Darfuri Refugees in Eastern Chad: Among world’s most forgotten people, and increasingly abandoned 

By Eric Reeves, Sudan researcher and analyst

8 July 2014   

[Note: This is the first of a series of briefs looking at the many aspects of ongoing catastrophe in Darfur and the western region of Sudan as a whole; over the coming weeks and months I will post sustained analyses of:

Rape—A topic that the UN and UNAMID refuse to raise in a serious way, despite the continuing avalanche of sexual assaults on girls and women in Darfur;

Mortality—The UN has not offered a figure for total mortality in the Darfur conflict for over six years, yielding to Khartoum’s sensitivities on the subject. The figure offered by former Undersecretary for Humanitarian Affairs John Holmes—300,000—was an off-the-cuff extrapolation made during a press conference in April 2008. It could take no account of significant data that were generated subsequently. There is good reason to believe the actual number of deaths from violence and its aftermath exceeds 500,000 | http://wp.me/p45rOG-AB

The collapsing economy and its effects on Darfur—Instead of boosting the agricultural sector, the Khartoum regime is investing heavily in a growing arms industry (see Small Arms Survey report, “Sudan’s Military Industry Corporation,” 3 July 2014). In fact, the agricultural sector has declined dramatically over the past 25 years of NIF/NCP rule. Inflation is soaring well above 50 percent; the Sudanese Pound continues to lose value at a precipitous rate; there is little or no Forex with which to buy critical imports, including wheat for making bread; unemployment and under-employment are very high; poverty and food insecurity affect some 5 million Sudanese; and a majority of Sudanese wish to emigrate. The external debt—$US45 billion—is completely unmanageable.

As a consequence, there is no investment in traditionally marginalized regions such as Darfur; they bear the brunt of Khartoum’s economic mismanagement. Food prices in Darfur are dramatically skyrocketing, a very dangerous sign.

Water—A number of camps are reporting severe shortages; the impending rainy season promises to bring even more difficult conditions for the provision of clean water. As a consequence, water-borne diseases are very likely to spread widely. We have seen early signs of this already. There are vastly inadequate financial resources in place, inevitably crippling humanitarian capacity. Large influxes of the newly displaced can overwhelm what may have previously been adequate water supplies.

Food—The UN continues it refusal to promulgate data on Global Acute Malnutrition (GAM) and Severe Acute Malnutrition (SAM), two of the most significant indicators of food insecurity and shortages. Even with reports of children dying of malnutrition, we have no malnutrition data, including that for children under five.

Darfur is only the most extreme example of chronic food insecurity in Sudan, this year estimated to affect approximately 5 million people, 1.5 million in East Darfur alone, according to UN OCHA (“East Darfur” was largely carved out of what was previously South Darfur).

Primary medical care—Numerous diseases in the camps are reported from the ground on a regular basis, chiefly through Radio Dabanga. There are not nearly enough primary health care workers, or adequate supplies of medicine and equipment for hospitals. Much of this shortage can be directly attributed to Khartoum’s war of attrition against international relief organizations, which continue to be expelled, suspended, or intimidated to the point of becoming ineffective. Their supplies are often delayed by Khartoum.

Sanitation—Many camps have latrine and other sanitary facilities that have not been adequately maintained. This is a primary cause of disease in the oppressively close quarters of the camps.

Security—UNAMID, despite recent revelations of its duplicity and egregious omissions of important incidents from its reports, remains the only security force on the ground. Despite revelations by the former spokeswoman for UNAMID, Aischa Elbasri, the UN Secretariat and UN Department of Peacekeeping Operations seem determined to conduct only a perfunctory review and leave UNAMID essentially as it is: a massive, and massively expensive, failure. UNAMID will certainly not stand up to the “new Janjaweed” (the Rapid Support Forces, RSF). Despite the clear evidence of the scale of UNAMID’s failure, the UN seems content simply to kick the can down the road.

