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Headline
Since the start of the war in Sudan on April 15, 2023, 8 million Sudanese have fled the fighting. More than 620,000 of them have found refuge in Chad, notably in Adré, in the Ouaddaï province. Action contre la Faim is working in the Lycée transit site and the Metché refugee camp.
When the wind picks up, the tents disappear in a cloud of sand and dust. Makeshift shelters crumble and pieces of tarpaulin blow away, leaving some families in total destitution. In the refugee arrival zone on the outskirts of Adré, the temporary has become permanent for almost 200,000 Sudanese. Having fled their country in haste, they have settled here in the hope of being able to provide for their families. Some have found odd jobs in town, while others cultivate plots of land in the surrounding area. Because of its proximity to the Sudanese border, Adré is one of the main entry points for refugees into Chad. Hundreds of Sudanese arrive here every day, on foot or by cart. Some have a few suitcases with them, while others have only what they can carry on their backs.
With little access to basic services, Ouaddaï province is one of the most vulnerable in the country. The arrival of refugees has exacerbated the needs of the local population and created tensions in the town, as some families have been settled on land that the people of Adré can no longer cultivate. Finding land to accommodate the hundreds of thousands of refugees is difficult: UN agencies and the Chadian authorities are seeking to relocate them to official camps set up outside the town, but the initiative is slowed down by the under-funding of the humanitarian response. The new camps are much further from the border, and many refugees, like Salma, refuse to go there. “We came here expecting to find refuge, and now we’re being asked to go back to a camp further away. We tried to rent a house in town, but it costs 10,000 CFA francs and it’s hard to pay.” Like eleven other women that day, Salma is taking part in a discussion group set up by Action contre la Faim’s mental health and psychosocial support program (MHPSS). Sitting around Agnès, the psychosocial worker, the young mothers bow their heads under the weight of memories and the anxiety of being able to feed their families. Women and children account for 89% of Sudanese refugees in Chad.
“We all have a lot of nightmares. We’ve lost family members and we’re very stressed. Here, we feel a bit at home again, we have the support of Agnès. She’s become like a sister to us. The children also feel better when they come. As soon as it’s light out, they ask to come to the clinic to do activities” continues Salma. Suddenly, a thunderstorm interrupts the session. The mothers grab their children and put them on their backs to get to their tents and quickly get their few belongings to safety.
At the clinic, the nursing mothers are invited to attend a workshop on mental health and nutrition. As they fled to Chad, many of them were exposed to aggression. “Mothers who have been raped may refuse to breastfeed because of a sexual taboo. This causes early weaning, which leads to malnutrition” explains Evariste Kajibwami Ndjovu, MHPSS program manager in Adré. Draped in their long veils, some twenty women listen attentively to him speak. He explains the impact of stress on breastfeeding. “The fact that women have mental health problems means they have no appetite. Children who are still breastfeeding won’t be well nourished, and there will be consequences for their nutritional status.”
Djawahir, from Al-Genaïna, left Sudan with her three children when she was 5 months pregnant. She struggled through the end of her pregnancy, searching for shelter and food for her eldest children. Since the birth of her youngest child, her anxiety has only increased. “Sometimes I can’t breastfeed my baby. It’s difficult for me. Children need food and you, the mom, just stress and don’t know what to do. If there’s something to eat, you give them everything and keep nothing for yourself.”
Action contre la Faim teams focus primarily on the mental health of women, but also of teenagers and children, who are among the most vulnerable populations. The voices of the youngest children echo through the clinic. This morning, around forty of them are learning songs whose words encourage them to keep hope alive and take care of themselves. There’s laughter, bickering and a bit of jostling too. The workshop has the air of a schoolyard. “Sudanese refugees have often lost family members, homes and possessions. This has led to mental health problems for many people. With group activities, we can express ourselves and receive human warmth. Thanks to this, many symptoms diminish. The children, some of whom hardly slept at all, are better too” concludes Evariste Kajibwami Ndjovu.
Nearly 10,000 refugees have been registered with the MHPSS program in Adré since January 2024, and every month the number of requests for psychological support increases by the hundreds. Resources are still sorely lacking to respond to the distress of the hundreds of thousands of refugees and the host population. To date, only 35% of the humanitarian response in Chad has been funded.
The Metché camp is about 50 km from the town of Adré, one and a half hours’ drive. On the road, herds of camels and goats drive away to the sound of horns. Action contre la Faim teams make the journey several times a week to visit the clinic at the heart of this site, home to 50,000 refugees.
On this particular morning, Noël Djodinan Djimadoum, head of the Water, Sanitation and Hygiene (WASH) program, starts with the distribution of 120 NFI kits (non food items). A group of women wait in the sweltering heat to receive pots, ladles, jerrycans, buckets, soap and other items that will enable them to collect and store water, as well as take care of their hygiene. “Once the lots have been collected, they open the bags and check that everything is in good condition. There’s a complaints management committee right next door so they can claim what they’re missing” explains Noël Djodinan Djimadoum. Dented jerrycans and cracked pots are replaced, and the women return to their tents.
