North-East

Fifty-five-year-old Tabitha Iorchon used to work as a nanny at a rural primary school in her community, Demevaa, in Chanchanji District of Takum Local Government Area, in Taraba State, northeastern Nigeria. The job provided her with a steady income which she used to support her children and grandchildren who lived with her. She supplemented her earnings with farming. 

Tabitha loved her job and was very fond of the children she cared for. 

But that life has been snatched from her. 

In September 2025, terrorists invaded Demevaa and surrounding communities in Chanchanji District. “They killed pregnant women and ripped their babies out of their bellies. They slaughtered men and cut off the hands of many people,” she recounted. 

Tabitha is among those who escaped that night of terror. She, alongside other residents, fled to reach Chanchanji town, where they are now living in displacement. Her parents, who lived in a different neighbourhood and were weak and vulnerable, were left behind, but fortunately, they survived the attacks.

The genesis of violence

This is not the first time communities in southern Taraba have come under attack. However, locals say that early September last year was when the wave of violence reached Chanchanji District. It began with the discovery of two farmers dead on their farms. Before residents could make sense of the incident, more farmers were attacked and killed. The weeks that followed saw communities like Demevaa and Amadu raided.

Over the years, Taraba communities, such as those within Takum bordering Benue, have experienced attacks often described as farmers-herders clashes or carried out by local militia gangs. One of the most notorious figures linked to violence in the region was Terwase Akwaza, alias Gana, who, before his death, claimed that terrorists disguised as herders contacted him to carry out attacks in “about three states they want to [capture], being Plateau, Taraba, Benue…”. 

Since the Nigerian Army killed Gana in September 2020, his once-cohesive network has fractured into rival factions, with groups led by criminals such as Fullfire and Chen now operating independently and often violently in border areas.

Residents in Chanchanji told HumAngle that herders often come to graze in the area during the dry season, but clashes have never occurred. HumAngle contacted Lashen James, the Taraba State Police Command spokesperson, but he did not respond.

Life in displacement 

In the wake of the attacks, several displacement camps were established by non-government and faith-based organisations in Chanchanji town, an urban area in Takum to accommodate people fleeing the violence in Demevaa, Amadu, Tse-Bawa, Tse-Tseve, and other affected communities within the district. 

Tabitha and several other displaced persons sought refuge at one of the camps. There, they rely on humanitarian organisations for survival. Although the food supplies are inconsistent, she said they felt somewhat safer there.

“Old people and children were dying because there was insufficient food,” she noted. “Our yams, guinea corn, millet and cassava were all destroyed and burnt by the terrorists who attacked our people.”

Tabitha said that even the tents in the camp are not sufficient and the available ones are always overcrowded. “We just spread our wrappers on the floor to sleep,” she said. 

Despite the difficulties in the camp, the displaced persons persevered, hoping peace would eventually be restored. However, another wave of terror erupted on February 8, when terrorists attacked Chanchanji district and raided several villages. Locals said the terrorists returned the next day and unleashed more havoc.   

No terror group has claimed responsibility for the attacks. 

Avangwa Emmanuel, a resident of Tse-Bawa, told HumAngle that his father and three uncles were killed during the February incident. He noted that many others were killed in their homes that day. “They [terrorists] were heavily armed,” he added.

Avangwa and others from his village are currently taking shelter at a secondary school that has been converted into a temporary camp.

“No water, no food, nothing. Everybody is just struggling. Our major problem here is food. Also, what we need is peace. If there’s anything the government can do to restore peace so that we can return to our homes and continue our work, that is all,” he said.

Amadu, another community in Chanchanji District, was among the hardest hit. Terkuma Moses, the community leader, said scores were killed, and locals have fled to displacement camps. HumAngle could not independently confirm the figures as the police authorities did not respond to enquiries. 

“The attackers come here daily. We’ve been living in perpetual fear. There have been many rape occurrences during these attacks,” Abraham Nyingi, a resident of Amadu, told HumAngle. He noted that no government official had been dispatched to assess the displaced persons’ situation. “We are at the mercy of humanitarian organisations. If the government really wants to help us, we would be very grateful,” he said.

“The environmental conditions are very harsh. Our children can’t go to school. We lack medical care,” he lamented.

In recent months, the worsening hunger has compelled some displaced persons to return to their communities. Tabitha said that none of those who left made it back. “They got killed,” she said. “Their bodies were found in the bushes.” 

Life at a standstill

The school where Tabitha once worked has remained closed since the crisis began. She has lost not only her livelihood, but also her sense of independence, as she cannot return home or secure alternative work. She continues to fear for her elderly parents, who remain in the village. She sometimes reaches them by phone, and they tell her they are also experiencing food shortages, as their barns were burnt during the attacks.