Displacement—the UN and UNAMID have a very poor record over the past five years of presenting credible figures for displacement. The task is a daunting one, but the current figure of 2 million is not tenable, particularly in light of the vast number of people newly displaced over the past six years. Since the deployment of UNAMID (1 January 2008) over 2 million people have been newly displaced, some for the second or third time. At the time of the last Darfur Humanitarian Profile (No. 34, conditions as of January1, 2009), the figure for internally displaced was already 2.7 million. It is simply not credible to suggest that with 2 million people newly displaced since 2008 and a UN figure of 2.7 million in 2009 that the current total figure is 2 million. A thorough statistical reckoning will be offered, including the fact that the UN has increased the figure for newly displaced in 2013 to 480,000—approximately a quarter of the figure used by UN OCHA in their weekly bulletins (for months no figure was given, as the previously promulgated figure of 1.4 million displaced [UN OCHA, Sudan Bulletin #39, September 29, 2013] was so completely untenable).

Humanitarian capacity, access, expulsions and withdrawals—Although the expulsion of thirteen critical international humanitarian NGO’s in March 2009 was the single biggest blow to relief efforts in Darfur, expulsions had preceded and have followed. Major subsequent expulsions include Médecins du Monde from Jebel Marra, Merlin (UK), and the recent suspension of operations by the International Committee of the Red Cross (ICRC), among others. The suspension of the ICRC comes in the wake of the Committee’s refusal to submit to extortion that would have it send funds to the regime-controlled Sudan Red Crescent.

Humanitarian reach and capacity continue to contract, as does donor giving, the life’s blood of humanitarian activities by both the UN and INGOs.

DARFURI REFUGEES IN EASTERN CHAD

Refugees from Darfur in eastern Chad fall awkwardly between the reporting responsibilities of various UN organizations and the country responsibilities of different UN and nongovernmental organizations (no cross-border relief from Darfur to eastern Chad is permitted). As a consequence, there appear to be in the eyes of the UN humanitarian organizations, particularly the UN High Commission for Refugees (UNHCR), rather different views of the plight of Darfuri refugees in eastern Chad, many having lived there now for over a decade. There is the relatively upbeat account offered by UNHCR in its broad overview, “UNHCR: Providing for basic needs,” June 2014:

Thanks to sustained focus on acute malnutrition management measures undertaken in all camp health centres, the result of the nutritional survey conducted amongst Sudanese refugees in eastern Chad indicated the Global Acute Malnutrition fell from 11.6 percent in 2011 to 10.1 percent in 2013.

This suggestion of “improvement” is belied, however, by every other reporting source we have, including the UN itself. Indeed, even UNHCR seems to be speaking differently to different audiences:

For its part, UNHCR needs $39 million for nutrition support to malnourished and vulnerable refugees in Africa. Supplies have been cut by at least 50 percent for nearly 450,000 refugees in remote camps and other sites in the Central African Republic, Chad, and South Sudan.

The cuts [to funding for the UN World Food Program (WFP) and UNHCR] threaten to worsen already unacceptable levels of acute malnutrition, stunting and anaemia, particularly in children. (Radio Dabanga [Geneva], 2 July 2014) (all emphases in all quotes have been added—ER)

Agence France-Presse reports in broader terms on the grim outlook for Africa that emerged from Geneva:

Nearly 800,000 refugees in Africa have had their food rations slashed due to a lack of global aid funding, threatening to push many to the brink of starvation, the UN has warned. The cuts of up to 60 percent are “threatening to worsen already unacceptable levels of acute malnutrition, stunting and anaemia, particularly in children,” the United Nations’ World Food Programme and refugee agency UNHCR said in a joint statement. The heads of the two agencies were in Geneva on Tuesday to make an urgent appeal to governments for more funds to help feed Africa’s refugees. “It is unacceptable in today’s world of plenty for refugees to face chronic hunger,” said UNHCR chief Antonio Guterres. (AFP [Geneva], 1 July 2014)

It seems inappropriate in this context to speak simply of a funding “shortfall”: as of March 2014, a graphic produced by the UN Office for the Coordination of Humanitarian Affairs (OCHA) shows that in response to a “Strategic Response Plan for 2014,” with a request for US$527 million, less than 1 one percent had been funded (US$46 million).

