In northwestern Nigeria, particularly in Zamfara State, the rainy season brings more than relief from the heat. It brings distress, disease, and preventable deaths.
Between May and September, daily survival becomes a struggle as flooding, outbreaks of infectious diseases, and worsening food insecurity converge. For communities already affected by years of insecurity, the consequences are devastating.
Years of armed violence in Zamfara State—marked by kidnappings, village raids, cattle rustling, and ambushes—have uprooted tens of thousands of people, shattered livelihoods, and severely restricted access to essential services. Communities face overwhelming barriers to healthcare due to poverty, insecurity, long distances, and weak health infrastructure. When the rain arrives, their already fragile health situation worsens.
A season of disease
“The rainy season affects the way we see patients,” explains Sani Adamu, Nursing Activity Manager at Médecins Sans Frontières (MSF) hospital in Zamfara. “It increases the risks and transmission of many diseases, like malaria, cholera, and other acute watery diarrheal diseases.”
As rainwater collects in stagnant pools, it creates ideal breeding grounds for mosquitoes. Malaria cases surge, cholera outbreaks erupt, and other waterborne illnesses like typhoid fever take hold rapidly, particularly among vulnerable groups such as pregnant women and children.
In 2025, MSF treated 136,778 patients for malaria and 13,877 for cholera in Zamfara.
“In places where sanitation is poor, and water sources are unsafe, any contamination can spread quickly,” Adamu adds. “Flooding washes waste, garbage, and faecal matter into water sources, spreading waterborne diseases. Children play in this water, households use it, and people fall sick. Poor sanitation and overcrowded living conditions further exacerbate this spread.”
When illness becomes life-threatening
For families like that of Rakiya Usman, who lives in Shinkafi Local Government Area (LGA), these risks are part of daily reality. Her grandson, Auwalu Biliya, fell seriously ill with typhoid fever after developing symptoms in February 2026.
“We took him to the hospital in Shinkafi. We were told his intestines had been affected,” she says. “They explained that unclean water and contaminated food can cause this.”
Auwalu Biliya developed severe complications and was referred to the MSF-supported General Hospital in Zurmi LGA for life-saving surgery.
“Typhoid perforation is caused by bacteria transmitted through contaminated water or food,” explains Adamu. “Early treatment is crucial. When treatment is delayed, the intestine can perforate—a severe condition in which the intestine ruptures. At that stage, complications can be fatal, and surgery is the only option.”
Auwalu Biliya reached care in time, but many others arrive too late—or not at all—with often deadly consequences.
Malnutrition and disease: a dangerous cycle
As the rains drive a rise in disease, they also coincide with the lean season, when household food stocks are exhausted, and new harvests are still months away. Undernutrition weakens the immune system, making even common illnesses deadly, particularly among children.
In Zamfara State, MSF treated 60,566 children for malnutrition in 2025.
“All groups are affected,” says Adamu, “but children under 15 and pregnant women are most vulnerable.”
For many households already displaced by violence, this combination of hunger and illness has severe, life-threatening consequences.
Barriers to healthcare
In this context, with rising malnutrition and exposure to disease, timely access to healthcare is critical, yet for many it remains out of reach. Insecurity restricts movement, leaving some areas completely cut off. Health facilities are too far away, understaffed, or under-equipped. Flooded roads and damaged bridges further isolate communities, while the cost of transport and care forces many families to delay seeking treatment or rely on informal care.
Saratu, whose daughter Jamila fell ill after repeated displacement, watches the distance stretch between her and survival. The simple act of seeking care has become an ordeal. From Tudubali to Shinkafi, the journey costs ten thousand naira—money she barely managed to raise. Without it, she knows treatment would remain out of reach.
“We live close to the river and sleep in the bush. We don’t have mosquito nets,” she says. “During the rainy season, many children get malaria. One child recovers, and another falls sick. Sometimes three of your children are ill at the same time, and you don’t know what to do.”
MSF’s response during the rainy season
Across northern Nigeria, the organization directly runs or supports four healthcare facilities to treat diseases caused by the rainy season and the seasonal peak of malnutrition.
Most illnesses and deaths during the rainy season are preventable.
“Preventive action before and during the rainy season is critical. Strengthening community awareness, improving access to safe water and sanitation, and ensuring timely vaccination campaigns can all reduce the impact of diseases,” Adamu says. “Health facilities must also be properly equipped and supported to diagnose and treat patients quickly and effectively.”
