INVESTIGATION: How IDPs ‘keep’ their kids malnourished ‘using citric acid’ and profit from a nutrition program to heal them

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BY ABDULHAMID AL-GAZALI, USMAN MOHAMMED, FATI MUSA MARTE & ABDULKADIR M. LAWAN, SEPTEMBER 06, 2022 | 07:19 PM


Internally displaced persons, IDPs, across the North East have fashioned out a criminal commercial enterprise at the expense of their kids to enrich themselves. They help to ‘make’ or ‘keep’ their kids, aged 0 to 5, malnourished, in order to profit from their condition.

An epic story told of this criminal, yet inhumane enterprise is this:

A woman made sure her son remained malnourished so she could perpetually keep him on an ongoing nutritional food program put in place by the Nigerian government and various donor agencies to contain the severe cases of malnutrition in the North East. Officials at a newly built primary healthcare center located at 1000 Housing Estate where the child receives weekly medical attention, seeing that he was not responding to treatment, threatened that should the child’s weight and nutritional condition fail to improve upon his next appointment, he would be dismissed.

Interestingly on her next presentation of the child, which was to receive additional doses of the nutritional food supplements (as part of the program), his condition had rapidly improved, which raised suspicion as to what could have been the reason.

Health workers, suspicious of such a rapid transformation, subjected the child to further examination, after which the ruse was busted.

The mother of the child loaded sand in a polythene sack and wrapped it up in the child's napkin, consequently causing the child to hit unprecedented weight increase on the scale, leaving his mid upper-arm circumference (MUAC) still ‘low’.

The reason was simple: the mother was receiving the food supplement, generally termed Ready to Use Therapeutic Food, RUTF, in the name of the child but sells them off instead of feeding him, leaving the unsuspecting child perpetually malnourished.

The nutritional crisis in the North East: A background

In 2016 and 2017, alarming figures of malnutrition in the northeast of Nigeria, especially among displaced families, were published.

It was one of the emergencies governments, non-governmental organizations and donor agencies were out to contain as one of the major fallouts of the Boko Haram crisis.

In 2016, an estimated 160, 000 children were treated of malnutrition while 75, 000 others were reported to have been at the risk of Severe Malnutrition in the region.

In 2017, 216, 639 were admitted for Severe Acute Malnutrition, 731 of whom eventually died.

The figure rose to 256, 639 in 2018, with 654 deaths.

The matter was brought down in 2019 to 150, 422, with 544 deaths.

It went further down in 2020, with 140, 349 cases. However, there were more deaths, amounting to 1, 354.

In 2021, 85, 027 cases were recorded with 239 losses.

However, the situation was not still comprehensively addressed, especially in hard-to-reach areas. There are still alarming numbers of the cases in some unofficial IDP camps across Borno. For instance, in a sample of 100 kids tested at two of the unofficial IDP camps: Doron Baga and Umara Bolori IDP camps in Maiduguri, over 60 turned out to be still malnourished, even though their cases were not as severe.

Similarly, reports suggest that over 2.5 million Nigerian children below three years are severely malnourished, while over 11 million children are stunted in the country; a scenario that negatively affects the infant mortality rate of the country.

Mr. Sanjay Kumar Das, UNICEF’s nutrition manager in the Fund’s Maiduguri office was quoted by ThisDay Newspaper to have said Borno State alone has at least 370, 000 children who are presently severely malnourished, adding that the situation in some parts of the North East still require.

He said ‘Global Acute Malnutrition (GAM) in Borno is around 11 per cent. Any GAM more than 10 per cent is referred to as (being) (at) emergency level. Urgent lifesaving interventions need to be scaled up. But if we compare the trend in the last three years, we can say it has improved. In 2018 we estimated 440,000 children with it, in 2019 we have estimated around 371,000. In 2020, we are estimating 259,000. UNICEF statistics showed that one out of two child deaths under the age of five is attributed to malnutrition in Nigeria.’

YERW EXPRESS NEWS learned from speaking with stakeholders that the case could not be effectively ended for a number of factors, such as poverty among the IDPs, hunger, poor parenting and etcetera.

