‘I have sought aid repeatedly’: these Sudanese women abandoned to survive day by day in Chad’s desert camps.

For an extended period, jolting along the flooded dirt track to the clinic, 18-year-old Makka Ibraheem Mohammed clung desperately to her seat and focused on stopping herself being sick. She was in labour, in severe suffering after her uterus ruptured, but was now being jostled relentlessly in the ambulance that lurched across the uneven terrain of the road through the Chadian desert.

Most of the close to a million Sudanese refugees who have fled to Chad since 2023, barely getting by in this harsh landscape, are women. They reside in secluded encampments in the desert with insufficient supplies, no work and with treatment often a dangerously far away.

The medical center Mohammed needed was in Metche, another refugee camp more than a considerable journey away.

“I kept getting infections during my gestation and I had to go the clinic seven times – when I was there, the labour began. But I wasn’t able to give birth naturally because my uterine muscles failed,” says Mohammed. “I had to endure a long delay for the ambulance but all I recall is the pain; it was so intense I became disoriented.”

Her maternal figure, Ashe Khamis Abdullah, 40, was terrified she would lose both her offspring and descendant. But Mohammed was hurried into surgery when she reached the hospital and an urgent C-section saved her and her son, Muwais.

Chad was known for the world’s second worst maternal fatality statistic before the ongoing stream of refugees, but the circumstances suffered by the Sudanese put even more women in risk.

At the hospital, where they have birthed 824 babies in often critical situations this year, the medics are able to rescue numerous, but it is what occurs with the women who are not able to reach the hospital that concerns them.

In the 24 months since the civil war in Sudan started, the vast majority of the displaced persons who came and remained in Chad are mothers and kids. In total, about 1.2 million Sudanese are being sheltered in the eastern region of the country, a large number of whom escaped the earlier war in Darfur.

Chad has taken the lion’s share of the millions of people who have run from the war in Sudan; others have gone to South Sudan, Egypt and Ethiopia. A total of millions of Sudanese have been forced out of their homes.

Many adult men have stayed behind to be near homes and land; some were killed, taken hostage or made to join the conflict. Those of adult age move on quickly from Chad’s barren settlements to find work in the main city, N’Djamena, or elsewhere, in adjacent Libya.

It results in women are abandoned, without the ability to provide for the children and the elderly left in their care. To avoid overcrowding near the border, the Chadian government has relocated people to smaller camps such as Metche with usual resident counts of about a large community, but in distant locations with few facilities 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 operating theatre, but little else. There is a lack of jobs, families must walk hours to find fuel, and each person must subsist with about nine litres of water a day – much less than the suggested amount.

This remoteness means hospitals are receiving women with complications in their pregnancy when it is almost too late. There is only a sole emergency vehicle to travel the path between the Metche hospital and the medical tent near the settlement of Alacha, where Mohammed is one of close to fifty thousand refugees. The medical team has seen cases where women in extreme agony have had to wait an entire night for the ambulance to reach them.

Imagine being nine months pregnant, in childbirth, and travelling hours on a donkey-drawn vehicle to get to a medical facility

As well as being uneven, the route passes through valleys that fill with water during the wet period, completely cutting off travel.

A surgeon at the hospital in Metche said each patient she treats is an critical situation, with some women having to make long and difficult journeys to the hospital by on foot or on a mule.

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

Malnutrition, which is growing, also increases the risk of complications in pregnancy, including the uterine splits that medical staff frequently observe.

Mohammed has stayed at the medical facility in the couple of months since her surgical delivery. Suffering from malnutrition, she developed an infection, while her son has been closely watched. The father has journeyed to other towns in search of work, so Mohammed is totally dependent on her mother.

The nutritional care section has expanded to six tents and has cases exceeding capacity into other sections. Children rest beneath mosquito nets in sweltering heat in almost utter stillness as health workers work, mixing medications and measuring kids on a scale made from a container and string.

In less severe situations children get sachets of PlumpyNut, the specially formulated peanut paste, but the worst cases need a consistent supply of fortified formula. Mohammed’s baby is fed his through a medical device.

Suhayba Abdullah Abubakar’s infant son, Sufian Sulaiman, is being fed through a nasal drip. The child has been ill for the past year but Abubakar was repeatedly given only painkillers without any diagnosis, until she made the travel from Alacha to Metche.

“Every day, I see further minors coming in in this tent,” she says. “The food we’re eating is low-quality, there’s not enough to eat 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 relying on what we’re provided.”

And what they are given is a limited quantity of sorghum, edible oil and salt, distributed every two months. Such a basic diet is deficient in nutrients, and the little cash she is given acquires minimal items in the local bazaars, where values have increased.

Abubakar was transferred to Alacha after reaching from Sudan in 2023, having fled the paramilitary Rapid Support Forces’ raid on her home city of El Geneina in June that year.

Finding no work in Chad, her spouse has traveled to Libya in the desire to earning sufficient funds for them to follow. She stays with his relatives, dividing up whatever food they can get.

Abubakar says she has already witnessed food distributions being reduced and there are fears that the sharp decreases in overseas aid budgets by the US, UK and other European countries, could deteriorate conditions. Despite the war in Sudan having caused the 21st century’s gravest emergency and the {scale of needs|extent