The funding situation for eastern Chad is simply disastrous, with funding cut annually, even as the budget was grossly inadequate for the number of people in need. Of the 450,000 refugees referred to in the UNHCR/WFP report, 362,000 are from Sudan, virtually all from Darfur (http://www.unhcr.org/528a0a22b.html/). And reporting from the ground, as opposed to Geneva, gives us a clear sense of what the consequences of these cruel cutbacks have been. Perhaps no refugee population in the world is as under-served as that of Darfuris in eastern Chad (the much smaller number of refugees from Central African Republic are equally poorly served). And contrary to any upbeat account of treatment of malnutrition, especially among children, the word from Geneva on this occasion was at sharp variance:

Nutritional surveys conducted between 2011 and 2013 showed that stunting and anaemia among children was already at critical levels in the majority of the refugee sites. (Radio Dabanga [Geneva], 2 July 2014)

Over the past year a number of reports from the ground in eastern Chad by Radio Dabanga suggest the grim truth of the nutritional situation:

•  “Reduced WFP rations for Sudanese refugees in eastern Chad”  (GAGA CAMP, 20 May 2013) –The Sudanese refugees of camp Gaga in eastern Chad are suffering from a reduction in food rations, poor medical services and a lack of medicine.

Yassin Abdel Karim, the deputy president of the camp told Radio Dabanga that the World Food Programme (WFP) has reduced sugar, salt and oil supplies by 50 percent. The WFP has also withdrawn millet mixture from the food ration since the beginning of this year, without providing any explanation.

There may be another side to this story, but it comports all too well with a host of other reports about the performance of the World Food Program in both eastern Chad and Darfur, including a number of reports from the past half year:

•  “WFP stops food rations for Gaga refugee camp in Chad: Sheikh” (CHAD / GAGA CAMP (22 January 2014) – The refugees of the Gaga refugee camp in eastern Chad will not receive food rations in 2014.Speaking to Radio Dabanga, sheikh Juma reported that the 23,200 Darfuri refugees residing in the camp received reduced food rations from the World Food Programme (WFP) in December and January.

Representatives of the WFP told the refugees that there is no budget for food rations for the year 2014. The refugees received rations of sorghum, sugar, beans, and oil, all reduced by 75 percent, in December and by 50 percent in January. These rations, paid from WFP’s 2013 budget, were the last ones for the camp.

•  “Darfur refugees in Chad’s Farchana camp eating grass,” Radio Dabanga (EASTERN CHAD, 29 April 2014) – Darfuris in the eastern Chad refugee camps are on the brink of starvation after food rations were reduced in December last year. Darfuri refugees in South Sudan’s Western Bahr El Ghazal state, are also living in poor humanitarian conditions. “The Gaga, Farchana, Treguine, Bredjing, and Touloum refugee camps are witnessing a rapid deterioration of the humanitarian situation owing to the reduction of food rations,” Haider Suleiman Gadiria, the head of the Tuloum camp reported to Radio Dabanga. “The World Food Programme reduced the rations of sorghum and sugar for the refugees in eastern Chad camps by 50 percent since December last year.  In April this year the distribution of salt and a mixture of soap was stopped.”

The head of the Farchana camp, Mohamed Dafallah told Radio Dabanga that the camp population has reached the brink of starvation. “They are now eating grass, and digging in ants’ hills in search of food…. The situation in the camps is nearing a humanitarian disaster.

These most urgent complaints go back to the beginning of the year and earlier:

•  “Deteriorating food rations for Sudan’s refugees: Chad camps,” (Farchana/Abeche, 7 February 2014) -The Sudanese refugees of twelve camps in eastern Chad, totalling about 300,000, face severe food shortages after aid organisations have reduced food rations to the lowest level. They have also reported a significant deterioration in health and educational services.Mohamed Dafalla, the head of the Farchana refugee camp, told Radio Dabanga that the World Food Programme (WFP) has cut the sorghum ration from 14kg per capita to 4kg. “The refugees in the camps have had to live 34 days now on 4kg of sorghum, without the WFP announcing dates for the next rations.”

