November 10, 2004
Doctors Without Borders/Médecins Sans Frontières (MSF) has been providing relief for the refugees in Chad for over a year now and is giving medical assistance in two hospitals and four refugee camps with a total population of some 85,000 people. For several weeks,
It is unlikely that the Sudanese refugees will be able to return to Darfur in the foreseeable future. What sort of conditions are the people currently living in in Chad?
While they may be safe from attack in Chad, for many of the refugees, the living conditions in Chad one year on since they fled are still unbearable. Take the camp in Breidjing, for example: it is the largest of the camps along the Sudanese border and, with more than 43,000 refugees there, it is more than overcrowded. A third of the refugees are not registered, and those who do not have official refugee status were unable to find a place in the tents set up by the UN's refugee agency. They are living in simple makeshift shelters made using branches and plastic. Furthermore, they are not receiving sufficient food rations, resulting in malnutrition, especially amongst the children. But even when there is enough food to go round, the children can very quickly become malnourished as a result of diseases such as tuberculosis. In Breidjing alone, around 400 children are being treated by MSF with special nourishment.
Fortunately, there were no outbreaks of cholera in any of the camps during the rainy season, in spite of the particularly bad hygiene levels at that time. Our efforts to install more latrines and improve drinking water supplies certainly helped in this respect. We are, however, now very concerned that there are cases of Hepatitis E in Breidjing camp. It shows just how bad the level of hygiene remains in the camp, as the pathogen for this acute liver inflammation is often passed on via contaminated drinking water. In the case of pregnant women, this disease can often be fatal. There is no effective medication for Hepatitis E, so we are only able to treat the symptoms. We are also scaling up prevention efforts by deploying more hygiene and health educators.
We are now also seeing more and more cases of malaria in our clinics â€“ in Breidjing camp alone, we see around 160 cases every week. Not surprisingly, the majority of cases crop up in this region from October onwards, because the number of anopheles mosquitoes, the carrier of the malaria parasite, is much higher after the rainy season. The number of infected refugees has remained relatively low, however, because we sprayed the tents the refugees are living in with insecticides a number of weeks ago.
Measles also pose a serious threat in a camp such as Breidjing. When the disease reaches epidemic proportions, it can be fatal for up to ten per cent of all the children who catch it. We have so far managed to prevent the outbreak of an epidemic by vaccinating almost all children under the age of 15 in Breidjing â€“ that amounts to more than 17,000 vaccinations.
What is more of a problem is that we are invariably faced with the after-effects of violence before and during the refugees' flight. On the one hand, we treat lots of old wounds and fractures, and on the other hand, we have to treat the psychological repercussions of the violence experienced in Darfur.
Let's not forget that most of the refugees have either been mistreated themselves or were witness to extreme violence. In many cases, friends, family or neighbors were murdered before their very eyes. Consequently, many of the refugees are traumatized and suffer from panic attacks, anxiety, sleep disorders, and depression.
© 2013 Doctors Without Borders/Médecins Sans Frontières (MSF)