Zamfara has been one of the states hardest hit by the insecurity that has spread across north-western Nigeria over the past decade.
It started with a sharp pain in Musa Saidu’s stomach.
This was August 2025, during a cholera outbreak in Bukkuyum Local Government Area of Zamfara State, where Mr Saidu and his family were living after fleeing their home in Dan Bago village following attacks by bandits.
Like thousands of people displaced by years of insecurity in the state, the family had already lost the stability of home. Now, as Mr Saidu became increasingly ill, they faced another problem: getting medical care.
His parents first tried what they could afford. They gave him some medicines and mixed a local herbal remedy with water, hoping his condition would improve. But it did not.
With the health facility serving their community no longer functional, the family eventually took Musa to the Orphan and Less Privileged Clinic (OLPC) in Bukkuyum town, where he was diagnosed with cholera.
But reaching a health facility did not immediately end their difficulties.
The clinic was struggling with an influx of cholera patients. Only three health workers were on duty, while essential medicines were unavailable.
Many residents affected by the outbreak were brought to the same facility, while some had to seek treatment elsewhere because of shortages of staff, medicines and space.
For displaced families such as Mr Saidu’s, the outbreak exposed a problem that went beyond cholera.
Years of insecurity have displaced many communities across Zamfara, forced health workers away from some rural areas and disrupted access to healthcare, safe water and disease surveillance. These are services that become particularly important during an outbreak of a disease that can kill within hours if severe dehydration is not treated.
Zamfara is one of the states hardest hit by the insecurity that has spread across north-western Nigeria over the past decade.
What began largely as cattle rustling has evolved into organised violence by armed groups commonly referred to as bandits. Communities have been attacked, residents killed or abducted and thousands forced from their homes.
The armed groups have also imposed levies on some farming communities, stolen livestock and harvests and carried out kidnappings for ransom.
Data obtained from the Mass Atrocities Tracker show that 28,974 people were killed across Nigeria between 2021 and 2025. Borno recorded the highest number, with 4,539 deaths, followed by Zamfara with 3,936 and Kaduna with 2,811.
Zamfara recorded the highest number of abductions during the same period, with 5,447 people kidnapped. Kaduna recorded 4,050 and Niger 3,331.
But deaths, abductions and displacement are only some of the consequences.
In Bukkuyum LGA, residents and health workers told The ICIR that insecurity has also weakened access to healthcare. Some communities have been deserted, while health workers have stopped providing services in areas they consider unsafe.
Reports in 2025 indicated that only about 200 of Zamfara’s more than 700 Primary Healthcare Centres (PHCs) were functional, with persistent insecurity blamed for the closure or abandonment of many facilities.
For residents of affected rural communities, the closures mean illness can require travelling several kilometres, sometimes through unsafe areas, before reaching a health worker.
For people displaced by violence, the risks are compounded by overcrowding, poor sanitation, poverty and limited access to safe water.
During a cholera outbreak, those conditions can become deadly.
Buba Muhammad had already fled his home in Sadawa with his family because of repeated bandit attacks when his son began vomiting and passing frequent watery stools.
The 40-year-old farmer and his family were living as displaced persons in Bukkuyum, where several families shared limited space and sanitation facilities.
Mr Muhammad immediately tried to find medical help.
There was no functioning health facility close to where they were staying.
“My first attempt when my son was affected was to go to a hospital, but there was no facility nearby,” he said. “I had to take him to a medicine shop.”
The medicines he obtained there did little to improve the boy’s condition.
As the vomiting and diarrhoea continued, Mr Muhammad decided to take him to General Hospital Bukkuyum, the nearest facility where he believed the child could receive appropriate treatment.
But another problem awaited them.