Dafalla accused parties, which he did not identify, of planning forced returns through decreasing health and education services, and denying food for the refugees. “The situation in Sudan does not allow them at all to go back.”

The basic problem in providing for the Darfuri refugees has grown steadily more apparent during the decade in which many have lived in exile. A report by UN IRIN from 2012 concludes with the basic issue still confronting the humanitarian response in the larger region:

•  [T]his year [2012], UNHCR resources for Chad have been drastically reduced and could reduce further in 2013, [representative of the UNHCR in Chad, Aminata]Gueye said. “When the plan to respond [to the Sahel crisis] was put up, they did not include the refugees because they said UNHCR is there. There is a need for a harmonized response to the crisis; the refugees should not be left out of any response.”

And this “drastic reduction” is precisely what has occurred, not only in funding for UNHCR but for WFP. One might well imagine the difficulty a WFP or UNHCR worker might feel in the face of questions from very hungry people about severe reductions in food rations, or the inability to specify when the next rations will be delivered. But the consequences are all too conspicuous; here again from earlier this year:

•  “Sudanese refugees face starvation in Chad camps,” Radio Dabanga (CHAD / KOUNONGOU CAMP, 30 January 2014) -Sudanese refugees in the camps of eastern Chad say that their overall situation is deteriorating rapidly after the reduction in food rations, health and educational services, by international relief organisations.Sheikh Eisa Tijani, the head of the Kounongou camp, told Radio Dabanga that international organisations’ decision to reduce the budget since the beginning of this year will lead to starvation.

He described the arguments for the reduction as “flimsy.” “They told us that donors have failed to pay and that other conflict zones emerged in the world.”He called the budget cuts “inhumane,” “considering that the world and its institutions are fully aware of the reasons that forced us to flee from our homes. We get the idea that the whole world is fighting us in the same way as Omar Al Bashir.”The sheikh explained that there are no jobs or other sources of income in eastern Chad. “So how can they request us to rely on ourselves?” He appealed the international community and the UN Security Council to bear their responsibilities and supply the refugees in eastern Chad with the basic needs for life.

The issue of returning to Darfur is constantly on the mind of the refugees; but even with insecurity as great as it has been in eastern Chad at various times, including the present, they refuse to return to a Darfur defined by present levels of violence directed against the African tribal groups which make up virtually the entire refugee population. Renewed scorched-earth attacks by the reconstituted Janjaweed (the Rapid Support Forces, RSF) have certainly become widely known among Darfuris in Chad. Revealingly, as displacement surges in Darfur itself, the refugee population—with additional cross-border movement this year—is at an all time high: 362,000 according to UNHCR. This is up substantially from the relatively stable population of 280,000 that had existed for a number of years, most of the refugees fleeing in the early years of the conflict.

And as the number of refugees continues to grow with ongoing, indeed intensifying violence, the most recent arrivals are sometimes given no food:

•  “No food for new Darfuri refugees in Chad,” Radio Dabanga (TOULOUM CAMP, 4 February 2014) -Some 135 families from North Darfur who reached the Touloum refugee camp in eastern Chad in September last year do not have access to food.Ahmed Abakar Shatta, the coordinator of new refugees at the Touloum refugee camp told Radio Dabanga that the UN High Commissioner for Refugees (UNHCR) and the Chad National Committee for the Reception of Refugees on Monday distributed sheets, blankets, and mattresses, household utensils, and mosquito nets. The families also received refugee identity cards.However the families, originally from El Sareif Beni Hussein, did not receive food. The coordinator described their situation as “extremely bad.” “They have to go around in the camp begging for food.”  