An official of the state government in Borno who refused to be named because he spoke to us unofficially said it was why the IDPs are being resettled in their communities. The official said the purpose is to put them back on their previous economic activities and restore their broken livelihoods.

While this is also correct, this paper's investigation shows an entirely new dimension in the problem, which is the criminal conversation of a supposed parenting into an unholy commercial enterprise.

The investigation revealed how malnourished children become commercial commodities and how a value chain of criminal businesses emerged around what is ordinarily a humanitarian and nutritional crisis.

Malnourished children for hire

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The summary of it is that parents ‘give out’ their children for rent. But renting them out, or rather to make them ‘rentable’, they have to be ‘made’ malnourished, through very crooked, yet inhumane ways. Parents deliberately underfeed their kids; or administer substances such as citric acid that make them malnourished by instigating purging and vomiting.

Our reporters went undercover to understand how the parents, especially mothers orchestrate the unholy business.

Ordinarily, NGOs who are providing the RUTF supplements, popularly known as Maganin Tamuwa (or just Tamuwa) among the locals, go round to screen displaced kids aged between six months and five years. They log in kids who are found to be malnourished and issue them hospital cards with which to receive the supplement, also sometimes known as PluppySup, within given intervals and specific primary healthcare centers.

Millions of dollars have been donated by several donor agencies in providing the therapeutic supplements. The United Kingdom, UK, announced a £15 million donation to fund UNICEF and WFP a fortnight ago to address malnutrition in the region. The Chinese government also donated $5 million to the cause, while the government of Japan UN $600, 000.

These were some of the funds, coming in annually, with which the supplements and nutritional interventions are provided to heal the malnourished children; but which the IDPs steal and sell.

Presenting the same kid(s) by different parents

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When some of our reporters organized in June a similar exercise in two IDP camps in collaboration with some aid workers to understand the situation, many IDP parents presented ‘their kids’ for the screening.

Upon proper scrutiny, some of them presented the same set of kids at different times. Our reporters snapped multiple photographs of the kids, which were taken unknown to the parents.

After cross – checking the records, some of the kids were presented at least two to three times by different parents. When asked, the chairman of an unofficial IDP camp in Maiduguri confirmed this to be a common practice among the IDPs when there are similar interventions in the camps.

How RUTF operate in the IDP camps

One of our reporters engaged a woman standing by the crowd as to why she did not present any child to the screening. Seeing that she might receive some favors from her (our reporter) if she opened up, she confided in our reporter and told her that she had no malnourished child but could provide one if she would be assisted.

‘I don’t have malnourished children, but I need this thing because I want to sell it, I have customers who are ready to buy any number,’ Furaira the IDP, whose second name we are withholding as her permission was not sought for publication, told our reporter when she became comfortable with her.

When our reporter realized Furaira could be part of the syndicate, she took it further to uncover many of their antics.

She told the reporter that if she would cooperate with her, she can provide several malnourished kids. A week after the exercise in the camp, she, through hiring, assembled 20 of them at once, seeing that our reporter had given in.

Furaira was in fact the leading dealer of Tamuwa in the camp. She buys and sells it with a network that, she said, goes as far as Chad and Cameroon, even though she did not say who they are.

‘I can provide 20 malnourished children in a day, and I can get even more than that number if you give me some days.

‘You see those people, the beneficiaries of the food supplement, they will come to my house after this intervention and sell what they get to me, I am a renowned dealer in the community,’ Furaira confessed to our reporter.

Since she thought our reporter works in one of the NGOs donating the supplement, she invited her to join the ‘business’, promising that she would provide any number of malnourished kids if she (our reporter) would also provide the Tamuwa or RUTF. She offered a 50 – 50 deal with the reporter, promising to handle all the sale.

Tamuwa is supposed to be free for the IDPs, but it is now in sale in Maiduguri. It is sold between N100 and N150 per piece.

It is consumed by many who are not malnourished. Our reporter learned that it is used for several other purposes, aside from treating nutrition. It is used for making pap or eaten as a snack, among other various other ways.

