Sometimes, it feels to Zara Ali as though her daughter was born already sick in the womb.

On a recent weekday, the 30-year-old mother clutched the ill toddler in her lap as she sat outside a government hospital in Maiduguri, the capital of northeast Nigeria?s Borno State. The two had just finished yet another doctor?s appointment in hopes of curing the child.

Although cranky as any other sick two-year-old, it is Amina?s hair ? brownish and seemingly bald in several spots ? that?s a visible sign of the malnourishment doctors had previously diagnosed. Yet, despite months of treatment with a protein-heavy, ready-to-eat paste, Ali says progress has been slow, and her daughter might require more hospital visits.

?She gets sick, gets a little better, and then falls ill again,? she said, frustrated. Already, Ali and her family have had to move homes several times because of the Boko Haram conflict. They were displaced from Damboa town, about 89km (55 miles) away, and now live in Maiduguri as displaced persons.

Adding to her woes is the reduced access to care in recent months as several aid clinics she visits for free treatment have begun to scale back operations, or in some cases, completely shut their services. ?Honestly, their interventions were really helpful, and we need them to come back and help our children,? Ali said.

Amina is only one of some five million children across northeast and northwest Nigeria suffering from malnourishment in what experts have called the region?s most severe food crisis in years. The troubled northeast region has, for a decade and a half, been in the throes of a conflict waged by the armed group Boko Haram, and prolonged insecurity has disrupted food supplies. In the northwest, bandit groups are causing similar upheavals, resulting in a hunger crisis that state governments are struggling to contain.

Compounding the problem this year are the massive, brutal funding cuts roiling aid organisations, which have often stepped in to help by providing food assistance to the 2.3 million displaced northeast Nigerians. Many of those organisations were dependent on funds from the United States, which, since February, has reduced contributions to aid programmes globally by about 75 percent.

The World Food Programme (WFP), the United Nations food aid agency and the world?s largest provider of food assistance, was forced to shut down more than half of all its nutrition clinics across the northeast in August, Emmanuel Bigenimana, who leads northeast Nigeria operations, told Al Jazeera from the agency?s site in Maiduguri. Some 300,000 children are cut off from needed nutrition supplements, he said.

Already, in July, WFP doled out its last reserves of grains for displaced adults and families, Bigenimana added, standing by a row of half-empty tent warehouses. A few men removed grain sacks from the tents and loaded them onto trucks bound for neighbouring Chad, a country also caught in complex crises. For Nigeria, he said, which is in the lean season before harvest, there was no more food.

Northeast Nigeria should be a food basket for the country, due to its fertile, savannah vegetation suitable for cultivating nuts and grains. However, since the Boko Haram conflict broke out, the food supply has dwindled. Climate shocks in the increasingly arid region have added to the problems.

Boko Haram aims to control the territory and has been active since 2011. The group?s operations are mainly in Borno, neighbouring states in the northeast, and across the border in Niger, Chad, and Cameroon. It gained global notoriety in 2014 for the kidnapping of female students in Chibok. Internal fractures and Nigeria?s military response have reduced the group?s capacity in recent years, but it still controls some territory, and a breakaway faction is affiliated with ISIL (ISIS). More than 35,000 people have been killed in attacks by the group, and more than 2 million are displaced.

Before the insecurity, families in the region, particularly outside the urban metropolis of Maiduguri, survived on subsistence farming, tilling plots of land, and selling surplus harvest. These days, that is hardly an option. The military has hunkered down in garrisoned towns since 2019 to avoid troop losses. It is hard to find cultivating space amid the trenches and security barriers constructed in such places, security analyst Kabir Adamu of intelligence firm Beacon Consulting, told Al Jazeera. Those who venture outside the towns risk being targeted by armed fighters.

In rural areas not under army control, Boko Haram operates as a sort of government, exploiting villagers to generate money.

?The armed actors collect taxes from them to use land for farming,? Adamu said, adding that for rural farmers, those taxes often prove heavy on the pockets. In more unlucky scenarios, farmers have been killed if they were believed to be military informants. In January, 40 farmers were executed in the town of Baga. Fishermen have similarly been targeted.

The vicious cycle has repeated itself for years, and the compounding effect is the current food crisis, experts say.

