Sudanese refugees brace for a new threat to life and limb

Globe and Mail

a day ago

Arbab Sharif Ahmad, 33, survived a massacre during an ethnic cleansing campaign, but his five-year-old son was executed in front of him. As Mr. Ahmad fled from the Arab-led Rapid Support Forces (RSF) in El Geneina, the capital of West Darfur in Sudan, a bullet shattered his knee. Over a year later, he lies in agony on the dirt floor of a makeshift hut in the remote Farchana refugee camp in eastern Chad, unable to walk properly and still awaiting surgery.
'One of my daughters, when she sees my injured leg or the crutches, she becomes scared and doesn't want to come near me,' he explains, adding that he now spends most of his days hiding inside his hut to avoid frightening her.
Mr. Ahmad's story is echoed throughout Sector P1 of the new Farchana camp – known locally as the 'wounded sector'– which houses around 250 households of injured Sudanese refugees, most from the Masalit ethnic group. These families represent only a fraction of the more than 17,000 Sudanese refugees in Chad living with disabilities or severe medical conditions, according to the United Nations Refugee Agency.
For those who barely escaped the RSF, survival in Chad presents a new ordeal. The country's fragile health care system is overwhelmed by what humanitarian agencies now call the world's largest humanitarian disaster. Refugees with serious injuries are going without treatment.
But the crisis is expected to worsen as critical healthcare programs face discontinuation.
To support Chadian hospitals, the World Health Organization (WHO) and Doctors Without Borders (MSF) have brought in foreign surgeons, mainly from other African nations, says Dr. Blanche Anya, the WHO's representative in Chad. 'WHO funded emergency medical teams to provide care for the people that were wounded. But this is very expensive, so we cannot sustain it,' she says, noting that funding for the surgical teams is only guaranteed through June.
Dr. Anya cites broader geopolitical forces that have worsened the crisis. U.S. President Donald Trump's withdrawal from the WHO, suspension of foreign aid and dissolution of the United States Agency for International Development (USAID) have collectively drained critical resources.
While U.S. contributions represent less than 10 per cent of WHO's Chad budget, according to Dr. Anya, she says they have a disproportionate impact on key programs such as maternal care and polio eradication, where the U.S. Centers for Disease Control and Prevention (CDC) also provided personnel. The cuts also affect NGOs working with WHO to deliver essential health services.
'[If] those NGOs that were supported by the U.S. government do not have the capacity to continue providing health services, of course, this will have a big impact on lives and increase mortality,' she says, adding that a large part of the population will lose access to health services. 'The type of population that will be most affected will be the vulnerable population, children, women.'
According to Dr. Anya, WHO Chad is now seeking alternative funding while also drafting a list that ranks programs by priority to determine which can be maintained and which may need to be cut.
The RSF and the Sudanese Armed Forces have been at war since April 2023. It's a conflict that has displaced millions of people, killed thousands and seen famines declared in parts of the country. In January, then-U.S. Secretary of State Antony Blinken classified the RSF's actions in Sudan as genocide.
Survivors describe targeted killings of Masalit and non-Arab civilians by the RSF during their ongoing campaign of ethnic cleansing in West Darfur. Those who remained behind have reportedly been forced to renounce their ethnic identity and identify as Arab.
'They are targeting people based on race. If you are Black, they will just kill you,' says Ayub Abdallah, 25, who was shot and stabbed seven times while fleeing the city of El Geneina in West Darfur.
Khalil Ahmad Khalil, 30, was shot in the leg by RSF militants inside his home. One and a half years after fleeing to Chad, his leg remains fractured in the shin, essentially split into two pieces. Doctors told Mr. Khalil he needs surgery, but they lack the capacity to perform it.
'You can see it's not fixed. It just moves,' he says, pointing to the exposed bone beneath tattered dressings. 'I am suffering from a lot of pain . . . I stopped going to the doctors because, unfortunately, I've lost hope.'
Jumah Bakhit, 31, the chief of the camp's P1 sector, warns that if more time passes, many cases will become untreatable, noting that some refugees have already died due to lack of care.
In Farchana camp, the only health care facility is a small primary care clinic run by the International Rescue Committee (IRC).
According to a USAID Chad report, the NGO received US$5.3-million in 2024 from the U.S. State Department's Bureau of Population, Refugees, and Migration for its operations in Chad. But even that hasn't been enough.
In a statement to The Globe and Mail, IRC confirmed that the clinic had experienced staff shortages in the past.
Meanwhile, the organization in Sudan continues to face challenges related to qualified human resources, adequate infrastructure and the supply of drugs, consumables and other medical supplies.
Patients with serious conditions are supposed to be referred to hospitals in nearby Adré or the city of Abéché.
But in practice, many wait months without transfer, and even then, appropriate care is often unavailable.
Kaltouma Khamis Arbab, 56, still has metal rods in her leg from a bullet wound that shattered the bones. The surgical hardware should have been removed months ago. She was told that the only facility capable of performing the procedure is in N'Djamena, Chad's capital 865 kilometres away by road – a trip she cannot afford physically or financially.
'This iron has been in my body for 13 months. It should have been removed last August,' she says. 'If nothing happens, we will try to remove it ourselves.'
The risks in the camps extend far beyond lack of surgical care. According to Dr. Anya, the camps face continuous outbreaks of diseases such as measles, hepatitis E, malaria and yellow fever – driven by a combination of overcrowding, poor sanitation, malnutrition, limited access to clean water and the constant arrival of new refugees. Dr. Anya noted that the U.S. aid suspension would lead to a reduction in services and medical supplies, increasing the risk of disease transmission and higher mortality rates. 'The crisis is continuing, and resources are becoming very rare,' she says.
For now, the wounded and sick are left waiting.