set aside for anticipatory action to fight hunger in Ethiopia.
Since the violence began, aid organizations have been struggling to keep up with the declining humanitarian crisis and groups previously focused on development are trying to adapt, but the process is slow.
AFD, the French development agency, had to suspend some of its programs in the Sahel and is looking for ways to collaborate with organizations more familiar with crisis contexts while still implementing development projects, Gilles Chausse, the agency’s Burkina director, said.
The agency is funding the renovation of two health facilities in the Sahel, which are expected to be completed at the end of November and three more next year, Chausse explained. It is also funding “caravans for peace,” a new initiative that facilitates intercommunity dialogue to help understand and reduce points of tensions and agriculture projects to support people in being self-sufficient.
However, people in hard-hit areas like Dori say they either don’t have land to farm or are too afraid to access it for fear of being killed and for now, are completely reliant on handouts from aid groups.
Standing in a makeshift displacement site on the edge of Dori, a man who did not want to be named for fear of his safety, flails his arms in desperation.
“If it wasn’t for [food assistance], we’d die here,” he said.