🔗 Share this article

For an extended period, travelling roughly on the soggy dirt track to the clinic, 18-year-old Makka Ibraheem Mohammed clung desperately to her seat and tried hard stopping herself being sick. She was in labour, in extreme pain after her uterine wall split, but was now being shaken violently in the ambulance that jumped along the uneven terrain of the road through the Chadian desert.

Most of the hundreds of thousands of Sudanese people who ran to Chad since 2023, living hand to mouth in this harsh landscape, are women. They live in isolated camps in the desert with insufficient supplies, little employment and with medical help often a perilously remote away.

The clinic Mohammed needed was in Metche, a different settlement more than two hours away.

“I repeatedly suffered from infections during my gestation and I had to go the health post on numerous visits – when I was there, the labour began. But I could not give birth normally because my womb had given way,” 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 confused.”

Her mother, Ashe Khamis Abdullah, 40, was terrified she would lose both her child and grandchild. But Mohammed was hurried into surgery when she reached the hospital and an emergency caesarean section saved her and her son, Muwais.

Chad was known for the world’s second worst maternal mortality rate before the ongoing stream of refugees, but the conditions endured by the Sudanese place additional women in risk.

At the hospital, where they have delivered 824 babies in often critical situations this year, the medical staff 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 24 months since the domestic strife in Sudan erupted, over four-fifths of the displaced persons who came and settled in Chad are mothers and kids. In total, about 1.2 million Sudanese are being accommodated in the eastern region of the country, four hundred thousand of whom escaped the earlier war in Darfur.

Chad has hosted the bulk 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 uprooted from their homes.

Many adult men have not left to be near homes and land; many were slain, captured or forced into fighting. Those of employable age rapidly leave from Chad’s barren settlements to seek employment in the main city, N’Djamena, or elsewhere, in adjacent Libya.

It results in women are stranded, without the ability to sustain the children and the elderly left in their responsibility. To avoid overcrowding near the border, the Chadian government has transferred refugees to more compact settlements such as Metche with usual resident counts of about a large community, but in isolated regions with limited infrastructure and minimal chances.

Metche has a hospital established by a medical aid organization, which started off as a few tents but has expanded to include an procedure area, but not much more. There is a lack of jobs, families must journey for extended periods to find fuel, and each person must survive on about minimal water of water a day – much less than the suggested amount.

This seclusion means hospitals are treating women with issues in their pregnancy at a critical stage. There is only a one medical transport to cover the route between the Metche hospital and the medical tent near the Alacha encampment, where Mohammed is one of nearly 50,000 refugees. The medical team has observed instances where women in severe suffering have had to remain overnight for the ambulance to reach them.

Imagine being nine months pregnant, in childbirth, and journeying for a long time on a animal-drawn transport to get to a hospital

As well as being bumpy, the road traverses valleys that flood during the rainy season, completely blocking travel.

A surgeon at the hospital in Metche said all the situations she encounters is an critical situation, with some women having to make long and difficult journeys to the hospital by foot or on a donkey.

“Imagine being about to give birth, in delivery, and journeying for an extended time on a donkey cart to get to a hospital. The primary issue is the wait but having to arrive under such circumstances also has an impact on the childbirth,” says the surgeon.

Malnutrition, which is increasing, also raises the chance of issues in pregnancy, including the uterine splits that medical staff see regularly.

Mohammed has remained in hospital in the two months since her surgical delivery. Experiencing malnutrition, she developed an infection, while her son has been carefully monitored. The parent has gone to other towns in seek jobs, so Mohammed is completely reliant on her mother.

The undernourishment unit has increased to six tents and has individuals overflowing into other sections. Children are placed under mosquito nets in oppressive temperatures in almost total quiet as health workers work, creating remedies and weighing children on a instrument created using a bucket and rope.

In moderate instances children get small bags of PlumpyNut, the uniquely designed peanut paste, but the most severe instances need a regular intake of enriched milk. Mohammed’s baby is given his nourishment through a syringe.

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

“Every day, I see more children coming in in this tent,” she says. “The food we’re eating is low-quality, there’s insufficient food and it’s lacking in nutrients.

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

And what they are provided is a small amount of sorghum, cooking oil and salt, distributed every two months. Such a minimal nutrition is deficient in nutrients, and the little cash she is given purchases very little in the regular markets, where values have increased.

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

Unable to get employment in Chad, her husband has gone to Libya in the aspiration to gathering adequate cash for them to follow. She lives with his kin, distributing whatever nourishment they obtain.

Abubakar says she has already observed food supplies decreasing and there are concerns that the sharp decreases in international assistance funds by the US, UK and other European countries, could worsen the situation. Despite the war in Sudan having caused the 21st century’s most severe crisis and the {scale of needs|extent