Just 45 minutes from Maiduguri, in Konduga town, farmer Mustapha Modu, 55, tilled the earth in anticipation of rainfall on a cool weekday. He had just returned from a short journey to Maiduguri, braving the risky highways to buy seedlings in hopes of a good season.

Even as Modu planted, he worried that harvest might be impossible. There are widespread fears that Boko Haram fighters often lie in wait and then pounce on farmers to seize harvests. At one time, he said, his family of three wives and 17 children depended on handouts, but those hardly reached Konduga anymore, so he had to do something.

?It?s been a long time since we saw them in our village,? Modu said of food aid distributors. ?That?s why I managed to go and get some seedlings, even though the insurgents are still on our neck.?

The UN and its agencies were the focus of aid cuts from Washington in April, leading to the WFP receiving zero aid from the US this year, Bigenimana said. Like the US, other donors such as the European Union and the United Kingdom have also cut back on aid, instead diverting money to security as tensions remain high over Russia?s war in Ukraine.

The agency catered to some 1.3 million displaced people and others in hard-to-reach areas, fringe locations accessible only by helicopter. For children, the agency ran several nutrition clinics and supported government hospitals with ready-to-use food, a protein mixture made mostly of groundnut, which can rapidly stabilise a malnourished child.

Funding cuts caused the WFP to begin rationing supplies in recent months. In July, resources in Nigeria were completely emptied. At least $130m is required for the agency to speedily get back on track with its operations here, Bigenimana said. Extended lack of support, he said, could push more people into danger.

?People are attempting to go and get firewood to sell outside the secure points,? the official said. ?Even when we delay distribution on normal days, people protest. So we are expecting that, and it could get violent.?

Multiple other NGOs across the region were also hit by the Trump aid cuts. They not only provided food aid or nutrition treatment, but also medical services, and crucial vaccines children need in the first years of life to guard against infectious diseases like measles.

Analysts like Adamu, however, criticise aid groups for what he said is their failure to create a system where people don?t rely on food aid. In Borno, the state government has, since 2021, gradually shut down camps for internally displaced people and resettled some in their communities. The aim, the government argues, is to reduce dependency and restore dignity. However, the move faces widespread backlash as aid agencies and rights organisations point out that some areas are still unsafe, and that displaced people simply move to other camps.

?They should have supported the government on security reforms for the state,? Adamu argued. That, he said, would have been a more sustainable way of empowering people and would have eased the food crisis.

Mourners attend the funeral of 43 farm workers in Zabarmari, about 20km from Maiduguri, after they were killed by Boko Haram fighters in rice fields near the village of Koshobe in November 2020 [File: Audu Marte/AFP]

For now, the food crisis looks set to continue, and children in particular appear to be bearing the brunt, especially as heavy rains arrive.

Muhammad Bashir Abdullahi, an officer with medical aid group Doctors without Borders, known by its French initials MSF, told Al Jazeera that more malnourished children are being admitted to the organisation?s nutrition facility in Maiduguri since early August. It is possible, he said, that the shuttered services in other organisations were contributing to the higher numbers.

?We used to admit 200 children weekly, but last week we admitted up to 400 children,? Abdullahi said. MSF, which is not dependent on US aid, has recorded more than 6,000 malnourished children in its Maiduguri nutrition centre since January. Typically, children receive the protein paste, or in acute cases, a special milk solution. Abdullahi said more children are likely to be admitted in the coming weeks.

Back at the government hospital where Ali was seeking treatment for her daughter, another woman stopped outside the clinic with her children, twin baby boys.

One of them was sick, the mother, 33-year-old Fatima Muhammad, complained, and is suffering from a swollen head. This is the third hospital she was visiting, as two other facilities managed by NGOs were overwhelmed. Unfortunately, her son had not been accepting the protein paste, a sign that medical experts say signals acute malnutrition.

?His brother is sitting and crawling already, but he still cannot sit,? Muhammad said, her face squeezed in a frown. She blamed herself for not eating enough during her pregnancy, although she hardly had a choice. ?I think that?s what affected them. I just need help for my son, nothing more.? (Al Jazeera)

? PHOTO: A woman and young girl displaced by Boko Haram attacks push a cart in Dikwa, Borno State, northeast Nigeria, in April 2025 [Sunday Alamba/AP]

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