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MSF in Chad, 2006/2007
Field Staff: 802
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The need for humanitarian aid in eastern Chad has critically increased since July 2006. Ongoing confrontations between government forces and rebels, combined with border military incursions from Darfur, have fueled a home-grown civil crisis leaving numerous Chadians killed or wounded and tens of thousands forced to flee their homes. Despite difficult security conditions, MSF has managed to increase its assistance toward internally displaced Chadians without hampering the aid provided to refugees from Darfur. In the southwest of the country, MSF assists refugees from Central African Republic, and has run a malaria treatment project since 2003.
Sustained assistance to Darfur Refugees
Since 2003, some 200,000 refugees from Darfur have been living in camps in eastern Chad. Whilst many carry a heavy burden of psychological trauma from events in Darfur, they continue to fear attacks when straying from the camps, or of being forced back to Sudan. Although they receive assistance, their situation remains critical as they depend entirely on international aid, which is subject to variation if security or funding deteriorates.
MSF provides medical care, including pediatric and maternal care as well as psychosocial support, to more than 100,000 people living in Iridimi, Touloum, Farchana, and Breidjing refugee camps, and to the surrounding Chadian population. The teams also treat the consequences of sexual violence, address malnutrition, provide health education, and help control communicable diseases. In Adré and Iriba hospitals, MSF surgical teams also offer elective and emergency surgery to refugees from nearby camps, residents, and displaced Chadians.
Ensuring care as violence flares In Eastern Chad, the number of internally displaced people (IDP) increased dramatically from 40,000 in May 2006 to 170,000 by June 2007. Ongoing civil violence caused the population of the area to gather in camps and IDP sites around Goz Beïda, Koukou, Am Timan, Am Dam, and Dogdoré. The displaced population has been deeply traumatized.
Poorly sheltered, lacking food, clean water, and with limited access to healthcare, the displaced were long neglected by international assistance. This led to an emergency sanitary and health situation, particularly regarding malnutrition.
Despite difficult security conditions, MSF provided primary and secondary medical assistance, drinking water, food, and material aid to improve shelters, whilst trying to follow people through their displacement. Between April and June, confronted with soaring malnutrition rates, MSF developed nutritional projects and increased its hospitalization capacity. In July 2007, MSF was assisting displaced in camps and IDP sites around Goz Beïda, Adé, Koukou, Arkoum, Am Timan, Am Dam, and Dogdoré.
Supporting refugees from Central African Republic
Since June 2005, increasing violence in neighboring Central African Republic has prompted tens of thousands of villagers to flee. Many are still hiding in the bush, and more than 45,000 have gathered in southern Chad, around the city of Goré. MSF provided assistance including water, sanitation and healthcare in the camps until April 2007. MSF continues to work in Goré district hospital, supporting all wards to provide secondary medical care and surgery to refugees and local residents.
Treating malaria with innovative strategies
Malaria is a concern in the southern district of Bongor: in 2004 an MSF survey showed the number of deaths for children under five was close to emergency status during malaria season. When the project to prevent and treat malaria was launched in 2003, MSF faced a severe lack of local healthcare workers and a high resistance to the treatment usually available. Further, the area is often flooded and many places remain without access to medical care for long periods. To overcome these barriers, MSF introduced a therapeutic strategy using artemisinin combination therapy (ACT), and favoring decentralized care through the empowerment of the local population. Between July 2006 and June 2007, 88,000 people were treated in the project, representing over 20 percent of the total number of people treated for malaria within the country.
MSF has worked in Chad since 1981.