Japa: Nigeria’s Malnourished Children Battling for Breath in Strained Wards

Hunger is worsening in Nigeria at a frightening pace, and with it, malnutrition. A sudden policy shift at the onset of present administration has pushed prices of staples, including children’s essential diets by as much as 353 per cent, leaving many households struggling even more. Now ranked Africa’s worst-hit and second globally for child malnutrition, within this figure lie heart-breaking tales of mothers’ desperation to keep their children alive with the unsafe like scavenged leftovers, chicken feeds, and even worse. Omolabake Fasogbon reports that the consequences of poor diets forced on children, such as record child illnesses and deaths are slipping beyond what the nation’s medical capacity can contain, amid medical migration (Japa) crisis.

Little Chima’s voice fades into thin air as he loses the strength to cry the more. His small body lies limp on the cold market floor. His siblings, their faces etched with worry, gently brush  away the flies swarming around him. At just eight months old, Chima is a mere shadow of a child, a victim of hunger so deep it silences even his cries.

This scene greeted the reporter at Mrs. Rose Okafor’s sparse stall at Ile-Epo market, Abuleegba, Lagos. Rose, Chima’s mother, ekes out a living selling homemade dishwashers. The bustling market, typically a hive of commerce, hummed indifferently to the children’s silent suffering. Chima’s siblings, barely more than toddlers themselves, guard their mother’s wares, their eyes vacant with hunger.

 “He is hungry,” Chima’s younger sister about four years, whispered, her voice barely audible. “My mummy went to buy food,” added their eldest brother. Their eyes fixed on the market entrance, it was just after 1:00 pm, and they were still awaiting their first meal. This reporter found the children had become used to skipping meals, in direct violation of their right to timely nutrition enshrined in the Child Rights Act. A United Nations Children’s Fund (UNICEF) report says 11 million or one in three Nigerian children under five face severe food poverty, in this home, the three siblings are victims, a reality that literally cut across struggling households.

Scavenging to survive

Rose returned about half an hour late for an interview prearranged two weeks earlier, following our first encounter at Orile-Agege General Hospital, Ile-Epo, Oke-Odo, Lagos, where she had brought sick Chima for treatment. 

In her hand, a black polythene bag emits a pungent smell of soured food. Her children swarmed around her, as their eyes lit-up with anticipation. Rose emptied a heap of leftovers: sour jollof rice, wilted salad, and congealed melon, all scavenged, from a party she had attended uninvited. Both mother and children savoured the meal.

“This is how we have survived. Food has since become the preserve of the rich”, Rose lamented. “I’ve been collecting leftovers from any available parties where I disguise as a guest. A neighbour showed me this way. I can’t watch my children die of hunger, the little I make wont buy food ”, she complained. 

Chima’s health fails

Like his siblings, Chima survives on scraps and rarely breast milk,far short of the World Health Organization’s (WHO) threshold of at least five daily food groups, including breast milk, grains or starchy roots, legumes, animal proteins, and fresh fruits or vegetables. He soon paid the price with repeated bout of illness and delayed growth,same as medics warn are common consequences of poor diets.

 In Rose’s household, hunger forces everyone to eat anything available, however inadequate for children, mirroring exact findings by lifestyle-focused publication, ‘Good Health Weekly‘ that Nigerians no longer eat for nutrients, but to fill their stomach for survival.. 

President of Paediatric Association of Nigeria (PAN), Prof. Ekanem Ekure, blamed situation on poverty and unaffordable food prices. 

“This development also threatens to reverse previous gains in childhood survival, likewise obstructs SDG 3 achievement”, she stated. 

Also citing consequences of poor nutrition, Maternal and Child Health Expert, Blessing Akombi said, “Children risk stunted physical and cognitive development, weak immunity, frequent infections, and lifelong effects on education, productivity and health.”

For Chima, these consequences hit close to home, especially being an infant whiich WHO says is more vulnerable. Getting Chima treated at Orile Agege General Hospital, Rose said, was another hurdle. Even after physician tied his ailments to poor feeding and infections,corrective diets prescribed remained elusive to her. 

“I rarely make N2,000 daily ($1.31), how am I expected to get money for therapeutic food? Even the recommended local substitutes are beyond my reach, but I still try to give him beans and add some milk to his pap, though not consistently, due to the cost.  My husband is just a site labourer who struggles to get engagements, so I expect little or no support from him”, she said, strapping sleeping Chima to her back. 

 Frying pan to fire

Though not entirely pleasant prior, Rose’s family dietary pattern declined especially in 2024 when food prices soared more than doubled, following economic reforms. Nigeria’s food inflation reached a 28-year high of 40.87% in June 2024. For Rose’s family already surviving on bare minimum, the effect of rising food inflation is that they now struggle for even the cheapest meal.

