Amina is 15 years old, she looks like she has the weight of the world on her shoulders. Her small frame shrinks further in size as she talks about what she has experienced. Sleeping on the hospital bed besides her is her son Yaqub, who she gave birth to a few days ago in Médecins Sans Frontières’ health facility in Maimusari, 15 kilometres from the centre of Maiduguri, the capital of Borno State, north east Nigeria.
The Médecins Sans Frontières health centre in Maimusari is heaving with women and children, everywhere you look women are huddled holding their babies or seated on benches waiting to be seen by health workers. I say women, but many of the faces in the crowd are teenager girls similar in age to Amina. Some of these girls have given birth to their second or third child. More than five hundred women and babies are being treated in this Médecins Sans Frontières health facility daily and more than seventy babies are delivered every week. Médecins Sans Frontières runs an In Patient and Out Patient Department, a maternity and ante natal services and an Ambulatory Therapeutic Feeding Centre – ATFC. This is where malnourished children and babies are provided with threaputic treatment.
"Many bad things happen to girls, unspeakable things happen and they start happening to little girls as young as ten"
Amina says she is her husband’s second wife, he has five children from his first wife, Amina says she has no idea where he is and he has yet to meet their newborn son. Amina is from Bama, a town in north east Nigeria. Bama is one of the frontlines in the ongoing conflict between the Nigerian army and Boko Haram that has left more than two million displaced and facing a growing nutrition crisis. Amina was evacuated from Bama and refered to Médecins Sans Frontières’ health facility in Maimusari. The journey by road takes two and a half hours, the road is in poor condition and dangerous because it is part dotted with military checkpoints and is close to the Sambisa Forest in Gwozah, where Boko Haram are said to have a base.
“I don‘t remember the journey from Bama to Maiduguri because I was in so much pain I had passed out. My youngest sister, Noor, aged five accompanied me on the journey. Was I scared? I have spent my whole life being scared and so this was no different”, says Amina. “It is very hard to be a girl here. Many bad things happen to girls, unspeakable things happen and they start happening to little girls as young as ten.” Amina twists the fabric of her dress as she talks and looks away frequently trying to avoid eye contact with the nurse in the room. “What can I tell you? It is impossible for me to talk about these things.” I ask her how she feels about being a mother. She shrugs her shoulders and then leans back and looks in to the distance.
“Our women patients are mostly in poor general health and for most it is very difficult for them to get to see a doctor because they don’t have the money or their family members do not see it as a priority,” says Médecins Sans Frontières midwife Etsuko. “We deliver up to fifteen babies daily, many of the women have had repeat pregnancies and deliveries in a short space of time – their bodies are weak and exhausted. As always with our work, we see the daily impact of conflict and poverty. We see how women and children’s lives are made harder by violence and instability. It is the women and children who are the most vulnerable and suffer the most.”