Leaving people in such condition—invisible, powerless, and no longer in Darfur—is ultimately a measure of the success enjoyed by Khartoum in ambition best articulated by the notorious Janjaweed commander Musal Hilal:

The ultimate objective in Darfur is spelled out in an August 2004 directive from [Janjaweed paramount leader Musa] Hilal’s headquarters: “change the demography” of Darfur and “empty it of African tribes.” Confirming the control of [Khartoum’s] Military Intelligence over the Darfur file, the directive is addressed to no fewer than three intelligence services—the Intelligence and Security Department, Military Intelligence and National Security, and the ultra-secret “Constructive Security,” or Amn al Ijabi. (Julie Flint and Alex de Waal, Darfur: A Short History of a Long War (2005)

The refugees in eastern Chad are from precisely the “African tribes” that were to be “emptied” from Darfur; the “demography,” especially of land ownership, has indeed been profoundly “changed.” Ultimately, this reflects the goals of Khartoum’s genocidal “counter-insurgency on the cheap,” and there can be no understanding of the plight of Darfuri refugees in Chad that does not take account of the regime that has orchestrated their flight and their inability to return to their lands. Indeed, Khartoum has typically allowed these lands to be taken as payment by Arab militias (and not only Sudanese) for doing the dirty work of ethnic destruction and displacement.

The Real Problem

Donor fatigue has become an immense issue for both UN and nongovernmental humanitarian organizations, as donors become less and less reluctant to respond to the multiple crises in greater Sudan (including eastern Chad). And the overall problem is staggering: Sudan Tribune reported last month that,

Over 5 million Sudanese could face different levels of food shortage in the southern and western parts of the country where the government fights rebel groups said the Famine Early Warning Systems Network (FEWS NET) on Thursday. According to the USAID-funded network, forecasts suggest average to below average rainfall across the country. Given the country’s very poor cereal harvest last year, a below-average rainy season could negatively impact the food security particularly in Darfur and have significant food security impacts. Darfur, North Kordofan, and areas hosting IDPs are of most concern.

“Between 5 and 5.3 million people are likely to face varied levels of acute food insecurity until September,” [FEWS NET] said in its June report. The group further pointed that “crisis” and “emergency” levels of food insecurity will continue among 40% of the displaced civilians and poor communities in the rebel held areas in South Kordofan.  (Khartoum, 4 June 2014)

But let us be clear here about the causes of these extraordinary levels of chronic need in Sudan, and eastern Chad: they derive directly from years of gross economic mismanagement by the National Islamic Front/National Congress Party regime. While enriching themselves and their cronies, and expending over half the national budget on the military and the multiple security services, the regime found it all briefly sustainable while the oil revenues flowed, and in the decade run-up to the first export shipment of oil (August 1999), against which it had borrowed heavily. But these revenues have shrunk dramatically with the secession of South Sudan, the closing of the Unity State production field, and the growing threat to the Petrodar oil production areas of Upper Nile, which may fall to the rebel forces or face such a threat that critical expatriate technical workers are forced to withdraw, compelling a shutdown of the complex infrastructure.

This would deny Khartoum critical revenues, in hard currency, from the high per barrel transit fees it charges both South Sudan and the Chinese-dominated Petrodar consortium in Upper Nile (South Sudan).

A ghastly disordering of budget priorities, a complete neglect of the agricultural sector, and the vast expense of paying for political support necessary to remain in power—all have sent the economy into free-fall, with no end in sight to increasing inflation (the July figure of 45 percent certainly understates considerably, especially the rise in costs for food and fuel). Crippling hyper-inflation remains a clear possibility. Coupled with an almost complete lack of foreign exchange currency (Forex), inflation has brought the Sudanese Pound to record low exchange rates with the dollar in the increasingly telling urban black market in currencies. External debt stands at over US$45 billion—a completely unmanageable burden created largely under this regime during its twenty-five years of tyranny, during which the marginalized regions of Sudan have been ruthlessly excluded from access to national wealth and power.

