Early last year, 500 people fled violence in Niger's western Tillaberi region. A few months later, that number had risen to 20,000. In 2019, more than 100,000 people may be displaced.
That's according to Alice Bardot Tsegne, who monitors human rights violations and the movement of people along the Niger-Mali border for the UN's refugee agency, UNHCR.
Intercommunal violence and jihadism � which began in Mali before spreading to Burkina Faso � have brought a spillover humanitarian crisis to Niger.
Tsegne says that through 2018 she received weekly phone and email alerts with reports of sexual violence, kidnappings for ransom, mass killings, murders, looting, and destruction of houses. Attacks were occurring at a much higher rate than in the past, increasing rapidly throughout the year.
The level of violence was hard to bear, said the UN worker.
Reported fatalities from direct attacks on civilians in Niger between November 2018 and March 2019 rose by a startling 500 percent compared to the same period last year, according to the Armed Conflict Location & Event Data Project (ACLED). In Mali and Burkina Faso, they rose by more than 300 percent and 7,000 percent respectively.
According to UN agencies, more than 62,000 internally displaced Nigeriens and nearly 52,000 Malian refugees are now seeking shelter across Tillaberi and its neighbouring region of Tahoua.
We're at the centre of a storm affecting all the Sahel, from Burkina Faso to Mali, Nigeria, Chad, and Libya, Niger's defence minister Kalla Moutari told The New Humanitarian in the capital, Niamey. He had just attended a memorial for a young customs officer who was killed days earlier by armed groups near the border with Burkina Faso.
One of the world's poorest countries, Niger is ranked last on the UN's Human Development Index. Plagued by food insecurity, malnutrition, natural disasters and disease outbreaks, security threats along both its western and southeastern borders have in recent years made a desperate population even more vulnerable.
Niger, Moutari argued, is doing its best to reduce damages brought on by the conflict. But he admitted to being worried by recent developments.
In Tillaberi, we fell into a circle of intercommunal violence, deliberately fabricated by terrorists and drug traffickers, the minister said.
'An enemy comes from the outside'
Two hours drive northeast of Niamey, the city of Tillaberi retains the small-town feel that attracted tourists before the war in Mali erupted in 2012.
Here, the issa beeri (or 'big river' � the Zarma term for the Niger) splits into an intricate maze of streams. Islands are inhabited by communities devoted to rice farming and fishery.
Once peaceful, l'insecurite � as locals call it � didn't directly hit this unassuming regional capital until January 2019. But unrest had been encroaching across the vast frontiers of the wider Tillaberi region since 2016.
This newer unrest in western Niger represents a second border crisis for a country already tackling militancy some 1,500 kilometres away. In Diffa, far in the southeast, the ongoing Boko Haram insurgency, which erupted in neighbouring Nigeria in 2009, long ago crossed Lake Chad, bringing militants and mass displacement with it.
Read more: Countering militancy in the Sahel
In both areas, those affected live in constant fear from extremists actions, Alessandra Morelli, UNHCR's country director in Niger, told TNH. But, despite security concerns, the government of Niger kept its borders open to people fleeing.
It's a similar pattern: an enemy comes from outside, forcing people to flee to Niger, where these refugees cohabit with internally displaced communities, she said.
As a result, the humanitarian needs are enormous. According to the UN, 717,000 people will be in a vulnerable situation along Niger's border with Mali and Burkina Faso in 2019.
Overall, 10 percent of the country's population, 2.3 million people, are expected to need humanitarian assistance this year.
Morelli described UNHCR's presence in the region as a recent one. Although present in the country since 2012, when the war in Mali forced about 60,000 people to flee to Niger, she said that from 2014, funds and energy were mostly absorbed by the crisis in Diffa, where hundreds of thousands of people were fleeing Boko Haram-related violence.
Only in 2018 did attention shift back to Tillaberi and Tahoua.
Malnutrition worsened by conflict
Portrait of a man in profile.Francesco Bellina/TNH
Mohammed Mamman, a Fulani herder, fled violence in Mali to seek medical care in Niger for his son.
