1Department of Human Kinetics and Health Education, Federal University Dutsin-ma
2Discovery Learning Alliance, FITILA Project, Funded by the Department of International Development, UKAID
3College of Nursing and Midwifery Kano, School of Nursing Kano
4Nigerian Police Medical Unit/Clinic, Gombe State
5Physical and Health Education Unit, Kano Educational Resource Department
6Department of Public Health, Ministry of Health, Kano
*Corresponding Author’s Email: ajiya_mj@yahoo.co.uk
This is a descriptive retrospective study of mass human-made disaster of Boko haram background that occurred in Kano from 2012 to 2015. The emergency preparedness and the challenges faced by the first responders were investigated with a view to improving the practice to international standards. Objective: This paper aimed at reviewing the challenges of first responders in managing Boko Haram casualty in Kano, North-western Nigeria with a view to delineating the best practice of handling casualties of mass disasters. Method: Six (6) focused group discussion (FGD) involving 36 participants from the responding agencies were conducted to explore the challenges faced during the Boko Haram emergency management. Data from the official reports of security agencies and emergency service providers as well as Nigeria newspaper reports were also reviewed. The standard protocols for disaster victim’s identification and management developed by the World Health Organization, International Committee of the Red Cross and the INTERPOL were analyzed and compared with the response of the main responding agencies in Kano. Results: The findings indicate lack of sufficient equipment as the main challenge faced by the responders, followed by inadequate training, lack of effective co-ordination and poor safety of responders. Conclusion and Recommendation: Researchers concluded that first responders in Kano are working below the International standards and have faced major challenges of insufficient equipment and inadequate training during Boko haram insurgency. It was recommended that the state government should provide enabling environment for first responders to work in cases of disaster. First responders need to improve their co-ordination; ensure best practices and obey local and international humanitarian laws.
Keywords: Emergency Preparedness, Challenges, First Responders, Boko Haram, Kano
Since the aggressive surfacing of Boko Haram’s campaign of terror in 2009, its activities have remained the biggest barriers to security in Nigeria. Coupled with the escalating pastoralists and farmers clashes across the country, the struggle to eclipse the insurgency has been daunted. The earlier ideological objective of the group has evolved from simple advocacy for Islamic puritanism in Maiduguri and some parts of northern Nigeria, later escalated into the media explained aggressive move to the creation of Islamic State in West Africa and Lake Chad region. Its campaign of violence started as a less organised and less sophisticated uprising in 2002; but by 2015 it has acquired the infamous title of the “world's deadliest terrorist organization in Nigeria and West Africa”. Violent attacks on civilians by Boko Haram since 2009 have caused widespread devastation in northern Nigeria with high devastation in the north east and gradual spread across some northern states, generating a crisis that caused the loss of over 100 thousand lives and rendered over 2.2 million people internally displaced (Shetima, 2016)
According to the World Health Organization 7 million people are estimated to be in need of humanitarian assistance and an estimated 3 million people lived in unknown conditions in inaccessible areas by 2015 (WHO, 2016).
In Nigeria evidences have indicated that all individuals, families, societies, public and political leaders tend to direct their long term preparations towards normal circumstances and where they prepare for accidents and emergencies, it is usually prepared for those known and or are familiar. Insurgencies like that of Boko Haram are new dimensions of crisis in Nigeria that are yet to be properly perceived, understood and managed. Managing conflicts and its consequences is a demanding state requiring not an on stage action but a preparation before, during and after the incidences. A diverse number of agencies and personnel are commonly on stage for rescue, first aid assistance and evacuations after every Boko Haram attacks; but the most unfortunate fact is the lack of preparedness among these agencies and personnel.
