One year ago in Northwest Nigeria’s Borno State Aboubacar Aboubacar was born under the thatched roof of his family’s wood and straw hut, the air thick and still with heat in the confines of that single tented space. Aboubacar didn't know much when he appeared in his family’s room. His body knew how to breathe and feed, but even still the air was unfamiliar, the very act of breathing incessant and foreign, and his cry echoed out through that new expanse as he found himself in the world. He didn't know the name of his family's village was Madriya or what a village even was, but he began to live in it all the same, quickly learning who was familiar and who wasn’t. His father was named Aboubacar Yunnus and was 40 years old, his mother, Halima Aboubacar, was 25, his sister, Houwa Aboubacar, 13, and his older brother Yunnus Aboubacar was 3.
Life in Madriya, was basic. There was food, the constant work to acquire food, and family. These were the essentials. It was hot for most of the year and for a few weeks every July and August there was some rain and wind and dust. These were the world’s rhythms. Aboubacar fed and he slept. While his father worked the fields, he spent the days with Houwa and Halima as they cooked and cleaned. His brother Yunnus played and helped with chores. This was the orbit of his family.
At the end of the day his father would come home, his clothes bearing flecks of earth and sweat and he would change into his clean jalabiya, the tails of the robe flapping as it let fresh air in. He was a tall, rail-thin man who smiled when he was nervous, cracking his narrow face with a bashful grin. His calloused and sinewy hands often held a small light blue Nokia even though it had no SIM card and rarely a charge. At the end of the day he’d sit and eat whatever Houwa had prepared and this was often his only meal of the day. Aboubacar had no idea what violence was in these early months but he had been dropped right in the middle of it that day in the humid room of his family’s home.
There was the violence of the nearly constant attacks by Boko Haram in villages close by - the violence of their killings, and kidnappings, and wonton maiming. There was the violence of the uncertainty families bore each day as they wondered whether this would be the day Boko Haram struck, the uncertainty of whether a mother would wake one morning to find a son gone - disappeared into the dark to the life as a fighter for Boko Haram - or wake to a dead husband, his throat slit simply because the terrorists knew he was old enough to fight but too old to bend into one of their own. Then there was the violence of the hunger that increasingly gnawed into the bellies of those around Aboubacar. With each year of Boko Haram’s mounting brutality and bloodshed, more fields had become mined and working large, exposed fields had become increasingly dangerous. The constant possibility of being struck had strangled trade routes and humanitarian access. Local markets dwindled and like others, Aboubacar’s father was able to plant less and less. Food stocks had become low and neighbors increasingly talked about the news of people in nearby villages like Bama dying of starvation.
Madriya was luckier than some though and even amidst the uncertainty life followed a tenuous routine. Aboubacar’s days revolved around feeding and sleeping as he grew into the family, becoming another person amid one home. On days Halima would braid Houwas hair he would rest in his sister’s lap and she would play with him. For eight months this life continued. Aboubacar grew and his world became bigger in kind.
It was nearly one o’clock when they came that day in February and Aboubacar’s father was in the field, trying to salvage a spoilt harvest. Aboubacar was at home next to his mother as she ground the guinea corn the family grew. Even before she saw anything, Halima knew exactly what was happening and the uncertainty of when an attack would occur was shattered with the gunshots fired into the air and the screams of her neighbors as trucks and motorcycles tore into the village.
Hearing the guns, Aboubacar’s father sprinted home and found his family outside the hut as 18 Boko Haram militants rounded villagers up, yelling and spitting with guns drawn.
“Where are your guns?” they demanded once everyone was within earshot, “give us your guns!” The villagers insisted they didn’t have any, apologizing each time they repeated it.
“You are Fulani and Fulani always have guns!” the men yelled, referring to the main tribe of the village, “give them to us or we'll slaughter you!"
Aboubacar was clutched tightly in Halima’s arms as his neighbors maintained there were none to give, their voices becoming more frantic each time. Back and forth the men demanded and the villagers pleaded until everyone was finally ordered to lie down and Aboubacar was soon held on the ground, wedged between bodies, unaware of the fear and anger and violence rising around him. The men gathered six young men - the strongest among the village - and laid them down in a line.
