In June 2023, Burkina Faso’s humanitarian and nutritional crisis was ranked as the most neglected crisis in the world, a classification based on a lack of funding for humanitarian response, little media attention, and a lack of international political initiative to provide support to the country.
With a population of around 20 million, this country in the vast Sahel region has been mired in a humanitarian crisis since 2019, according to the United Nations. This crisis is tied to armed conflicts in the north and the country’s political instability that has been ongoing since 2014, when President Blaise Compaoré resigned after 27 years in power. The country has since experienced a period of political transition, a failed coup attempt in 2015, the election of a new president in December 2015, a series of terrorist attacks in the capital, Ouagadougou, every year from 2016 to and 2018, an increase in terrorist attacks in the northern and eastern parts of the country that displaced roughly 60,000 people in early 2019, the president’s re-election in December 2020, his overthrow in a coup in January 2022, and a second coup in September 2022 by a faction of the military at odds with the transitional military government.
Over 14,000 people have lost their lives since the outbreak of armed conflict in 2015, half of these since January 2022. Roughly two million people are currently internally displaced within the country, fleeing armed conflicts in their neighbourhoods. They leave behind family members, homes, lands, and livestock to seek refuge in the country’s major cities. Many have no choice but to beg to survive.
The 800,000 people who were unable to escape because they are in areas under the blockade that was put in place in early 2022, with access controlled and cut off by non-state armed groups, are experiencing malnutrition and are in IPC Phase 4 out of a total of five phases – what the United Nations calls the “pre-famine” stage. They can only rely on some food and medicines delivered by humanitarian helicopters, and this aid only trickles in.
According to the United Nations Office for the Coordination of Humanitarian Affairs (OCHA), 4.7 million people, 25% of Burkina Faso’s population, need humanitarian assistance. Nearly four million require food aid, and two million are directly deprived of access to health care, a situation exacerbated by the closure of 336 health centres; an additional 371 are operating at minimum capacity or intermittently, significantly undermining primary healthcare services.
Additionally, patient referrals to hospitals are highly challenging due to a series of reasons, including long distances to hospitals (50-plus kilometres in certain regions), poorly maintained roads (particularly during the rainy season), the lack of individual and state-owned transportation (27 ambulances have been stolen or destroyed by armed groups), and the risk of attacks or landmines on the roads. A consequence of these conditions is that under-five children who have severe acute malnutrition with complications have an in-hospital mortality rate of 19% (standards require a rate under 10%) at Dori Hospital (Sahel region) because they arrive too late to get treatment.
Health is an area that has been particularly impacted by the crisis in the country. Not only have ambulances been stolen or destroyed—sometimes while transporting the sick, who are dumped regardless of their state of health—86 healthcare workers were kidnapped between 2016 and 2022, and 15 health centres or medication storage facilities were looted. In response, the international community, including NGOs and the UN, mobilised to support the country’s public health system and civil society in covering the needs of those most affected by the humanitarian crisis.
However, these efforts fall well short of meeting the population’s needs. To improve care for the most vulnerable, some of the challenges posed by this crisis must be addressed: