"The living conditions in the camp are particularly difficult at this time of year, with temperatures falling to close to five degrees Celsius at night," said Stephane Reynier, MSF field coordinator in El Geneina.

On the morning of Thursday, February 1, a rebel group attacked the city of Adré, in eastern Chad, near the Sudan border. Many people were wounded during the confrontations with the government army and were treated by a Médecins Sans Frontières (MSF) surgical team at the Adré hospital.

On Thursday at 8:30 am, a rebel group attacked the city of Adré. Fighting between the rebels and government forces occurred in the city, including around the hospital. A piece of shrapnel even passed through one of the hospital gates. Heavy weapons were used during fighting in the center of the city, which lasted for nearly three hours. The rebels then moved out of Adré and fighting continued outside the city.

The MSF team, including a surgeon, anesthetist, doctor and two nurses, was in the hospital during the attack. The wounded began arriving quickly, at around 9:30 am, and the team was able to treat them right away. The team continued to receive, treat and operate on wounded people throughout the day, until 11 pm.

This high influx of patients, many of whom were seriously wounded, required a major triage and organizational effort, beginning with the most serious cases that required immediate surgery. Assistance was provided by the Chadian Red Cross, which mobilized some 15 first-aid workers to help th MSF team triage the patients and dress injuries.

In total, 140 wounded people were treated throughout the day. Nearly 30 per cent were civilians. Approximately 30 people were seriously wounded, requiring thoracic, abdominal and orthopedic surgery (including two amputations). Six patients died at the hospital. MSF also treated three prisoners of war. Twenty wounded persons were transferred to Abeche after being stabilized.

MSF staff took turns throughout the night in the hospital to provide care. On Friday, calm returned to the city. Part of the team that MSF evacuated on Thursday — primarily Chad paramedicals working with MSF — will now be able to return to Adré because MSF needs additional help to handle post-operative care.

Follow-up care will be a major task, after the surgeries, which were performed immediately. A plane from N'Djamena is also expected to deliver additional medical supplies.