Tabitha described the displacement as the worst experience of her lifetime. 

“We lack basic things like food and we buy water since the camp doesn’t have a water supply. The harmattan season is still here, and many of us are still sleeping outside because all the rooms are overcrowded,” Tabitha said. 

With the new arrivals following the February 8 attacks, she said the struggle for survival has intensified. 

“I can’t further my education now. I can’t do any business. I’m just stuck here,” said Veronica Iorchan, a 22-year-old resident of Demevaa. 

When the attacks began in September, she was in her final year at the Taraba State Polytechnic in Suntai. By the time she completed her studies in October, instead of returning home to a joyous celebration, Veronica was informed that her community was deserted. The rest of her family had moved to the Abaya IDP camp. 

“I came straight to the camp from school,” she said, adding that she lost two of her uncles in the attack.

While the camp provides them with accommodation and food, Veronica said they must fend for themselves when it comes to obtaining hygiene products and toiletries, such as sanitary pads. Even though she is determined to seek employment in the host community, she feels unsafe whenever she leaves the camp. She dreams of a time when she can return home and make plans for her future.

A cry for peace

Tabitha looks forward to a time when she can return to her community, re-unite with her parents, resume her job as a nanny, and supplement her income with farming. 

“That will only happen if there is peace,” she said. 

While Avangwa is still grappling with the loss of his father and three uncles, he says the hardship at the makeshift camp intensifies with each passing day. He noted that Tse-Bawa is an agrarian community, and the crisis, which has persisted for about five months, has severely disrupted farming activities, as locals can no longer access their farms. Several farmlands and barns were also set ablaze in the attacks.

“So if we can have peace, then we can go back to our places and settle. All we need is just peace and nothing more,” he said. 

Abraham calls on the government to urgently look into the crisis. “Our people do not really need much from the government,” he said. “Just secure us.”

Residents say the government’s lack of concern for their plight has been deeply shattering. Recently, religious leaders affiliated with the Catholic Church led a peaceful protest in Jalingo, the state capital, calling on the government to extend security interventions to the southern Taraba area, which includes Takum and Donga Local Government Areas.

“As a matter of urgency, adequate security personnel should be mobilised and deployed to the hinterlands, where this carnage is taking place unabated,” James Yaro, a priest and Vicar Pastoral of Taraba’s Catholic Diocese of Wukari, told journalists. 

“The government at all levels must be deliberate in ensuring security guarantees and bringing enablers and perpetrators of these dastardly acts, or heinous crimes against humanity, to justice through their immediate arrest and prosecution, irrespective of their ethnic, political, and religious affiliations.” He added that, “IDPs require immediate intervention by the government.”

HumAngle wrote to the Taraba State Ministry of Special Duties and Humanitarian Affairs for comments but received no response at the time of filing this report.

Terrorists attacked the Garahamojili military camp in Garaha, Hong Local Government Area of Adamawa State, in northeastern Nigeria, on Saturday, Feb. 21. Alison Hassan, a resident of the community, told HumAngle that the attack, which began around 11 p.m., lasted about an hour, as the terrorists engaged the soldiers in a fierce gun battle.  

Although the Nigerian Army is yet to release an official statement regarding the attack or the number of casualties, residents say three soldiers were killed in the exchange, while several others were severely injured. HumAngle contacted Suleiman Yahaya Nguroje, the Adamawa State Police Command spokesperson, but he declined to comment on the situation.

Locals said that during the confrontation, a bullet landed inside a neighbouring house and struck a young woman. Chinapi Agara, a relative of the deceased, told HumAngle that she was the only civilian from the community to lose her life, as the terrorists were focused on the military base. “She was 20 years old. We buried her yesterday [Sunday, Feb. 22],” he said. 

Chinapi also noted that the camp was set ablaze, forcing some of the soldiers to flee. 

“The community wasn’t burnt, but the camp and three houses close to the camp were burnt, including two armoured tanks and their excavator,” Alison added. 

According to Musa Simeon, a local vigilante, several attacks had been launched against the military base in the past, but none had been successful until Saturday’s incident. While locals are unsure of the terrorists’ identities, Musa said several armed groups have terrorised the area over the past decade. “Boko Haram, Islamic State – West Africa Province (ISWAP), and kidnappers, so we don’t know which one is responsible for now,” Musa said. 

ISWAP reportedly released visual evidence and has claimed responsibility for the attack. 

