A young child suffering from severe malnutrition is treated at the In-Patient Therapeutic Feeding Centre in Maiduguri, northeastern Nigeria, on September 17, 2016
Maiduguri (Nigeria) (AFP) - Doctors crowded around Abdullahi. One squeezed a drip and another prepared a plastic syringe. The young boy didn't move. Only the shallow rise and fall of his chest indicated he was still alive.
Fluid was injected to try to stabilise the two-year-old's blood sugar levels. "He's better than he was 20 minutes ago," said one doctor. "But his condition is still critical."
Abdullahi's mother, Hadiza, perched on the end of the bed, as if trying to get as far away as possible from the machines and lines attached to her tiny son. She turned her head and sobbed.
All of the children brought to the intensive care unit at the field hospital in the Gwange area of Maiduguri are starving to death because of Boko Haram.
Abdullahi's body was swollen from the protein deficiency kwashiorkor. In the next bed lay Hafsat, a 13-month-old girl whose body was little more than skin and bone.
"Her mother died five weeks ago," explained Hafsat's aunt, Fatima Ladan, holding the girl up. "I tried to breastfeed her but there wasn't enough milk.
"I took her to hospital, where she was given Plumpy'Nut (a high-energy food supplement given for severe acute malnutrition) but she wouldn't take it. Each time she would vomit."
Fourteen-month-old Maryam was born in a camp for the displaced after her family fled an Islamist attack in the town of Baga, in northern Borno state, in January last year.
Her grandmother, Hauwa, sat quietly by her bedside.
"My wish is for her to recover and get well," she said. "I pray God gives us food to eat."
- Echoes of Biafra -
There have been repeated warnings about the effects of food shortages caused by the Boko Haram conflict, which has killed at least 20,000 people and left 2.6 million homeless since 2009.
But despite the huge numbers involved, the situation has received little attention compared with other humanitarian crises around the world -- even within Nigeria.
In July, the United Nations said nearly 250,000 children under five could suffer from severe acute malnutrition this year in Borno state alone and one in five -- some 50,000 -- could die.
Last month, the world body said 4.5 million people in three northeast states needed immediate food aid -- double the number in March.
Of those, more than 65,000 people were said to be facing famine. But fighting and insecurity has left some hard-to-reach rural areas cut off from help.
Dr Bamidele Omotola, a nutrition specialist with the UN children's fund UNICEF, said global acute malnutrition rates were "far, far, far above what (we find) in an emergency situation".
"I do remember that the last time we had such serious cases was like when we had the Nigerian civil war (from 1967-70)," he added.
Then, more than one million people died from the effects of starvation and disease in a war sparked by the declaration of an independent republic of Biafra in Nigeria's southeast.
Now, the fighting has left farmers unable to sow crops, land has been destroyed or mined and water sources contaminated while food shortages have pushed up prices in local markets.
At the same time, Nigeria is in recession. The naira currency has lost value and inflation has risen to more than 17 percent, making food, fuel and goods more expensive.
- 'Already too late' -
Doctors and healthcare workers running feeding programmes in camps for the displaced and at public health clinics across Maiduguri, deal with the consequences every day.
Desperately underweight children are weighed and have the circumference of their upper arms measured for signs of malnutrition. Nurses shout out measurements to be recorded.
Those too weak to fight complications such as measles, malaria or diarrhoea are referred to the in-patient therapeutic feeding centre in Gwange run by Doctors Without Borders (MSF).
The medical charity typically treats children aged between six months to five years old but doctors at the facility said they are seeing increasing numbers younger than that.
The 14-bed intensive care unit is "always full", they added.
MSF said 290 patients were admitted in July and 30 children died due to severe acute malnutrition. In August, the figures jumped to 387 admissions with 72 deaths.
"Most of these cases come in very late into the crisis," said MSF's emergency medical coordinator in Maiduguri, Dr Javed Ali Baba.
"By the time they come here it's already too late. Every day we see two, three deaths."
- 'Terrible catastrophe' -
The Boko Haram conflict and its consequences has spilt into northern Cameroon, western Chad, and southeast Niger, leaving 6.3 million people in the region severely food insecure.
Of those, some 568,000 children have severe acute malnutrition. As a result, the UN has significantly revised upwards its funding estimates for the rest of this year.
The UN regional humanitarian coordinator for the Sahel, Toby Lanzer, said $385 million (345 million euros) more was needed for northeast Nigeria alone.
For the region, $559 million is still required.
"We are really addressing this as we would any of the most serious crises," he told AFP from New York, where UN Secretary General Ban Ki-moon will launch an appeal for funding on Friday.
But with Nigeria in economic crisis, the expectation is for the international community to "step up" and provide the resources needed, he said.
"The international community will have to do more or we will have a terrible catastrophe on our hands and that doesn't help anybody," he added.
Back in Gwange, Dr Ali Baba said despite a marked increase in work by the government and aid agencies in recent months, he was expecting no let-up in malnutrition cases.
"There are still a lot of people out there who need a lot of help," he said. "I'm pretty sure it will get worse...
"From what we have seen over the last two months... I don't think it's going to slow down at any moment from here."