The implications for Darfur, and Darfuri refugees in eastern Chad, are grim. Insecurity has grown dramatically over the past two years and more; the “new” Janjaweed are even more potent because Khartoum has shown a complete willingness to accept that this brutal militia force is its ally, indeed is part of the “armed forces.” Support for, arming of, and directing the militia forces is now done openly by Khartoum, and various areas of Darfur have seen a level of violence unlike anything since the early years of the genocide. It is indeed “inhumane,” as one sheikh put it, to ask refugees to return to such a maelstrom of killing, raping, kidnapping, extortion, land appropriation, and wholesale destruction.

Indeed, if we look closely at the suffering endured by the refugee population, it becomes in itself a measure of how dramatic the insecurity in Darfur must be for them to remain in eastern Chad. Water shortages in this parched land are chronic, and have been reported in dire terms for years:

 •  Serious water shortage in eastern Chad camp,” Radio Dabanga (Eastern Chad, 9 August 2011) – 45,000 Sudanese refugees from the Brejean camp (eastern Chad) are suffering from acute water shortage after the water pump’s generator after the water pump’s generator broke down, residents complained on Tuesday. This has resulted in refugees traveling to nearby valleys in search of water for drinking and domestic purposes. The water from the valleys is, however, not suitable for consumption. Refugees in the camp told Radio Dabanga that the water was contaminated by both human and animal waste and carcasses leading to the spread of waterborne diseases.

Gaga camp: Yassin Yahya, vice-president of Gaga camp, told Radio Dabanga that the lack of water causes suffering for women, particularly in summer time. He explained that the scarcity leads to verbal and physical violence among the refugees in the camp. Yahya demanded the organizations to provide water in order to contain the violence among the refugees.

Farshana camp: Furthermore, Mohamed Dafalla, president of Farshana camp, told Radio Dabanga on the occasion of the International Day for the Elimination of Violence against Women, that the problem of access to potable water inside the camps is one of the main causes of violence among refugees.

Notably, water shortages are often a product of the recent sharp cuts in the UNHCR budget for refugees in eastern Chad:

•  “Water scarcity ‘threatens lives of 19,500 Sudanese refugees,” Radio Dabanga (DJABAL CAMP, 13 August 2013) – Sudanese refugees in camp Djabal in eastern Chad are suffering an “acute drinking water crisis” as the only water engine at the camp is said to have broken down. Sources say that “the lives of 19,500 people are threatened” as a result. They explained to Radio Dabanga that organisations working on the field providing water could not repair the problems with the water pumps due to lack of technicians. Refugees are calling upon organisations to expedite the repair of the pumps and install an existing reserve engine to avoid a similar situation in the future.

•  “Water scarce in Chad camp for Sudanese refugees,” Radio Dabanga (ABECHE, 4 April 2014) – The Sudanese refugees living in camp Farchana in eastern Chad have complained of a lack of drinking water. Mohamed Daffala, the head of the camp, told Radio Dabanga that the refugees have been suffering from an acute scarcity of drinking water for a period of two weeks. “We have to fetch water from traditional wells located at a distance far from the camp, where the water is unsafe for drinking.

The organisation in charge of water at the camp told Dafalla that the reason for the scarcity is that the UN High Commissioner for Refugees (UNHCR) has reduced the fuel allocated for water by 50 percent. 

Water shortages are also often the source of violence, both among refugees and between host communities and refugee populations that are often looked on with envy because of even scant relief assistance.

•  “Refugees: ‘water scarcity causes violence,'” Radio Dabanga (Eastern Chad, 29 November 2012) – Darfuri refugees from Gaga and Farshana camps in Eastern Chad have appealed to all public and environmental health organizations to urgently address the scarcity of drinking water in the camps, Radio Dabanga was informed on Tuesday November 27. The refugees claim that the scarcity of drinking water sparks violence among women and children while searching for water. They added that solving the scarcity issues will reduce clashes between women and children around the water pumps.