Several locals have lost their lives in the insurgency since it began in 2014. “We are close to the Borno border. Lots of communities like Kopure, Gabba, Lar and others have been completely displaced,” Chinapi added. Similarly, communities within Garaha have experienced a surge in kidnappings within the area in the last few years, forcing many to flee. 

While calm has been restored in the area since Saturday’s incident, Alison noted that residents are deserting the area. “We are seriously in trouble because once it’s evening, people leave their houses to go and sleep somewhere. Some sleep in people’s houses inside town, and those of us who don’t have anywhere to go to sleep with our eyes open,” he said. 

Residents who spoke to HumAngle called on the government to tighten security around the area as people are currently living in fear. 

Hannatu Charles* carried her pregnancy to full term. She attended all antenatal sessions and was eager to meet her baby. 

In January, when she was due, she went into labour around 7 p.m. Unfortunately, the primary healthcare centre in Kirchinga, a community in Madagali local government area of Adamawa state in northeastern Nigeria, closes around 6 p.m. Her family immediately called one of the traditional birth attendants in the community.

Hannatu laboured for hours, yet her baby did not emerge despite the efforts of the traditional birth attendant. By 10 p.m., warning bells began to ring in her mind, as by that time, all doors in Kirchinga had been shut and all access routes deserted. 

“We decided to try to see if we could at least meet one person at the primary healthcare centre, so my husband and my neighbour took me there that night, but we didn’t meet any midwife or any healthcare staff,” she told HumAngle. 

The centre was closed. All the healthcare staff had gone and would only return the next morning. Night shifts no longer hold. These changes were made due to the scale of insecurity. 

Hannatu told HumAngle they returned home, where she continued to push, but despite her efforts, she was unable to deliver. The birth attendant noted that the baby was in breech position and, therefore, an experienced midwife or a gynaecologist was required. The only way they could access such care was by travelling to the Cottage Hospital in Gulak Local Government or the General Hospital in Michika Local Government, both many hours away. 

Hannatu said they would have made the journey that night on a regular day, but now,  it was too risky. Movement in Kirchinga was restricted after dark as Boko Haram terrorists roamed the area, especially at night. There was also no way to access vehicles or get a driver to take the,m as all routes were closed. 

She said she was willing to persevere until dawn when the roads would reopen, but by midnight, the pain intensified, and the midwife doubled her efforts. A stillborn was delivered. 

“I’m not the first to lose a child because of the security situation in this region,” Hannatu said as she talked about how insecurity destroys healthcare. “In fact, I’m lucky to be alive,” she added, stressing that several women and their babies had died.

According to Hannatu, the women who went into labour during the day in Kirchinga are considered lucky. 

The healthcare crisis 

Kyauta Ibrahim, a community health extension worker, spends her days at the primary school in Limankara, another community in the same Madagali that has, since the past decade, been repurposed as the community’s healthcare centre. Since residents began returning to Madagali in 2016 — two years after Boko Haram attacks displaced them — she and her colleagues have provided medical services from this makeshift facility.

“We are yet to move to the permanent site. We were asked to stay here to perform our duties,” she said. When the insurgents struck, they torched several structures, including the original primary healthcare centre where she worked.

For Limankara residents, this temporary facility remains the only nearby source of medical care. With few doctors remaining in the region, patients are often forced to travel long distances to better-equipped centres in Shuwa, Michika, or Gulak, particularly in emergencies.

Before the insurgency, the primary healthcare centre in Limankara served the local population and neighbouring communities such as Sakur and Lakundi, providing antenatal care, deliveries, and basic medical services. After peace was gradually restored in 2016, the state government converted one of the primary schools into a modest healthcare facility to meet the community’s needs.

A decade later, the school still functions as the healthcare centre. The situation worsened as medical doctors and other professionals began withdrawing, leaving indigenous community health extension workers to manage the facility. In 2016, most health centres in Madagali and Michika were closed because many professionals had either been killed or fled permanently.

As of 2019, the World Health Organisation’s Health Resources Availability Monitoring System (HeRAMS) highlighted that only 45 per cent of health centres in Adamawa were fully functional after 12 per cent had been destroyed and 34 per cent severely damaged by Boko Haram attacks. 

Kyauta told HumAngle that, aside from staff shortages, inadequate healthcare equipment continues to affect healthcare delivery in the area. The temporary primary healthcare centre now closes by late evening due to recurring Boko Haram attacks, leaving pregnant women and children most vulnerable.

“When a woman starts labour at night, she can’t even go to the primary healthcare centre and has to give birth at home,” she said. Complicated cases are referred to Shuwa, and if necessary, to the General Hospital in Michika or the Gulak cottage hospital, all of which are some distance away. 

