The UN has been accused of failing to act quickly enough to save hundreds of thousands of lives in northern Nigeria where a food crisis already killing hundreds of people a day is poised to become the most devastating in decades.


Nigerian authorities, who maintain tight control over humanitarian and media access to the region, have also been accused of deliberate negligence and attempting to conceal the scale of the crisis.

The UN Office for the Coordination of Humanitarian Affairs (OCHA) has categorised 4.4 million people in the Lake Chad region as "severely food insecure" – meaning they are in need of urgent food aid.

Toby Lanzer, UN assistant secretary general and OCHA's regional humanitarian coordinator for the Sahel, said: "This is about as bad as it gets. There's only one step worse and I've not come across that situation in 20 years of doing this work and that's a famine."

"We have to step in and quickly or we are going to have hundreds of thousands at risk of dying in the north-east of Nigeria."

Facebook Twitter Pinterest The Muna settlement on the outskirts of Maiduguri. The UN has warned that without fast action hundreds of thousands of people will be at risk of dying in north-eastern Nigeria. Photograph: Stefan Heunis/AFP/Getty Images

Boko Haram's seven-year insurgency has left Borno's farmland – which previously fed Nigeria – devastated and abandoned. This will be the region's third year without a harvest.

The hunger crisis is claiming lives even in Maiduguri, the capital of Borno state and the hub of humanitarian and security forces in the region. The city has doubled in size in two years and now hosts 2.4 million displaced people. Food prices are soaring in the markets, where it now costs $100 (£75) to buy a large bag of rice.

Lanzer said UN agencies have not had the resources necessary to tackle the crisis and has called on international donors to prevent a greater catastrophe. Of the $279m (£210m) required, only $75m has so far been secured.


Isabelle Mouniaman, head of Médecins Sans Frontières operations in Nigeria, said MSF has been raising the alarm in northern Nigeria for two years and UN organisations have failed to respond.


"We've been calling to the UN, to the headquarters of Unicef, WFP [World Food Programme], OCHA and their response has been 'Yes, we're doing this and that'… But you cannot just be satisfied to say you built X number of latrines, delivered X bags of food when people are dying. It's not enough," Mouniaman said.


"The Red Cross is doing their job, MSF is doing their job, but the vast majority of humanitarian organisations are failing in their responsibility towards the crisis in Borno."


This is about as bad as it gets. There's only one step worse ... and that's a famine Toby Lanzer, UN assistant secretary general

International aid agencies have focused on Maiduguri's overstretched camps, but more than 80% of displaced people in the city, around 1.9 million people, are living among the community, the vast majority without access to food aid or medical support.

The most desperate crisis is unfolding outside Maiduguri, where aid agencies fear hundreds of thousands of people are trapped, cut off by Boko Haram and the military operation against them. As the Nigerian army clears more of these areas, the true scale of the crisis is only just becoming clear; those who have escaped tell of watching children die from hunger and being prevented from calling for help.


Mouniaman said: "We're talking about areas in which 39% of children have severe acute malnutrition. This is a really, really dramatic situation. In my whole MSF career – since 1999 – I've never seen anything like it."


In June, a humanitarian convoy reached Bama, Borno state's second largest city. It was recaptured by the Nigerian army in March 2015, but the 37-mile journey (60km) from Maiduguri is still considered too dangerous to make without military escort because of Boko Haram attacks and landmines.

They found Bama destroyed and a camp of about 30,000 people, mostly women and children. Many were starving. MSF found the graves of 1,233 who had died in the camp, 480 of whom were children. More than 3,000 severely malnourished people were evacuated by the state governor to Maiduguri for emergency treatment. Several died en route.


The Guardian was refused entry to Bama by the Nigerian military on security grounds. But Maj Gen Leo Irabor, who leads the military operation against Boko Haram in the region, said hunger in the Bama camp was "relative".


"Very largely I think their needs are being met," Ir