Sudanese Refugees in Eastern Chad Face Severe Shortages of Shelter, Water and Healthcare
Credit: Tania Elloye/MSF, Creator: Tania Elloye
More than 2,500 Sudanese refugees spent over six months at a transit site in eastern Chad without adequate shelter, sanitation, safe drinking water and food assistance, Médecins Sans Frontières (MSF) said.
The refugees were staying at the Adémour transit site in Sila province while awaiting relocation to a permanent settlement. MSF launched an emergency response from May to July 2026 after authorities reported the deaths of five children under age 5.
Initial assessments by MSF found cases of measles and malnutrition, while many refugees were suffering from diarrhea, parasitic infections, respiratory illnesses and skin diseases associated with inadequate access to clean water.
“Our first assessments of the situation in Adémour confirmed cases of measles and malnutrition,” said Dr. Souley Harouna, MSF’s head of mission in Chad.
Over two months, MSF teams provided free primary healthcare, including malaria prevention and treatment, sexual and reproductive health services, and screening and treatment for malnutrition.
The nutritional situation was particularly severe. MSF recorded a global acute malnutrition rate of more than 37%, with 343 of 916 people screened found to be acutely malnourished. Severe acute malnutrition affected 8.4% of those screened, or 77 people.
MSF also worked to improve access to safe water and sanitation for refugees and host communities. The organization rehabilitated four hand pumps, installed latrines and handwashing stations, and deployed two water tanks to help meet the emergency standard of 15 liters of water per person per day.
The availability of safe drinking water and expanded hygiene activities contributed to a significant reduction in diarrhea cases, according to MSF.
The organization also trained refugee community mobilizers to conduct health awareness activities, follow up with families and identify children requiring nutritional support.
By early July, nearly all refugees at Adémour had been relocated to the Kerfi refugee settlement. However, MSF warned that relocation alone does not resolve the humanitarian needs of displaced people if receiving sites lack essential services.
“Relocation alone is not a solution if the receiving areas also lack adequate water, shelter, sanitation, healthcare and food assistance,” Harouna said.
Sila province remains one of the less visible areas of Chad’s response to the Sudanese refugee crisis. Unlike major border areas such as Adré and Aboutengué, refugees in Sila are more dispersed and often live in remote locations that are difficult for humanitarian organizations to reach.
MSF said some refugees choose settlement areas based on existing ethnic and cultural ties with host communities, resulting in many families arriving in smaller groups and staying temporarily in spontaneous sites where essential services are unavailable.
Since the outbreak of war in Sudan in April 2023, more than 930,000 Sudanese refugees have crossed into Chad, more than 80% of them women and children.
According to MSF, UNHCR and Chadian authorities have relocated 646,216 refugees from border transit sites to inland locations since April 2023. About 45,321 people have been relocated since January 2026 under an accelerated relocation program.
MSF urged humanitarian actors to ensure that relocation is accompanied by sustained access to essential services, including food, clean water, sanitation, shelter and healthcare, for both refugees and host communities.
