In many parishes across the United States, foreign aid remains an abstract concept—a line item in the budget, a title in the news tickers, a political debate. But thousands of miles away, in the villages and informal settlements of Nigeria, foreign aid is neither abstract nor distant. It is the difference between daily hunger and daily bread, between a community clinic staying open or closing its doors, the difference between life and death for people living with HIV or other health and humanitarian needs.
That fragile charity safety net abruptly unraveled earlier this year, when the United States Agency for International Development (USAID) shut its humanitarian programs on the first day of President Trump’s second administration. USAID had long been a major partner in public health, education, WASH (water, sanitation, and hygiene), food security, and governance in sub-Saharan Africa. In places where Catholic sisters have served faithfully for decades, USAID support did not replace the sisters’ mission but rather strengthened it.
And then, suddenly, it disappeared.
In Nigeria, Africa’s largest nation, the impact has been devastating. The World Bank estimates that the number of Nigerians living in poverty has risen to 139 million from 129 million due to the impact of the global economic downturn. The Nigerian government responded with an emergency fund of $200 million to support the health sector, but quietly acknowledged it was nowhere near enough.
Yet behind these statistics lie real people, families, and communities, many of whom now turn to Catholic sisters as their last remaining support. Catholic sisters’ efforts in Nigeria tell of a faith-driven moral duty that continues even when the world turns away. These sisters refuse to leave.
For many years, the church has supported international aid programs like USAID as a moral obligation, urging wealthy nations to protect human life and dignity. Catholic social teaching stresses that solidarity is essential, especially for those with abundance. However, the sisters’ mission has become more difficult as the United States reduces its support for vulnerable populations, ultimately leaving the poor and their advocates to bear the burden.
The day the medications ran out
St. Teresa’s Clinic, formerly called Community Health Project, is a primary health care facility run by the Congregation of the Medical Missionaries of Mary in the Amukoko area of Lagos. Sr. Gladys Dimaku, the clinic’s administrator, remembers the moment she realized her Tuberculosis and HIV patients would no longer receive their USAID-supported testing and referrals for antiretroviral(ART) medications nor antibiotics for TB care.
“At first, there was a lot of discussion and concern about possible changes under the Trump administration. By February, it was evident [that] the support would be withdrawn,” she recalls. “We received a notice from our partner overseeing most of our TB patients and those living with HIV at the end of January. It was very devastating, as we weren’t prepared.”
For years, USAID programs ensured a steady supply of HIV and TB medications at no cost to patients. The clinic served more than 350 people living with HIV, many of whom walked miles each month for testing and referrals to partner hospitals where they received free ART.
Now, resources for that vital care have disappeared.
Nigeria has the largest HIV epidemic in West and central Africa, and the second-largest HIV epidemic globally, with about 1.9 million people living with HIV and around 120,000 new infections annually. USAID has made significant contributions to Nigeria’s health initiatives, including HIV/AIDS, malaria, tuberculosis, polio, and maternal and child health, financing over $600 million in 2023 and roughly $2.8 billion between 2022 and 2024. Global donor supporters, including PEPFAR (President’s Emergency Plan for AIDS Relief), have financed more than 80% of HIV services in Nigeria.
The sisters, led by Dimaku, are holding things together with makeshift solutions—covering costs for treating opportunistic infections, transport for support group meetings, and nutritional aid for patients. Yet, their lifeline is quickly falling apart.
“Since February, we have intensified our efforts. The clinic had to source supplies urgently, as many patients cannot pay for lab tests, nutritional support, and other essentials. Our congregation has been instrumental in supporting these efforts,” Dimaku says.
The Medical Missionaries of Mary “continued monitoring the situation until there was a concession to keep basic services for people living with HIV running, but there was nothing additional for TB,” she says. “This was a significant blow, especially for beneficiaries dealing with both HIV and TB.”
The sisters stretch every naira (Nigeria’s currency), involving their congregation to pull resources for affected patients and partnering with government hospitals. Still, the need outpaces their capacity.
“This period has been tough for our patients and us,” Dimaku says. “Still, many appreciate access to ART, even though they now get only three-month supplies rather than six, raising costs and time loss. Despite hardships, community support, prayer, and group activities keep hope alive. Our yearly theme, ‘programs of hope,’ continues to inspire us.”
The girls who returned from darkness
The most heartbreaking impact of the USAID cuts is felt among survivors of human trafficking, especially teenage girls who have returned after suffering exploitation in the Middle East or North Africa.
In Lagos, the Sisters of St. Louis operate a safe house known simply as “Bakhita House,” serving as a haven of healing with counseling rooms, skill acquisition classrooms, a chapel humming with soft hymns, and bedrooms where young women relearn what it means to sleep without fear.
