Nigeria: In Nigeria’s Maiduguri, a Doctor Has a Simple Cure for Adapting to Extreme Heat
Maiduguri — “Apart from helping to reduce and abate the temperature and mitigate climate change, we can also provide fruits for our patients and our staff at subsidised rates.”
At less than a year old, the papayas are already fruiting outside the University of Maiduguri Teaching Hospital (UMTH) in the capital of Borno State, northeast Nigeria.
The fruit is joined by other crops – bananas and plantain – though they were still small and not yet ready to be eaten when The New Humanitarian visited in December 2025. Dotted among less edible plants like young baobab trees, the fruits fill up 26 plots, each 25 metres in length. Together, they form a 1.75 hectare orchard of roughly 826 trees – all selected for their ability to withstand extreme heat and arid conditions.
Inaugurated at the beginning of 2025, the hospital’s orchard was a direct response to one of the most pressing challenges doctors and staff are facing: rising temperatures caused by climate change.
Extreme heat is a global challenge with major implications for humanitarians. As the climate crisis intensifies, it won’t be uncommon to see emergency responders like doctors and nurses forced to take up adaptation measures like the orchard at UMTH.
Such projects can come with co-benefits, according to Ahmed Ahijo, chief medical director of UMTH. The hospital is a major healthcare institution, which caters to patients from across Borno, a region which has long grappled with a deeply entrenched conflict. A bombing in Maiduguri on 16 March killed 23 people and injured more than 100 others, a violent incident said to be indicative of a resurgent Boko Haram.
“Apart from helping to reduce and abate the temperature and mitigate climate change, we can also provide fruits for our patients and our staff at subsidised rates,” he told The New Humanitarian on a tour of the gardens.
The orchard is not yet complete, with many areas still empty, but fountains and benches have already been installed. The fountain water is intended not only for irrigation and for patients to enjoy, but also for animals like birds and bats. Some of the plots are named after real people, including Ahidjo, who has one dedicated to him.
In the coming years, the green spaces are expected to expand, offering shade, rest areas, and moments of relief for patients, visitors, and hospital workers alike.
“The fight against climate change is multifactorial,” Ahijo reflects. “It involves people, the environment, the machines, and the systems we depend on. Many aspects are involved. But I believe that with enough effort, coordination, and commitment, we can still reverse what is happening.”
Soaring temperatures and unreliable rains
Like much of the Sahel, Maiduguri and Borno State are particularly vulnerable to climate change, seeing rocketing temperatures, shifting rainfall patterns, and extreme weather.
A study conducted in Bolori 2 ward, a suburb of Maiduguri, highlights the extent of these changes: Between 2014 and 2024, average temperatures rose from approximately 30.5°C to 37.1°C. At the same time, annual rainfall increased from around 450 millimetres to 550 millimetres, contributing to more frequent and severe flooding.
These environmental shifts have profound effects, including on the health of the local population.
“Temperatures during the hot season are becoming higher and higher. And the season is longer and longer,” says Ibrahim Ummate, director of the Kidney Center at UMTH. “Along with this, people need more water to replace the fluids they lose through sweat.”
In a region where the vast majority of people work outdoors, adequate hydration is a matter of survival. Dehydration not only reduces physical capacity and increases the risk of fainting and heat exhaustion; it also places severe stress on a vital organ: the kidneys.
“The kidneys need adequate water to excrete waste products generated by our diet, medications, and other substances we take,” Ummate explains. “If a person doesn’t take enough fluids, the kidneys struggle to eliminate metabolic waste, and that is when problems start.”
During the hot season, temperatures in Maiduguri can reach 44°C. Under such extreme conditions, medical professionals generally advise adults to drink at least 2.5 to 3 litres of water per day, and often more for those engaged in heavy physical labour. Proper fluid intake is essential to maintain urine production and prevent urinary tract stones, kidney stones, ureteric stones, and bladder stones.
But access to safe drinking water is not a given in Maiduguri. Studies show water managed locally has long been poor and may have worsened over the last decade. People displaced by the region’s conflict and living informally in the city have an especially difficult time accessing safe drinking water, and face greater risks from water-borne diseases, which can further dehydrate the body and cause greater vulnerability to extreme heat.
