"The shortfalls are obvious and immediate, which is why people require more aid organisations to respond quickly", says Braaksma. "We can't understand why the response has been so slow."

In the face of the assistance gaps MSF has increased its operations. Every week, its teams treat about 1,600 patients in health centres and mobile clinics in 15 locations in Dar Sila and Salamat regions.

As the international humanitarian organisation Médecins Sans Frontières (MSF) continues to provide medical care, drinking water and relief goods to over 60,000 displaced in south-east Chad, it urges other aid agencies to do more.

A number of relief agencies are claiming that insecurity is preventing them from carrying out their humanitarian activities.

"The security situation in eastern Chad is indeed volatile", says Martin Braaksma, MSF Head of Mission. "But balanced against the huge humanitarian needs, we feel that we can and need to continue to work here."

Thousands of displaced are still lacking food, access to water and sanitation in Chad's south eastern Dar Sila region, an area that has been significantly affected by recent violence and displacement. While relief agencies are present in its capital Goz Beida, MSF is being overwhelmed by the huge demand in the border and rural areas of the region, where MSF, in many places, is the only aid actor reaching out to thousands of people.

"In Kerfi, for instance, a remote location 40 kilometres south of Goz Beida, the displaced are still living in very basic, make-shift shelters made out of straw and desperately require food, blankets, plastic sheeting for shelter and hygiene kits", says MSF nurse Elin Jones. "But apart from our weekly mobile clinic services they have not received any assistance to date."

The main health problems are respiratory tract infections, diarrhoea and eye infections - conditions that are closely related to poor living conditions.

"The high incidence of diarrhoea indicates that there is not enough water and specifically, a lack of clean drinking water," says Jones.

"We have also seen an increase in malnutrition among children who are the most vulnerable in a camp setting. We are concerned that people have lost their coping mechanisms and after several months of living in harsh conditions, may deteriorate rapidly."

In the face of the assistance gaps MSF has increased its operations. Every week, its teams treat about 1,600 patients in health centres and mobile clinics in 15 locations in Dar Sila and Salamat regions. The organisation provides about 200,000 litres of safe drinking water to over 23,000 people every day and has given basic relief goods, such as blankets, plastic sheeting, buckets and soap, to about 50,000 displaced.

"The shortfalls are obvious and immediate, which is why people require more aid organisations to respond quickly", says Braaksma. "We can't understand why the response has been so slow."

MSF is particularly worried about food aid as it may not be provided in sufficient quantities before the start of the rainy season in May when access to the vulnerable populations becomes ever more limited.

MSF started to provide medical care to displaced people in eastern Chad in December 2005 and with more people fleeing their homes has since steadily stepped up its assistance.

In eastern Chad, MSF continues to provide medical care to about 80,000 refugees from neighbouring Sudan (Darfur) and works in the Adré, Iriba, Tiné and Guéréda hospitals. The organisation has been present in Chad since 1981.