Hadiya Beshir Issa and her 15-month-old daughter Munira wait in the shade outside an International Rescue Committee health facility in Bahai, a desolate village in eastern Chad along the northern border with Sudan.
They are recent arrivals in a seemingly endless stream of 130,000 refugees who have fled violence in Sudan 's Darfur region and now live in appalling conditions in Chad 's desert. Munira hardly has the strength to open her eyes and her skin is shriveled from dehydration.
“She is severely malnourished,” says IRC's emergency health coordinator Camilo Valderrama , instructing Hadiya how to administer oral re-hydration solution and antibiotics. The medicines are not enough, however. Later in the day, Valderrama took Munira to the closest hospital in the region, but the infant was beyond help.
“There is an emergency here that has been neglected,” Valderrama says. “There is very little food. Water is scarce and of poor quality. Diarrhea is endemic and becomes dangerous and deadly when immune systems are already so weak.” He says there was a steady increase in cases of acute diarrhea over the past month, with 10 deaths as a result.
The IRC has been the only organization providing humanitarian assistance in the area around Bahai and the settlement of Cariari further north, assisting an estimated 20 per cent of all Sudanese refugees in Chad . Dozens more arrive every day. The influx has tripled the population here, stretching the resources of the already impoverished host communities.
The refugees are living under scraggly acacia trees and thorn bushes with all the belongings they could carry when they fled. For most, that's a bucket and some clothes. The landscape is extremely harsh; the air trembles with heat and the slightest gust of wind sends plumes of yellow grains into the air. The nights are bitter cold.
IRC mobile clinic nurse examines Sudanese child in Cariari, Chad. Photo: Peter Biro/IRC
Focusing on emergency health and sanitation in this remote region, the IRC has set up a health network of nurses, traditional birth attendants and community health and hygiene workers, all recruited from the refugee community. Under Valderrama's guidance, health posts and mobile health teams provide curative and preventative services, and medical care for war-related injuries. To further alleviate the growing health crisis, the IRC is also distributing large quantities of medicines donated by AmeriCares, to refugees and their host communities.
Water quantity, quality and access remain significant problems, with few functioning wells. Thousands of water purification sachets have been distributed and the IRC is working with the refugee community to dig new wells at appropriate sites and to rehabilitate existing ones. In addition, the IRC has collected and disposed of thousands of animal carcasses that contaminate the settlements and pose a grave public health risk. For more information on this project, see: IRC Responds to Public Health Threat at Refugee Sites in Eastern Chad.
All of the refugees in Chad accuse the Sudanese army or the Janjaweed militia of atrocities, in a campaign U.N. and U.S officials describe as one of ethnic cleansing and forced migration, aimed at driving non-Arab black tribes from their ancestral lands in Darfur.
Hadiya Beshir Issa's nightmare began in August 2003, when militias armed with rifles and rocket-propelled grenade launchers attacked her village, forcing the inhabitants to run for their lives, burning houses and stealing livestock. The family settled further west, only to be attacked by the Janjaweed again less than a year later.
“There were at least 200 of them on horses and camels,” Hadiya says. “They were screaming and shooting in the air. They killed many people, raped many women. We lost everything.”
Inside Sudan , humanitarian access to the nearly 900,000 displaced Darfurians is strenuously impeded by the government, which issues few permits to travel to and work in the region. Nevertheless, the IRC was able to set up a base in Al Fasher, in North Darfur state, and began rushing aid to tens of thousands of desperate people living in deplorable conditions at makeshift camps around the town.
Most of the displaced are living out in the open or in flimsy dwellings composed of discarded cardboard and coarse brush. Providing urgently needed shelter, the IRC's operations coordinator Alan Manski quickly designed inexpensive yurt frames, which, along with plastic sheeting, were distributed to more than 30,000 people.
Our staff also established a primary and reproductive health care clinic in one of the camps and is completing work on two birthing rooms, a laboratory and hundreds of latrines. And in late April, the IRC airlifted 15 tons of sanitation supplies to Al Fasher, to aid efforts to improve the quantity and quality of water, amid dire shortages at the camps.
“We know what the needs are,” says Manski. “The problem is poor security and next to no access to people who need help.” Some 80 percent of the displaced people from Darfur remain out of reach.
