MSF TANZANIA : 10 Years of MSF in Nduta Refugee Camp

After violence erupted in Burundi in 2015, up to 120 000 (2019) people fled into Tanzania’s refugee camp Nduta, one of the most chronically underfunded camp in the world.

Since then, MSF has been one of the main healthcare providers in the camp. As time has passed, the situation in Nduta has changed. What began as an emergency response has become a long-term humanitarian operation.

From Refugee to Responder: I Escaped War in 1996 and 2015, Now Finding Purpose in Every Delivery and Child's Smile.

By Ndayumvire Antoinette, Nurse Aide at Nduta Refugee Camp, Tanzania

I have spent most of my life as a refugee. The first time I ran from Burundi was in 1996. I was just a child then, and finally settled in Muyogozi in Kasulu, Tanzania. Later, we moved to Mutabila camp, where we stayed until 2012, when refugees were returned to Burundi. We thought the nightmare was over. We were wrong, and in 2015, unrest forced us to flee once more. Tanzania welcomed us again, and we passed through Nyarugusu camp, where the UN Refugee Agency (UNHCR) and partner organizations provided food, healthcare, and support that allowed us to start rebuilding our lives. This time, arriving at Nyarugusu camp, the fear was sharper because I knew what it meant to lose everything twice. But it was in that second exile that I found my true mission.

Shortly afterward, I applied to Médecins Sans Frontières (MSF). By June 2015, I was working at a health center Nyarugusu camp. In October, MSF selected six Burundian staff to help establish services at the newly opened Nduta Camp, and I was among them. We arrived in October, starting with a single clinic to assist newly arriving refugees. Within weeks, the organization expanded services, renovated hospital buildings, and increased staffing to meet the growing needs of the camp. As refugees arrived, I stood ready to help receive them. My own journey of flight ended the moment my work began.

I have rotated across services over the years, from maternity to pediatrics to the adult ward, and back to maternity in 2024. Throughout this time, I have been supported by supervisors, colleagues, and mentors. Today, I am a Nurse Aide in the busy maternity ward. The collaboration and mutual respect we share make the work meaningful, and the gratitude from patients is deeply motivating. There is a quiet satisfaction in knowing that the lives you touch are better because you were there.

Working with children has always been my greatest joy. I spent several years in pediatrics, and there is something magical about the way a child responds to care. With adults, improvements can be slow and hard to see. But with children, even small progress is visible: a smile, laughter, playful energy. That immediate, pure joy reminds me every day why I chose this work. Of course, not every day is perfect. When a child’s health fails despite our efforts, it is painful. That is part of the reality of this job; success and setbacks are both constant companions. These are the moments that have defined my life for the past ten years at Nduta Refugee Camp.

For us, working with MSF is more than a salary, it is dignity. It is an anchor against the sea of anxiety that defines life in a camp.

We receive essential aid, but it can only stretch so far. This work has helped me as much as it has helped others. It allows me to provide for my family, supplementing the support we receive as refugees. The little income I receive helps us buy clothes for my children, change up our diet from the usual rations, and acquire simple things like soap or salt that are often missing.

Crucially, it gives me the means to help my neighbors. When I have a little extra, I can share with a fellow refugee who completely lacks something simple, like salt or matchsticks. That simple act of cooperation and giving brings happiness to my heart. It reduces the stress of uncertainty and allows me to focus on the care of others.

If I did not have this work, I would often be stuck at home, consumed by the constant sadness and uncertainty of lacking, which would only intensify my anxiety.

As Nduta Refugee camp celebrates ten years, it is a testament to the resilience of our community. For MSF, whose work in Tanzania stretches back to the 1990s, I hope they continue to provide these crucial services and to empower more refugees like me. We are not just survivors, we are the hands that rebuild life, one safe delivery at a time. The good reputation MSF has in the community is well-deserved.

Over ten years, I have also built friendships with Tanzanians, fellow refugees, and people from other countries. Together, we have formed a supportive community where cooperation and trust are vital. That community, that sense of belonging, is one of the greatest gifts of my work. Watching mothers deliver safely, seeing babies thrive, and witnessing the relief and happiness of families these are the rewards that no material benefit could replace.

I tell myself, “I didn't waste time doing this job and going to school.”

As I reflect on my decade here, I see not only the difference this work has made in the lives of others, but the difference it has made in mine. Every smile, every healthy delivery, every word of thanks is a reminder of why I chose this path. In a world that often feels harsh and uncertain, I have found purpose, community, and hope in the corridors of Nduta Camp.

For me, this is more than a job; it is a calling. Ten years later, I am proud to be part of the story of Nduta, proud to be a nurse aide who has witnessed courage and resilience at every turn.

MSF at the Frontline: Protecting Mother and Child in Nduta Refugee Camp

Soline, refugee from Burundi displaced multiple times, mother of triplets born in MSF facility in Nduta in 2018

When Hatungimana Soline speaks, her voice carries the weight of a life shaped by conflict, displacement, motherhood, and resilience. At 45, she is a mother of ten; her youngest are eight-year-old triplets. One of many Burundian refugees who have rebuilt their lives in Nduta Refugee Camp in northwest Tanzania.

Born in 1979 in Burundi, Soline’s childhood ended early. At 17, she was married and, like hundreds of thousands of Burundians affected by the 1996 conflict between two warring parties, fled to Tanzania for safety. She settled in Mtendeli Refugee Camp, where she had her first four children. When her husband later left for the Democratic Republic of Congo, Soline returned to Burundi to raise her children in Cankuzo, a province hosting many displaced families from neighboring countries.