In view of the above and the current understanding of global practices concerning the management of disaster victims developed by the World Health Organization, International Committee of the Red Cross and the INTERPOL, Nigeria would appear to lag behind in managing different types of casualties ranging from managing crowds, offering first aid and evacuation of both injured and dead victims (Obafuwa, Fadulile, Soyemi, Eze, Nwana and Odesanni, 2015). Evidences of human right violation, mishandling of the dead and survivors are always seen in the operations and services offered by our security agencies and other first responders as a result of many circumstances that need to be clearly identified and ameliorated. Video clips and newspaper images have depicted naked human remains on trucks or other improvised and on stage alternatives. Sometimes dead bodies are left on streets without cover, or buried hurriedly without proper identifications and records which is one of the factors that left many families and victim relations on suspense for a long period. The large causality witnessed in Kano, February, 2012 and December, 2014 had shown generally poor preparedness from both first responders and the receivers at hospital emergencies. It was a horrible moment that left human remains undignified at the level of collection, transportation and storage.
The research question posed was how the main operational responding agencies responded to the incidences of Boko Haram terrorist attacks in Kano between 2012 and 2015. This paper also intends to review those experiences as described by official reports, media and other documented sources with a view to postulating strategies for improving the practice of first responders in Kano and Nigeria. Focused group Discussion (FGD) was conducted with six responding agencies.
The aim of this study is to investigate the challenges faced by the first responders in managing Boko Haram casualty in Kano. The following sections outlined the methodology used in conducting this study:
Design and Participants
This is a descriptive retrospective survey involving first responders who provided emergency response during the Boko haram attacks between 2012 and 2015. Thirty six (36) responders were recruited for one- hour interview per group. All the participating agencies nominated the participants in accordance with the main criteria that the nominee must have attended at least one incidence as a first responder. Six (6) focus group discussions were conducted with first responders from the Nigeria Police Force (NPF), Kano State Hisbah Board (Hisbah), Kano Road Traffic Agency (KAROTA), State Emergency Management Agency (SEMA), Nigerian Red Cross Society (Red Cross) and Nigerian Security and Civil Defense Corps (NSCDC).
Focus Group Discussion Guide
Good morning/ Good afternoon/ Good evening. My name is . I am part of a research team that focused on “the challenges of first responders in managing Boko Haram casualty in Kano in the past years of rampant attacks”. Your contribution to the discussion is very valuable, and we hope you will actively participate in the focus group discussion. All information will be treated with utmost confidentiality. We seek your consent to record the discussion so that we could capture all the ideas expressed. We expect this discussion to last for no more than 60 minutes. Names of respondents will not appear anywhere in the research report; rather it will be used only during data analysis.
Q1: Have you participated as a first responder to the past Boko Haram attacks in Kano? Q2: Has your agency participated officially?
Q3: Have you received any training from any emergency service provider? PROBE FOR: type of training, training provider and certification and year of training
Q4: What kind of equipments has the first responders in Kano used during the responses? PROBE FOR: Ambulance, body bags, PPE, Stretcher, Truck, identification forms, etc
Q5. Are the first responders in Kano well-coordinated and performed their functions professionally and according to the best practices. PROBE FOR: coordination and leadership, care of survivors, identification of bodies, managing the dead, safety precautions, including the use of PPE, support for families of the victims.
Q6. What are the main challenges you faced as a team during the emergency response? PROBE FOR: common challenges related to lack of training, equipment, effective local co-ordination, etc
Q7: What recommendation do you have for improvement? PROBE FOR: recommendations to first responders, team leaders, organizations, international service providers and Government
Q8: How do you arrive at the scene of incident? Is it through police clearance, JTF, or communities? PROBE FOR: personal responders’ safety and access to the scene of incident/accidents,
The arrangement of the FGDs conducted is explained in table 3. The table provided the number of personnel interviewed, the date and language of the interview.
Unstructured interviews and one-on-one discussions were conducted with the representative of NEMA and the senior officers of the participating agencies who were not part of the FGD, to clarify certain issues that came up during the FGDs. The changing roles of SEMA related to the transition from SERERA to SEMA were one of the issues that called for the interview/discussion. Other issues discussed with the senior officers include the willingness and roles of the agencies’ leaders in co-ordination and subordination to one another in disaster management. The issue of bureaucracy as a challenge faced by the responding teams was also one of the issues discussed during the interactions.
Permission was sought from all the participating agencies to conduct FGD with their staff. Also each participant signed a consent form to participate in the FGD. Participants were informed of the detailed procedure of the FGD and that they are free to respond with whatever answer they fill is applicable to the questions. They may also decide not to answer a particular question or questions asked. Anonymity was assured and that the audio taping was to be used only in the analysis of data and deleted thereafter.
