Since 2009, the violent conflict between Boko Haram and various government and civilian security forces has continued to threaten the stability of Nigeria’s northeast region, with 1.7 million people still internally displaced at the end of 2017[1] and 3.7 million forecasted to be critically food insecure in 2018.[2] Indiscriminate attacks by all forces, along with Boko Haram’s attacks on communities, hospitals, and schools and its forced recruitment of women and children as suicide bombers have claimed the lives of thousands of civilians since the start of the conflict.[3]

There were at least 23 attacks on health in 2017. In the deadliest attack, the Nigerian air force dropped two bombs on a displaced persons settlement on January 17 in Rann, Borno state, during an MSF vaccination campaign. The attack killed three MSF-contracted water and sanitation workers, six Red Cross volunteers delivering food aid, and at least 90 civilians.[4] [5] [6] Nigerian officials apologized for the accidental airstrike, faulting inadequate marking of the area, although Human Rights Watch had observed that tents were clearly visible from the air and there was an apparent Nigerian military compound barely 100 meters away from the bombing site.[7] [8]

While perpetrators were unknown in most other cases, Boko Haram carried out four attacks on health facilities and one attack in which they looted medications.[9] In an attack on a town in Adamawa state in August, Boko Haram completely destroyed the town hospital, depriving inhabitants of their main health facility and leaving them no other option than to travel long distances to access medical care.[10] In August, two Boko Haram suicide bombers tried to attack Molai General Hospital in Maiduguri. Instead, two dogs attacked the pair and detonated their explosives, killing the suicide bombers and the dogs. In October, two suicide bombers again targeted Molai General Hospital. While trying to enter the hospital through the rear exit gate, they detonated the IEDs strapped to their bodies, killing themselves and damaging the gate. Though not attributed to the group, the second bombing also fits Boko Haram’s pattern of attack.[11][12] On Christmas Day, Boko Haram fighters attacked the same town with firearms, stole two vehicles belonging to the hospital, and burned three civilians to death.[13] The perpetrators of other attacks are not reported.

Attacks affected at least 36 health staff—13 were killed, two were injured or assaulted, 15 were kidnapped, and six health workers experienced sexual violence. In February in Kogi state, unidentified gunmen attacked several members of the Ministry of Health, killing one.[14] In February, gunmen entered the home of a local tradi­tional healer in Moro, Nasarawa state, killing his security guard. They abducted the traditional healer and later killed him.[15] In October, a local criminal gang in Delta state stormed the town of Enekorogha and abducted four British health workers in an optometry aid group. Though three were released in November, the gunmen killed Dr. Ian Squire, an optometrist from the group.[16]

In September, armed men entered a facility in Osun state, sexually assaulted six nurses, and stole property from both staff and patients.[17] In November, unidenti­fied armed perpetrators attacked a team of Government of Nigeria health workers conducting a polio vaccination campaign in Borno state. While the health workers were not injured, the campaign was suspended, leaving some of the local population without access to the vaccine and further threatening efforts to eradicate the disease in the country.[18] In June, Boko Haram militants attacked a police-escorted convoy carrying medical supplies in Borno state, headed for the town of Damboa. While no medical staff were present, the event threatened the safe arrival of medications to Damboa.[19]

Kidnapping was the most frequent threat to medical personnel. Fifteen health workers were abducted in ten separate incidents in 2017, with eight of the victims being doctors. Attacks on health staff and facilities occurred most frequently in Borno state, the center of the Boko Haram conflict. Other attacks occurred most frequently in the south and central states, where nine of the ten reported kidnappings took place. Effiong Mkpa­nam, Cross River state chairman of the Nigerian Medical Association, called for immediate statewide strikes in response to any future doctor abductions, stating that in 2017, five doctors had been kidnapped in the Calabar area alone.[20] [21]“We cannot continue to save the lives of others while ours is not secured,’’ he stated.[22]

[1]International Organization for Migration. December 2017. Displacement tracking matrix round XX report – Nigeria.

[2] United Nations Office for the Coordination of Humanitarian Affairs (UNOCHA). March 5, 2018.Nigeria: Humanitarian dashboard (January 2018).

[3] Human Rights Watch. World report 2018: Nigeria – Events of 2017. Accessed March 23, 2018.

[4] Médecins Sans Frontières. January 17, 2017. Nigeria: MSF strongly condemns the aerial bombing of a camp for displaced people in Rann.

[5] International Federation of Red Cross and Red Crescent Societies. International Red Cross and Red Crescent movement deplores the death of

Nigerian Red cross Society aid workers in Rann, Nigeria. Accessed March 23, 2018.


[6] Médecins Sans Frontières. January 19, 2017. Nigeria: Death toll rising in Rann attack.

MAY 2018 41

[7] Erunke, Joseph. “Updated: Why air force fighter jet bombed IDPs in Rann—Defence hqts.” Vanguard News, July 22, 2017.

[8] Human Rights Watch. January 18, 2017. Nigeria: Satellite imagery shows strikes on settlement.

[9] Confidentially shared agency report. 2017.

[10] Sani, Daji. “Boko Haram attacks Adamawa village, raze hospital, houses.” THISDAY, August 23, 2017.

[11] Olugbode, Michael. “Three suicide bombers die in failed Borno hospital attack.” THISDAY, October 13, 2017.

[12] “Two heroic dogs die after foiling Boko Haram’s suicide attack in Maiduguri.” Vanguard News, August 4, 2017.

[13] Maina, Maina. “Molai attack: Boko Haram burnt 3, stole 2 jeep belonging to leprosy hospital in Borno.” Daily Post Nigeria, December 28, 2017.

[14] Confidentially shared agency report. 2017.

[15] Yusuf, Omotayo. “Prominent healer killed in Nasarawa.” Naij. Accessed April 18, 2018.

[16] “Nigeria kidnapping: Ian Squire killed and three freed.” BBC News, November 6, 2017.

[17] Young. “Hoodlums rape 6 nurses on night-shift in Osun hospital.” Information Nigeria, October 11, 2017.

[18] USAID. December 14, 2017. Lake Chad complex emergency fact sheet #4 FY2018.

[19] Bolashodun, Oluwatobi. “Police give detailed report of Boko Haram attack on convoy in Maiduguri-Damboa highway.” Naij. Accessed April 20,


[20] Note the five kidnappings referenced by Mkpanem likely include two incidents included in this report. Two of the ten accounts of kidnapping

doctors happened in the Calabar area in 2017, including the abduction of Dr. Ekanem referenced here.

[21] Kidnapping: Cross River doctors threaten strike.” Premium Times Nigeria, January 5, 2018.

[22] Ibid.