Three months have passed since Maryam* and her family fled the conflict in Tigray, Ethiopia and crossed the border into Hamdayet, Sudan. Three months have passed since she and her family had their last decent meal. While the refugees in Hamdayet have many unmet needs, food concerns are overshadowing every other in this reception centre.

In recent days, the patience of refugees has been running low, and people have started to demonstrate, as they are tired of begging to receive proper food.

“If they don't want to feed us then they should take us to someone who does,” says Maryam. “Every day they tell us the food is coming and every day it does not come. The youth protested to get food, but they tell them it is not right and stop them.”

Fleeing violence in Tigray, Ethiopia, more than 61,000 people have registered as refugees after crossing the border into Sudan since November 2020. From the border town of Hamdayet, many of them have been relocated to Um Rakuba and Al-Tanideba, the two permanent camps in Gedaref.

However, teams from Médecins Sans Frontières (MSF) estimate that some 10,000 to 12,000 refugees are still scattered in and around Hamdayet, without being provided with proper shelter and their basic needs such as water, food, blankets and sanitation are barely met.  Some of them have been there for months. Though the number of new arrivals has significantly decreased over the past few weeks, there are still new people arriving every day.

Stuck in limbo in Hamdayet, affecting people’s health

According to UNHCR guidelines, refugee camps should not be located near border areas due to safety concerns. Since the very first arrivals, the authorities implemented a transit location in the border area, where people who arrived would stay only a short time, before being moved to permanent camps within 72 hours. As part of that strategy, services to the refugees in these border locations were kept to a minimum, with the justification that refugees would only stay a few days.

Providing adequate services such as water, food, healthcare, education, social services and proper shelter for each family and individual in the permanent camps would have supported this strategy, by meeting people’s basic needs. Instead, identifying and preparing appropriate spaces for the permanent camps, and the scale-up of services in them, have been slow and late in coming.

Humanitarian assistance in the border town remains substandard. Refugees are living in unhygienic and appalling conditions. This situation is taking a toll on people, severely affecting their physical and mental health.

“These people had to flee a conflict zone, with many directly or indirectly affected by violence, often not knowing where their family is or if they are still alive,” says Crystal van Leeuwen, MSF Emergency medical advisor. “These people were looking for safety. The current situation in Hamdayet has only created more frustrations, anxiety and fear for this vulnerable group and is having a detrimental impact on their health.”

There is no proper camp set up, with no tents or shelter provided. People are being haphazardly scattered in the area, with several families living in the same communal shelter. The lucky ones have been able to build themselves huts with whatever materials they could find to protect them from the very high temperatures or found refuge with residents in the local village.

Many others, however, are sleeping in the open. Relief items such as blankets have been distributed sporadically; for example, a survey in January showed that just over one in 10 people had received jerry cans to collect and store drinking water. Those who fled Tigray alone, without any family members, were not eligible to receive them.

Lack of food leads to hunger – and danger

The lack of adequate food is also a good example of how the refugees are struggling to have their basic needs met. People in Hamdayet are provided the same food every day, hot meals, consisting of porridge and lentils. The portions are small, and people are supposed to receive food twice a day. Often there is not enough to go around.

“Sometimes the food runs out before all the people have received their portion,” says Hadahra, a 60-year-old refugee in the temporary camp.
 
Meanwhile, the refugees desperately look for other means to feed their families. Some people have chosen to endanger their lives in going back and forth across the border to find food, or bring firewood from Tigray that they can sell in Sudan.

“I crossed the river to Humera in the Tigray region to bring back food,” says a refugee in Hamdayet. “I know it is dangerous, but I would rather die trying to get food than starve.”

MSF teams have been providing medical screening at the Hamdayet border crossing points and basic healthcare in the town for both refugees and local residents since November. A recent malnutrition screening has indicated the shortage of food and the hunger people are experiencing; 14 per cent of pregnant and lactating women are malnourished, a concerning number.

Finally, this week, people have received dry food rations of sorghum, pulses, oil and salt, and been able to cook the ingredients themselves. However, it remains unclear whether distributions of rations will continue for those in limbo in Hamdayet or if the refugees will receive regular monthly food distributions only once they are in the permanent camps.

Services in Hamdayet need to be urgently improved

Even if people will be moved to a new location in the coming days and weeks, providing acceptable shelter, improved basic services, and sufficient, regular food provisions remain essential for every person who will arrive in Hamdayet over the coming months. The town will remain the main entry point for people fleeing the conflict in Ethiopia, while relocation to the permanent camps will be impossible for several months during the rainy season due to inaccessible roads.

Therefore, an appropriate response plan needs to be urgently developed, including a set-up for people to stay in acceptable conditions with access to water, sanitation and shelter, and which allows adequate supplies to be delivered and made available.

“Refugees will never be relocated within the proposed 72 hours and they should receive proper care wherever they are staying,” says van Leeuwen. “Services and assistance need to be planned for and provided in Hamdayet with this in mind. People should be treated with dignity, respect and their basic humanitarian needs should be addressed as soon as they manage to cross the border.”