At UMTH, the consequences of insufficient hydration are increasingly visible, a trend linked to the rising temperature.
“Cases related to these conditions have increased to about 30 percent of our daily clinic visits,” says Ibrahim. “The main reason is what we call insensible fluid loss – the water the body loses through sweat and breathing without the person being fully aware of it.”
Under normal circumstances, insensible fluid loss ranges between 1.5 and 1.8 litres per day. But in Maiduguri, during the hottest months, that figure can double.
“In this environment, insensible loss can rise to three or even four litres in 24 hours,” Ibrahim explains. “If people do not compensate for that loss, dehydration becomes inevitable.”
The trend is affecting all age groups.
“This isn’t the only exception we’re facing,” says Hassan Dubu, consultant urologist and associate professor of urology. “In recent years, unlike 20 years ago, we are seeing more and more children coming to our clinic with these heat-related conditions.”
Paediatric kidney and urinary tract stones, once considered rare, are now becoming increasingly common – a worrying indicator of chronic dehydration linked to prolonged heat exposure.
An overlooked global problem
The impacts of extreme heat are not limited to West Africa – and not always as visible as patients in hospitals.
Deaths from higher temperatures are predicted in countries across Africa, in some cases exceeding deaths from strokes, a leading cause of mortality. Lower-income countries have fewer resources to adapt to climate change impacts like heat, prompting the need for low cost adaptations like UMTH’s orchard.
Even when human life itself is not at risk, extreme heat can still make life miserable, and harm economies. A recent survey – of over 1,000 people in Nairobi, Kenya; Dar es Salaam, Tanzania, and Kariba, Zimbabwe – showed extreme heat caused a quarter of respondents to miss out on work. Some 40% had difficulty sleeping, and most people’s homes were uncomfortable, with extreme heat lasting into the night, according to the study by the International Institute for Environment and Development. Far away in Indonesia, extreme heat is among the climate impacts that have been linked to child marriage.
Extreme heat’s impacts “are felt particularly in humanitarian contexts because… they are compounded by poverty, a lack of services, by poor housing, by lack of access to water,” according to Paul Knox Clarke, principal of the ADAPT initiative, which helps humanitarians prepare for climate-related crises. Speaking on a webinar, he continued: “The good news is… there are a lot of things that can be done at fairly low cost to decrease the mortality and related impacts” of extreme heat.
Other speakers on the same webinar highlighted how in many countries, particularly those affected by humanitarian crises, extreme heat is often not given the same treatment as other climate hazards, and not included in national disaster risk planning or early warning systems.
“You have to be optimistic in life”
Back in Maiduguri, UMTH’s patients are not the only ones bearing the burden of climate change. Doctors, nurses, and hospital infrastructure are also under growing strain.
In September 2024, massive flooding swept through large parts of Borno state, including the hospital itself. Water submerged facilities and operating theatres, destroying millions of dollars’ worth of medical equipment that had to be replaced.
Even in the absence of such disasters, daily operations are increasingly disrupted by heat.
According to Ahijo, during peak heat periods, energy consumption rises sharply – in some cases by as much as 50% compared to the rainy season. Sensitive machines such as MRI scanners require constant cooling. Medications, vaccines, and biological materials must be stored in tightly controlled environments.
“At the same time, maintaining generators becomes more difficult,” Ahijo explains. “The hotter the environment, the more frequently they break down.”
Due to the unstable electricity supply, UMTH relies on fossil fuel-powered generators to keep the institution’s thousands of air conditioning units running.
While some in the humanitarian sector are encouraging the adoption of cleaner energy sources, including for healthcare settings, “we cannot operate without them,” Ahijo says. “Refrigerators are essential. We need enormous amounts of energy, and we are constantly facing breakdowns and power interruptions.”
Despite these challenges, the orchard stands as a reminder that climate adaptation is possible. Following Ahijo through the gardens he built, at times it seems the green space is his biggest achievement.
“You have to be optimistic in life,” he says, gently touching a plant bearing his name. “It’s the only way to reach your dreams.”
Humanitarians interested in learning more about extreme heat, and how to recognise heat exhaustion and heat stroke, can sign up here for Heat Action Day on 2 June, run by the American Red Cross’s Global Disaster Preparedness Center.