Table 1: Incidences and Nature of Boko Haram Attacks in Kano
S/N | Place | No of Victims | Nature of attacks/Victims | ||
Injured | Dead | Total | |||
1 | AIG Office + 6 other places | 100+ | 86 | 186+* | Bombings, gun shots; dead & wounded |
2 | Central Mosque | 122 | 134 | 256** | Bombings; dead, wounded, parts & debris |
3 | Kantin Kwari Market | 22m | 2 | 24** | Bombing; dead & wounded |
4 | Hotoro Filling Station | 5 | 2 | 7** | Bombing; dead & wounded |
5 | NNPC Mega Station | 21 | 5 | 26** | Bombing; dead & wounded |
6 | School of Hygiene | 43 | 10 | 53** | Bombing; dead & wounded |
7 | St Chalect Catholic Church | 18 | 7 | 25** | Bombing; dead & wounded |
8 | Sumaila Local Govt. | 17 | 6 | 23** | Bombing; dead & wounded |
9 | Gold Coat Rd Sabongari | 15 | 7 | 22** | Bombing; dead & wounded |
10 | Emirs Convoy | 4 | 3 | 7* | Gun shots; dead& wounded |
11 | Trade Fair | 7 | - | 7** | Bombing; wounded |
12 | FCE Kano | 37 | 19 | 56** | Bombing; gun shots; dead & wounded |
13 | Central Admin Kano Poly | 24 | 3 | 27** | Bombing; dead & wounded |
14 | New Rd Motor pack | 6 | 6 | 12** | Bombing; dead & wounded |
Table 2: First Responders in Kano
Category | Team | Main Concern |
Security Organization | Military, NPF, FRSC, NSCDC, Immigration | Provide Security, Evacuation, Detection, Provide access to the scene |
Government Agencies | SEMA, Fire Service, Hisbah | Fire Fight, Rescue, First aid Treatment |
Voluntary/Humanitarian Organization | Red Cross, Vigilante | First aid Treatment, Rescue Operation |
Table 3: Arrangement of FGDs Conducted
S/No | Agency | Venue | NO | Date | Language |
1 | Hisbah | Hisbah Board HQ | 7 | October 31, 2018 | Hausa |
2 | Red Cross | Red Cross State Office | 7 | November 6, 2018 | Hausa |
3 | NSCDC | NSCDC State HQ | 6 | November 6, 2018 | Hausa |
4 | KAROTA | KAROTA HQ | 5 | November 7, 2018 | Hausa |
5 | Police | Police HQ Bompai | 4 | November 7, 2018 | Hausa |
6 | SEMA | SEMA State Office | 7 | November 8, 2018 | Hausa |
TOTAL | - | 36 | - | - |
Evaluations of challenges of first responders were captured through discussions during the FGD. Evidences of key challenges in words and pictures from governments, agencies, newspapers and reliable internet pages were used to substantiate some of the key points raised in the FGDs as well as specific interviews and discussions with agencies’ senior officers.
The following findings are from a series of six (6) focus groups conducted with first responders from the Hisbah, Red Cross, NSCDC, KAROTA, NPF and SEMA. Thirty six (36) responders were recruited for one- hour interview per group. Each agency nominated the participants in accordance with the main criteria that the nominees must have attended at least one incidence as a first responder.
Participants in all the groups have described the horrible situations that happened in Kano during the insurgency, the works of the first responders and the kind of challenges faced by the responders generally. The finding of this study identified four major challenges related to: equipments, training, co-ordination and safety of responders. Majority of the groups prioritize the ordering according to importance with more than half of the groups mentioning equipment as the main challenge faced, followed by training, co-ordination and then safety of responders, respectively.
