More than 500,000 people from Sudan’s embattled western Darfur have crossed into neighbouring Chad over the past six months but face critical shortages of food, water, shelter, and healthcare due to a desperately underfunded relief effort.
Adré, once a small border town, is now swollen with the makeshift shelters of new arrivals. With no end in sight to the civil war in Sudan between the army and paramilitary Rapid Support Service (RSF), an additional 100,000 refugees and returning Chadians are expected to make their way into eastern Chad before the end of the year.
At best, most refugees have received one food ration from the UN’s World Food Programme (WFP) since their arrival. “If we don’t receive more funds, we will not be able to assist anyone after the end of this month,” Eloge Mbaihondoum, WFP’s spokesperson, told The New Humanitarian.
The agency estimates it needs $250 million to run its operation in Chad for the next six months. So far, donors have provided less than 20% of that figure – despite repeated warnings by WFP that its aid pipeline is close to breaking.
Last month, The New Humanitarian witnessed a food distribution at Ourang, a new refugee camp hosting more than 44,000 people outside Adré that kicked off several days late. It then ran out of the sorghum, oil, and beans ration before everyone could be reached.
A frustrated WFP official, who asked not to be named, said the number of people who had lined up for the aid “was much higher than the beneficiary lists” that had been compiled.
Um Zuhor Adam Osman was one of the refugees who initially missed out on the relief food her family was relying on. “We were given some sorghum some time after we arrived in Chad, but nothing since – it’s very difficult for us,” she told The New Humanitarian. “The children eat only once a day.”
Severe acute malnutrition rates are peaking in eastern Chad – a historically deprived region, but with refugees now the bulk of the vulnerable. Although the paediatric ward at Adré hospital has been expanded from 50 to 200 beds, it’s still always full.
“Most of the malnourished children we receive here are refugees from Sudan,” said Médecins Sans Frontières (MSF) nurse Ghaïs Masrangar. “More than 70% of the cases with complications – who need to be hospitalised – come from the refugee camps.”
Sudan’s conflict has produced the world’s fastest-growing and now largest displacement crisis, according to the UN. Some 1.2 million people have crossed into neighbouring countries, while more than 7.1 million people have been displaced internally, 4.5 million since fighting erupted mid-April.
The majority of those arriving in Adré are from El Geneina, the capital of West Darfur – just 30 kilometres from the border – where Arab militia and RSF have targeted non-Arab Masalit in an intense campaign of ethnic cleansing that has raged since the start of the civil war.
Non-Arab communities like the Masalit are identified with rebel groups that rose up to protest Darfur’s marginalisation by successive governments centred in the distant capital, Khartoum. The RSF and allied militia have ratcheted up their long-standing campaign of violence against the Masalit aimed at driving them off the land.
Refugees are finding shelter in a large informal settlement in Adré known as Camp École; long-established camps further west in Farchana and Ambelia; and newly- developed sites in Metche and Ourang. A number of host villages along the border also provide help to what are often kith and kin.
Since September, there has been a growing influx of refugees from Nyala, the capital of South Darfur, escaping both attacks by the RSF and allied militia, and indiscriminate bombing and shelling of the city by the army.
Physical scars
The scale of the violence in Sudan means the MSF medical team sees a flow of bullet wounds, fractures, and infections. Many of the patients that have made it this far have had to survive several weeks without care before reaching Chad.
“I was in my house and [the militia] shot through my door and hit me,” said Kaltuma Khamis, a woman in her fifties who escaped El Geneina with a bullet wound to her thigh. “My son and my son-in-law were killed. Others were injured.”
“Many wounded will suffer lifelong physical consequences.”
Her daughter, Zeinab Yacoub Dfala, sitting next to her hospital bed, fears Khamis might never fully recover. “She needs surgery with a bone specialist,” Dfala told The New Humanitarian. “They must use metal plates and screws to realign her leg. It won’t heal properly otherwise.”
But in a small hospital like Adré, all the overworked medical staff can do for Khamis is to attach a heavy jerrycan to her leg to put it in traction.
“Many wounded will suffer lifelong physical consequences,” said Serge Kouadio, the doctor coordinating medical care at the hospital. “Then there are also the cases of psychological damage, and these must be addressed too.”
Invisible wounds
In the sprawling Camp École, which shelters roughly 200,000 people, almost every family has lost someone – a father, mother, sister, brother, a child.
“Many have seen their relatives killed in front of them. They’ve seen their houses looted and burnt,” said Omer Mohamed Omer, a Sudanese psychologist.
Omer, a refugee himself, is one of two psychologists working with the International Rescue Committee who shuttle between the camps seeing patients. As The New Humanitarian visited Ourang, a woman was brought into Omer’s tarpaulin tent, shaking and screaming, calling out the names of her dead sons killed by Arab militia.
Too agitated for a consultation, Omer instead advised her brother to take her home, and handed him some medication to calm her: “Most have experienced this type of traumatic shock,” he said.
Many refugees have also lost contact with families and friends in Sudan. To try and reconnect them, the Red Cross has set up call centres so they can speak for a few minutes with their loved ones.
In the call centre at Farchana camp, Arafa Djor was crying as she spoke to her only son for the first time in months, wiping her tears with her green headscarf.
As an El Geneina businesswoman, she had managed to save enough to send him to study in India. But with everything now lost and no more money to remit, he had been barred by the university from further classes.
“I wanted him to have a better future,” said Djor. “We want our children to be educated so they will reject violence and avoid everything that is happening today in Sudan.”
A long stay ahead
Adré is not only overcrowded but also expensive. The drastic fall in cross-border trade with Sudan, and the arrival of well-heeled aid workers, has driven up prices of even basic necessities on the market. Poor rains have also impacted production of the staple millet, while hungry refugees have encroached on farmers’ fields.
Chadian authorities have allocated more land in the eastern Ouaddaï region to alleviate the congestion in Adré. The UN’s refugee agency, UNHCR, and its partners are organising the daily transportation of thousands of people and their belongings to these more permanent camps further from the border.
“The task is huge,” said Sherif Moussa, a UNHCR protection officer. “Every day, new people are coming and settle spontaneously near the border. We empty one part of the camp, and new shelters appear on the other side.”
Metche is one of the new camps being hastily built to accommodate the new arrivals. Set between rocky hills, about 40 kilometres from Adré, it takes almost three hours to reach by road over difficult terrain.
The perfectly aligned regimented huts, with tarpaulin walls and tin roofs, stretch as far as the eye can see. That delighted Soraya Yacoub when she first glimpsed Metche. “Look how the houses are well spaced from each other,” she said. “We will even be able to farm!”
UNHCR plans to relocate up to 100,000 people, eventually providing services like healthcare, latrines, and potable water. But currently there is only a single borehole in Metche, with a flow rate far too low to meet the needs of the camp.
Nevertheless, Zeinab Yacoub Dfala – Soraya’s sister – clings to the hope of a better life here, and was already planning how to find work in the local market to help support her family.
“Sudan is not safe and will not be for a long time,” she told The New Humanitarian. “Since I was young, there have been wars, wars, wars – until today. We won’t go back. We will stay here or go to another country.”
This project was funded by the H2H Network's H2H Fund, which is supported by UK aid.
Edited by Obi Anyadike.
