More than 2,500 refugees fleeing the ongoing violence in Sudan have spent over six months enduring harrowing conditions without adequate shelter, latrines, access to safe drinking water, or food assistance. Stranded while awaiting relocation from the remote Adémour transit site in Sila province, eastern Chad, these vulnerable families faced a catastrophic lack of humanitarian support that ultimately resulted in preventable tragedies.
The dire reality of the Adémour transit site came to light only after local authorities were alerted to the deaths of five children under the age of five years. In response to the unfolding crisis, Médecins Sans Frontières/Doctors Without Borders (MSF) mobilized and launched an emergency response that ran from May to July 2026.
“Our first assessments of the situation in Adémour confirmed cases of measles and malnutrition, while many people were suffering from diarrhoea, parasitic infections, respiratory illnesses and skin diseases linked to limited access to safe water,” explains Dr. Souley Harouna, MSF Head of Mission in Chad.
Over the course of two intensive months, MSF teams stepped in to provide free primary health care. Their medical interventions included the prevention and treatment of malaria, critical sexual and reproductive health care, and the systematic screening and treatment of severe and acute malnutrition.
The nutritional situation uncovered by MSF teams was described as deeply alarming. A Global Acute Malnutrition (GAM) rate of over 37% was recorded, with 343 people out of 916 screened falling into this category. Furthermore, the Severe Acute Malnutrition (SAM) rate reached a staggering 8.4%, accounting for 77 people out of the 916 screened. These figures highlight the severe gravity of the humanitarian emergency and the desperate need for sustained nutritional backing.
Beyond medical care, MSF teams worked urgently to improve access to safe water for both the Sudanese refugees and the vulnerable host communities, a vital step toward curbing the spread of infectious diseases. Efforts included rehabilitating four handpumps, installing latrines and handwashing stations, and utilizing two large water tanks to meet the standard of 15 litres per person daily. Within two months of expanding hygiene activities and providing safe drinking water, cases of diarrhoea among the population dropped significantly.
“As the refugees pass through Adémour before relocation, we focused on hygiene-related messages,” explains Bonaventure Djedouboum Tobah, MSF Health Promotion Supervisor. “Simple practices such as handwashing and water treatment are essential to help prevent waterborne diseases and protect families living in such a vulnerable setting.”
The success of these public health measures relied heavily on community involvement. The majority of community mobilisation agents were refugees themselves, specifically trained and supported by MSF to share essential health messages, follow up with families in need, and identify children requiring urgent nutritional support.
Sila province often remains a less visible part of the broader Sudanese refugee response in Chad. Unlike larger border crossings and established sites in areas like Adré or Aboutengué, Sila is much more dispersed, remote, and difficult for humanitarian organizations to reach. Settlement choices are also heavily influenced by geographical and sociocultural factors, with many refugees choosing to settle in areas where they share ethnic or cultural ties with local host communities.
“Families often arrive in smaller groups and end up in spontaneous transit sites such as Adémour, where services are simply non-existent,” notes Dr. Harouna.
By early July, nearly all of the refugees residing in the Adémour transit site had been relocated to the Kerfi refugee settlement. However, humanitarians warn that relocation does not automatically guarantee safety or stability. Refugees at the new settlement continue to face uncertain conditions, as minimum emergency standards for both refugees and host communities in relocation sites are frequently unmet.
“Relocation alone is not a solution if the receiving areas also lack adequate water, shelter, sanitation, healthcare and food assistance,” Dr. Harouna stresses. “Refugees, and host communities, need timely access to all essential services, whether that is in a transit or relocation site, or within communities.”
Since the war in Sudan erupted, more than 930,000 Sudanese refugees have crossed the border into Chad, with over 80 percent of them consisting of women and children. Since April 2023, the UN Refugee Agency (UNHCR) and Chadian authorities have successfully relocated 646,216 people from border transit sites inland, including 45,321 relocations since January 2026 under an accelerated program. While these relocation efforts are ongoing, humanitarian organizations emphasize that all actors must ensure sustained assistance and lifesaving essential services remain available to both refugees and their host communities.
