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N’Djamena floods deepen humanitarian crisis, raising concerns over disease outbreaks

On Wednesday, December 7, 2022

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Major floods have hit central and southern Chad since mid-August, with the latest floods affecting the capital, N’Djamena, where rivers have burst their banks and whole neighbourhoods have been left underwater. International medical organisation Médecins Sans Frontières/Doctors Without Borders (MSF) has launched an emergency response to address the most acute needs of people left with minimal access to basic services and exposed to heightened risks of infectious disease outbreaks.  

“These latest floods have exacerbated an already dire humanitarian situation,” says Alexis Balekage, MSF’s emergency response project coordinator in N’Djamena. “Chad experiences floods every year, yet the scale of the phenomenon this year is far more significant. It has led to large-scale displacement and immense needs that greatly outweigh the current response, in a country that continues to be almost invisible in terms of international attention.”

A recent dramatic rise in the water levels of the Chari and Logone rivers – which reached 8.14 metres high near their confluence in N’Djamena and saw both rivers bursting their banks – is attributed to unusually heavy rainfall in the south of the country. As of 15 November, more than 155,000 people in N’Djamena have been displaced from by their homes by the floods, according to the UN, and are sheltering in various official and unofficial displacement sites, putting them further from essential services and increasing their vulnerability to serious health risks, particularly during the current seasonal peak of malaria.

“The displaced people are living in precarious and sometimes overcrowded conditions, with poor access to clean water, food and proper hygiene,” says Balekage. “Pools of stagnant water risk becoming the breeding sites for mosquitoes, which will likely increase the transmission of malaria, a leading cause of child mortality in Chad. We are also concerned about the possible emergence and spread of other infectious and waterborne diseases if water levels do not recede quickly and humanitarian operations are not scaled up to meet people’s needs.” 

Houses, schools and even markets were completely submerged by water for weeks.

Houses, schools, health facilities and marketplaces have been completely submerged in water for weeks. People are using canoes to access some flooded neighbourhoods, exposing them to the risk of potentially lethal attacks by hippopotamuses. In one week alone, five people, including a pregnant woman, have reportedly lost their lives due to hippopotamus attacks.  
The floods have also submerged vital infrastructure such as roads and water networks, and have severely impacted the livelihoods of a population dependent on farming. More than 465,000 hectares of crops have been damaged and 19,000 heads of livestock destroyed, raising concerns over agricultural production and food insecurity. 

“Our house was flooded and the water levels reached 1.2 metres inside the rooms,” says Doglessa, who is sheltering in Walia Hadjarai displacement site in N’Djamena. “My family and I left together and we are now living in a tent, exposed to cold, mosquitoes and other dangers. Our one hectare of rice was engulfed by water and I am currently jobless. Because of the floods, we are unable to reach a health centre quickly and see a doctor. We would need to pay to see a doctor and it is difficult without any income. My biggest wish is for the waters to go down quickly so that we can return home.”

In Toukra, south of the capital, an MSF-supported health centre was completely inundated, forcing staff to relocate to another health centre and to transfer patients there for continuation of treatment. 

MSF response to the floods in the N'Djamena region.

 Is an urgent need to mobilise additional funding

MSF teams, in collaboration with the Ministry of Health, are running mobile clinics in displacement sites and supporting existing health centres where people have sought shelter, including Toukra, Ngueli, Guilmey, Melezi, Digangali, Karkanjeri, Miskine, Walia-Hadjarai and Walia-Lycee camps. As well as basic healthcare, nutritional support and vaccinations, teams are providing water and sanitation services.  

For the past few weeks, MSF teams have carried out more than 15,500 consultations, mainly for malaria, respiratory tract infections and diarrhoea. They have also transferred at least 80 patients to hospitals for specialist care and vaccinated 345 babies against common childhood diseases. Teams have also provided clean drinking water and essential relief items, including hygiene kits and malaria prevention kits, to displaced families.
Since the start of 2022, Chad has witnessed extreme weather conditions related to the climate crisis which have caused severe droughts and erratic rainfall, affecting more than one million people across 18 of the country’s 23 regions, according to local health authorities. 

“Looking at the situation in N’Djamena, in particular, we anticipate that the drastic consequences of the flooding will persist for weeks to come,” says Sami Al Subaihi, MSF Head of Mission in Chad. “While water levels are slowly receding, there are no indicators that the situation will improve anytime soon or that people can return to their homes. MSF’s emergency response is aimed at meeting people’s direct needs, but there is an urgent need to mobilise additional funding and long-term programming to allow for a sustained and proportionate response to this crisis.” 

MSF in Chad

MSF has been working in Chad since 1981 and currently runs medical projects in several regions of the country in support of local health authorities. 
In Moissala, in Mandoul region, MSF provides healthcare for women and children in hospitals, health centres and through community-based activities. In Massakoury, in Hadjer Lamis province, MSF runs a nutritional programme for women and children. In Toukra hospital in N’Djamena and in various outpatient nutrition centres, MSF provides treatment for acutely malnourished children. In Sila province, in eastern Chad, MSF is treating common illnesses through a community-led health project. In the town of Adré, in Ouaddaï region, close to the eastern border with Sudan, MSF is providing healthcare for children under 15 and responding to the needs of refugees. In Salamat region, in southeast Chad, MSF is running an inpatient therapeutic feeding centre (ITFC) in Am Timan hospital and in five outpatient nutrition centres. In N’Djamena, MSF has an emergency response unit which is ready to respond quickly to the consequences of conflict, natural disasters and disease outbreaks across the country. 

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