Inevitably, weakened by lack of nutrition and clean water, people die and children are the most vulnerable. Several recent reports from Radio Dabanga also speak to the issue of inadequate primary medical care for Darfuri refugees:

•  “Darfuri refugees severely lacking medical treatment in eastern Chad,” (Eastern Chad, 21 March 2012) – Darfuri refugees in eastern Chad are severely lacking access to desperately needed medical treatment.’When they arrive at Abeche hospital there is often a wait of up to two weeks to see a doctor, patients are exposed to the heat, moving from tree to tree to try to find some shade’, said Abdul Gadir Abdel Rahman a refugee at the camp.

“There is another problem with communication as the doctors speak French and English, there are no translators to talk to the Darfuri patients,” added Abdel Rahman. UNHCR reportedly allocated three people to assist the refugees with medicine and expenses, but the headquarters of those people was never known.

The accumulation of these circumstances is leading to many people dying at the hospital. Bodies end up piled up for hours and sometimes days waiting to be buried, said Abdel Rahman.

For those who would ask seriously what the total mortality figure is for the Darfur conflict—the direct and indirect consequences of more than a decade of violence—these numbers must also be reckoned with in some fashion. Another report from 2012 adds more deaths to the overall mortality figure:

•  “Three children die at Gaga camp, East Chad Radio Dabanga,” (ABECHE, 22 August 2012) -Darfurian refugees at the Gaga camp, in East Chad claim the camp’s children are suffering from outbreaks of diarrhea and vomiting. Sources informed Radio Dabanga that three children died so far and dozens are sick.

On Thursday a camp’s resident, Adam Baraka, told Radio Dabanga his two-tear old daughter recently died as a result of vomiting and diarrhea after she had been transferred to a hospital in Abeche, East Chad. Baraka added that another two children also died recently because of the same symptoms.

A camp’s medical source informed Radio Dabanga that there are currently six children at the Gaga clinic being treated for vomiting and diarrhea. He added there are many other cases of sick children at the camp.

And it is not only physical health that deteriorates in circumstances such as eastern Chad presents to Darfuri refugees. Mental health issues have long been acute, and Physicians for Human Rights published in May 2009 an extraordinarily important and statistically rigorous profile of Darfuri women in eastern Chad. A great many of those women interviewed had been raped, and unsurprisingly the most striking finding was of widespread severe depression. An extended excerpt follows, suggesting just how profoundly painful life is for these women who have fled brutal attackers, but now must cope with living as refugees:

Researchers asked women to rate their physical and mental health status in Darfur and now in Chad on a 1 – 5 scale with 1 being “very good” and 5 being “poor.” Women reported a marked deterioration in their physical health status since leaving Darfur, with an average ranking of 3.99 for health in Chad versus 2.06 for Darfur. The Istanbul Protocol medical evaluations indicated that women experienced multiple acute and chronic physical symptoms and disabilities. Acute symptoms included pain, swelling, bleeding, bruising, lacerations, difficulty walking, and loss of consciousness. Those who were raped also reported vaginal bleeding, discharge and pelvic pain. Some went on to develop scars which were consistent with allegations of injury or bony deformities from fractured bones that were documented by visual inspection by the clinical evaluators.

The study indicated a marked deterioration in self-reported mental health, where the average score in Chad was 4.90. “I am sad every day (since leaving Darfur). I feel not well in my skin,” explained one respondent. Few women felt comfortable using the mental health services in the camp. One refugee, who herself had been trained as a counselor had not told anyone that she had been raped at knifepoint in Chad. Other women said that they felt ashamed and did not want to tell anyone about the violation. Women who experienced rape (confirmed or highly probable) were three times more likely to report suicidal thoughts than were women who did not report sexual violence.

“I am very sad, especially when I am alone.”

“How can I feel happy? They raped me. They killed my family. They raped me here.”

She reported marked sleep disturbances and frequent nightmares about “what happened.” She also experienced frequent exaggerated startle reactions and constant hyper-vigilence:

“I always think someone is following me and wants to rape me. It is better to die.”

