Story highlights
- Aid groups alarmed by the scope of rampant malnutrition across Borno state
- Boko Haram militants have fought the government, terrorized villages for years
(CNN)A frail woman hesitates for a moment before handing over her sick child to a nurse.
"This child cannot stand," says another medic as the severely malnourished boy is carried to the intensive care unit at the Gwange therapeutic feeding center on the outskirts of Maiduguri, the capital of Nigeria's Borno state.
That scene, captured on video by Doctors Without Borders (MSF), plays out countless times in the northeastern state, where hunger is rampant, according to new numbers. The group says 500,000 people are in urgent need of food, shelter and medical care.
Nearly 244,000 children are suffering from severe acute malnutrition in Borno state and an estimated 49,000 of them, about 1 in 5, will die if they don't receive urgent treatment, UNICEF said in a new report.
"Some 134 children on average will die every day from causes linked to acute malnutrition if the response is not scaled up quickly," said Manuel Fontaine, UNICEF regional director for Western and Central Africa, who recently returned from a visit to Borno.
"A lot of these children are arriving in a very advanced stage of malnutrition, they are extremely weak," Claire Magone, MSF emergency coordinator in Maiduguri, told CNN on Sunday. Many more in other parts of the state are still out of reach for the humanitarian teams because of the volatile security situation, she said.
It's difficult to know how many people have died in recent months. Doctors Without Borders said a late June visit to the Bama area showed more than 1,200 graves had been dug since internally displaced citizens had gathered in a hospital compound. Five children died while an assessment was being undertaken.
A July return visit provided this grim scene of what the group called a ghost town, hundreds having been evacuated: "There are hardly any men or boys older than 12. We don't know what has happened to them."
'True scope of this crisis yet to be revealed'
Since taking office last year, Nigerian President Muhammadu Buhari has pledged to defeat the terror group Boko Haram, which operates mainly in the northeast of the country but also conducts attacks across the borders.
Despite some setbacks, the Nigerian military, working with neighboring countries that include Chad and Cameroon, which also have been affected, has been able to regain significant territory.
As Boko Haram is pushed out of more areas, the magnitude of the humanitarian crisis aggravated by the extremist group's deadly insurgency is becoming more palpable.
Hundreds of thousands have been cut off from the outside world, in some cases for as long as two years, Doctors Without Borders said in a statement. People in those areas are relying entirely on outside help, the group said.
Reaching some of those towns and villages is still very dangerous, Doune Porter, UNICEF Nigeria communications officer, told CNN. "There are attacks on the roads, there are land mines," she said.
Photos: Penetrating Boko Haram's stronghold: The Sambisa Forest
Photos: Penetrating Boko Haram's stronghold: The Sambisa Forest
Under Operation "Lafiya Dole" -- meaning "peace by any means" in Hausa -- the Nigerian army is working under intense scrutiny to locate and return the stolen Chibok girls to their parents.
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Photos: Penetrating Boko Haram's stronghold: The Sambisa Forest
Boko Haram's violent footprint is evident across the vast expanse of Nigeria's northeast, where village after village has been left devastated by the group's fighters.
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Photos: Penetrating Boko Haram's stronghold: The Sambisa Forest
What Boko Haram couldn't loot, it burned to the ground. To this day, people remain afraid to return home.
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Photos: Penetrating Boko Haram's stronghold: The Sambisa Forest
Frequent attacks from Islamic insurgents have prompted residents to flee their villages and head to Maidugiri where it is, to an extent, safer.
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Photos: Penetrating Boko Haram's stronghold: The Sambisa Forest
The city of Maidugiri is at the heart of the military's campaign. Something of a safe haven for many fleeing Boko Haram, it has become an oasis in northeastern Nigeria, where around 2.5 million displaced people now reside.
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Photos: Penetrating Boko Haram's stronghold: The Sambisa Forest
The region's soft sand is ideal for hiding improvised explosive devices, or IEDs. This means the military must travel in heavily armored convoys with mine-proof trucks providing protection from the front.
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Photos: Penetrating Boko Haram's stronghold: The Sambisa Forest
Empty ammunition cases litter the ground, untouched since they flew from the machine guns used in a skirmish between the Nigerian army and Boko Haram fighters.
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Photos: Penetrating Boko Haram's stronghold: The Sambisa Forest
The operation's "theater commander" Maj. Gen. Leo Irabor tells CNN that while he is proud of his men's achievements in pushing back Boko Haram, they are in need of more international support to quash the insurgents.
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Photos: Penetrating Boko Haram's stronghold: The Sambisa Forest
A vehicle full of troops scans the horizon scouting for any indication of insurgent presence.
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Photos: Penetrating Boko Haram's stronghold: The Sambisa Forest
The terrain in the northeast is unforgiving and troops face dehydration in the blistering heat while on patrol.
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"This is a problem that the government of Nigeria cannot handle alone," she said. "It's a huge emergency that requires an enormous scale-up of assistance from around the world."
Homes and livestock have been looted or destroyed in the ongoing violence, and people are unable to cultivate crops. As a result, malnutrition in the state is rampant, said the charity.
"There are 2 million people we are still not able to reach in Borno state, which means that the true scope of this crisis has yet to be revealed to the world," said Fontaine.
Urgent need for more assistance
Humanitarian organizations have been able to provide support to some areas, like Dikwa and Bama, and people who require urgent medical help have been transported to facilities where they can receive treatment.
Children often are the most vulnerable.
"It is heartbreaking to see children who are just very obviously emaciated and in desperate, desperate need of help," said Porter. Severely malnourished children are nine times more likely to die from diseases like malaria or diarrhea, she said.
Last Thursday, an aid convoy delivered 31 metric tons of food and a limited amount of non-food items to residents in Banki near the border with Cameroon, Jens Laerke, spokesman for the Office for the Coordination of Humanitarian Affairs (OCHA) told journalists in Geneva. The food delivery is expected to last for less than a week, he said.
Since the beginning of the conflict in 2009, nearly 2.5 million Nigerians have fled their homes, according to the latest OCHA data.
More than 20,000 people have been killed in the violence and thousands have been abducted.
Boko Haram, which in the local Hausa dialect means "Western education is forbidden," is considered one of the most dangerous terror groups on the continent.
It operates out of Nigeria and its purpose is to institute Sharia law in the country.
Boko Haram has recruited child soldiers and reportedly uses children as suicide bombers.