“Before now, we could afford two decent meals a day, with a little spice of protein.  I would split one egg among the three of them, but it is now too costly. If I couldn’t give Ponmo (cowhide), I’d add Puff Puff for flavour, this too is now on the high side”, she recounted when asked about their feeding routine. 

Although this household’s previous diet already fell short of UNICEF’s recommended food groups for children, Rose worried that their inadequate previous were running over the family’s means.  With neither spouse earning a stable income, life has been a constant struggle. On days when there are no parties to scavenge food, she said she enters food stores to pick up spilt grains of raw rice and beans. 

Worsening hunger 

Hunger and malnutrition remain endemic in Nigeria. Once seen largely as Northern crisis, the scourge is tightening its grip nationwide. National inflation peaked 34 per cent in December 2024, far beyond regional averages. While it tapered to 21.88 per cent in July 2025, market checks alongside experts report suggest cost pressure persists.
From February 2025, food inflation has remained above 2.0% month-on-month, contrasting disinflation in core prices.

Year on year, Nigeria slips on the Global Hunger Index, currently ranked 110th out of 127 countries. This, fuelled by rising food inflation, heightens nutritional risks.Analysis by data platform, ‘Intelpoint’ comparing prices food items between April 2023 and December 2024 revealed prices rose by up to 353 per cent, surpassing a wage rise of 133 per cent.

Resultantly, child malnutrition worsens to leave Nigeria with the highest burden in Africa, with no fewer than 3.5million children suffering from Severe Acute Malnutrition (SAM) – deadliest form of malnutrition which compromises children’s immune systems and makes common illnesses life-threatening. 

Suggesting present situation may even get worse, Country Director at International Rescue Committee, IRC, Babatunde Ojei noted that donors’ reluctance and global food aid cuts will likely compound an already precarious situation. 

“It’s heartbreaking to see the needs of children growing while the support to reach them is shrinking. Fewer implementing partners are active, as donor reluctance, driven by insecurity, limited access, and global aid cuts, continue to restrict funding”, he remarked. 

 Animal feed to the rescue

 Far away in oil-rich Akwa Ibom state, Southern Nigeria, about 700 kilometres from Nigeria’s richest economy, Lagos state, another mother’s desperate choice reveals nationwide scope of the crisis.   Like Lagos, ravaging hunger defies this state’s modernity, forcing desperate widow, Grace Eseneowo to seek respite in animal nutrients. 

 For 22-year-old Grace, chicken feed from the farm where she works became her last resort to defeat a gnawing hunger. By the way, steep prices of food nationally mean Grace’s entire N15,000 monthly salary would narrowly cover three days’ worth of nutritious food for her and four children. 

Grace’s plight gained attention after her employer’s daughter, Queen  Praise discovered her struggles and shared publicly, with the intention to solicit help for her, and  draw attention to broader hunger crisis.

“She usually saves some feed from my father’s farm where she works and prepares same as pap for her children”, Praise briefed. 

While troubling, Grace’s plight is not unique in a state that barely subsists, with a poverty rate of 26.8 per cent, far below the national threshold of 52.1 percent. With Akwa Ibom ranked 27th of 36 states on the National Bureau of Statistics (NBS) poverty index of 2023, hunger reality in poorer regions can be best imagined. 

Increasingly, Nigerians across regions are seeking succour in unhealthy cheap substitutes, such as consuming rice waste instead of rice, enduring forced starvation, and rationing food, all of which pose different health risks. 

For Grace and offspring, including her one year old child, they  are already vulnerable by consuming chicken feeds, said to often contain  growth enhancing arsenic-based drugs linked to cancer, heart disease, and diabetes in humans. 

Double woes

 Consuming unhealthy food exacts a heavy toll on children’s health, especially those under five, which WHO affirms are disproportionately affected by malnutrition.

 A consultant paediatrician at Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nma Jiya said that many more children are being admitted to clinics on causes related to malnutrition. He disclosed that about 80–90 percent of paediatric case in recent times are malnutrition-related, adding that the surge was unprecedented.  Particularly, he worried that the surge was, ill-timed given medical brain drain plaguing health system. 

 Relating the situation in Northern Nigeria, Jiya said, “We’re witnessing a historic surge in vaccine-preventable, communicable and non-communicable diseases among children. We’ve had to deal with several cases of hypoglycemia, hypothermia, excessive coldness, anaemia, liver failure, and electrolyte imbalances, largely due to poor diet.”

