In Alibori Department of north-eastern Benin, a rapidly changing security situation is creating a profound humanitarian crisis. The instability that once remained confined to the immediate northern borders of Alibori and Atacora has begun to spread, pushing its way southward into Borgou Department.
This expansion represents a worrying turn in the crisis. The spillover from the wider Sahel crisis has brought unexpected challenges: armed groups are using the dense forest and river corridors to move freely across the region, forcing families to seek safety in secondary towns and neighbouring municipalities.
A rise in violent incidents
Between 2024 and 2025, violent incidents linked to regional armed groups increased by 80% while the death toll tripled. When violence flares – whether through a direct assault on a community or a sudden ultimatum delivered to a rural market – entire families are forced to pack what they can carry and flee. This has triggered a massive, accelerating wave of internal displacement, forcing thousands of people out of rural border areas and into secondary urban centres.
Between 2024 and 2025:
According to the International Organization for Migration (IOM), the number of internally displaced people has surged from 27,294 in December 2025 to nearly 42,500 by May 2026. Families who were farming or trading just months ago are now arriving in unfamiliar towns, seeking refuge among host communities whose own resources and public services were already stretched thin.
around 27,000 internally displaced peoplein December 2025
- almost 42,500 internally displaced people
in May 2026
By mid-2026, violent incidents have spread southward into Borgou Department, marking a volatile evolution in the country's security landscape. Between May and June 2026 alone, nearly 160 security incidents were recorded across these 3 northern departments.
When displacements destabilise healthcare
This shifting population movement has directly undermined an already limited healthcare system. Alibori faces severe baseline health challenges, with a maternal mortality rate of 391 deaths per 100,000 live births and an under-5 mortality rate of 80 per 1,000. Malaria remains the leading cause of death among children, a vulnerability worsened by the fact that over half of the region's children are not vaccinated against measles.
Furthermore, chronic malnutrition affects nearly 1 in 2 children under 5, leaving them highly susceptible to severe acute malnutrition and medical complications. As the security crisis expands into new territories such as Borgou, the sudden influx of displaced families is compounding already precarious conditions and creating a severe health emergency.
The frontline response
To address these compounding crises, Première Urgence Internationale (PUI) since late 2024, has been operating in the health zones of:
- Banikoara
- Malanville-Karimama
- Kandi-Gogonou-Ségbana
This response is built on a vital partnership with European Union humanitarian aid, alongside support from the Crisis and Support Centre (CDCS) of the French Ministry for Europe and Foreign Affairs. Together, they provide the financial backbone required to make essential medical services entirely free for the most vulnerable populations.
PUI’s strategy uses a 2-pronged approach that balances immediate emergency interventions with the long-term stabilisation of local health structures. When violence escalated along the border corridors in early 2026, PUI quickly deployed emergency teams to Ségbana to support local health authorities, an approach that continues to adapt as the conflict moves.
In this landscape, getting to a doctor is not just about a long walk. It is about overcoming the daunting barriers of cost, distance and insecurity.
To bridge the gap caused by geographical remoteness and rampant instability, PUI teams also use advanced outreach strategies. Medical workers travel directly to isolated villages to:
- conduct free consultations
- screen for malnutrition
- host nutritional cooking demonstrations
- refer critical cases to regional facilities
Advanced strategies are important because they allow us to reach communities that are very far from health centres and to treat children and vulnerable people in these communities.
Removing the financial barrier to care
For displaced families and impoverished host communities, the cost of medicine is often an insurmountable barrier.
Backed by EU humanitarian aid and CDCS funding, PUI covers these costs: ensuring free targeted care for pregnant women, breastfeeding mothers and children under 5.
For children suffering from severe acute malnutrition with complications, support also includes free meals for their caretakers during hospitalisation.
The tangible effect of this support is visible in the restored hope of local families. Aïssatou fell severely ill after she and her family were displaced. Through an outreach campaign, community health workers detected her condition and provided comprehensive care. Koffi, her father, now living near the Nigerien border recalls:
At first, we were a little sceptical, but we decided to trust them. We did the right thing. I never thought my daughter would smile again. Thanks to this support, she is alive today.
In Malanville, the impact is equally personal. A young pregnant woman named Alimiyaou shares how free antenatal consultations have given her the guidance and peace of mind she needs to carry her baby safely to term.
‘I am given information about my health and that of the baby I am carrying, as well as advice on how to manage my pregnancy through to the end’, says Alimiyaou.
Her neighbour, Roukaya, echoes this relief, recalling a time before PUI’s arrival when women with limited financial means often did not seek care because they could not afford treatment.
Another mother, whose child was hospitalised at a therapeutic feeding centre for severe malnutrition, recalls the fear of facing a hospital bill she could not pay. Instead, she found an open door, free treatment for her child, and the nutritional support she needed to stay strong at his side during the recovery.
A shared regional challenge
This mission in Alibori does not exist in isolation. It is part of a broader regional monitoring strategy across coastal West African nations. As the effects of the Sahel crisis continue to spill southward into departments such as Borgou, sustained humanitarian funding remains essential to anticipate growing needs, track shifting corridors of displacement and build resilient healthcare systems capable of weathering future shocks.
To sustain these critical interventions, the EU committed nearly €7.5 million in 2025 and more than €6 million in 2026 to humanitarian assistance in West Africa's coastal countries, including Côte d’Ivoire, Benin, Togo and Ghana. In response to the growing urgency of its domestic situation, Benin received the largest single allocation of 2026 funding, totalling over €2.5 million.
