A humanitarian drama is unfolding on the border between Sudan and Chad. Following fighting in Western Sudan, the UN High Commissioner for Refugees (UNHCR) estimates that tens of thousands of people have fled to neighbouring Chad. A reconnaissance mission by Medecins Sans Frontieres (MSF) has confirmed the appalling situation. "Thousands of people, mainly women and children, are packed together in the village of Tine. There is no aid."

"Most of the refugees arrive in Chad in a dreadful condition. They arrive empty-handed with nothing but the clothes they are standing in. They did not have the chance to bring other possessions, food and water with them. At first the refugees were supported by the local population but that is now beginning to change. The number of refugees is continuing to grow and the infrastructure is now already stretched to the limit."

This plea for help was made by Virginie Cauderlier, a nurse, on September 10 to her headquarters. Since then the situation has not improved. "On the contrary," says Aine Markham, operational director of MSF Belgium. "It is just getting worse."

Markham explains how the refugees started arriving at the end of July but only attracted attention at the beginning of September when, following a reconnaissance mission, the UNHCR reported that an estimated 65,000 refugees had crossed the border with Chad following fighting in Darfur, in Western Sudan.

The human tide remained undetected so long due to the fact that they crossed the border in small groups over a distance of 400 kilometres. The UNHCR reported Friday that the refugees are now present at about 20 locations in Chad. Due to the insecurity and lack of roads not all the refugees have been located.

The MSF reconnaissance workers managed to get through to the villages of Tine and Birak where they found a truly dreadful situation.

"In Tine in particular, the situation is appalling," says Markham. "Between six and ten thousand refugees are packed in there so tightly together that there is scarcely 20 centimetres between the families. Seventy-five percent of the refugees are women and children. They are receiving no aid at all. There is little water, no food (the stocks of the local population are insufficient), no shelter and they are not yet receiving any medical aid. As the present season is one of high day-time temperatures which drop sharply at night, and the rainy season is not yet over, many of them are suffering from chest infections."

In Birak, where there are currently between four and six thousand refugees, the only water available comes from a river. As the water is not purified many of them are suffering from diarrhoea. Without clean water and care this can quickly result in dehydration. As it is the rainy season, malaria flies are also abundant, with all the consequences for the unprotected victims.

In the village of Agan the UNHCR reports a similar situation: "There is no water fit for drinking. The refugees are drinking from stagnant rain pools." Five thousand refugees in the village of Kissi, on the borders of Sudan, Chad and the Central African Republic, could not be reached by anyone.

The UNCHR has asked the Chadian authorities to assemble the refugees in four camps to permit easier access for aid organisations. But MSF does not want to wait so long and has already sent out a team. Psychologists are to follow later "because our teams report that many of the women are in a state of shock," says Markham. "In Sudan sexual violence is all part of the practice of war."

The Sudanese Government is currently holding peace talks with the Sudan People's Liberation Army (SPLA), with which it has been waging a civil war for the past 20 years. In Darfur the government has been fighting the Sudan Liberation Movement (SLM), a dissident rebel movement, since February.

The SLM has not been invited to the national negotiations and feels that its impoverished region is being neglected. On September 3 the Sudanese Government and the SLM nevertheless agreed a cease-fire, but one that has already been violated. According to the rebels, pro-government militia killed 81 people last weekend and villages are still being bombed.