‘I have sought aid repeatedly’: these Sudanese females abandoned to scrape by in Chad’s desert camps.

For an extended period, jolting along the flooded dirt track to the medical facility, 18-year-old Makka Ibraheem Mohammed gripped firmly to her seat and concentrated on stopping herself throwing up. She was in childbirth, in agonizing discomfort after her womb tore, but was now being jostled relentlessly in the ambulance that lurched across the potholes and ridges of the road through the Chadian desert.

Most of the hundreds of thousands of Sudanese refugees who have fled to Chad since 2023, barely getting by in this harsh landscape, are women. They reside in secluded encampments in the desert with scarce resources, few job opportunities and with healthcare often a perilously remote away.

The hospital Mohammed needed was in Metche, a different settlement more than 120 minutes away.

“I continuously experienced infections during my term and I had to go the health post multiple occasions – when I was there, the pregnancy started. But I could not give birth naturally because my uterus had collapsed,” says Mohammed. “I had to remain for 120 minutes for the ambulance but all I recall is the suffering; it was so unbearable I became delirious.”

Her mother, Ashe Khamis Abdullah, 40, worried she would suffer the death of her child and grandchild. But Mohammed was hurried into surgery when she got to the hospital and an emergency caesarean section preserved the lives of her and her son, Muwais.

Chad already had the world’s second-highest maternal fatality statistic before the current influx of refugees, but the situations faced by the Sudanese expose further women in peril.

At the hospital, where they have assisted in the arrival of 824 babies in mostly emergency conditions this year, the medical staff are able to save many, but it is what occurs with the women who are cannot access the hospital that alarms the professionals.

In the couple of years since the domestic strife in Sudan started, 86% of the displaced persons who came and stayed in Chad are females and minors. In total, about 1.2 million Sudanese are being hosted in the eastern part of the country, a large number of whom fled the earlier war in Darfur.

Chad has hosted the bulk of the 4.1 million people who have run from the war in Sudan; the remainder moved to South Sudan, Egypt and Ethiopia. A total of 11.8 million Sudanese have been displaced from their homes.

Many men have remained to be near homes and land; others have been murdered, taken hostage or made to join the conflict. Those of employable age move on quickly from Chad’s desolate refugee camps to find work in the capital, N’Djamena, or elsewhere, in nearby Libya.

It means women are stranded, without the means to provide for the young and old left in their care. To prevent congestion near the border, the Chadian government has transferred refugees to less crowded encampments such as Metche with typical numbers of about a large community, but in isolated regions with no services and few opportunities.

Metche has a hospital built by a medical aid organization, which was initially a few tents but has grown to feature an procedure area, but few additional amenities. There is a lack of jobs, families must walk hours to find fuel, and each person must subsist with about a small amount of water a day – far below the suggested amount.

This seclusion means hospitals are admitting women with complications in their pregnancy when it is almost too late. There is only a sole emergency vehicle to cover the route between the Metche hospital and the clinic near the camp at Alacha, where Mohammed is one of nearly 50,000 refugees. The medical team has encountered situations where women in extreme agony have had to wait an entire night for the ambulance to reach them.

Imagine being expecting a child, in delivery, and travelling hours on a cart pulled by a donkey to get to a hospital

As well as being bumpy, the path goes through valleys that flood during the rainy season, completely blocking travel.

A surgeon at the hospital in Metche said each patient she treats is an crisis, with some women having to make long and difficult journeys to the hospital by on foot or on a pack animal.

“Imagine being about to give birth, in childbirth, and travelling hours on a animal-drawn vehicle to get to a clinic. The main problem is the lag but having to arrive under such circumstances also has an impact on the birth,” says the surgeon.

Malnutrition, which is on the rise, also elevates the likelihood of problems in pregnancy, including the womb tears that medical staff frequently observe.

Mohammed has continued under care in the two months since her caesarean. Suffering from malnutrition, she developed an infection, while her son has been regularly checked. The father has travelled to other towns in search of work, so Mohammed is completely reliant on her mother.

The nutritional care section has expanded to six tents and has patients spilling over into other sections. Children lie under mosquito nets in oppressive temperatures in almost complete silence as doctors and nurses work, mixing medications and assessing weights on a device constructed from a container and string.

In less severe situations children get small bags of PlumpyNut, the uniquely designed peanut paste, but the critical situations need a regular intake of enriched milk. Mohammed’s baby is fed his through a injector.

Suhayba Abdullah Abubakar’s 11-month-old boy, Sufian Sulaiman, is being given nutrition by a nose tube. The baby has been ill for the past year but Abubakar was repeatedly given only painkillers without any medical assessment, until she made the trip from Alacha to Metche.

“Every day, I see further minors joining us in this shelter,” she says. “The meals we consume is inadequate, there’s insufficient food and it’s deficient in vitamins.

“If we were at home, we could’ve adapted ourselves. You can go and farm produce, you can get a job, but here we’re relying on what we’re distributed.”

And what they are given is a meager portion of grain, vegetable oil and salt, distributed every couple of months. Such a simple food is deficient in nutrients, and the little cash she is given cannot buy much in the regular markets, where prices have become inflated.

Abubakar was transferred to Alacha after coming from Sudan in 2023, having escaped the paramilitary Rapid Support Forces’ raid on her native town of El Geneina in June that year.

Failing to secure jobs in Chad, her spouse has gone to Libya in the desire to earning sufficient funds for them to come later. She lives with his kin, distributing whatever meals they acquire.

Abubakar says she has already witnessed food supplies decreasing and there are concerns that the abrupt cuts in foreign support money by the US, UK and other European countries, could make things worse. Despite the war in Sudan having produced the 21st century’s most severe crisis and the {scale of needs|extent