Getting water is a daily challenge for the refugees. Action contre la Faim has set up six water distribution points supplied by tanker truck, first in the morning at 7am, then again in the afternoon at 3pm. Sometimes the truck doesn’t arrive. Sometimes two days pass without any water flowing from the tap. The water ratio then drops to 10 or 12 liters per person per day. This is below the emergency standard of 15 liters per day. Noël Djodinan Djimadoum admits that access to water is a major problem in the Metché camp: “The supply by tanker is a short-term solution because we are in an emergency situation. ACF is planning to drill boreholes to provide autonomous water points. The aim is to supply 12,000 people with drinking water in the future. »
At around 3 a.m., the camp’s inhabitants get up to place their jerrycans at the foot of the tanks. They line up in their places until the tanker arrives. Then, at dawn, the silhouettes reappear and settle into the queue. Those who forget to wake up will have a day without water: their jerrycans rejected by the early birds.
Hamida lives just a few hundred meters from one of these water points. Since an accident in Sudan 2 years ago, the young woman has had difficulty walking. When she arrives too late to fill her jerrycans, she has to rely on the solidarity of her family and friends. “My sister leaves with several other women to fetch water from the borehole 4km from here. They go as a team to avoid being raped, but also to support each other during the walk, which lasts 3 or 4 hours.” When you’re a woman, straying from the camp means running the risk of being attacked. But insecurity also exists within the compound. Hamida admits that since her husband left a week ago to look for work, she hasn’t been sleeping peacefully. She fears that a man will come in and attack her or her children. So at 6pm, as soon as it gets dark, she closes the big door made of faggots that opens onto the alley.
On her lap, little Inas chirps in her pretty white dress. The little girl was born in Chad, shortly after Hamida decided to leave Sudan. “One day a bomb fell near our home in Zalingei and everything burned down. My husband had already left for Chad and I was alone with Anis, my little boy. My husband found a way to get us here and we left everything behind. We took millet and water in a can and traveled with that as our only food. The journey was really difficult. There was nothing to carry us. I came alone on foot with my son. I was 7 months pregnant.”
Inas, 9 months old, was diagnosed with moderate acute malnutrition a few weeks earlier at the ACF clinic in the Metché camp. Hamida returns regularly for follow-up consultations. She also collects the supplements she needs to feed her daughter to help her get better. Even if Inas is taken care of, it’s hard for this young mother not to worry. “I’ve lost a lot of family in Sudan. When she’s sick, I worry a lot. If she doesn’t take milk, it stresses me out. Then I think of my relatives who have died, and I wonder if my daughter is going to die too.”
Just inside the entrance to the clinic is a small shelter where mothers come for their child’s first check-up. Ali Mansour, head of the Nutrition and Health program, watches as his team perform the necessary procedures. “We have to check for oedema, measure the brachial perimeter, then weigh and measure the child” he explains. In the large basin used as a scale, little Zarra cries. She will only be consoled by her mother’s breast, once the measurements have been completed and recorded in a register. The baby is in a situation of severe acute malnutrition and will have to take Plumpy’Nut – a therapeutic food – twice a day for eight weeks.
“Every month, we have a total of almost 400 severely malnourished children monitored at the Lycée and Metché sites” explains Ali Mansour. These children are particularly vulnerable during the rainy season. “There are cases of malaria, and it’s a vicious circle between the two. Malaria can cause malnutrition, and malnutrition can complicate malaria.”
When he receives new patients, Ali Mansour always asks them why they left Sudan. “At first, refugees said they left to escape the violence. Now 90% of them tell me they left because of famine.” The influx of Sudanese refugees into Chad has accelerated in recent weeks. In June, some 3,000 crossed the border every week at Adré. At a time when both Chad and Sudan are going through the lean season and the rainy season, this figure doubled at the beginning of July¹. For many, it’s disillusionment after a few months in the camp, says Ali Mansour. “Some patients tell me they’re thinking of going back to Sudan because the food rations are insufficient. Others prefer to return to Adré or near the ouadis to get water.”
As for Hamida, she can’t imagine leaving the camp. To earn enough money to buy more food, she sells wood at the market. “They give us millet, oil, beans and salt. At the end of each month we get a ration, but it doesn’t always last until the next distribution. When I sell something I use it to buy a piece of meat.” Hamida has been in Chad for almost a year now. “In Sudan, before coming here, my two brothers were killed. We looked for them everywhere, but we couldn’t find them. Sometimes I still dream that they come in the night to wake me up.”
As time goes by, bad dreams become rarer, and her country, just a few dozen kilometers away, seems far away. “Even if Sudan recovers, I don’t think I’ll be able to go back and help my family there, because we’re too poor. My future there would be too bleak.” Resigned, Hamida wants to start by looking after herself and finding work to offer a decent life to Anis and Inas, here in the Metché camp.
¹This figure fell in August due to flooding.
Chad
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