In Chad, refugees and residents face health and security crisis

The withdrawal from Abéché in eastern Chad of non essential United Nations staff, including those working for the World Health Organization (WHO), has left refugee and displaced populations and local communities facing a potential health crisis, WHO said today.

Facing increased levels of insecurity in the area, the UN was forced to withdraw most of its operational staff from Abéché following an attack on a warehouse and staff in the past ten days. Many people living in camps and local communities have little access to health care and their situation could deteriorate quickly.

The situation in Chad, which has been gradually deteriorating since the beginning of 2006, has taken a turn for the worse in recent weeks. In the eastern region, which has been hosting more than 234 000 Sudanese seeking refuge from the conflict in Darfur since 2003, the rebellion has also displaced an estimated 63 000 Chadians in 2006.

Late last month, a rebel assault on Abéché, a town which is central to aid operations in eastern Chad, has forced international relief agencies to scale down their presence in the region and evacuate non-essential staff, maintaining only skeleton staff in the 12 refugees camps scattered along the border with Sudan.

Due to the reduced humanitarian health assistance, the health status of refugees and IDPs can rapidly deteriorate. The increase in the local population has overstretched the capacity of health services and aid agencies, while supply chains have been affected.

So far, the outbreak early warning and response network set up by WHO, which continues to work despite security problems, reports that the primary causes of illness among refugees are acute respiratory infections, diarrhoea and malaria.

Added to that is the increasing number of injuries as a result of fighting between rebels and government soldiers in the area. Dr Innocent Nzeyimana, Coordinator of the WHO sub office in Abéché, said that “as violence intensifies, the number of persons wounded by fighting is becoming a serious concern,” adding that ”local personnel is not sufficiently trained nor local resources sufficient to handle these cases.”

When the town of Guéréda was attacked on 1 December, 82 people were injured and about another 100 were reported injured last weekend in Abéché. Non-governmental organizations working in the camps still have enough medicines for current health care needs. However, wounded civilians are left without proper care if they are not in an area covered by Médecins Sans Frontières (MSF)-Holland, which is managing the care of wounded people in Abéché and in other areas. The International Committee of the Red Cross has also deployed a surgical team in Abéché for emergency intervention.

Overall, WHO’s work in eastern Chad has concentrated on coordination and leadership of health activities through the Cluster Approach. The main activities include routine epidemiological surveillance, nutritional surveillance and control of micronutrient deficiency in some regions. In collaboration with other health partners, an Early Warning System for detection and response to outbreaks has been established. WHO has also worked to build laboratory capacity in N’Djamena and Abéché and to provide kits and rapid diagnostic tests.

The WHO sub office in Abéché has been supporting the local hospital and MSF for the care of people injured by fighting, providing technical expertise for blood testing as well as laboratory reagents, supplies and essential drugs. A New Emergency Health Kit – sufficient to support 10 000 people for three months – and a Trauma Kit – for the treatment of 100 people affected by trauma – have been sent to N’Djamena, to be dispatched to Abéché shortly.