First patient admitted following the increase in the influx of refugees from Sudan following the intensification of fighting in El Geneina. 4 November 2023.
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Conflict in Sudan: More people forced to flee to Chad as fighting intensifies across Darfur

On Wednesday, November 8, 2023

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In the first three days of November, we have seen more new arrivals of Sudanese refugees than during the whole previous month: about 7,000 people crossed the border,” explains Stephanie Hoffmann, MSF outreach coordinator in Adré, a Chadian city on the border with Sudan.

We have seen mothers and children who had to leave Sudan with nothing, as their homes were being destroyed.

In a health post right at the border crossing in Adré, MSF teams provide medical services to the newly arrived refugees by vaccinating children against measles, screening for malnutrition, and referring those in need of urgent specialised healthcare directly to Adré hospital, where they are being treated by MSF and staff from the Chadian Ministry of Health.

A few hundred metres from the border crossing, refugees wait for new arrivals from Sudan, hoping to get news of their families. Often, they learn about the loss of their loved ones back home in Sudan. MSF teams now also offer mental health support to people in distress at the crossing and have installed a water tank to provide safe drinking water after the gruelling journey. 

Last night, my sister’s house was bombed,” describes Amne, 33, who crossed the border with her four children. “It was next to ours. Our house caught fire from the explosion, and we immediately got out. I do not know what happened to my sister, whether she survived or not.” She points to her dress, saying that it is the only possession she was able to bring with her.

At the MSF hospital in Adré, a 27-year-old man arrives. He fled El Geneina with sixteen other people, but their group was attacked on the road to Chad. He tells us that the attackers killed everyone else, but he survived by playing dead. Eventually a new group of refugees arrived and helped him reach the border. He has multiple bullet wounds on his hands and legs.

El Geneina experienced a nightmarish escalation of violence last June, and it pushed a large proportion of the city's inhabitants to flee to Chad, despite the many dangers and attacks that awaited them on the road. The city then experienced a relative lull and even hosted displaced people from other locations," says Alkassoum Abdourahamane, MSF project coordinator for El Geneina. "Now, the blasts and the fear have once again taken over."

On Sundaythe 5th of November 2023, MSF donated 3.5 m3 of medical equipment to the emergency unit of the El Geneina Teaching Hospital. Already, these supplies have helped to treat 120 patients.  The team has also made donations to three health centres on the road between El Geneina and Adré, providing kits to treat malaria, diarrhoea, and respiratory infections in both adults and children.

The stories of the latest arrivals echo those of the massive numbers of refugees who reached Adré in June, when the population of the small town tripled. From June 15 to 17 the hospital received over 850 war-wounded people, one of the largest number of casualties that our teams have ever had to manage. Many patients suffering gunshot wounds, particularly to the abdomen, back and legs, reported harrowing violence in El Geneina and attacks on the road to Chad, with armed men who shot at people fleeing. Meanwhile, our teams in the North Darfur capital of El Fasher have been witnessing significant numbers of people leaving the city for fear of finding themselves trapped by the growing violence.

First patient admitted following the increase in the influx of refugees from Sudan following the intensification of fighting in El Geneina. 4 November 2023.

Since the war in Sudan started in April over six months ago, millions of people have been forced to flee, leaving behind their homes and livelihoods. While most are still in Sudan, an estimated 1.1 million people have crossed the border into neighbouring countries. The majority of these are now in Chad, a country already facing multiple humanitarian crises.

"Despite the collective efforts of local communities, authorities and humanitarian organisations, the humanitarian response doesn't yet match the magnitude of the crisis in eastern Chad, which is also putting a strain on vulnerable host communities,” explains Claire Nicolet, head of MSF emergency response for Chad and Sudan. “Many people are living in makeshift camps where conditions remain dire. Meanwhile the latest increase in refugee arrivals is another indication that needs are continuing to grow and that the conflict fuelling them is far from over. We continue to call for an immediate scale-up of humanitarian aid to help the most vulnerable, both refugees and Chadians, and to ensure access to basic services such as water, healthcare, shelter and food.

MSF teams are delivering vital medical care in Adré, Ourang, and Metche camps in Ouaddai province, as well as in the Goz Achiye, Daguessa and Anderessa camps located in the Sila province border region.

Since the onset of its emergency response in eastern Chad, MSF has provided over 96,000 consultations, hospitalised 8,492 patients, treated 7,155 for malnutrition and 31,955 for malaria, performed 1,634 surgeries, and assisted in 1,043 deliveries. Our teams are also distributing essential relief items and providing up to 80% of the safe water available to refugees.

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