NEWS UPDATE

The conflict under way in the Dar Sila region of Chad has forced more than 150,000 people to flee their villages. Displaced persons are living under extremely precarious conditions, and the risk of an acute emergency developing in the coming months is high. Doctors Without Borders/Médecins Sans Frontières (MSF) is already working at several sites in the Dar Sila region and will strengthen its operations there. The international community and aid groups in the region must also expand their assistance immediately, before the rainy season begins.

"People here need water, food, and shelter," says Franck Joncret, MSF head of mission in Chad. "They have been weakened by precarious living conditions, and when they fall ill, access to care is extremely limited. If nothing is done to improve the situation quickly, we could soon face an emergency and high loss of human life."

Joncret has every reason to worry. Since late 2005, a conflict between government forces and rebel groups has been raging in the eastern part of the country. In addition, Chad and Sudan wage war on each other by sending armed militias across the border. Villages have been attacked, livestock and other possessions seized, and civilians killed. Violence intensified during the second half of 2006 and continues, causing residents to flee. The number of internally displaced villagers is climbing–it grew from 40,000 in June 2006 to nearly 150,000 today.

"After a two-week visit to Chad, I think there is a significant risk of emergency in the coming months," Emmanuel Drouhin, MSF's program manager for Chad, says. "In the east, aid is concentrated primarily on refugees from Darfur, ignoring the displaced persons. Today, organizations are starting to focus on them but sufficient assistance has yet to arrive. The international community must step up to its responsibilities and send more aid to eastern Chad quickly. In two months, the roads will be impassable because of the rains, and it will become much more difficult to reach the displaced populations there."

In Dar Sila, the region most affected by the conflict, more than half the population–124,000 people–have settled in unhealthy camps clustered around cities and villages, including Goz Beïda, Adé, Dogdoré, and Koukou. On March 31, a deadly attack on the villages of Tioro and Marena–resulting in 250 to 400 casualties, according to the International Committee of the Red Cross (ICRC)–prompted residents to take to the road.

"Armed men attacked early in the morning. They killed my husband and burned everything. Almost all the donkeys were dead, so I left on foot," said a woman who, with her children, walked 40 kilometers (25 miles) to Koukou, where they and others set up a displaced persons camp, the third in the town. For lack of water, several died of dehydration along the way.

Limited Resources in Settlement Areas

Displaced persons are settling wherever and however they can around the villages where they have sought refuge. Makeshift huts of straw and branches have been assembled in local fields, which will undoubtedly create tensions with residents during planting season. These flimsy shelters do not protect against daytime high temperatures that can reach nearly 46 degrees Celsius (115 degrees Fahrenheit) in the shade and drop precipitously at night. They are also no match for the sand and rain storms that are beginning in the region. In February, a World Food Program survey estimated that merely six percent of families had received plastic sheeting to reinforce their shelters. Other distributions are scheduled but will not meet all the needs.

The towns hosting the displaced persons are unprepared to handle an influx of this scale. More than 50,000 refugees have settled in Goz Beïda, a town of 10,000. The gap is even wider in Dogdoré, with 2,000 inhabitants and nearly 30,000 displaced persons. There is little cultivable land, and water supplies are inadequate. Traditional wells are drying up and, in the best cases, provide only muddy water that is unfit to drink. Many of the rivers, known locally as wadis, are dry by now and any water lasting into the dry season is of poor quality. The systems that aid organizations have set up to provide additional water are also inadequate.

Nutritional Situation Worsening

MSF teams have already noticed an increase in the number of cases of child malnutrition. The displaced persons often leave their villages abruptly and are unable to bring food with them. They struggle every day to feed their families.

"We go into the bush to gather bales of straw or bunches of sticks to sell at the market," says a displaced woman. Others work in brick factories to earn enough to buy a few kilograms of millet and pay the miller to grind it into flour.

Distributions like those scheduled as part of the United Nations' three-month emergency plan, set up in early April in collaboration with the ICRC , supplement these survival strategies. However, the total calories provided are lower than the standard food-aid ration, and the population of certain camps has been underestimated, resulting in distributions that will meet only around half the daily need.

In response to the nutrition situation in Dogdoré, MSF will provide a month's supply of ready-to-use therapeutic food to all children under age five (approximately 6,000) until September, the end of the rainy season. The team will also vaccinate all children under age 15 (about 13,000) against measles, a highly contagious virus that can spread like wildfire through displaced children and can exacerbate malnutrition. To increase the supply of water, MSF has brought in a drill that will help boost distribution to 20 liters per person per day.

Poor Access to Health Care

Beyond shelter, food, and water, health care is a primary concern. For the most part, health centers and public hospitals are too small to address the needs of displaced persons and residents. The Goz Beïda hospital, with 40 beds, will not be able to serve the many patients who are expected to arrive as soon as the rainy season starts, with sicknesses that result from poor living conditions in the surrounding camps.

"Diarrhea, respiratory illnesses, and malaria are the most common illnesses here," says Dr. Alberto Kalume Otshudiongo, who is part of the MSF team in Dogdoré. "I am worried because the rains have started and we will soon see a sharp increase in malaria and acute respiratory infections, which are particularly dangerous for children."

Aid Needed Before Rainy Season

In general, despite the presence of many aid organizations, assistance to displaced persons in eastern Chad remains inadequate, while the needs are enormous. MSF is working to strengthen its assistance to the displaced populations in four key areas: access to food, medical care and water, and shelter improvements in anticipation of the rainy season.

© 2007 Doctors Without Borders/Médecins Sans Frontières (MSF)