Mohammad Adam, a resident of Maiduguri, said he is a regular consumer of the supplement. ‘I eat it with bread, I enjoy it,’ he said, adding that ‘it is surprising why people think it is only for malnourished people.’

Another respondent told our correspondent that he buys it for his children because they like it, without telling us whether they are also malnourished or not.

How sellers secretly network, sell RUTF

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Most of the people spoken to do not know the criminal processes through which the supplements are sourced, even though some of them said it was justifiable since members of the public also like to consume it.

Many households across Maiduguri sell the product but largely secretly, with the supplies almost entirely coming from IDPs, to whom it is given freely.

YERWA EXPRESS NEWS could not find a single piece for sale in any of Monday and Gomboru markets, the city’s major markets—the fact of which confirms the source was the IDPs.

The vendors receive the supply from them (the IDPs) – mothers of the malnourished kids within a certain sharing formula.

Strict conditions for RUTF sale

First, they make sure all used sachets of the product are returned to the seller, mostly housewives in their compounds, who in turn return them to the IDPs.

The reason for this is that the donor agencies have made it mandatory for the IDPs to return the empty sachets before they are given additional doses.

The donors, one of their staff, Muhammad Baba, told us, have understood that the parents sell theirs upon collection, without administering it to their kids.

Secondly, the IDPs sell the Tamuwa to the vendors at N100 per piece. They also add N40 or N50 as their profit. They sell it mostly on the condition that the empty sachets are returned to them after usage.

They also hardly sell it in a large quantity, which is a plan to prevent being interrogated about their source, since it is known among them that it is meant for IDPs under five, for free.

When our reporter asked Ya Mallam, 68-year-old vendor, whether she had them in large numbers, she sensed he could be up to something. She said she wasn’t in the business of selling Tamuwa at all.

But after she was taken into confidence that nothing was going to happen, she brought out over 100 pieces from her room in her residence in Bulunkutu, Maiduguri. Bulumkutu is one of the places where it is largely sold. But it is also sold in other parts of the town, including Gwange, London and Gomboru.

She also admitted receiving supplies from the IDPs. ‘I buy it from IDPs,’ she said.

Making the children malnourished through use of critic acid, detergents

There was a strong allegation that the parents of the kids administer substances such as citric acid and detergents that instigate purging in them.

The excessive purging is also believed to result in rapid and instant loss of weight, which is the goal as it is what qualifies them to receive the RUTF. After these, the parents present the kids to the donor agencies, who put them on the RUTF, which are received weekly or fortnightly from designated PHCs.

This allegation was strong among the IDPs, as many of them confirmed. Furaira too confirmed to our reporter that some of the parents who give out their kids for hire keep them malnourished through these means.

YERWA EXPRESS NEWS’ reporters could not witness these in all the camps visited.

Despite devising different means, this proved difficult.

But it is understandably the kind of the things that are difficult to witness, especially in the case of the use of powdered citric acid, known as tsami or bla lemu.

Tsami is usually applied to porridge, which is used largely in place of tamarind, to cause it to be slightly sour; as it is a taste of some of the varieties of porridge in the state.

As such, parents will secretly apply it while making porridge, with no one ever knowing. The allegation that a small quantity of detergent is also used in food to instigate purging was also made, but YERWA EXPRESS NEWS could not entirely verify it. The general belief is that detergents also cause a ‘running tummy’, which also cause sudden weight loss.

A search on internet showed citric acid, known as a chelating agent, is also used in most detergents as an ingredient to remove bad smells after washing.

Some of the kids interviewed in two IDP camps last June said they regularly experience stomachache and purging. But that could be a diarrhea as a result of several other factors, including hygiene and other environment problems.

When contacted in June, the Borno State Emergency Management Agency said it is not involved in managing issues related to malnutrition.

Similarly, the regional office of the National Emergency Management Agency, NEMA, in Maiduguri said it is also not aware of the case, but promised to investigate it.

Mr. Ibrahim Abdulqadir, the spokesman of NEMA, told our reporter on phone that ‘we are not aware, but we will definitely investigate, you may please send us the location.’

‘The issue of Tamuwa is handled by NGOs like UNICEF,’ he added.


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