Corroborating Jiya’s revelation, international charity organisation, Médecins Sans Frontières (MSF) recently alerted the public to the deteriorating condition of malnourished children in the country, reporting a 74 percent increase in admitted malnourished children to its facility in Kebbi State in first half of 2025, and more than 100 percent increase across Northern region. 

“Not just the children, even mothers accompanying young patients are themselves acutely malnourished”, MSF noted. 

Jiya expressed that while the influx coincides with mass exodus of health workers, ailing children may not get the best. The Nigerian Medical Association (NMA) reports that at least 50 medical doctors leave the country every week in search of greener pastures abroad over poor working conditions.  This leaves the country grappling with a shortage  of 600,000 doctors, a gap said will take another next 60 years to bridge. 

“We’re losing doctors and nurses almost every day, while patients keep streaming in. We are facing a crisis. It is even worse in the North, where we face local and International Japa”, Jiya said, shaking his head in despair. 

A Paediatric Nephrologist at the Lagos University Teaching Hospital, Dr. Chris Esezobo, also flagged paucity of pediatricians in the country, warning shortage now gives room for incompetent child specialists to thrive.

“Some states have no paediatricians. Some local government areas in Lagos lack paediatric doctors. Children in Nigeria are dying due to a lack of skilled manpower,” he disclosed.  

Chima fades in the shadow of care

A chaotic medley of sounds—wails, murmurs, and sobs filled the air at the pediatric section of Orile Agege General Hospital. The number of patients awaiting few physicians was unusually high for a Friday afternoon. Lately, however, this has been the norm, with waves of sick children flooding the hospital on both weekdays and weekends. This, incidentally, is the situation in most paediatric wards across clinics in South West Nigeria, where Lagos alone battles 30,000 doctor deficit.

“Hospital visits and admissions of children are now increasing in the South West due to malnutrition” revealed PAN President, who is also a Consultant at Lagos State University Teaching Hospital. 

In the ward, one mother’s cry stood out.  “She had just lost her two-year-old child to anaemia,” a relative of the bereaved (name unknown) had hinted. A check on a medical site shows Anaemia is a common consequence of poor nutrition.  In between, some emergency cases were turned away due to lack of bed space. Curiously, this reporter, posing as mother of a sick child to observe situation firsthand, following tip-off on declining services,was attended to before Rose who arrived much earlier.

In less than two minutes, a visibly tired and impatient doctor (without a name tag) was done; he referred reporter’s child for a full blood count (FBC). “Next patient please,” the doctor called.  Still, it was not Chima; it was the patient next in line. Chima’s mother, obviously ignored, forced a first time conversation between us. 

“This is my fourth visit this week, I’ve only seen doctor once. They’ll probably ignore us again”, she wept.

 Chima’s ordeal began around his fifth-month birthday when Rose noticed he was falling behind on growth and struggling to hold his neck. Initially, neighbours and even nurses at a health centre dismissed her concerns, suggesting it was a temporary developmental delay. 

By six months, with no improvement, Rose started bringing him to the clinic almost daily, presenting new symptoms. On this day, Chima was battling erratic temperature changes and persistent cough refuse to go

“Today, he has malaria. Tomorrow, he is stooling, every time, it is always one infection or the other, but they keep saying he is not eating well. I’ve been trying in my capacity, yet, his condition is not improving. His mates are already crawling, but he doesn’t show any sign yet. Some people are suggesting herbal treatment, I’m afraid it may even compound his situation.

“I’ve been coming here every other day for three months now, but his condition only worsens. The health workers already know us, so they ignore us or attend to us hastily. 

“They tell me they’re short-staffed and have many children to treat. At times, they will say I should continue with old medications even when I have new complaints. I’m tired, I just want him to be well. 

“His condition has drained us. The little help we get goes on drugs and tests. He has been placed on special diets, including infant formula and vitamin C. I still try to give him vitamin C, but could not sustain others recommended because of the cost,” she grieved. 

 Chima’s plight mirrors that of eight out of ten Nigerian malnourished children, which UNICEF says lack access to treatment. His condition remains dire, even amid doctor shortage. Like UNICEF, the IRC reported that more than four out of five children suffering from nutritional ailments are denied life-saving treatment due to lack of funds and bureaucracy. These, and now medical brain drain, bode an unsettling outcome.  Asked about Chima’s medical record, Rose could not provide any physical documents, understandably so, due to the now digitised operations across public hospitals.

Japa’s toll on starving innocents

The repercussions of medical migration on children, especially in public hospitals are harrowing. From fruitless, unending wait and half-baked treatment to ignored cries of hurting kids, rushed consultations and diagnosis, including avoidable deaths, all witnessed firsthand by this reporter, highlight the urgency for intervention.

