They survived Boko Haram. Now many of them are on the brink of starvation.

Across the northeastern corner of this country, more than 3 million people displaced and isolated by the militants are facing one of the world’s biggest humanitarian disasters. Every day, more children are dying because there isn’t enough food. Curable illnesses are killing others. Even polio has returned.

About a million and a half of the victims have fled the Islamist extremists and are living in makeshift camps, bombed-out buildings and host communities, receiving minimal supplies from international organizations. An additional 2 million people, according to the United Nations, are still inaccessible because of the Boko Haram fighters, who control their villages or patrol the surrounding areas.

“We will see, I think, a famine unlike any we have ever seen anywhere,” unless immediate assistance is provided, said Toby Lanzer, the top U.N. official focused on humanitarian aid for the region.

The staggering hunger crisis created by the insurgents has been largely hidden from view, partly because it has been extremely dangerous for aid groups and journalists to visit the area. But institutional failures have exacerbated the situation: For over a year, the United Nations and humanitarian groups dramatically underestimated the size of the disaster, and the Nigerian government refused to acknowledge the huge number of people going hungry in Africa’s second-richest nation. Thousands of people have already died because of the inaction, aid experts say.

“It’s just a complete failure of the system,” said Natalie Roberts, an emergency program manager with Doctors Without Borders, an international aid group.

It took over a year for U.N. humanitarian teams to arrive in cities that were “liberated” from the rebels by the Nigerian military in a major offensive starting in early 2015. Until recently, the United Nations had only tiny staffs working in the northeast. The world body had deferred to Nigeria’s woefully unprepared government agencies to provide assistance, not realizing, U.N. officials said, the scale of the disaster.

Even now, the United Nations admits it is distributing food to only a fraction of those who need it. It says its mission in Borno state, the focus of the crisis, is dramatically underfunded. UNICEF warned recently that as many as 75,000 children will die in faminelike conditions in Borno and two adjacent states over the next year unless more assistance arrives.

The rising toll of the crisis is evident in such places as Banki, a city of about 15,000 near the Cameroonian border that was controlled by Boko Haram until a year ago. On a recent morning, four malnourished children writhed in beds in a clinic run by Doctors Without Borders.

One of them, Fana Ali, was 6 months old but weighed only 12 pounds, her skeletal frame convulsing with each breath. She wore a tiny, bright yellow dress and she had big brown eyes. A doctor fed her sugar water through a syringe. She locked her lips around it.

Less than an hour after she arrived at the clinic, health workers decided Fana needed to be evacuated to a hospital with electricity and more medicine. Xavier Henry, the local coordinator for Doctors Without Borders, called the Cameroonian military for an escort. This is still a war zone, and access to roads is largely dictated by the armed forces in the region.

But the request was rejected without explanation. Thirty minutes later, Fana died. She had malaria and severe acute malnutrition.

The baby’s aunt carried the body back to their two-room home. Fana’s mother, Adama Adam, wept, the tears streaking onto the blue headscarf wrapped under her chin. She was only 15, her skinny arms mostly hidden under flowing clothes.

“We never have enough food,” said Jeme Bukar, Adam’s cousin, who lives in the same house.

Male relatives washed Fana’s tiny body and placed it in a wheelbarrow. Then they picked up shovels and axes, walking toward the packed cemetery just outside the town.

“I tried to call for the escort,” said Henry, shaking his head, his voice cracking.

His last posting was in Yemen, where yet another hunger crisis was unfolding. But the desperation and the scale of the problem in Nigeria have leveled him.

“I’ve never seen anything this bad,” he said.

‘Progress was far too slow’

In 2014, after years of guerrilla attacks, Boko Haram fighters swept across Borno, forcibly recruiting young men to fight and detaining young women in what effectively became rape camps. The insurgents killed thousands of civilians. The rebels became notorious worldwide in 2014 for kidnapping nearly 300 schoolgirls, an atrocity that prompted the “Bring Back Our Girls” campaign. Less well-known was the insurgents’ destruction of the agricultural output of Borno, a Belgium-size state that was once a breadbasket for the region.

The Nigerian military, working with the armies of neighboring countries, launched an offensive in 2015 that reclaimed major cities across Borno. But Boko Haram fighters still moved freely throughout much of the vast countryside. Often, humanitarian workers say, it was too dangerous to send food to those areas, and it wasn’t even possible to learn the level of need in isolated cities. Only the military moved around much of the state.

Even as malnutrition rates soared, army commanders in this oil-rich country were reluctant to call for international assistance. They finally did so in June. Now aid trucks can move along some roads.

“Every time I think I know how bad it is, we get more data and it’s worse,” said Arjan de Wagt, the head of nutrition at UNICEF in Nigeria.

In parts of Maiduguri, the relatively safe capital of Borno, where more than a million people fled and where aid groups have been working for two years, many are still dying of malnutrition. There is not enough food being distributed in enough places to sustain them. The mortality rate in some camps and informal settlements is five times what is considered an emergency, according to Doctors Without Borders.

“Each time we hear of these [gaps in aid] we try and verify and, if we can, begin a distribution,” said Mutinta Chimuka, the head of field operations for the World Food Program in northeastern Nigeria.

The government still does not publicly acknowledge how dangerous the state remains. Last month, President Muhammadu Buhari said in a speech that residents in Borno and neighboring Yobe and Adamawa states lived in relative safety. “Commuters can travel between cities, towns and villages without fear,” he said.

But in July, a U.N. convoy was attacked by Boko Haram gunmen outside the city of Bama, which is east of Maiduguri. The vehicles were armored and no one was injured.

In August, the United Nations sent two helicopters to Maiduguri, to fly humanitarian workers to reclaimed cities across Borno. Late last month, a Washington Post reporter and photographer traveled with aid workers to three newly accessible cities across the state.

But a huge portion of the state is still off-limits, too dangerous for the helicopters to land.

“You look out the window and you wonder: How bad are things down there? We just don’t know,” said Carmen Yip, an emergency health coordinator with the International Rescue Committee.

http://www.washingtonpost.com/sf/world/2016/10/13/they-survived-boko-haram-now-millions-in-nigeria-face-a-new-threat-starvation/?tid=sm_fb

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