In a world full of humanitarian emergencies north-east Nigeria might not be highest on the news agenda but the troubled region is facing a crisis the likes of which Africa or the world at-large rarely sees. Seven years of conflict have pushed families and children to the brink of survival. With an estimated 400,000 children suffering from life-threatening severe malnutrition, this week Nigeria was named as one of four countries currently facing famine.

Family physician Dr. Isaac Bot gave up his job at a teaching hospital to become resident physician at Save the Children’s stabilsation centre for severely malnourished children located in Borno State in north-east Nigeria.

At this intensive care unit set within the grounds of an aging district hospital, Save the Children offers life-saving care to young children suffering from combinations of severe malnutrition and another medical complications such as malaria or respiratory tract infections.

Dr. Bot, thank you for speaking to us. Tell us about the stabilisation centre

“The centre here takes care of severely acutely malnourished children. But not only those, specifically those that have medical conditions and cannot be treated at the community level. We take care of them here until they are well enough to go back to complete their treatment at our Outpatient Therapeutic Feeding Programmes where they go for weekly visits and receive food rations.

What are the sorts of complications children are presenting with?

With malnutrition, immunity is usually very low so children are prone to all sorts of conditions. They get things ranging from malaria to diarrhoea and skin infections. We have respiratory tract infections, even pneumonia or more serious stuff like sepsis, which is multiplying of bacteria in the blood. They can be really very sick when they come. Severe acute malnutrition is already bad enough. Whenever they develop a medical problemon top of that, that makes the condition very much worse and the child can deteriorate very rapidly.

Have you lost many children?

I’ve lost a number. Yes. I’ve lost a number. And it can get really tough because the child mortality here is bad enough and it becomes very painful if they come in bad shape and you can’t help them. It can be really tough to take in, you know.

Many times we get some really, really, really horrid stories and you can’t help but be moved by what you hear. Because the kind of patients that come here tend to be those who are really, really affected by the current situation in terms of access to food and medicare so they are coming in pretty bad shape. We have mothers who come here crying who we need to talk to and reassure.

Does it affect you emotionally?

Yes, of course. I’ve lost a number of patients and it’s challenging because we face a lot of difficulties. It’s difficult to appreciate how parents allow their children to get so sick before they bring them to the centre, but it becomes clearer when you understand the situation where we are – here in Maiduguri – where it is still difficult to access healthcare.

How have you found the transition to humanitarian work?

It has its challenges at times. Not only because of the sheer numbers that we see but we do get very sick children amongst those that come. Some may require extra attention and it pulls-in a lot of manpower to take care of those really sick ones. When you have that, and you have other patients to take care of, it can really get stretched. When I came here I didn’t really expect the scale of the problem but it is a rewarding experience.

How does it feel as a Nigerian to see this humanitarian crisis play out in your own country?

It’s painful to see how this senseless crisis would easily lead to this really unfortunate situation for these patients. Sometimes it’s hard to take in when you look at the sheer numbers of people who are affected by this. We have so many children who have lost their mothers. In these cases feeding becomes a problem and they can deteriorate very fast. When you talk to them they have really horrid stories. It’s really tough to take in.

What do you need to help you do this job?

Personally, I’ve not had much of a break for some time. We have situations where I have to go and refill the oxygen tank and come back and when that is finished I have to go back again and again – up and down. It’s relentless work. On a larger scale we probably need more facilities like this spread out in the city and in different places. If we could expand this facility too that would help. That kind of support would go a long way.

What is your message to your fellow staff members and Save the Children supporters around the world?

They should know there is a lot of good work going on here in Maiduguri and we are saving a lot of lives. Some of the work might not always look like it’s doing much – our work in the community and advocacy work for example, but it makes the world of difference from preventing people from slipping into a bad situation.

I appreciate the opportunity Save the Children has given me to do this work and the support I get from the staff is something I will take back with me, maybe years down the line, when I settle down. It’s a kind of family here and it’s nice to work in that sort of environment.