NEW YORK, NOVEMBER 27, 2020—Ethiopian refugees arriving in eastern and southeastern Sudan after fleeing violence in Tigray are in need of physical and mental health care, as well as clean drinking water and proper sanitation, said the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF).
The displacement of more than 40,000 Ethiopian refugees to Sudan comes after Ethiopia’s prime minister ordered military action against the Tigray People’s Liberation Front (TPLF) in the Tigray region, in northern Ethiopia, on November 4 following an attack on a military base. The escalating violence has already affected hundreds of thousands of people and runs the risk of destabilizing other parts of the country and the region, which could lead to potentially catastrophic humanitarian consequences.
On November 7, the first wave of people fleeing Ethiopia started to arrive in Sudan. As of November 25, the United Nations High Commissioner for Refugees (UNHCR) had registered 42,000 arrivals, but the number is likely higher as many people have not been registered.
Today, people from Ethiopia are entering Sudan at three locations: The main arrival point is at Hamdayet in Kassala State, in Sudan’s east, which accounts for two-thirds (68 percent) of arrivals. Nearly one-third (30 percent) are entering Gedaref State, in the southeast. A very small number of people (two percent) are entering Sudan further south, in the country’s Blue Nile State. MSF is currently providing aid at the Hamdayet border crossing point in Kassala State and in Um Rakuba camp in Gedaref State.
Hamdayet Crossing Point in Kassala State
Teams from MSF are present at the crossing point in Hamdayet, where they are witnessing people crossing the river that separates Ethiopia from Sudan. Many people tell MSF they fled their homes abruptly and quickly, without even being able to pack basic supplies for the journey. Many say they left their belongings behind and had to walk for hours—sometimes days—in a very harsh, arid environment before reaching Sudan.
Upon arrival in Sudan, the vast majority of refugees are located in a transit and border area of Hamdayet, where shelter, food, sanitation, and clean drinking water continue to be significant issues. Most refugees in Hamdayet, specifically those without shelter, have to sleep in the open—near roads, under trees—and are staying in a market area in Hamdayet village. Some people are being hosted in homes. So far, people living in border villages in Sudan have been very open and supportive towards their neighbors from Ethiopia.
MSF teams are also seeing people cross back to Ethiopia, either to help bring family members who stayed behind or to collect their belongings. Some are going back to sell their assets and return to Sudan with money. A small number of the people arriving are originally from Eritrea, and they were previously displaced into Ethiopia, before now fleeing to Sudan.
The first MSF team arrived in Hamdayet on November 16. Three days later, MSF began running activities. As a first response to address the needs of the growing numbers of refugees, the MSF team working at this crossing point started providing health care, health education, and mental health services. They are also screening new arrivals to see if they are suffering from malnutrition. Additionally, MSF is carrying out water and sanitation activities to make sure people have clean water and help prevent disease outbreaks. Teams in the MSF clinic are currently conducting about 300 consultations per day, most of which are diagnosed as respiratory infections, malaria, or diarrhea.
A small number of wounded refugees and some people who have experienced gender-based violence have also been treated at the clinic. Additionally, there are many people requiring continuing treatment for diseases such as tuberculosis. Shortage of medications for non-communicable diseases (NCDs) and chronic illnesses is a major problem right now among refugees. MSF is currently working with other organizations locally to quickly secure needed supplies as interruptions in treatment for NCDs can be deadly.
Um Rakuba camp in Gedaref State
After screenings and registration by the UN, some people arriving in Hamdayet are being placed on buses and driven to Um Rakuba camp in Gedaref State, which is the only official camp in the area dedicated to arrivals from Ethiopia. Um Rakuba is a 7- to 8-hour drive from the border. The camp is meant to host 10,000 people and is already near capacity at 8,000 people. Discussions are ongoing about establishing an additional camp to host people as the number of refugees continues to increase.
The sanitary conditions in the camp are extremely poor. There aren’t enough latrines, and people are forced to defecate in the open.
In Um Rakuba camp, MSF teams provided 453 medical consultations between November 19 and 23. Teams there are treating mostly diarrhea and urinary tract infections. Two patients arrived with bullet wounds and were referred to Gedaref hospital for further treatment. Fifteen people with severe acute malnutrition and 154 people with moderate malnutrition were identified and given nutritional supplements. Additionally, some people are showing symptoms of anxiety and insomnia due to the violence they saw or experienced in Ethiopia and on their journeys to Sudan.
“On November 3 or 4, I was working in the shop, suddenly I heard war sounds, very loud noise,” said a young Ethiopian man in his mid-30s who is staying in Um Rakuba camp. “I don’t know why they are fighting, I saw many people dying, even old people. I know so many of them. I’m confused, I don’t know why they did this.”
“In Tigray, the people are hiding in the bush, young and old," he added. "The most difficult is that we have no money, nothing to cook, no one brought anything from their home. We had to leave. I came with two pairs of trousers. Before the war started, electricity, the phone network, the banks, were all closed. I have money back there but not here.”
MSF has identified many doctors among the arrivals from Ethiopia who are staying in the camp as refugees. Since staff from humanitarian organizations are not allowed to stay overnight in the camp, MSF is working with these doctors to find a system that allows for 24-hour medical support. Additionally, MSF’s team in Khartoum, the capital of Sudan, is currently negotiating with authorities to facilitate the import of medical supplies and urgent visa processes for additional staff to come into the country to provide care for more people in need.