As people continue to flee the conflict in Sudan, more than 358,000 refugees have arrived at the border town Adré, in eastern Chad. Refugee camps are being built, but shelter and basic facilities available in the camps are wholly inadequate to meet the needs of the incoming people. 
 
Médecins Sans Frontières (MSF) is calling on the international community and humanitarian organisations to urgently address essential needs for people seeking safety from the conflict to avoid a catastrophic situation. 

“We are present in three refugee camps here, where approximately 2,000 refugees arrive daily,” says Susanna Borges, MSF emergency coordinator in Chad. 

“The existing camps in this area are already at full capacity, as are the temporary transit shelters. So people are being transferred to other locations far from the city, where new camps are still being built,” says Borges. 

“But these camps are not ready to host all the people who have been relocated there, so they are exposed to harsh sun and rain, with insufficient food, water, and even cooking supplies. There are enormous needs, and very few resources.”

In just one camp in Adré, Camp Ecole, there are 150,000 refugees. Our teams support a 250-bed paediatric ward in the Adré hospital. We also run a 38-bed clinic within Camp Ecole, with an ambulance for patient referrals. The clinic is continuously full, averaging 400 consultations per day. 

There is an alarming rate of malnutrition. In Camp Ecole, 351 malnourished patients have been registered, but some of them cannot continue their treatment as they have been relocated. Our teams are trying to track them, but the fast relocation makes it very difficult. 
 
We have installed three boreholes in Camp Ecole and more will be installed over time if more people keep crossing the border. We are delivering clean water by trucks around the camps, but the scale of needs is far greater than what we can deliver alone. The dire shortage of water in Ambelia and Ourang camps forces people to begin queuing at 2 am with their jerrycans. 

The rainy season has arrived in Chad, which brings with it a huge increase of malaria, and reaching the affected areas has  become very challenging. In just one week, our clinic in Camp Ecole recorded 956 malaria cases, nearly three times the previous week's count. 
 
“People are arriving in really concerning health conditions, because they don't have access to food and are living in very poor circumstances,” says Trish Newport, MSF head of emergencies. 
 
“With all of this rain, we know from working in similar crises, that this brings the risk of diarrhoeal diseases such as cholera. With conditions like this, we are extremely concerned about outbreaks that could occur if the humanitarian response is not urgently scaled up.” 

In a country where there were already one million people either living as refugees or who have been internally displaced, this latest wave of refugees from west Sudan has further strained available resources. 

Food prices have gone up in Adré, and most of the new arrivals cannot afford to buy food. This situation also affects the local community as their cost of living has risen while incomes remain stagnant. There is a crucial need for international donors to mobilise resources to address the humanitarian aid gap. 

We appeal to the international community to urgently provide shelter, food, water, sanitation, and healthcare and protection services for the thousands of people who have fled unspeakable violence and lost their homes, livelihoods and loved ones in Sudan. A timely and sufficient humanitarian response is their only hope for surviving yet another disaster.