Esther Markus, a mother of six from Wagga, another community in Madagali, travels six hours for a round trip to Gulak for medical care. Emergencies are further complicated by a 6 p.m. curfew. Traditional birth attendants handle routine deliveries, but high-risk cases, like breech births or sudden illness at night, go untreated until morning.

“Once it’s 6 p.m., we can’t take sick people to the hospital, so we leave them till the next day in the hands of God, and if the person dies, then we accept it,” said Hamidu Ahmadu, Limankara’s community leader.

Residents said security remains precarious. “A few days ago, the soldiers guarding us were attacked, so since then, they leave once it is 5 p.m. and head back to their headquarters in town. Our youths guard us all through the night,” Esther added. 

Hamidu told HumAngle that the community has a population of about 3,000. He acknowledged the efforts of some humanitarian organisations that have visited the area in the past to treat malnourished children and provide basic healthcare services to residents, but the gap remains. 

In 2024, the International Committee of the Red Cross (ICRC) resumed operations in Madagali after being unable to operate since 2018. The following year, the organisation provided basic healthcare and nutrition services to residents and also renovated the existing healthcare facility in Madagali town, which has become a haven for displaced persons in villages around the area. This has helped mitigate how insecurity affects healthcare in Madagali. 

Despite these humanitarian efforts to restore healthcare access in conflict-prone communities in Madagali, however, factors like the curfew, abductions, and the absence of medical professionals continue to limit access to services. 

Medical professionals are fleeing 

Kirchinga, the community in Madagali where Halima had the stillbirth, faces a similar plight. Although it has a functional primary healthcare centre, the lack of medical professionals severely affects service delivery.  

“Since the insecurity started, the doctors have stopped staying. They no longer live in the community but only show up from time to time,” said Bitrus Kwada, a Kirchinga resident.

Boko Haram terrorists have abducted, killed, or threatened several health and humanitarian workers in the northeastern region. In 2018, some medical workers were kidnapped and later killed in Borno. The following year, Boko Haram attacked Kirchinga and Shuwa communities, burning houses, shops, and clinics after killing three people. 

By 2020, Bitrus explained, healthcare workers, including doctors, who once lived in Kirchinga had either been transferred or fled, leaving them only occasionally available and unable to respond to emergencies.

“We suffer when it comes to emergency treatment at night,” Bitrus stated.  

Over the years, several women with complicated pregnancies have died during childbirth, along with their babies, due to the absence of doctors and surgeons. 

Blessing Dingami, another resident of Kirchinga, told HumAngle that before the insurgency started in 2014, the primary healthcare centre in the community was staffed by a medical doctor, two nurses, and another healthcare provider who ran the facility round the clock, with support from community health extension workers.

Following the attacks, the centre collapsed, forcing the professionals to flee. Although the government has since renovated it, community health extension workers now manage the facility, and the quality of services has declined.

Even though movement in Kirchinga is unrestricted until 10 p.m., accessing medical care is increasingly difficult. “There was a time when people from our community were involved in a ghastly accident at night, and we rushed them to the centre, but there was no professional to handle their case,” Blessing recounted. 

She noted that the healthcare centre no longer provides scanning, surgery, and other services it previously offered. Residents now have to travel for over half an hour to Shuwa and sometimes to Gulak, where there is a cottage hospital.

In Wagga Lawan, another community in Madagali, the primary healthcare centre was destroyed during Boko Haram attacks in 2014 but was recently rebuilt and commissioned by the state government.

Despite the renovation, many Madagali residents remain unable or afraid to use the facility. People from Wagga Mongoro, Thidakwa, and even Limankara travel there, yet fear of kidnapping, its remote location, and the surrounding bushes keep many away, particularly at night.

“The centre is located on the outskirts of the town, and bushes surround it, so people are afraid to go there for services, especially at night, due to fear of kidnapping,” said Cyril Ezra, a resident. Travel to the facility takes over an hour by bike. 

In 2025, Boko Haram attacked Wagga Mongoro, killing four people, injuring many others, and razing property—underscoring why many remain hesitant to use even the newly rebuilt facility.

Uncertainty 

Peace Ijanada Simon, a midwife at Shuwa’s primary healthcare centre, said the facility is overburdened with deliveries and emergencies from surrounding communities, as theirs lack night services. Although staff work night shifts, service is inconsistent due to recent kidnappings and a lack of reliable electricity. 

“There is no power supply. We use torchlights for most deliveries. If we can’t handle it, we refer immediately to Gulak or Michika,” she said.