Training: Based on the findings of this study, lack of adequate training was identified as a challenge by all the groups. This includes not only basic first aid training which most of the responders have acquired; but training of managing mass disaster casualties, including management of dead bodies. When coupled with date of certification this problem becomes worst, for instance, some of the responders have acquired basic first aid training but, the certificates were out of date. Some of the participants cited examples to justify lack of training and ignorance about the best global practices related to the emergency service responses of Boko Haram. These include handling of dead bodies without properly covered, using of ambulances in transporting the dead at the expense of survivors, lifting of dead bodies instead of rolling, misidentification or no identification of dead bodies, quick evacuation at the expense of first aid treatment, etc. International guidelines as outlined in the ICRC (ICRC, 2016). Humanitarian forensic action and Islam provided that after armed conflict or disaster those who died, their bodies must be handled with respect and with dignity. It also stressed that the remains of unknown individuals must be searched for, recovered and identified (Islam and Hamza, 2015). The INTERPOL (INTERPOL, 1996) maintained that every person has the right to be identified after death. According to the world health Organization, records of death and funerals need to be kept to monitor mortality rate and incidence of disease and to be able to provide timely, understandable and accurate information to relatives of dead (WHO, 2015). Survivors’ rights to physical, mental and moral integrity; to family life and to religious freedom are guaranteed under the International Human Right Law. All these require training and re-training.
Safety of Responders: Safety of Responders was mentioned by all the groups as a challenge usually last or second to the last. However, it has affected the quality of the responses and distant them from the global best practices. Most of the participants confirmed that in all the attacks only in two places the police had to give clearance and assured safety of the responders, despite the facts that all the attacks were terrorist attacks that usually came in sequence; where the first attacks served as invitation for more victims. Some of the incidences left burnt vehicles and hideouts that can cause harm to the responders. In two of the incidences gun shots continues for hours after the attacks. The safety measures emphasized by the ICRC and the Center for Disease Control and Prevention (CDC) (ICRC, 2013; CDC, 2008) in any case of disaster management also include: use of basic personal protective equipments- PPE (gloves, apron & boots) and hand washing with soap and water.
This research investigated the challenges of first responders in Kano during the Boko Haram attacks. It was concluded that the major challenges faced were related to equipments, training, coordination and safety of responders. Lack of adequate equipments was found to be the major challenge followed by low knowledge and skill, lack of effective co-ordination, and poor personal safety of responders.
The researchers recommended the following:
The state government should provide enabling environment for first responders to work in cases of disaster. This can be achieved by empowering SEMA and supporting the responding agencies in terms of their specific needs, welfare and logistics.
First responders need to improve their co-ordination; ensure best practices and obey local and international humanitarian laws. In-house and refresher trainings must complement the efforts of training providers.
Based on the findings, there has been serious concern over inadequate and or lack of equipment and therefore recommends that any attempt by the governments, emergency service providers like ICRC, NEMA, SEMA and community to provide standard equipments will go along meeting the global best practices.
Responders received most of their trainings, from emergency service providers like Red Cross and the ICRC. Thus government has virtually done very little to strengthen and update knowledge and skills of responders. It is therefore recommended that the government should ensure regular and updated training of responders in accordance with international standards towards achieving global best practices.
It is important to have co-ordination among first responders and plan together in advance, including plan for leadership and easy contacts among the responding teams. NEMA and SEMA should be responsible for co-ordination of responders.
It is important to have clearance by the security agencies, usually the police or joint task force to the responding teams before work begins.
NEMA and SEMA as the major coordinating bodies should conduct at least quarterly meetings with all the responding agencies to plan and execute programmes that will improve knowledge and skill of responders, plan for emergency, design regular trainings and make arrangements for proper co- ordination.
The authors declare that they have no conflict of interest.
The researchers wish to acknowledge the contribution of the following individuals who served as research assistants: Musa D. Abdullahi, Branch secretary, Aminu D. Muhammad, Disaster Management Coordinator and Alhassan A. Aminu, Community First aid Training Coordinator, Nigerian Red Cross Society; Adamu Haruna Bayero Officer-in-Charge of Investigation, Kano State Hisbah Board; Garba Darki, SEMA, Ibrahim Koiranga KAROTA. Also wish to acknowledge the support of the following Institutions: Hisbah, NSCDC, KAROTA, NEMA, SEMA, NSCDC, NPF and Kano Branch of the Nigerian Red Cross.
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