Even before violence made its way to the city of Tillaberi, livelihoods were already affected by a cut in trade along the river and by road, while the local administration was accustomed to the revolving doors of humanitarian workers and security personnel coordinating operations in the region's north.
Refugees and displaced Nigeriens come here from informal, inaccessible settlements in the countryside to look for work, or a doctor. Such was the case of Mohamed Mamman, in his mid-thirties, who arrived at the hospital of Tillaberi � the only one in the region � to try to save his baby, Abdullahi.
Lacking medical care, the child's mother died after giving birth. Abdullahi's life was in danger too. At eight months old, necrosis had begun to spread in his intestine. So Mamman left the borderlands where he had lived his whole life for a camp close to Ayorou, northeast of Tillaberi. Since then, the child's health had been improving, and Mamman, a man of few words, opened up.
The child of cattle herders from Fafa, in Mali, he said he has followed the rhythm of zebu cows' hooves and seasonal transhumance his whole life. This peaceful existence was interrupted by the start of the war in Mali in 2012, and wiped out completely when violence escalated in 2017.
Unknown men would continue to attack our encampments at night, killing people and stealing animals, Mamman said. His family escaped from place to place, until they were left with just 30 animals, out of the more than 500 they had before the war.
At the hospital, his baby was treated by medics from COOPI, an Italian NGO that has worked in Tillaberi since 2012. Thanks to funds from the EU's humanitarian office, COOPI supports a unit specialised in treating malnourished children and their mothers.
Rachid Sama Seiny, the NGO's medical team leader, explained that malnutrition is an old scourge in Tillaberi, but one made worse in recent decades by the impacts of climate change. Families live with less than one dollar a day, so their kids are always at the edge of malnutrition: one small episode is enough to get them sick, he pointed out.
Food insecurity and malnutrition are chronic problems in Niger. In Tillaberi and Tahoua, this is mainly driven by conflict, which fuels displacement and puts added pressure on host populations and food supplies. Around 282,000 people in Tillaberi and 88,000 in Tahoua are facing crisis or emergency levels of food insecurity, according to Cadre Harmonisee, a tool used in West Africa for the classification and quantification of food insecurity.
A doctor in a white smock in a medical roomFrancesco Bellina/TNH
"Families live with less than one dollar a day, so their kids are always at the edge of malnutrition, said Dr. Sama Seiny, a physician in Tillaberi city.
Threats to aid access
Security threats further aggravate problems for people needing aid.
Some clinics can't be supplied with medicines, because roads are too dangerous and our colleagues are afraid to travel, Seiny said, mentioning a case in which a doctor was shot at.
Insecurity also hinders people's access to weekly markets where they buy food or sell their animals.
Many life-saving operations, such as vaccination campaigns � often conducted by teams on motorcycles � have suffered from the fear of attacks and from the government-declared state of emergency that banned motorbike circulation in certain areas from March 2017 onwards.
After long negotiations between aid and military actors, a humanitarian corridor was launched in September 2018. Four such corridors followed, up to February 2019, under the coordination of the UN's emergency aid coordination body, OCHA.
During such operations, 2,000 Nigerien soldiers create a safe perimeter to secure the passage of a convoy of NGOs and UN staff, from Ayorou to InatAs. They are vital, because these people lack everything, from food to shelter and healthcare, said Rachid Moussa Nouhou, a project assistant at COOPI who took part in the operations.
Nevertheless, many more displaced people remain out of reach.
There isn't enough time to treat people who are traumatised by violence, Nouhou said, recalling the case of a woman who developed signs of depression after her husband was killed by jihadists.
For Zeinabou Moussa Issaka, COOPI's psychologist at the paediatric ward, displacement is also a source of mental suffering for young mothers, who often get married and have children when still underage. Such stressful experiences affect their ability to take care of their children and provide them with adequate food, she explained.
In just one night, families lost all they had built in a lifetime and were forced to escape to unsafe places, she said. How can they provide properly for their kids?
Source: The New Humanitatian