In Kirchinga, locals have lost hope for the return of professional healthcare workers. “From 2014 to today, we’ve been facing security challenges because Boko Haram can attack at any time and destroy our things. Some of our people have been killed. Two years back, the situation changed into kidnappings,” he said. 

Bitrus explained that the terrorists mostly show up at night when locals are sleeping and carry out these abductions. “Ransoms have been paid, and some have been released. We have soldiers here, but I don’t think they are taking strong action,” he added.

Maradi, a community near Kirchinga, was attacked on Jan. 23. One resident who resisted capture was killed in his home, while a hunter who confronted the attackers that night was also killed, and another person was abducted that night. 

“We don’t sleep. From midnight, we stay awake till 3 a.m. because that’s the time they normally come. We have to stay conscious,” he said. 

A surge in armed violence has uprooted hundreds of locals from their homes in the Takum Local Government Area of Taraba State in northeastern Nigeria. Terrorists raided the Chanchanji District in the LGA on Sunday, Feb. 8, disrupting church services and opening fire on worshippers.

Residents told HumAngle that at least 14 churches were attacked in several villages across the Chanchanji District, leaving many dead. “People were confused and began to scatter. Most of the casualties were women and children,” said Monday Vincent, a resident in the Amadu area of the district.

The Sunday attack lasted for about two hours. Just as residents were trying to recover from the horror of this incident, another attack occurred the following day, in which terrorists killed dozens of people and set houses on fire. While there have been no official statements on the total number of casualties, locals said scores of people were rushed to the hospital for emergency care. The affected communities include Amadu, New Gboko, Adu, and Tse-Tseve.

In the past year, terrorists repeatedly attacked locals in the area, causing mayhem and violating law and order. In September, for instance, they attacked Akate ward, within the Tor-Damisa axis, leading to the establishment of a displacement camp in the area. 

“It used to be two to three casualties, but this time, it’s worse,” Monday said of the attacks, noting that the areas affected are the economic hubs of the Chanchanji District, which have now been deserted. 

He said people are leaving the district en masse, with thousands moving to the displacement camp for shelter and protection. He stressed that security officials have not been deployed to the area, despite the recurring attacks.

“There have been soldiers stationed around the area, but they said they are awaiting official orders,” Monday said. 

Terkuma Moses, a community leader in Amadu, told HumAngle that about 80 deaths have so far been recorded.  Lember Tyozua, the community leader of the Mberev community, corroborated this, saying about 200 people are generally affected. He said they are still documenting the tragic events, and investigations are ongoing.

“We can’t say the situation is under control. It feels like we are at the mercy of the attackers,” Terkuma said, noting that the biggest worry for most residents is survival. 

Kingsley Chidiebere, the commander of the 6 Brigade of the Nigerian Army, visited the area on Feb. 10 and ordered the deployment of soldiers to protect locals and extend patrols across all affected communities. However, locals insisted that security officials have not yet been deployed to the area.

“What we need the most is protection of lives and property because almost all the surrounding villages in Amadu are deserted,” Torkuma stated. 

Gina Bashir is a 46-year-old farmer from Askira Uba, in Borno, northeastern Nigeria. At the peak of the Boko Haram insurgency, she lived in Benisheik, a small town in Borno, with her husband and six children.

During the height of the Boko Haram insurgency, she lost her brother, nephew, and six other relatives.

In this video, we talk about her survival and her ambition for her children.

Reported and scripted by Sabiqah Bello

Voice acting by Rukayya Saeed

Multimedia editor is Anthony Asemota

Executive producer is Ahmad Salkida

It was early in the morning, and Yakubu Buba stood in front of his house in Gamboru, northeastern Nigeria, looking towards the horizon. He was not waiting for a vehicle. He was waiting for cattle.

From across the Cameroon border, they came in low, patient herds, hooves lifting dust into the air. Yakubu breathed in deeply and smiled.  He enjoys the smell of fresh animal droppings, he says. “It replenishes the soul.”

The herds come daily. “About ten of them,” the 57-year-old estimates. “They are guided into Kasuwan Shanu, where they are loaded onto trucks bound for Maiduguri.”

That same morning, he, too, was headed to Maiduguri. A bean merchant since he was 17, Yakubu began travelling the Maiduguri-Dikwa-Gamboru road in 1986, importing beans from Cameroon and selling them onward to traders at the Muna Market who supplied to markets across Nigeria.

Gamboru sits on the Nigerian-Cameroon border in the northeast. A few kilometres away is Ngala, which links Nigeria and Chad. Through these borders, traders export processed goods like flour into Cameroon and Chad, Yakubu says. And when crossing back, they would import beans, sesame, and groundnuts. Animals, in whole or in parts, like hides, are the most imported from these countries, he says.