“We'll slit the throats of every man here if you don’t give us your guns!” the leader threatened as he waved a large blade at the row of bodies splayed out at his feet, but again the villagers insisted they could provide nothing. The six men on the ground pleaded. The villagers pleaded. Fear rippled along the dusty earth.
The leader knelt down on a young man’s back and with the flick and thrust of one hand took the knife he held and began to saw. After the young man's head was severed four other militants raised their guns and fired, leaving just one. The villagers homes were quickly looted and their livestock rounded up. The men then mounted their vehicles with the sixth man and everything of value, and tore out of town with a final threat that they would soon return.
Aboubacar was rustled early the next morning as his mother wrapped him against her back and the family began walking West, leaving behind everything and nothing. For three days he stayed swaddled and hitched against Halima as the family walked. He was only taken down for feedings and at night when they slept out under trees speckled across the barren landscapes. His family had no food and barely any water. The heat was relentless.
Whatever Aboubacar had come to absorb of that humid room where he was born and where his life had begun to take root was now irrelevant. There would be no rhythm he would adjust to in the coming months, there would be no rest from the violence that had just bore him into the sun.
On the third day Aboubacar, his family, and the other villagers arrived to the town of Maiduguri and were quickly met by Nigerian military. More men with guns and stern faces lined them up and one by one took the village men aside, interrogating them on who they were and where they had come from. Any who was suspected of collaborating with Boko Haram would be taken aside, put in the back of a pick-up truck and driven off, oftentimes that view of him headed down the road being the last one any would get of him.
President Buhari, Nigeria’s recently elected president, came into office riding a wave of support for his vow to defeat the terrorism gripping the country’s northeast Borno State has been the center of this fight and Maiduguri, the state's capital, has absorbed nearly 1.7 million of the more than 2 million displaced in the region. The formal camps have become full, the government services overextended, but the stakes are high to keep up appearances that the fight is going well. Daily arrivals of hundreds of fleeing villagers doesn’t help that cause.
“The camps keep them hidden but they are full so the government wants them far away from where people look” said a local health worker in Maiduguri named Ibrahim who asked his last name be withheld, “They (the government) need to show they have control.” The effects of this informal policy have been disastrous for those arriving, as they’re increasingly forced into unsupported informal settlements with deteriorating conditions and mounting food insecurity.
Grema Terab, the previous head of an organization in charge of Borno State’s humanitarian response, has openly spoken out against the effects of this marginalization. “…there has been a lot of long-term neglect and a refusal to act upon the plight of the IDPs,” said Terab recently ,"and this is why starvation is occurring in most of the camps."
Without room in the city's formal camps, Aboubacar and his family were told to go to Muna, one of Maiduguri's quickly expanding informal settlements. The settlement was placed precariously at the farthest edges of town, just barely behind the security berm that encircled the city and a mere kilometer or two from the trees where Boko Haram moved freely. More than 14,000 were estimated to already be living at Muna and thousands more were coming, their soon-to-be built wooden huts spreading out across its dusty plains.
The family quickly collected sticks and branches and set to work building a new place to sleep. Life then quickly began to revolve around the search for food and gathering news of events outside. At night the voices of neighbors carried easily through the tightly packed huts, and sleep was often fleeting as empty stomachs churned. With a tiny amount of money that would soon evaporate, the family was left rationing out just the food distributed by one of the only humanitarian agencies working there. One month passed. Two months passed and finding food had become a daily battle.
The hunger that had been slowly cutting away at people back in the village had become unbearable on the journey to Maiduguri and people arrived depleted. With food sparse, hygiene minimal, and conditions cramped, people were quickly tipped past their breaking point. Disease and malnutrition flourished.
A tiny clinic was set up in a nearby thatched-roof hut and quickly began seeing over 300 patients per day. A total of 151 children with Severe Acute Malnutrition and 48 cases of measles had come in its first week. 14 children at the camp had died in the previous ten days. With just two clinicians and a small, finite package of medicine given each week, the clinic had quickly become overrun.
By the end of the third month Aboubacar became sick and Houwa and Yunnus soon followed. Having watched the children of her neighbor’s fall ill one by one while others died, Halima rushed the children to the clinic. They waited through the day only to finally meet an overwhelmed clinician who was just able to send them home with paracetamol, oral rehydration solution, and zinc.
