The Nigerian Civil War (1967–1970) fractured a young nation. When the Eastern Region declared independence as the Republic of Biafra, conflict erupted, accompanied by a strict federal blockade that devastated the region. Essential supplies of food, medicine, and medical equipment were cut off. Hospitals collapsed, and nurses, doctors, and missionaries transformed schools, churches, and private homes into makeshift wards. This account, drawn from multiple verified sources, examines the lived experience of medical care during the war, focusing on nurses’ voices and humanitarian action.
Background: The Collapse of Health Systems
By July 1967, military conflict had engulfed Nigeria. The blockade of Biafra severely restricted imports, crippling healthcare. Pre-war hospitals were overwhelmed by casualties and disease, while new wards emerged in unconventional spaces. Missionary hospitals, such as Mater Dei in Abakaliki, adapted classrooms and chapels into operating theatres and wards. According to the International Committee of the Red Cross (ICRC) archives, such improvisation became the backbone of healthcare in the conflict zone (ICRC, 1970).
Makeshift Hospitals and Humanitarian Care
The blockade rendered supplies scarce. Medical teams faced shortages of anaesthetics, antibiotics, and sterile dressings. Nurses often reused materials and resorted to local substitutes such as boiled cassava leaves for nutritional supplementation and palm kernel oil for energy provision (Okigbo, 2003). Improvised triage systems became essential in managing the influx of casualties.
A 1969 Reuters report confirmed that relief flights and airlifts were the only significant sources of supplies. Flights to Uli and other clandestine airstrips brought essential medicines, powdered milk, surgical materials, and evacuations of critical patients to Europe (Reuters, 1969). Humanitarian agencies such as Joint Church Aid coordinated much of this relief under fire.
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Nursing under Fire
Nurses became central to survival, practising medicine under extremely difficult conditions. Oral histories record that medical staff worked under candlelight or kerosene lamps, treating wounded soldiers and civilians alike. Mrs Georgina Nwangwu, a nurse in Amaimo, recounted working while pregnant, treating malnourished children, and improvising nutritional therapies under constant threat (My Biafran Story).
Conditions demanded both medical skill and resourcefulness. Sister nurses from missionary hospitals documented performing emergency surgeries without standard anaesthesia, relying instead on local analgesics and prayer (Free Online Library, 1970). Sterilisation of instruments was improvised through boiling, and bedding was reused after rudimentary disinfection.
Water, Food, and Nutrition
The blockade made water and food scarcity a constant threat. Makeshift wards depended on locally sourced supplies and improvised recipes to sustain patients. Cassava leaves, enriched with palm oil and groundnut paste, became a dietary staple for malnourished patients. Nurses organised feeding schedules to ration scarce resources. The World Council of Churches supported some nutritional programmes, delivering vitamins and protein supplements when possible (Okigbo, 2003).
Evacuations and International Aid
Critical cases were sometimes evacuated to Europe for surgery. Reuters (1969) documented the airlift of 47 Biafran patients to Switzerland, Italy, Denmark, and Norway for orthopaedic and reconstructive operations. These airlifts became a symbol of the war’s humanitarian dimension but were limited in scope. Most patients remained dependent on improvised local care.
Personal Accounts: Voices from the War
Sister Pauline (Composite Voice)
A diary voice drawn from missionary nurse testimonies describes war nursing as “a work of faith, endurance, and invention.” Entries often note early mornings spent triaging casualties, improvising dressings, and comforting the dying. One entry recorded an appendectomy carried out under shellfire with no general anaesthesia, a testament to the nurses’ courage under siege.
Mrs Georgina Nwangwu
A local nurse-midwife, Nwangwu described treating hundreds of patients with inadequate equipment, often without pay, while providing nutrition for kwashiorkor-stricken children. Her testimony highlights the gendered dimension of wartime caregiving, where women sustained healthcare even as the state collapsed.
Aftermath and Lessons
The end of the war in January 1970 brought relief but left lasting scars. Hospitals struggled to rebuild, and many nurses never returned to pre-war employment. Psychological trauma persisted among healthcare workers and patients. Studies on post-war Biafra highlight high rates of PTSD among former combatants and medical personnel (Okigbo, 2003).
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The Biafran conflict influenced later humanitarian practice by emphasising the importance of neutral aid under fire and the use of local resources in crisis. Yet it also exposed limitations in emergency healthcare delivery, such as inadequate epidemiological surveillance and inequitable access.
Author’s Note
Author’s Note
This article reconstructs the experience of Biafra’s nurses through verified historical sources and testimonies. The story of Sister Pauline, though composite, reflects the courage of countless women, missionary sisters and Nigerian nurses, who saved lives with little more than faith, ingenuity, and determination.
While wars are fought by armies, it is caregivers, quietly working in candlelit wards, who preserve humanity. Remembering their stories is not just history; it is a moral obligation to honour their service and learn from their resilience.
References
- International Committee of the Red Cross (1970). Nigeria–Biafra: Humanitarian Operations, 1967–1970. Geneva: ICRC Archives.
- Okigbo, K. A. (2003). Ghostly Narratives: Experiences and Roles of Biafran Women During the Nigerian Civil War. African Knowledge Project.
- Reuters Archive (19 February 1969). “Biafran Wounded Airlifted to European Hospitals.”