At the Muna Motor Park in Maiduguri, where I met Yakubu, this pattern was once predictable. Vehicles arrived full and left fuller. Mustapha Hauwami, a 47-year-old driver who began plying the route in 1980, remembers when the park felt like a tide. “We transport traders and passengers to Gamboru and Dikwa daily,” he says. “Most of those coming from Gamboru are Chadian traders.” He drove twice a day, sometimes more.

The pattern got interrupted, slowly. Conflict came, and fear crept in. “It became too risky to travel,” Mustapha says. Checkpoints began to pop up, and movement became impossible without military escorts. “There are at least 20 checkpoints on the road,” Mustapha says. “Importing goods became difficult,” Yakubu adds.

Movements became restricted

The effects were uneven. While Maiduguri’s economy tightened under restricted access, border towns like Gamboru adapted in unexpected ways. Cut off from Maiduguri at the height of the Boko Haram conflict, traders there turned outward. “We relied entirely on Chad and Cameroon,” Yakubu recalls.

Over time, goods from Maiduguri began arriving again, but now as just one stream among many. “They became cheaper in Gamboru,” he said. “Goods were coming from both Maiduguri and the neighbouring countries.”

The movement did not stop. It rerouted. The road’s restriction reshaped the advantage, redistributing it. What Maiduguri lost in centrality, border towns gained in flexibility.

Elsewhere, the pattern repeated with variations. On the Maiduguri-Bama-Gwoza road, Muhammad Haruna remembers when nights were just nights. He began driving in 1981, commuting passengers to Bama, Gwoza, Pulka, Yola, and Mubi. “Driving to Bama took at least 40 minutes,” he recalls. “For Banki, Gwoza, and Kirawa, it was one hour and 30 minutes.” There were few checkpoints, he says. And these existed because of criminals. “And travelling to Mubi was three hours, while Yola was not more than five hours.” The roads were free, even at night. “On market days, as many as 200 fully loaded Gulf cars carried traders into these towns,” says Bamai Mustapha, Chairman of the Bama Park National Union of Road Transport Workers.

Here, too, the Boko Haram conflict affected the flow. Most of the roads became inaccessible, forcing drivers to take a long route passing through the forest into Dikwa, before reaching Bama, until it became totally impossible to travel. “After escaping abduction in 2015, I stopped driving,” Muhammad says. “I sold the car and went into trading.”

Some traders shifted focus to Yola, Muhammad says. They would import from Cameroon into Yola instead. “Others import to Jalingo.”

When calm slowly returned, the routes reopened, but with limited access. “In some of the towns, curfew starts early,” says Muhammad. “They close Bama and Konduga by 5 p.m.” “If you leave Maiduguri by 2 p.m. with Gwoza passengers, you must spend the night in Bama.”

Still, it is not totally safe. “There was a time we got stuck for about a week in Konduga, while going to Gwoza, waiting for military escorts,” Muhammad recalls.

There have been recurring attacks and abductions on these routes for about a decade. The Boko Haram terror group has turned to the kidnapping economy as one of its revenue windows. “The most dangerous route is between Gwoza and Limankara,” Muhammad reveals. “The terrorists would plant mines on the roads. You cannot follow the route without a military escort.”

Despite that, they must travel the route. “It leads into Cameroon. We often transport traders and goods imported from Cameroon through Banki, Kirawa, and Pulka into Maiduguri.” At least seven trucks filled with grains enter Maiduguri from Pulka daily, he says. “It used to be around 30.” “This is the same for Gwoza, Madagali, and other towns.” 

The goods coming in, especially grains and animals, are transported onwards to Lagos in southwestern Nigeria and other cities, Bamai says. “They pass the Maiduguri-Damaturu road.”

The fish stopped coming

The story is the same on the Maiduguri-Baga-Monguno road. This is the backbone of Maiduguri’s fish trade. Audu Gambo began plying this route in 1990, transporting passengers, including traders and farmers, to Baga daily. “Driving to Baga used to take only two hours and 30 minutes,” the 54-year-old recalls. “There were few customs and immigration checkpoints, and the roads were good,” he adds. This enabled him to make a full trip twice, he says, until the conflict interrupted this frequency.

“Travelling has become difficult and restricted,” Audu says. “The entrance to Baga closes at 2 p.m.” So, they must leave Maiduguri as early as 8 a.m. “There are at least 30 checkpoints before reaching Baga,” he says. “Most of the drivers here are from Baga. Those of us from Maiduguri rarely travel the route.”

