🔗 Share this article

For hours, bouncing over the soggy dirt track to the hospital, 18-year-old Makka Ibraheem Mohammed clung desperately to her seat and concentrated on stopping herself being sick. She was in childbirth, in extreme pain after her womb tore, but was now being tossed around in the ambulance that bumped over the potholes and ridges of the road through the Chadian desert.

Most of the close to a million Sudanese displaced persons who escaped to Chad since 2023, surviving precariously in this inhospitable environment, are females. They reside in remote settlements in the desert with insufficient supplies, no work and with treatment often a dangerously far away.

The hospital Mohammed needed was in Metche, one more encampment more than a considerable journey away.

“I kept getting infections during my term and I had to go the health post seven times – when I was there, the pregnancy started. But I wasn’t able to give birth without intervention because my uterine muscles failed,” says Mohammed. “I had to remain for 120 minutes for the ambulance but all I can think of the agony; it was so bad I became delirious.”

Her maternal figure, Ashe Khamis Abdullah, 40, was terrified she would be bereft of her daughter and baby grandson. But Mohammed was rushed straight into surgery when she got to the hospital and an critical surgical delivery preserved the lives of her and her son, Muwais.

Chad was known for the world’s second worst maternal death rate before the ongoing stream of refugees, but the circumstances suffered by the Sudanese put even more women in risk.

At the hospital, where they have assisted in the arrival of 824 babies in often critical situations this year, the doctors are able to help plenty, but it is what occurs with the women who are fail to get to the hospital that worries the staff.

In the couple of years since the domestic strife in Sudan erupted, the vast majority of the refugees who have arrived and remained in Chad are women and children. In total, about 1.2 million Sudanese are being accommodated in the eastern region of the country, a large number of whom ran from the previous conflict in Darfur.

Chad has accepted the majority of the millions of people who have fled the war in Sudan; some have travelled to South Sudan, Egypt and Ethiopia. A total of almost twelve million Sudanese have been forced out of their homes.

Many men have remained to be near homes and land; many were murdered, abducted or made to join the conflict. Those of employable age move on quickly from Chad’s barren settlements to find work in the main city, N’Djamena, or beyond, in nearby Libya.

It results in women are left alone, without the ability to provide for the children and the elderly left in their responsibility. To reduce density near the border, the Chadian government has moved individuals to less crowded encampments such as Metche with average populations of about a large community, but in distant locations with limited infrastructure and scarce prospects.

Metche has a hospital set up by a medical aid organization, which was initially a few tents but has expanded to include an operating theatre, but little else. There is unemployment, families must journey for extended periods to find fuel, and each person must survive on about a small amount of water a day – well under the advised quantity.

This seclusion means hospitals are treating women with issues in their pregnancy when it is almost too late. There is only a one medical transport to cover the route between the Metche hospital and the health post near the settlement of Alacha, where Mohammed is one of close to fifty thousand refugees. The medical team has observed instances where women in extreme agony have had to endure a full night for the ambulance to arrive.

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

As well as being uneven, the route passes through valleys that fill with water during the wet period, completely cutting off travel.

A surgeon at the hospital in Metche said all the situations she encounters is an crisis, with some women having to make challenging travels to the hospital by foot or on a donkey.

“Imagine being nine months pregnant, in delivery, and journeying for an extended time on a cart pulled by a donkey to get to a hospital. The biggest factor is the delay but having to come in these conditions also has an influence on the childbirth,” says the surgeon.

Malnutrition, which is on the rise, also elevates the likelihood of complications in pregnancy, including the uterine splits that medical staff often encounter.

Mohammed has stayed at the medical facility in the couple of months since her surgical delivery. Experiencing malnutrition, she developed an infection, while her son has been carefully monitored. The male guardian has gone to other towns in look for employment, so Mohammed is entirely leaning on her mother.

The undernourishment unit has increased to six tents and has cases exceeding capacity into other sections. Children lie under mosquito nets in sweltering heat in almost complete silence as medical staff work, mixing medications and assessing weights on a device constructed from a pail and cord.

In less severe situations children get sachets of PlumpyNut, the specifically created peanut paste, but the critical situations need a consistent supply of enriched milk. Mohammed’s baby is fed his through a injector.

Suhayba Abdullah Abubakar’s baby boy, Sufian Sulaiman, is being nourished via a nasogastric tube. The child 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 arriving in this structure,” she says. “The nutrition we receive is inadequate, there’s not enough to eat and it’s not nutritious.

“If we were at home, we could’ve adapted ourselves. You can go and cultivate plants, you can find employment, but here we’re reliant on what we’re given.”

And what they are provided is a limited quantity of grain, edible oil and salt, handed out every two months. Such a basic diet offers little sustenance, and the meager funds she is given acquires minimal items in the regular markets, where prices have become inflated.

Abubakar was transferred to Alacha after arriving from Sudan in 2023, having run from the militia Rapid Support Forces’ raid on her home city of El Geneina in June that year.

Unable to get employment in Chad, her spouse has left for Libya in the aspiration to raising enough money for them to come later. She resides with his relatives, sharing out whatever nourishment they obtain.

Abubakar says she has already seen food supplies decreasing and there are worries that the abrupt cuts in overseas aid budgets by the US, UK and other European countries, could worsen the situation. Despite the war in Sudan having created the 21st century’s worst humanitarian disaster and the {scale of needs|extent