With each day that passed Aboubacar became sicker and more fragile. The bones of his frail body began to show, the contours of his frame becoming almost bird like. Food passed through him and the heat was incessant, coming from both inside his feverish body and out. After another handful of unsuccessful visits to the clinic his mother and father were at a loss. Two weeks passed and his body continued to wither. Eventually he stopped being able to move, his limbs straightening and his joints locking until he was encased in a kind of frozen body. Nothing made sense and words did not exist to say what hurt where. He knew very little except that there was pain - nearly constant pain.
Houwa and Yunnus were not fairing much better. Houwa's dehydration and malnutrition had become so bad it had actually made her crossed-eyed, the muscles in one eye simply declining to re-center the iris. She was barely able to walk and no longer held Aboubacar, her arms too weak. Yunnus had stopped playing altogether. They moved little and only slowly and the family began to mute. The smiles were rare, the laughter all but snuffed out.
Aboubacar cried in pain as Halima carried him into the pediatric ward of Maiduguri’s State Specialist Hospital, his face showing the agony and confusion his stiff body could not express. After a few more days at Muna the family finally made it the hospital and nurses quickly weighed the three children and brought them to a nearby room. In the hopes of replenishing some of the vital liquids and salts Aboubacar had lost, clinicians spent 15 minutes stabbing for one of the threadlike veins that wove up his reed-like arm. His body had begun shutting down.
As malnutrition grows the body enters a state of catabolism, gradually eating the muscles of the outer limbs and using them for energy. Muscle mass disappears and the body weakens. The peripheral nervous system then begins shutting down until the body barely moves at all. Moving from the limbs the body also slowly starts surrendering certain organ function in the core, gradually diminishing how the kidneys are maintained, the liver degrading. This rough sequence is laid out so that the body can sacrifice those parts that are least vital first and preserve the brain at all costs. While abilities like problem solving and decision making reduce, the mind stays alert and aware and as Aboubacar is brought back to his family, the new line of hydration running from his arm, his wide eyes frantically scan the surroundings as his brain desperately tries to absorb what is happening and react.
Houwa and Yunnus are diagnosed with Severe Acute Malnutrition, chronic diarrheal disease, severe dehydration, mild electrolyte derangement, and malaria. In addition to those, Aboubacar is diagnosed with marasmus, bronchopneumonia and severe electrolyte derangement. They weigh 46lbs, 22lbs, and 10.4lbs - the average weight of a 1-month old baby.
Fluids begin to flow and soon small amounts of donated medicine and food follow.
The children sleep. Exhausted, Aboubacar and Halima sit in silence in the stifling hospital room, their foreheads beaded with sweat.
Over the following days Yunnus and Houwa grow stronger, and emotion slowly comes back to their eyes, their faces begin to lighten. Houwa starts to stand on her own and then slowly walk. Worried about money for food and medicine, Aboubacar’s father paces the room, his small mobile phone clutched tightly in one hand. Camp conditions have remained unchanged and the return to the deprivation that nearly killed them weighs heavily on his mind.
After four days Houwa is released, returning to the camp with her father. Yunnus follows a few later but Aboubacar stays behind - he hasn’t improved. Some afternoons he cries more than others, but health workers have difficulty knowing whether this is because of more discomfort or more energy to cry. Halima cradles him constantly, sometimes rocking him back and forth in the hopes of lulling his pain and fear, and other times simply holding him quietly for hours, his small body drawn taught and locked.
Back at the camp families continue to search desperately for food and medical care, but more children fall ill daily. Across the road bordering Muna sits a small, but growing gravesite. Each evening a group of men make the walk across the road, a small body wrapped in white held in a man's arms, and each evening the group quietly walks back without it, the gravesite at least one plot bigger. The funerals are short and efficient, but the speed seems to have little effect on the weight the men carry as they return.
On June 18th, 16 days after coming to the hospital, Aboubacar Aboubacar dies, his small body finally unable to sacrifice anything more. Like the thousands of other civilians who have died from the region's conflict and the of culture neglect it has steadily built, his death goes unnoticed to those beyond his family. He is buried at the furthest margins of Maiduguri, in a small hole dug at the unmarked gravesite growing by the side of the road. He was one year old.