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

For a long time, travelling roughly on the soggy dirt track to the clinic, 18-year-old Makka Ibraheem Mohammed clung desperately to her seat and concentrated on stopping herself vomiting. She was in delivery, in extreme pain after her womb tore, but was now being tossed around in the ambulance that jumped along the potholes and ridges of the road through the Chadian desert.

Most of the close to a million Sudanese refugees who have fled to Chad since 2023, barely getting by in this harsh landscape, are females. They live in secluded encampments in the desert with insufficient supplies, little employment and with medical help often a dangerously far away.

The hospital Mohammed needed was in Metche, one more encampment more than 120 minutes away.

“I continuously experienced infections during my term and I had to go the clinic seven times – when I was there, the labour began. But I found it impossible to give birth normally because my uterine muscles failed,” says Mohammed. “I had to wait two hours for the ambulance but all I remember was the suffering; it was so bad I became confused.”

Her maternal figure, Ashe Khamis Abdullah, 40, feared she would be bereft of her offspring and descendant. But Mohammed was hurried into surgery when she got to the hospital and an emergency caesarean section rescued her and her son, Muwais.

Chad was known for the world’s second most severe maternal fatality statistic before the recent arrival of refugees, but the situations faced by the Sudanese put even more women in peril.

At the hospital, where they have assisted in the arrival of 824 babies in often critical situations this year, the doctors are able to save many, but it is what affects the women who are not able to reach the hospital that worries the staff.

In the 24 months since the domestic strife in Sudan began, 86% of the refugees who have arrived and settled in Chad are mothers and kids. In total, about over a million Sudanese are being sheltered in the eastern part of the country, four hundred thousand of whom escaped the previous conflict in Darfur.

Chad has hosted the bulk of the over four million people who have escaped the war in Sudan; others have gone to South Sudan, Egypt and Ethiopia. A total of millions of Sudanese have been uprooted from their homes.

Many men have remained to be in proximity to homes and land; many were slain, taken hostage or forced into fighting. Those of working age soon depart from Chad’s desolate refugee camps to seek employment in the main city, N’Djamena, or elsewhere, in adjacent Libya.

It results in women are stranded, without the ability to provide for the dependents left in their charge. To reduce density near the border, the Chadian government has relocated people to more compact settlements such as Metche with usual resident counts of about fifty thousand, but in remote areas with few facilities and scarce prospects.

Metche has a hospital set up by a medical aid organization, which began as a few tents but has expanded to include an operating theatre, but few additional amenities. There is unemployment, families must travel long distances to find firewood, and each person must subsist with about nine litres of water a day – far below the advised quantity.

This isolation means hospitals are admitting women with complications in their pregnancy dangerously late. There is only a single ambulance to serve the area 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 seen cases where women in desperate pain have had to wait an entire night for the ambulance to come.

Imagine being in the final trimester, in labour, and journeying for a long time on a cart pulled by a donkey to get to a hospital

As well as being uneven, the path goes through valleys that become inundated during the rainy season, completely blocking travel.

A surgeon at the hospital in Metche said each patient she treats is an critical situation, with some women having to make challenging travels to the hospital by on foot or on a donkey.

“Imagine being in the late stages of pregnancy, in labour, and travelling hours on a donkey cart to get to a medical center. The primary issue is the delay but having to arrive under such circumstances also has an influence on the childbirth,” says the surgeon.

Poor nutrition, which is growing, also raises the chance of complications in pregnancy, including the womb tears that medical staff often encounter.

Mohammed has stayed at the medical facility in the couple of months since her C-section. Experiencing malnutrition, she contracted an illness, while her son has been regularly checked. The male guardian has gone to other towns in look for employment, so Mohammed is totally dependent on her mother.

The undernourishment unit has grown to six tents and has individuals overflowing into other sections. Children lie under mosquito nets in oppressive temperatures in almost utter stillness as doctors and nurses work, creating remedies and weighing children on a device constructed from a bucket and rope.

In moderate instances children get packets of PlumpyNut, the specially formulated peanut paste, but the critical situations need a daily dose of nutrient-rich liquid. Mohammed’s baby is fed his through a medical device.

Suhayba Abdullah Abubakar’s 11-month-old boy, Sufian Sulaiman, is being fed through a nose 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 additional kids arriving in this tent,” she says. “The meals we consume is low-quality, there’s insufficient food and it’s not nutritious.

“If we were at home, we could’ve adapted ourselves. You can go and farm produce, you can work to earn some money, but here we’re dependent on what we’re distributed.”

And what they are allocated is a limited quantity of cereal, cooking oil and salt, provided every couple of months. Such a minimal nutrition is deficient in nutrients, and the small amount of money she is given acquires minimal items in the local bazaars, where values have increased.

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

Failing to secure jobs in Chad, her partner has left for Libya in the hope of earning sufficient funds for them to come later. She stays with his family members, distributing whatever nourishment they obtain.

Abubakar says she has already witnessed food supplies decreasing and there are worries 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 gravest emergency and the {scale of needs|extent