‘I have sought aid repeatedly’: these Sudanese women left alone to scrape by in Chad’s desert camps.

For a long time, travelling roughly on the soggy dirt track to the medical facility, 18-year-old Makka Ibraheem Mohammed clung desperately to her seat and focused on stopping herself being sick. She was in delivery, in severe suffering after her uterine wall split, but was now being jostled relentlessly in the ambulance that bumped over the uneven terrain of the road through the Chadian desert.

Most of the 878,000 Sudanese displaced persons who escaped to Chad since 2023, barely getting by in this difficult terrain, are women. They stay in remote settlements in the desert with limited water and food, little employment and with healthcare often a perilously remote away.

The clinic Mohammed needed was in Metche, another refugee camp more than two hours away.

“I kept getting infections during my pregnancy and I had to go the health post multiple occasions – when I was there, the labour began. But I could not give birth naturally because my womb had given way,” says Mohammed. “I had to endure a long delay for the ambulance but all I recall is the pain; it was so bad 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 got to the hospital and an urgent C-section rescued her and her son, Muwais.

Chad previously recorded the world’s second worst maternal mortality rate before the current influx of refugees, but the situations faced by the Sudanese place additional women in peril.

At the hospital, where they have birthed 824 babies in frequently urgent circumstances this year, the medical staff are able to rescue numerous, but it is what affects the women who are not able to reach the hospital that alarms the professionals.

In the two years since the internal conflict in Sudan started, over four-fifths of the displaced persons who came and remained in Chad are mothers and kids. In total, about one point two million Sudanese are being accommodated in the eastern part of the country, a large number of whom ran from the previous conflict in Darfur.

Chad has accepted the majority of the 4.1 million people who have escaped the war in Sudan; others have gone to South Sudan, Egypt and Ethiopia. A total of almost twelve million Sudanese have been forced out of their homes.

Many adult men have remained to be near homes and land; some were 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 beyond, in nearby Libya.

It implies women are stranded, without the resources to feed the children and the elderly left in their responsibility. To reduce density near the border, the Chadian government has moved individuals to smaller camps such as Metche with average populations of about fifty thousand, but in isolated regions with no services and scarce prospects.

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 no work, families must walk hours to find firewood, and each person must get by with about minimal water of water a day – far below the advised quantity.

This isolation means hospitals are receiving women with problems in their pregnancy when it is almost too late. There is only a one medical transport to serve the area between the Metche hospital and the clinic near the Alacha encampment, where Mohammed is one of nearly 50,000 refugees. The medical team has encountered situations where women in extreme agony have had to remain overnight for the ambulance to reach them.

Imagine being in the final trimester, in labour, 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 become inundated during the wet period, completely cutting off travel.

A surgeon at the hospital in Metche said every case she sees is an crisis, with some women having to make challenging travels to the hospital by foot or on a pack animal.

“Imagine being about to give birth, in labour, and travelling hours on a cart pulled by a donkey to get to a medical center. The main problem is the lag but having to come in these conditions also has an influence on the birth,” says the surgeon.

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

Mohammed has continued under care in the two months since her caesarean. Suffering from malnutrition, she contracted an illness, while her son has been closely watched. The parent has journeyed to other towns in look for employment, so Mohammed is entirely leaning on her mother.

The malnutrition ward has increased to six tents and has patients spilling over into other sections. Children are placed under mosquito nets in oppressive temperatures in almost total quiet as doctors and nurses work, preparing treatments and weighing children on a device constructed from a bucket and rope.

In mild cases children get small bags of PlumpyNut, the specifically created peanut paste, but the critical situations need a daily dose of enriched milk. Mohammed’s baby is fed his through a syringe.

Suhayba Abdullah Abubakar’s baby boy, Sufian Sulaiman, is being fed through a nasal drip. The child has been sick for the past year but Abubakar was only provided with painkillers without any medical assessment, until she made the journey from Alacha to Metche.

“Every day, I see further minors arriving in this tent,” she says. “The food we’re eating is poor, there’s insufficient food and it’s not nutritious.

“If we were at home, we could’ve adjusted our lives. You can go and cultivate plants, you can find employment, but here we’re dependent on what we’re distributed.”

And what they are allocated is a meager portion of grain, vegetable oil and salt, provided every two months. Such a basic diet is deficient in nutrients, and the little cash she is given purchases very little in the weekly food markets, where costs have risen.

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

Failing to secure jobs in Chad, her partner has left for Libya in the desire to gathering adequate cash for them to join him. She resides with his family members, distributing whatever food they can get.

Abubakar says she has already witnessed food distributions being reduced and there are fears that the sharp decreases in foreign support money by the US, UK and other European countries, could deteriorate conditions. Despite the war in Sudan having created the 21st century’s worst humanitarian disaster and the {scale of needs|extent