[Mhiz Rebecca]

MAIDUGURI, Nigeria — In a two-
room concrete house on the outskirts
of this city along the airport road,
Abdulrahman Adam’s 21-month-old
body trembled as he struggled to
keep down what little food he had in
him. At first, his grandmother,
Hauwa Saleh, sitting by his side on
the dusty floor, thought Abdulrahman was
teething.
But everything he ate came right back up. It
continued for days in September and he added a
cough and started to have diarrhea.
By then, the signs were clear: It was not a simple
illness. In this northeastern part of Nigeria
ravaged by the terrorist group Boko Haram,
where there is not enough food to go around and
no one goes to bed full, Abdulrahman was
withering away from malnutrition. Nearly
everyone in his neighborhood, crumbling under
the influx of refugees fleeing the Islamist rebels,
is skin and bones, starving and slowly dying.
Nearby in the house, his 22-year-old mother,
Iyatu Adam, seven months pregnant and weak,
slipped in and out of consciousness, and could not
help. She had not eaten enough, either. The boy’s
father had left the capital of Borno State to find a
job as a day laborer because there were few jobs
in the city. His uncles worked all day laying bricks
to earn $1 each.
With no one else able to help, Abdulrahman’s
survival depended on his 55-year-old
grandmother.
Over the next 40 days, she took him to one public
hospital and then another. Both denied him.
There were no vacant hospital beds, they told her.
An uncle spent $35 — nearly a month’s pay — to
pay for his admission to a private hospital for a
few days. He received fluids and medication and
was released.
ADVERTISEMENT
Back home, his grandmother continued to care for
Abdulrahman. They shared the only mattress in
the house with the other young siblings. Everyone
else slept on the ground, a thin mat between them
and the hard floor. The backyard was strewn with
trash, a hole dug in the ground for a toilet.
Ms. Saleh walked 600 feet to retrieve the family’s
drinking water from a well and took home what
she could carry in small containers. Abdulrahman
ate what grains the family could afford, or what
was left over after they paid their rent with their
harvest of groundnuts and beans, or what scraps
their neighbors gave them. But the family was
careful not to eat too much for dinner. They had
to save something for breakfast.
By early November, Abdulrahman’s health had
rapidly declined. He was always tired and had a
fever, no appetite and a stiff neck — a sign of
deadly meningitis. His mother, who was near full
term, was no better.
His grandmother rushed her grandson and her
daughter again to a public hospital, Umaru Shehu
Ultra Modern Hospital, praying that this time it
had enough room for them. A part of the hospital
with 24 beds that had opened only weeks earlier,
and was operated by the relief organization
International Rescue Committee, accepted them
on Nov. 4.
Abdulrahman was placed in a bed enclosed in a
mosquito net, with other malnourished children
nearby. About 200 children die every day in this
area of Nigeria, the international group Save the
Children reported in November .
“Our true way of being was always associated
with extreme hunger,” said Ms. Saleh, sitting on
the concrete stoop at the house. She has been the
head of the household since her husband died
seven years ago. “Ever since, my struggle to
provide the family began, because I was left with
no option other than to work hard and see the
children grow,” she said.
At the hospital, the boy’s mother was taken to a
separate area and received intravenous fluids and
medication. Her health improved, and Ms. Adam
gave birth to a girl, who was named after her
grandmother.
But Abdulrahman’s health deteriorated. He died
on Nov. 15, another victim in a region plundered
by Boko Haram rebels, who have destroyed
houses and schools, kidnapped thousands of young
women and forced millions to flee their homes,
plunging Nigeria into the worst recession in
decades.
During its yearslong insurgency, Boko Haram
stripped the area’s farmland dry, stealing crops
in the country’s most fertile region to feed its
fighters. Farmers fled, and many have not
returned. The rebels have warned that they left
behind mines on the fields.
“We only need food, food, food, and nothing else,”
Ms. Adam said in an interview in December.
“Hunger nearly killed me.”
By December, the International Rescue
Committee’s center in the hospital had treated
210 children with severe acute malnutrition.
Twenty-six had died. In the first 11 months of
2016, Borno State had nearly 75,000 extremely
malnourished children. The World Food Program
has declared that the region, where millions lack
sufficient food, is experiencing “faminelike
conditions.”
“The need for stabilizing children with severe
acute malnutrition with medical complications is
high,” said Mohamed Kassim, the operations
manager of the International Rescue Committee’s
medical center in the city. The center is working
this year to treat up to 60 malnourished children
a month, an increase from 50 a month in 2016, he
said.
ADVERTISEMENT
Founded in 1933 and based in New York City, the
International Rescue Committee is the newest
beneficiary organization supported by The New
York Times Neediest Cases Fund. Of the eight
groups assisted by the fund, it is the only one that
works beyond the New York region. In 2015, the
organization helped over 23 million people
affected by conflict and disaster in more than 40
countries and 26 cities in the United States, with a
focus on health, education and economic well-
being.
In addition to its health center in the city, the core
of humanitarian and military support in Borno,
the International Rescue Committee provides food
and hygiene supplies to residents, and offers
services for gender-based violence and therapy
sessions.
“This crisis is sorely underfunded and has largely
been ignored by the international community,
despite the extreme violence and clear evidence
of crisis levels of food insecurity,” said Stephanie
Puccetti, the organization’s senior emergency
program coordinator in Nigeria.
In the two months since Abdulrahman died, Ms.
Saleh and her daughter have returned home to
lives still filled with uncertainty and peril. Ms.
Saleh, who earned $10 a month as a housekeeper
for a family, has not worked since that family left
town.
The all-day job was grueling and the pay was only
enough to cover the cost of the bus fare there and
back, so she had started to walk the
approximately six miles round trip to save some
money. But it paid in other ways: The family gave
her leftovers to take home.
Her sons, after a day’s work of laying bricks, pool
their $2 to buy food to bring home. Ms. Adam is
eating more often, but not the nutritious food she
needs while she nurses her newborn daughter,
Ms. Saleh said. A few weeks ago, Ms. Adam’s
husband sent $15 to her that he had made
working in another city. It paid for food.
“We have been praying that may God grant that
we get out of this situation soon,” Ms. Saleh said.
“And for now, it’s only prayer, prayer and
prayer.”