This affected the city’s source of protein. “I stopped going to Baga in 2017,” Abubakar Mustapha, a fish trader, recalls. It was 10 a.m. when I met him at his stall at the Baga Road Fish Market. “If it were before [the insurgency], we would have finished trading by this time,” he says. The influx of fish into the market has reduced. “They were cheaper and in abundance in the past. We used to offload at least five trucks of fish daily in the market.”

When the insurgency peaked, Abubakar recalls, it became one truck in days, until it became too risky to travel. The road became totally inaccessible.

Then the focus shifted to neighbouring countries. “We began importing from Cameroon, Chad, and Niger,” Abubakar recalls. “Fish from Cameroon and Chad are imported through the Maiduguri-Gamboru road. Those from Niger are brought in through Geidam in Yobe State,” and are transported through the Maiduguri-Damaturu road. “At least four trucks from these countries are offloaded daily,” he estimates. However, transporting to Maiduguri became costly. “Each cartoon costs 4,000 to import,” he says. So, traders relocated to Hadejia and Yola. “More than 50 per cent left.”

In the past two years, however, there has been cautious improvement. The market’s population has increased as previously closed roads are now accessible, Abubakar says. “Some traders have returned and they can now directly import from Baga and Monguno. Yesterday, we offloaded four vans. And the day before, it was three. It doesn’t go below or beyond this number.”

Yet, consignments from neighbouring countries make up the majority. “Fishers cannot freely access the water from the shores of Baga and Monguno,” he says. The shore there is one of the strongholds of the Islamic State West Africa Province (ISWAP) terror group. To fish in the water, fishers must pay.

That afternoon, Yakubu Buba boarded a vehicle at the Muna Park back to Gamboru. His beans had been delivered. He has learned to accept delays as the new rules of the road. Still, he remembers it used to be free.

For years, 64-year-old Ibrahim Zira lived with high blood pressure, managing the condition at Jigalambu Primary Healthcare Centre (PHC) in the Michika area of Adamawa State, northeastern Nigeria. When his condition worsened, he was referred to the Michika General Hospital, where he faced a familiar struggle: incomplete medical records and repeated tests.

“When I got there, they asked for my records, and the file I had contained very little information. I was asked questions and told to repeat tests I had already done. I had to pay again. It was painful because I don’t have a steady income,” Ibrahim complained.

In Nigeria, about 77 per cent of health spending is paid out of pocket, so each additional test adds a financial burden that many patients can barely afford. But the challenge is not only financial. Without digital medical records, patients like Ibrahim are often made to reconstruct their medical histories whenever they move between facilities, relying on memory of dates, drug names, and test results. 

“Sometimes I forget dates or drug names,” he said. “When that happens, the health workers think I’m not serious. It’s stressful explaining the same sickness again and again, especially when you’re not feeling well.”

The same experience surfaced for Pwavira Akami during her first pregnancy. She began antenatal care (ANC) at Gweda Mallam PHC in her hometown of Numan but later relocated to Jimeta, Yola—more than an hour’s journey away—to stay with her sister. There, she registered for antenatal care at Damilu PHC. 

The transition exposed the same fault line in the absence of digital patient records.

“They asked me many questions that were already written in my ANC card, but some pages were missing,” she recalled. As a result, Pwavira was asked to repeat basic lab tests. “I had to spend more money. It’s tiring; you keep answering the same questions about your last period, past illnesses, and tests. Sometimes you’re not even sure if you’re saying it correctly.” 

In both cases, the problem was not medical knowledge or staff competence. It was the absence of a shared system that allowed patient information to follow people as they moved between facilities.

Frontline workers show concerns

This gap, healthcare workers say, affects patients across Adamawa every day.

Mercy Dakko, a midwife at General Hospital, Michika, said she works almost every month without patient files and that internally displaced persons (IDPs) and pregnant women often arrive with incomplete or fragmented medical histories. 

“It slows everything down,” she told HumAngle. “In emergencies, lack of history can be risky. You may not know past complications or drug reactions.” 

Mercy recalled the case of a woman who came into labour, only for the staff to later learn that she was diagnosed with high blood pressure in a previous clinic. “We found out late, and it almost caused serious complications,” the midwife explained.

Sam Alex, another medical practitioner, agreed that due to a lack of well-documented medical history, they rely only on what the patient remembers, which is not always accurate. “Very often we repeat tests. It’s not ideal, but sometimes it’s the only safe option,” Sam said, noting that the stakes are even higher for chronic diseases.  “It increases the risk of wrong medication, delayed care and poor outcomes, especially for conditions like diabetes or hypertension.” 