Most of these girls have recently returned from trafficking rings—some rescued by law enforcement, including international organizations like the IOM (International Organization for Migration), and others who escaped on their own. Many had crossed borders, walked through deserts, or spent months in captivity. They arrived at the sisters’ shelter with no belongings, no family support, and no access to the trauma counseling, medical treatment, or legal help they urgently needed.
Just about a year ago, USAID-funded partner programs offered psychosocial support, vocational training, trauma-informed counseling, free formal education, legal referrals, basic needs, and small-business start-up kits for these survivors. Now, much of that assistance disappeared almost overnight.
“We lost more than 50% of our operating budget,” Sr. Patricia Ebegbulem, a sister of St. Louis, says quietly. “But the girls didn’t stop coming. They still needed safety. They still needed healing. And the Lord did not permit us to close the doors.”
Her words echo a deeper truth that is becoming visible across Nigeria, especially in communities strained to breaking point by poverty, conflict, and lack of government investment: when the world’s safety nets fall away, the church’s last responders become its only responders, and they are overwhelmingly Catholic sisters.
The Catholic Church teaches that caring for the poor is a fundamental demand of justice, rooted in human dignity. So as aid systems fail, sisters continue to feed the hungry, heal the sick, shelter the vulnerable, and restore lost dignity—fulfilling the church’s call to justice, a call that many have chosen to ignore.
A safe house struggling to stay afloat
While the leprosy clinic struggles to stay afloat and the HIV center experiences service gaps, the Sisters of St. Louis’ anti-human-trafficking shelter is also becoming overwhelmed.
Ebegbulem heads the shelter that currently houses nine girls and eleven children. Many were trafficked into domestic servitude and subjected to various forms of exploitation, often across borders. Others were lured through online grooming and transported via clandestine networks that thrive in areas where poverty makes people vulnerable to false promises.
Many religious communities are pooling resources through the solicitation of support funds from local parishes.At the trafficking shelter, the sisters receive support from their congregation, such as the Laity Fund, and have launched small training classes in hairdressing, catering, baking, and tailoring—skills that help girls regain economic independence.
“These efforts not only help fund the shelter but also equip the girls with valuable skills, opening up opportunities for them beyond our care,” Ebegbulem says.
Sisters running leprosy clinics have cultivated gardens of rice and cassava and raised small flocks of pigs for protein on nearby land, feeding patients who used to rely on donated food. When HIV medicines ran out, they arranged carpool systems to ferry patients to far-flung facilities still stocking ART. And when girls returned from trafficking networks with no place to sleep, they moved their beds into storage rooms and gave the mattresses to the girls instead.
One of the survivors, Ekebisi *, remembers the moment she knocked on the sisters’ gate.
“I didn’t know if this was a real place or if they would send me back,” she says. “I came when I had lost all hope because I was told my situation was very critical. But the sister who opened the door smiled at me and assured me of safety and healing. I believed her.”
Since 1999, when she first came to the hospital, Ekebisi has been receiving care from the sisters who sat with her through her early days at the leprosy center, prayed over her, and helped her begin counseling. The absence of funding for holistic Hansen’s disease care means recovery takes longer. But the sisters refuse to compromise on love, patience, or protection.
Faith that drives improvisation
Across Nigeria, Catholic sisters’ resilience and heroism are hard to quantify. As nurses, teachers, counselors, and community builders, they serve in the most challenging areas where others won’t go, offering hope in communities without clean water resources, clinics, or paved roads. Sisters rarely draw attention to their sacrifices, choosing instead to speak of “divine providence,” “mission,” and “God’s children.” Their efforts quietly sustain Nigeria’s humanitarian fabric at a time when most other threads are fraying.
They demonstrate not only “resilience” but also true discipleship. Their ministries are prophetic, yet they are not limitless:Their efforts are not substitutes for sustainable funding. But they reveal a way forward rooted in Catholic identity: small, relational, deeply human forms of care that keep hope alive even when systems fail.
For many Nigerian Catholics, the crisis has shed light on something deeper: the interconnectedness of the Body of Christ.
“What happens in Washington doesn’t stay in Washington,” says Fr. Peter Abue, a parish priest who collaborates with several sister-run clinics in Ogoja, located in Nigeria’s southern Cross River State. “It touches the sick woman in the parish. It impacts the child who drinks from the dirty rivers. It affects the girl who gets back from trafficking without anyone to greet or hold her.” His words echo the church’s universal call to solidarity—a call that transcends borders.
For Catholics in the United States, especially those far disconnected from the daily realities in Nigeria, the story unfolding across Africa is a reminder of the global nature of Christian responsibility. The creative ways Catholic sisters’ ministries are evolving could serve as models for Catholic communities worldwide.
“Our faith urges us to recognize the dignity of every human person, including the HIV patient in the rural clinic, the girl healing from the trauma of trafficking, and the leprosy patient who has nowhere else to go,” Abue says. “The sisters are doing extraordinary work. But they cannot do it alone.”
Image: Unsplash/Witty Kartel
Add comment