Doctors Without Borders/Médecins Sans Frontières (MSF) teams in Baibokoum, Chad, are running programs for refugees coming across the border with Central African Republic (CAR), 30 kilometers [18 miles] to the west. Each day, an MSF team travels from Baibokoum to Bitoye, a smaller village that has seen its population of roughly 10,000 double with new arrivals from CAR, people who arrive on foot or in vehicles after fleeing the brutal violence that now plagues their homeland.
MSF set up a primary health center in Bitoye three weeks ago, and staff now carry out around 100 consultations per day. The waiting room is usually full of people—mainly women and children, most from the Fulani ethnic group—sitting on benches or on mats under a mango tree. One woman trying to nurse her one-month old baby says she was forced to flee her home barefoot and sprint into the bush with her seven children after armed groups known as “anti-balaka” forces attacked Bocaranga, her native village. Several other women have similar stories; their husbands are either dead or have stayed behind in the bush with the few cattle they have left.
“I’ve never seen this before,” admits Dr. Aaron Zoumvournai, an MSF physician who led the MSF assessment missions in Bitoye, Goré, and Sido, the three largest entry points into Chad for refugees from CAR. He’s talking about the injuries refugees from Bangui and other towns inside CAR have arrived with—children with machete wounds on their heads, a young girl who had had two fingers cut off with scissors, people with multiple bullet wounds and others whose injuries showed evidence of torture.
He tells the story of one patient at the Bitoye health center who was later referred to the hospital in Baibokoum: “He came from a village in the Bouar region,” Dr. Zoumvournai says. “That day he was alone at home when the anti-balaka forces came down and attacked his village. They set fire to his home. He managed to escape through a window, but as he was leaving, he saw at least four people being hacked to death with machetes, and [he] wondered how many others had been burned alive in their houses.”
This same man was later captured by the anti-balaka forces. “They ordered him to place his feet on a white-hot barrel and threatened to kill him it he didn’t obey,” Dr. Zoumvournai recalls. “When they no longer found amusement in torturing him, they left.” He was then taken to the side of the road by an old man who happened by and was finally picked up by a passing truck. “He does not know what happened to his family, but has not much hope left for them.”
Food, Shelter Needed
In Goré, 6,000 people crowd into and around an old hospital. Many come from Bossangoa. They often sleep on the ground and use branches and cloth to build shelters that offer a bit of protection, though they will be washed away when the first rain comes.
An old man stops the MSF team. He came in this morning, on foot, from the border. Further on, a woman approaches with a tiny baby in her arms. She gave birth here prematurely and is unable to breastfeed. “This child is simply hungry,” says Dr. Francis Koné, an MSF doctor. The newborn has eaten almost nothing over the past two weeks but is somehow clinging to life.
In Sido, the distress is all the more intense because of the numbers involved. More than 13,000 refugees have settled here, just a few hundred meters from the border. Just three days earlier, the eighth and final convoy escorted by the Chad army brought in another 3,500 people.
Kaltouma was one of them. She had been forced to flee Yaloke, her native village, more than six weeks ago because it had been attacked and then occupied by the anti-balaka forces. She spent 20 days in the bush with her oldest child, who is 13, and her one-year-old twins. Her husband and their eight-year-old son were among 20 family members who disappeared during the attack.
A Lack of Support
Food is a big problem; one MSF doctor says half the patients he’s seen have complained of hunger, and there are reports that some women have been forced into prostitution in an attempt to secure food for their children. What’s more, there are only 20 latrines, 300 tents, and 4 water distribution points for everyone in Sido. And, in late March, the first rains will come and sweep away the makeshift shelters and heighten the risk of epidemic.
The United Nations High Commission for Refugees (UNHCR) has yet to assess the situation here. The local authorities are doing what they can to deal with this crisis and defuse conflicts that have begun to arise between refugees and the local populations, but they are sorely lacking in means and support.
MSF is the only international agency on the ground in Sido. “As long as these families are unable to exercise their right to claim asylum in Chad, they will not be able to obtain refugee status and will not qualify for UNHCR assistance, or they could be sent unwillingly to a final destination where there will be absolutely no one to help them,” says Sarah Chateau, MSF's head of mission in Chad.
“It is critical that, on the one hand, recognition be given to the fact that the vast majority of these persons have fled violent situations in order to just save their own lives, and they are therefore indeed refugees and, on the other hand, that they receive international assistance here immediately, in the form of food, tents, water distribution points and sanitation facilities,” states Chateau. “What’s happening right now in southern Chad is unacceptable.”