He acknowledged that patients often bear additional burdens, spending more time and money, and some even refuse to come to the hospital because they are tired of having to repeat medical procedures. 

‘Everything is paper-based’

At the root of the problem is a paper-based system that requires patients to carry physical files. Emmanuel Somotochukwu, a Nigerian pharmacist, told HumAngle that in his hospital, about one in ten patients are sent back simply because a prescription is illegible or an old lab result is missing. 

Studies in Nigeria have found that illegible or incomplete prescriptions are a leading cause of medical error. In most hospitals across Adamawa, record officers are overwhelmed by paperwork. Bewo Gisilanbe, a record officer at the General Hospital in Michika, described how patient histories are stored. 

“Everything is paper-based. Files are created manually and stored in cabinets,” he said, admitting that old files or files from busy clinic days could get torn, misplaced, and slow to retrieve. “Once a patient leaves, their record ends here. There’s no connection to other facilities.”

Bewo stressed that searching for a lost history wastes time and distorts continuity of care. “We don’t know what happened to a patient’s prior care after they leave,” he said. If systems were linked, he argued, everything would change. “It would reduce workload, improve accuracy, and make record tracking easier.”

Why digitalised medical records matter

Experts say the solution to the flawed health system in Adamawa lies in Digital Public Infrastructure (DPI). In the health sector, DPI refers to shared, secure information systems that allow “medical histories, prescriptions, insurance status, and laboratory results to move electronically between units, without requiring patients to act as messengers”. 

The cornerstone of this system is a dependable digital identity. By mid-2025, Nigeria’s National Identity Management Commission (NIMC) had issued 123.5 million National Identity Numbers (NIN). These IDs, if utilised, can act as a digital passport, enabling the connection of patient records across various healthcare facilities.

Recently, the National Health Insurance Authority (NHIA) and NIMC signed an MoU to establish a unified framework linking citizens’ national identity data with health insurance records. This integration is meant to streamline verification, reduce fraud, and expand access to healthcare, especially for underserved communities.

Beyond identity, DPI seems to require an interoperable health information record system. In 2024, the government launched the Nigeria Digital in Health Initiative (NDHI) to build a national health information exchange and patient registry. The goal is for health facilities to securely and seamlessly share information. 

Nzadon David, a digital innovations specialist working with the African Union, and Asor Ahura, a Nigerian-based AI engineer and digital health expert, highlighted several key requirements for success in digital health systems. Nzadon emphasised that “every system needs a way to recognise each person. In Nigeria, this means using the NIN or similar IDs in health records.” Asor also stated that “clinics must agree on data formats and coding systems to ensure that one hospital’s notes can be understood at another. He stressed that privacy laws, such as Nigeria’s 2023 Data Protection Act and clear guidelines about who can access information are essential for building trust. 

Across Africa, early DPI projects show what’s possible. Rwanda has an integrated e-health platform (Irembo) that links digital IDs to patient records and lab results. Kenya’s Afya Kenya initiative likewise allows a clinic in Kisumu to retrieve the same information as a clinic in Nairobi, eliminating duplicate efforts. The payoff is clear: fewer medical errors, faster diagnosis, and better continuity of care, according to the DPI Africa platform. Even India’s Aadhaar ID system now covers 1.4 billion people and is tied into programs including health insurance.

Nzadon noted that these countries didn’t digitise everything at once. They started small, created shared standards, scaling gradually. “States that succeed focus on shared standards and simple, open systems more than expensive software,” he added.

The road map

In 2025, Nigeria joined the UN’s Digital Public Goods Alliance, pledging that government systems, including health, should be open, inclusive, and interoperable. These moves seem to reflect lessons from around the world. Rwanda, Kenya and other countries show that with a national ID, electronic medical records, and a clear privacy framework, health services can become seamless. In Nigeria’s case, there is no shortage of data on why it matters. Aside from the human toll of broken care, inefficiency has economic consequences. According to McKinsey Global Institute’s digital identification report, scaling digital ID systems worldwide could add $5 trillion to global GDP. 

Frontline healthcare workers, seeing the impact firsthand, have a clear wish list. 

With connected records, Mercy said, “we can focus more on care instead of paperwork.” Bewo admitted that a shared system would “reduce mistakes” and free up resources for patients. Perhaps most pointedly, patients themselves feel the difference. Reflecting on his own experience, Ibrahim says a digitalised health system would make life easier. 

This report is produced under the DPI Africa Journalism Fellowship Programme of the Media Foundation for West Africa and Co-Develop.