The fight between Boko Haram and regional West African forces has displaced hundreds of thousands. In Cameroon's border regions this has put pressure on an already overstretched health system.
The sound of an emergency vehicle at the Cameroonian district hospital of Mora alerts the hospital staff on duty. Mora lies some 20 kilometers from the border with Nigeria. Nurse Dorothee Etoundi and her colleagues are preparing to receive the patients: victims of a landmine explosion, some of whom are severely injured.
Etoundi has already called for additional support to attend to the traumatized patients. "When we notice that patients are not able to respond to our questions because of the shock they have had, we send them to our colleagues who are in charge of their psychological health." After that, the patients go for the first emergency consultation and the nurses carry out the necessary laboratory tests. "When there are complications, we immediately ask them to be evacuated to Maroua," said Dorothee Etoundi. That's the regional capital, which is approximately 60 kilometers away.
Regional forces from Cameroon, Nigeria, Chad, Niger and Benin have been launching raids on Boko Haram strongholds along the border since December last year. 1,500 victims of Boko Haram atrocities have died in hospitals on its northern border with Nigeria between January 2015 and March 2016, Cameroonian authorities said. The United Nations and Amnesty International report that more than 20,000 people have been killed during the six year insurgency.
Months in the bush
The raids, suicide bombings and landmines planted by the insurgents have increased the number of victims. The Mora district hospital with a capacity of 50 beds now hosts 350 victims from Cameroon and Nigeria. Most of them are traumatized.
Gwendoline Amekeh, a 16-year old girl, is among the new arrivals. She was rushed to the hospital by the Cameroonian and Nigerian army after they organized raids against Boko Haram fighters on her Nigerian hometown Goshe. "We were in school when we heard shooting from all sides," she said with panic still in her voice. "Even planes were shooting at us and we were so confused. I don't even know how I got here."
Julienne Houli, a 36-year-old mother of four, lost her leg by a landmine explosion near Mora. She is one of the patients who have remained in the hospital to comfort victims and tell them there is hope. "After we were treated we decided to remain in the hospital to assist fresh victims of Boko Haram atrocities who need comfort and psychological care. Our testimonies give them hope."
Cameroon counted over 390,000 refugees and internally displaced persons in June 2015. Some of them live in refugees camps like Minawao, not far from Mora.
The next problem: malaria
At the moment, there are five crowded Cameroonian hospitals on the border with Nigeria where 1,700 patients are under the care of 400 staff members. The hospitals were built to accommodate 350 patients. Staff members face many problems with the increasing numbers of Boko Haram victims.
"Their health status and their mental status is very worrying. All these people, families, women, children have been hiding for so long in the bush, eating nothing and drinking dirty water, so they arrive in Cameroon in a very very bad state in terms of health," explains Hannah Lechantre, a French-born volunteer with Cameroon's medical council.
"The very first difficulty we have here is that there is no permanent flow of drinkable water," said laboratory technician Gabriel Guidja. "Then the nearest specialized hospital to where we can evacuate cases that need an urgent operation or that are in severe danger is very far. The climate here is also very hot for patients who come from colder areas." Another problem is making the situation worse: the rainy season is about to start, which also means that there will be more mosquitoes. As there are not enough treated mosquito bed nets to cater for the patients, the hospitals fear a rise in malaria.
Cameroon's government has tried to support the region. "Hospitals lack equipment and infrastructure to cope with the growing numbers of victims," confirmed Cameroon's health minister Andre Mama Fouda who visited the hospital to encourage both the victims of war and the medical staff. "Hospitals are running short of supplies despite international efforts to assist them."