In 2010, the heaviest rains for 40 years destroyed crops, flooded wells and cut off entire villages in Chad. These floods followed a long drought in 2009, which had already resulted in a significant drop in farm production. Chadians faced a major food crisis and several outbreaks of disease, including cholera, meningitis, measles and malnutrition. One quarter of children under the age of five were suffering from acute malnutrition in the Sahel region of western Chad in 2010. In eastern Chad, conflict continued.

Insecurity in eastern Chad

The political relationship between Chad and Sudan improved in 2010.  Based on an agreement between the two countries regarding the provision of weapons and protection of insurgent groups, the UN peacekeeping mission MINURCAT left the country in December 2010. But sporadic clashes continued to be reported in eastern Chad and humanitarian staff were the targets of kidnapping, robberies and violence. Many aid organisations were obliged to reduce their activities, or stop work altogether, making life even more difficult for people living in the region.

In Dogdoré, 30 kilometres from the border with Sudan, residents live alongside a large number of displaced people. Médecins Sans Frontières teams carried out more than 12,100 consultations and treated 430 patients in hospital during the first seven months of 2010. They provided 2,460 antenatal consultations, assisted more than 200 births and vaccinated some 1,060 children against measles. More than 430 people were admitted to the nutritional rehabilitation programme.

In July 2010, however, Médecins Sans Frontières was forced to close the programme. Repeated security incidents made it impossible to maintain a team in Dogdoré. Before leaving, we donated drugs and medical supplies to the hospital to help ensure the continuation of medical care after the team’s departure.

In Kerfi, in the southeast, our staff worked in a small health centre where both displaced people and members of the settled community came for treatment. In 2010, almost 26,700 consultations were carried out, and more than 1,500 patients were hospitalised. Staff held more than 3,000 antenatal consultations, assisted close to 100 births, and admitted more than 1,000 people to the nutrition programme.

In February 2010, our staff began providing care to patients in the paediatric and maternity departments of Am Timan hospital. By the end of the year the team was also working in three health centres around Am Timan. They set up mobile clinics to make treatment for malnutrition more easily available to more people, and offered antenatal care. In total, close to 1,030 babies were delivered, more than 1,750 patients were hospitalised, and 2,970 children were admitted to the nutrition programme.

In the city of Abéché, Médecins Sans Frontières assisted more than 3,400 deliveries and treated 144 women with obstetric fistula (injuries to the birth canal).

Malaria in Moissala

In Moissala, a district in southern Chad, malaria is endemic throughout the year, although the number of cases peaks during and after the rainy season, between July and November. If a person with malaria is not treated quickly, the disease can cause death, especially in children and pregnant women.

In several health centres in the region, our staff trained community health workers to screen patients for malaria and offer early treatment for simple cases. People suffering complicated cases of malaria were referred to Moissala hospital, where we run a 50-bed malaria treatment unit. More than 20,000 patients were treated for malaria over five months. More than 1,030 patients were hospitalised in the malaria treatment unit.

Measles

During the first months of 2010, there was an outbreak of measles in the capital city, N’Djamena. Staff cared for more than 1,000 patients, nearly 420 of whom had to be hospitalised. Médecins Sans Frontières also donated drugs and medical supplies to help health centres treat more than 2,770 patients. In March and April, our team immunised more than 482,000 children.

Emergency nutrition programmes

While responding to the measles outbreak, our staff observed high rates of acute malnutrition among children. This led to the opening of a nutrition programme in N’Djamena in March. The existing nutrition programmes in Dogdoré, Kerfi and Am Timan were strengthened, and a further 11 emergency programmes were opened in N’Djamena, the western regions of Hadjer Lamis, Kanem, Lac, Mayo Kebbi Est and Chari Baguirmi, Batha and Guera in central Chad, and Salamat in the southeast. In total, MSF treated more than 27,650 children, of whom more than 21,740 were severely malnourished.

Cholera

In September, there was an outbreak of cholera in N’Djamena. Our teams set up treatment centres in three of the city’s hospitals.

“The fact that more people are getting sick with cholera now is probably related to the fact that the heavy rains and floods hit a population that was already weakened. There have been recent outbreaks of measles and high levels of malnutrition, so people’s immune systems are low – a typical scenario for cholera outbreaks,” said Alexis Bahati, medical team leader in Bokoro. Staff treated close to 1,300 patients and donated drugs in the Bongor and Madelia districts, south of the city, and responded to outbreaks in Bokoro, Pala and Fianga, where almost 700 patients were treated. By the end of the year, 6,300 cholera patients had been registered across the country.

Meningitis

In March and April, we treated more than 1,280 patients for meningitis in the southern regions of Logoné Oriental and Tandjilé. Vaccination campaigns were carried out in Logoné Oriental, Mandoul and Tandjilé, and Médecins Sans Frontières and the Ministry of Health vaccinated some 765,000 people between the ages of 2 and 29.