In an already precarious environment where UNICEF reports only two of ten malnourished children being able to receive care in Nigeria, the exodus of doctors worsens a dire situation, leaving ailing children pleading for care, as just one doctor serves 8,000 patients.

Explaining the reality, immediate Past Country Representative of an international medical humanitarian organisation, MSF, Dr. Simba Tirima said, “We are resorting to treating patients on mattresses on the floor because our facilities are full”. Similarly, the current Country Representative of the organization, Ahmed Aldikhari bemoaned an escalating toll, revealing that over 652 malnourished children have died in its Katsina facilities this year alone. “They couldn’t get timely access to care”, he worried.

  Likewise, the IRC recently declared an outrageous number of severely malnourished children admitted to its clinic, with cases surged by 178 percent between March and July 2025.

In another troubling revelation, a paediatric nurse at Bola Ahmed Tinubu Health Centre, Aboru, Lagos, Mrs Yewande Gansallo observed a trend of recurring illnesses, mostly infections, among children visiting the clinic, just like it is with Chima, wondering why such is prevalent. 

“They keep coming back with the same complaints every week, and we keep treating the same condition repeatedly. It’s so strange”, she said.  But Jiya remarked that Gansallo’s concern is not uncommon among malnourished children, adding that such is very likely when their immune systems are already compromised by prolonged nutritional deficiencies. 

“The ongoing wave of brain drain couldn’t have come at a worse time”, Jiya lamented. “Unfortunately, those who suffer most as we see them often are children from low-income families. They can barely afford good food or private consultation”, he sighed.

 Stumbling interventions; experts’ stance

While governments at both federal and state levels have rolled out initiatives to address these scourges, their efforts remain nominal in light of disturbing statistics reality.  

Measures, including  33.7% increase in the 2025 nutrition budget, $12 billion loan from Japan to boost food production as well as sum of N12 billion(about $8 million) claimed to be  disbursed by federal government to enhance food production, barely bring relief. 

Most recent efforts were announced plans to harmonise levies on food transport and the ‘Nutrition 774’ Initiative, designed to decentralize nutrition interventions across the country’s 774 local government areas. 

Vice President of Nigeria, Kashim Shettima once admitting the cost of malnutrition, said, “This remains a national emergency that poses both health and security threats to Nigeria. At one point, the Ministry of Agriculture and Food Security worried, proposed a nationwide prayer & fasting, a move widely dismissed as unserious.

In the health sector, a proposed N110bn investment to upgrade medical schools; as well as the national policy on health workforce migration, which includes a housing scheme for healthcare workers and incentive programme were deemed dead on arrival. 

A public health expert, Dr. David Adewole said, “This policy may not do much. As much as it may be good, its proper implementation and sustainability might be a challenge due to the government’s habit of policy somersaults.”

Chairperson of the Lagos NMA chapter, Babajide Saheed in a statement issued on 2025 Workers’ Day underlined the urgency of resolving  Japa dilemma, noting still, delay in the  Implementation of policy on health workforce migration.  He urged improved remuneration, such as non-taxable call duty allowances and professional allowances indexed to the national inflation rate.

He added, ” “Better welfare packages, including affordable housing and car loans, and adopting Consolidated Medical Salary Structure, CONMESS salary structure while ending exploitative locum appointments  will drive fair pay and career growth.”

As for Ekure, she believed children’s present plight resulted from non-implementation of Child Rights Act (CRA), despite domesticated across states, urging governments to intensify enforcement. 

 “CRA guarantees Nigerian children’s rights to family life, nutrition, health. The Federal Government should lead by example and drive its enforcement across states”, she maintained.

Similarly, Ekure backed call by Child health expert, Akombi-Inyang for holistic solution to the dual crises. 

Akombi-Inyang said, “Since malnutrition stems from poverty, addressing it requires a multidimensional approach that tackles various deprivations that necessitate a commitment from government at all levels.

“At household level, efforts should be devoted to promoting good water, sanitation and hygiene, while at the community level, there should be deliberate and consistent move to support underprivileged households in form of food and cash transfers”.

A former Chairman of NMA, Prof Mike Ogirima advised on need to strengthen Primary Healthcare Centres, (PHCs) by integrating nutrition counselling, promoting exclusive breastfeeding and embracing local food supplements like soya beans.

A farmer, Mrs. Blessing Olugbemi also encouraged mothers to consider low budget, protein -rich alternatives, than outright ignore due to high cost. 

“Crayfish, Ugu (pumpkin) leaves and herring fish (Sawa) are all nutritious and flavorful cheap options that can be added to children’s meal for optimal health. 

Overall, integrated and bottom- up actions that engage key stakeholders, empower community clinics and families and ensure government intentionality in school feeding programme, are deemed essential to save children like Chima and prevent further tragedies.