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ChadThe various armed conflicts that marked the first half of 2008 left Chad fearing a troubled year ahead. In fact the rest of the year proved less tense, but Chad remained a highly unstable country. Insecurity continued to affect many of the people living there and to hamper humanitarian work. Violence and displacementLawlessness, banditry, confrontations between government forces and rebels are common in Chad, making exposure to violence a part of everyday life. The conflict between rebel and government forces reached a peak in February, when the capital N’djamena came under attack. An MSF surgical team supported N’djamena Bon Samaritain hospital, treating 126 wounded and performing more than 80 surgical procedures. Emergency assistance was also offered to victims of fighting in Ade and Gozbeida in April and June. In eastern Chad alone, an estimated 185,000 Chadians who have been forced to flee their homes and 250,000 refugees from neighboring Darfur still live in camps, and there is no short-term prospect of their returning to their villages. MSF worked to meet the basic medical needs of people in Iridimi and Touloum refugee camps, in Iriba hospital, and in the Tine health center. More than 71,000 consultations, 140 surgical interventions, and 1,000 deliveries were carried out. In the refugee camps in Arkoum, Farchana, and Breijing, MSF provided more than 44,300 consultations, including nutritional interventions. As the health emergency subsided, MSF was able to hand over projects in Farchana, Arkoum, and Breijing in June 2008, and will hand over the Iridimi and Touloum projects to partners in 2009. In Adre, Guereda, and Abéché, however, despite MSF’s continuing interventions, health care for Chadian people and Sudanese refugees is still inadequate. MSF focused its efforts in these areas on health care for women and children, and implemented a surgical program to treat obstetric fistula. MSF continued to provide assistance at Adre’s health facilities, where almost 2,400 people were admitted. More than 56,000 outpatient consultations were provided in Guereda district’s health centers, including in Birak, where approximately 10,000 new Sudanese refugees arrived early in the year. Further south, MSF provided health care to 80,000 displaced people and residents in the villages of Gozbeida, Kerfi, and Ade. The mobile clinics in Kerfi and Ade began providing inpatient facilities in early 2008. More than 81,800 consultations were carried out and an additional 1,700 people were treated for malnutrition. The situation in Gassire camp in Gozbeida has stabilized, so MSF will hand over the camp’s clinic to partners in 2009. In Dogdoré, a remote village in the district worst-affected by the internal conflict, MSF has been providing medical assistance to the 27,000 displaced people and 3,000 residents since July 2006. In 2008, 25,000 primary health consultations were carried out, 1,000 patients were admitted to hospital, and 600 severely malnourished children were admitted to the MSF nutritional center. In addition, MSF provided 3,000 antenatal consultations and performed 350 deliveries. Despite these accomplishments, repeated security incidents eventually forced MSF to reduce the size of the team and evacuate all international staff from the projects in October. Local staff were able to maintain some basic health services during this time, and international staff began returning at the beginning of 2009. Support in the southwestIn the southwest of the country, MSF continued to support Goré’s hospital, responding to the secondary healthcare needs of about 30,000 refugees from Central African Republic (CAR) and 137,000 residents of the Goré district. Overall, MSF provided 20,000 consultations, 4,300 hospital admissions, and 1,000 surgical interventions. Following the arrival of about 5,000 refugees from CAR, MSF provided, between May and October, emergency water supply, primary and perinatal health consultations, and preventive measles vaccinations for children under five years old. Patients in need of secondary care were referred to a nearby Ministry of Health hospital. After 25 years, MSF left Bongor in December 2008, handing the city hospital over to the Ministry of Health. In 2008 alone, MSF treated 154,000 malaria cases, provided 5,815 patients with medical consultations, performed 1,440 deliveries, and conducted 850 surgical interventions. In 2008, MSF also responded to epidemic outbreaks throughout the country. Following outbreaks of measles, MSF immunized more than 11,000 children in Goré and approximately 15,000 children in Adre. The population of Abéché was also vaccinated in early 2009. MSF has worked in Chad since 1981. |
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