At the 100-bed El Genina hospital, MSF is already treating 60 children for severe malnutrition, and more arrive everyday. Children lie wasted in their mothers' arms in tents that serve as feeding centers outside the hospital's main building. "We built one tent, then another, then a third," said Kris Bouden, a 44-year old Belgian nurse with MSF who has been here since April.

"Now we have to build another." Between 20 and 30 thousand displaced people are crammed into thousands of rickety huts made from whatever scraps people could find: sticks, leaves, bits and pieces of cardboard, strips of cloth. The lucky ones have a small square of plastic sheeting for a roof, but almost no one here is lucky. "Look where I live," said one woman pointing to the pitiful 3-foot tall shelter, barely big enough for one person. "I am here with four children."

Inside, there was nothing, and it offered little protection from the elements. Today the sun beats down with a fury, but soon heavy wind and rains will almost certainly demolish it. More than 80,000 people have built such structures at six camps in and around this dusty desert trading center near Sudan's far western border with Chad.

Over the past six months, these people have endured a nightmarish combination of violence, panicked flight, and deprivation, only to find more of the same in the place where they sought refuge. The pro-government militias that drove them from their homes, massacred their family members and friends, and burnt their villages and fields to the ground, now surround them in Riyad.

Almost every night militiamen sweep in on their horses to attack and kill, and they beat and rape women who forage for whatever wood, food, and water remains beyond the camp's periphery. "It happens everywhere," said Jennifer Pahl, a 30-year old nurse for Médecins Sans Frontières (MSF) from Alaska. She visits the camps regularly to refer the sickest patients to the MSF-supported El Genina hospital. "It's unbelievable to see little 14 or 15-year old girls on donkeys going over the hill with all their stuff for three days. They're sure to be beaten and raped, but they tell me, 'we don't have any choice.'" And they don't.

The shortage of assistance has reached a critical level. Mortality rates are well above the emergency threshold. Few men live in the camps, as most were either killed in the initial wave of attacks or have fled to other parts of the country. Aid agencies have appeared, but many may not be up and running in time and at the scale needed to avert a disaster.

So women and young girls still risk certain violence nightly because they are all that stand between their families and an early, ignoble death.

At the 100-bed El Genina hospital, MSF is already treating 60 children for severe malnutrition, and more arrive everyday. Children lie wasted in their mothers' arms in tents that serve as feeding centers outside the hospital's main building. "We built one tent, then another, then a third," said Kris Bouden, a 44-year old Belgian nurse with MSF who has been here since April. "Now we have to build another." T

en children from the camps were admitted this past week alone, sometimes on the brink of death. That morning, he said, one boy died as he reached the hospital gates. Donkeys, goats, and camels casually roam the unpaved streets in the center of town, and the marketplace bustles with trade.

But the rapid influx of so many displaced people has made life precarious for El Genina's tens of thousands of residents. Zeihab, a woman with a home and steady work, said she usually stores 90 bags of grain after the harvest. This year, she has stored nothing as the bleak landscape, made bleaker by war, has yielded little.

Back in Riyad, an ominous figure appeared on horseback on the hillside just as the sun began to set. People began to disappear into their rickety homes, and braced themselves for another long, terrifying night.