This situation .. is making medical care extremely difficult, and is especially unfortunate since the people sheltering in the bush tend to be the most disadvantaged and therefore the most in need of medical care.

With intensifying conflict and heightening insecurity in the Central African Republic (CAR) forcing ever-increasing numbers of refugees across the border to neighbouring Chad, MSF started the construction of additional shelters and latrines and reinforced its water and sanitation activities to care for the refugees.

Over 3,500 people have assembled in the MSF reception camps in Sido and Gorée, where MSF provides medical consultations free of charge for the refugees. In Sido that includes the local population.

"Thus far our teams are covering health care in Sido for some 4,800 people and in Goré for about 2,000 people," said Donatella Massai, MSF operational coordinator. "In Sido we ran a measles vaccination campaign, distributed blankets and sent in a nurse to increase the number of medical consultations. We see more people going to the villages around Goré now.

Thus far 1,800 refugees are counted in Dounia, 1,300 in Komba and 1,000 in Matité. We will assess their condition and needs to determine what kind of assistance they need." Four international staff have just arrived to provide shelter, access to health care and safe drinking water, by digging wells and building latrines.

Outside the main reception camps, more refugees are scattered throughout the surrounding areas and many are seeking refuge in the bush land. This situation, explained MSF emergency coordinator Pierre Desbareau from a transit camp between Sido and Sarh, 60 kilometres off the border, "is making medical care extremely difficult, and is especially unfortunate since the people sheltering in the bush tend to be the most disadvantaged and therefore the most in need of medical care."

According to Desbareau, "we are worried about those people living in the bush, as their conditions will worsen significantly once the harvest finishes and the rains begin. And with these conditions due in only a matter of weeks, time is running short."

There are two groups within the refugee population: those who want to wait in the camps until the situation in CAR calms down and then go back home; and the "returnees" who only want to return to their home villages in Chad.

"Most refugees and returnees are in quite good condition and some even managed to bring material along, such as roof tiles, animals etc. But there are also people that had to leave everything behind. Until now, there is still quite some solidarity coming from the population; most refugees are staying in local houses and have been asked to work on the field in exchange for food and shelter.

But since the population is quite poor, they have only limited resources to share", said Donatella Massai.