An estimated 80,000 refugees have made this journey from North Darfur since the end of April, yet the humanitarian response is grossly insufficient. To help meet the needs of new arrivals in Chad, Doctors Without Borders/Médecins Sans Frontières (MSF) is boosting activities in Tine and Oure Cassoni camps and calling on other organizations to scale up their support.
MSF teams in both camps are hearing harrowing stories of violence suffered in North Darfur and on the journey to eastern Chad. Most of the newly arriving refugees are women and children fleeing El Fasher and its surrounding camps after intense attacks by the Rapid Support Forces (RSF). Many have been hurt or have seen men and boys beaten, injured, or killed, and women and girls raped. Some people reportedly died of thirst on the way. And while they are now safe from bombs in the camps, they must now endure harsh living conditions, with severe overcrowding and only limited access to food, water, shelter, and essential medical services.
Care for the wounded
Eleven-year-old Mahanat lost his left hand on April 11, when RSF launched a massive ground offensive on Zamzam camp, which housed 500,000 people and is located near El Fasher. According to the UN, hundreds of people were killed in April alone and the camp has been completely emptied. Mahanat escaped the deadly attacks and is now living in Tine camp with his mother.
“Mahanat’s father was killed during the attack on Zamzam camp,” says Mahanat’s mother. “His left hand got ripped off by a shrapnel bomb, some got stuck in his right eye. He arrived at the MSF clinic in Tine camp several weeks ago. Each time, doctors and nurses struggled to even access the wound as the child was traumatized and in immense pain. Over the days, with time, patience and trust, Mahanat accepted care.”
Our teams have been treating people wounded by gunshots, shrapnel, bombs, and landmines. We are also helping patients with amputations through pain management and infection prevention and control measures, such as applying sterile bandages to keep wounds clean and dry. In Tine, we have recently added a mental health component to our work to better support patient recovery.
Hassania, Oure Cassoni camp
"They take water from children dying of thirst"
When the war came to El Fasher, my husband and I left with our seven children on foot. I was heavily pregnant. The armed men were burning everything. As soon as we arrived in Zamzam, we had to flee the war again—that’s where I lost my husband. I don’t know where he is, I don’t know what happened to him.
I saw a lot of suffering on the road. The armed men take everything from people. They take water from children dying of thirst. They kidnap young boys and then kill them. My older brother was taken in front of my eyes, then killed. I had no choice but to keep going, I had no time to look back and care for his body. I ran away with my children.
Expanding access to health care services
While MSF scaled up activities in Tine camp in April, the overall situation remains largely unchanged due to the overwhelming needs. We continue to do our utmost, but a coordinated and strengthened response from other humanitarian actors is essential to meet the urgent demands on the ground.
“Again, we ask donors, the UN, and humanitarian organizations to start providing or scaling up support in terms of food, shelter, sanitation, and medical care, including mental health services,” says Claire San Filippo, MSF's emergency coordinator for Sudan. “The current response is grossly insufficient.”
MSF is working to expand the availability of essential health care services in Tine and Oure Cassoni camps. Since April 2025, our teams have carried out over 7,700 consultations at the Tine health post. We are concerned about the global rate of malnutrition among children under 5 in the camp, which is as high as 18 percent, including 3 percent who are severely malnourished. We have also vaccinated 5,755 children to help curb the spread of measles in Tine.
At the health post, we provide care for pregnant women and survivors of sexual violence and refer critical patients to local hospitals. From April 2025 until now, 1,322 consultations on sexual and reproductive health have been carried out. Over the last four weeks, 16 survivors of sexual violence were seen at the health post.
In addition to medical activities, we have built 40 emergency latrines to support people’s overall health. MSF is the only organization in the camp providing people with water, which remains a huge need for residents. While we were providing the minimum amount of water required per person per day, the sudden influx of refugees means that the needs have increased.
Gisma, Tine transit camp
"I faced the enemy"
I suffer from psychological issues; I need tablets to sleep. It worsened after I gave birth four years ago. My husband took my baby from me because my body was full of medication. When I got better we all reunited. Since the bombing in Zamzam, I don’t know where my husband is. My eldest son has kidney failure and I don’t have the means to provide for my four children. On the road when we fled, I faced the enemy—they took my blankets, my money, some clothes. Now I can only hope for support from the community.
Understanding the growing needs in Chad
In Oure Cassoni camp, we carried out a rapid evaluation of the situation to understand the needs and prepare an appropriate response. For the time being, we are supplying water through trucking while exploring more sustainable interventions. While this camp was already home to 56,000 people, an additional 40,000 refugees have been accommodated there since last April. These new arrivals have set up with what they have, but they are living in makeshift shelters and without latrines and other basic infrastructure. While a humanitarian response is underway, there remain many unmet needs, and many more people are expected to arrive from North Darfur.
“The number of people arriving at the Tine border point is not expected to decrease over the coming weeks,” says San Filippo. “The upcoming rainy season is likely to worsen the already poor living conditions, spread disease, and exacerbate food insecurity and the lack of sanitation. We are deeply alarmed by the difficult conditions in Tine and Oure Cassoni camps. Large-scale humanitarian action is urgently needed to prevent the situation from deteriorating further.”