Of the 21 women examined on the basis of the Istanbul Protocol, all 21 women experienced one or more of the following conditions, Major Depressive Disorder (MDD), Depressive Disorder Not Otherwise Specified (DD-NOS),Post Traumatic Stress Disorder (PTSD), or some symptoms of PTSD. Nineteen of the 21 (90%) women interviewed demonstrated diagnostic criteria for MDD (15/21, 71%) or DD-NOS (4/21, 19%). In addition, diagnostic criteria for PTSD or some symptoms of PTSD were noted in 16 (76%) of the women. Women commonly reported feelings of persistent hyper-vigilance and a state of being easily startled, routine sleep disturbances, generalized feelings of sadness and dysphoria, decreased energy and generalized feelings of weakness and anhedonia, and recurrent flashbacks of the attacks in Darfur and murdered relatives.

And these women are right to be fearful; there are many such reports as this from March of this year:

•  “Two women raped near Chad refugee camp,” Radio Dabanga,”(ABECHE, 14 March 2014) – Two Sudanese refugee women were raped by two Chadian nomads near Gaga refugee camp in eastern Chad on Thursday.Mohamed Ishag, vice-president of Gaga camp, told Radio Dabanga that the victims are 28 and 37 years old. “They were about 4 km away from the camp, collecting firewood, when the nomads attacked them.”The attackers cut the refugees with knives, and whipped them. Then, they raped the women.

Children—who are less aware of the differences between a refugee camp in eastern Chad and a camp for the internally displaced in Darfur—also suffer acute psychological trauma from displacement. Two years after the study by Physicians for Human Rights, a study by The Lancet found that 75 percent of all children in Darfur camps suffered from symptoms of post-traumatic stress syndrome. The number of households led my mothers, grandmothers, and young girls has created profound social upheavals. And the epidemic of rape has created an environment of fear and terror so great as to threaten social stability for a generation. The same level of distress was reflected in reports coming contemporaneously from eastern Chad:

•  “Youth suicides reported at Sudanese refugee camp in Chad,” Radio Dabanga (DJABAL CAMP, Eastern Chad, 30 November 2010) -There is increased incidence of suicide among the youth at Djabal Camp for Sudanese refugees in eastern Chad. One refugee at the camp said he recorded five cases of suicide this year, and explained that most suicides were between 18 and 25 years old.

•  “Psychiatric treatment needed for 130 in Chad refugee camp,” Radio Dabanga (JEBEL Camp, Eastern Chad, 29 March 2010) –An international NGO has registered more than 130 persons who need psychiatric treatment in Jebel refugee camp, east of Chad. The organization said that since it took over the work last January it came to this conclusion from research it conducted from 15 till 27 March.

Such treatment is among the first casualties of the budget slashing that has occurred in international humanitarian responses to Darfuri refugees in Chad. Education is also a casualty, and the future of many children is being blighted for lack of opportunities to learn in school:

•  “Large number of school drop-outs in eastern Chad camp,” Radio Dabanga (EASTERN CHAD, 15 June 2014) – The number of pupils who dropped out of basic school in the Djabal refugee camp in eastern Chad in 2013 amounts to 1,420.

“At the start of the school year in 2013, a monthly school fee of 60 Chadian franc ($0.13) was imposed on each basic school student, while the budget of relief organisations working in the field of education was reduced,” Mohamed Juma Ahmed, the education supervisor of Gaga camp, reported to Radio Dabanga. “Last year 1,420 out of the 4,875 students at the six basic schools in Djabal camp quit their education. Educational NGOs cut their budgets, which forced the schools to impose a fee. Yet, because of their less than basic income, the parents cannot afford the monthly fees. The children are now working to assist their parents to earn a living.”

There is no evidence that the situation in eastern Chad will change any time soon. Some 362,000 Darfuri refugees, virtually all from the African tribal groups of Darfur, remain in a ghastly limbo—and their numbers may grow; a great many will never leave Chad, eventually dying outside their homeland. Many have given into despair; many more will soon; and, given present circumstances, the life that we can imagine them resuming on returning to their lands in Darfur, at some possible future date, is bleak beyond description.

Copyright 2014 Eric Reeves

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