Back home, life took another turn. Soline remarried, had three more children, and ran a small business selling goods in the market. Yet her home became unsafe. Her eldest daughter, then in Class 7, faced repeated sexual advances from Soline’s husband. Attempts to protect her daughter were met with violence, culminating in the girl being raped. Terrified and determined to protect her children, Soline confronted her husband. The confrontation escalated, leaving her injured, and he fled. That same night, Soline packed her children and left Burundi, heading to Nduta Refugee Camp, where thousands of Burundians had sought safety.

The journey to Nduta took three days, three days of fear, uncertainty, and hope that her children would finally find safety. She arrived on 16 October 2016, joining a camp that had opened the previous year to host more than 400,000 Burundian refugees fleeing the 2015 political crisis.

Life in Nduta offered safety but not ease; daily survival meant negotiating scarcity, disease, and trauma. Still, Soline rebuilt her life and remarried. On the night of 6 May 2018, she unexpectedly went into labor. Busy with daily survival, she had not attended regular antenatal clinics. As the pain intensified, she informed the community chairman, who called an ambulance and was rushed to the hospital run by MSF inside the camp.

On 7 May 2018, Soline prematurely delivered triplets, tiny, fragile newborns, immediately were admitted to the neonatal unit.

“I prayed my rosary every day,” she recalls. “They were so small. Every time I went to see them, I didn’t know whether to cry or be strong. The emotional weight was immense, but the constant reassurance and expert care of MSF staff anchored her hope.”

MSF medical teams monitored the babies, providing round-the-clock care. After two months, the triplets grew strong enough to leave neonatal care. A few days later, Soline returned home with all three children in her arms.

“I was happy. I didn’t know if they would make it, but MSF saved them,” she says.

Her triplets ( Nasasagare Save, Riuuzimana Jean Dlare, and Nsengiyunva Davi) are among 5,540 babies treated in MSF’s neonatal unit in Nduta over the past ten years. Soline is also one of more than 12,000 women who have safely delivered with MSF assistance, including 1,828 births in 2025 alone.

“Women here are not afraid to give birth anymore,” she says. “We are cared for. We do not give birth at home, and we see fewer mothers and babies dying.”

Raising triplets in a refugee camp is challenging. Food is limited, the environment is harsh, and children are exposed to disease. But Soline remained vigilant, attending all clinic appointments and following health advice.

“I didn’t know if these boys would survive,” she says. “Now, when I look at them, I feel contented.”

Soline sustains her family through a small kitchen garden, growing vegetables and selling what she can spare. Her vision for the future is to achieve self-reliance; she hopes to own a sewing machine to make clothes for her family and community. For Soline, independence is about providing stability and creating a foundation her children can build upon.

Now eight years old, Soline’s triplets run, laugh, and play like other children in the camp. She hopes they will grow up to support the family. With ongoing repatriation efforts in Nduta, she says she is not ready to return to Burundi. As a divorced woman without land or property, she fears having nothing to return to.

The story of Hatungimana Soline reflects the resilience of thousands of Burundian refugees who have called Nduta home for a decade. It underscores the importance of continuous medical and humanitarian support in camps like Nduta Refugee camp, where families rebuild under difficult circumstances, yet continue to hope, work, and persevere.

Soline’s life is rooted in courage, shaped by displacement, carried by hope, and strengthened by the medical care that gives thousands of refugees a chance to rebuild their lives, one day at a time. For MSF, her story exemplifies why healthcare in humanitarian settings is not just essential, it is a life-saving.

Ten Years in a Refugee Camp: A Tanzanian Doctor on the Frontlines of Humanitarian Care

By Dr Goodluck Motta, Tanzanian MD who has been working in Nduta for the past 10 years

When I first stepped into Nduta Refugee Camp ten years ago, I thought I understood medicine. But nothing in my training prepared me for the reality of a refugee camp, where illness piles on top of trauma. I remember being struck not only by the number of sick people but by its diversity: skin diseases, diarrheal diseases, infections, chronic conditions, often all within the same family. It was overwhelming, and it changed me instantly.

People had fled with whatever strength they had left. Mothers clutching newborns they weren’t sure would survive. Elderly men who had carried their last strength across the border. Families who had fled Burundi with nothing but the will to keep walking. What struck me most was not the suffering, but the determination of people who, despite losing so much, still fought to live.

My role has evolved across various critical departments. I’ve worked in the emergency room, the maternal health ward, the adult inpatient department, and most complexly, the neonatal unit, caring for infants born as early as 28 weeks. This variety has demanded constant adaptation and continuous professional development.

Over the years, the camp’s hospital grew in ways none of us expected. Nduta was never designed to hold a functioning medical facility, yet today it shelters a neonatal ward capable of saving babies weighing under a kilogram. Our maternity unit dramatically reduced maternal and newborn mortality. We established a fully functional clinic for chronic diseases like diabetes and hypertension, strengthened HIV and TB care, expanded mental health services, and improved emergency response systems. One major shift came when we finally secured formal referrals to Kibondo District Hospital, just 20 kilometers away, replacing the exhausting 90-kilometer transfers to another camp. This change alone has saved countless lives.

In Nduta, medicine is more than treatment, it is protection. A refugee patient does not only need treatment, they need privacy, confidentiality, and a sense of control in a life that has been stripped of it. The systems we built for survivors of sexual violence are among the work I am most proud of because they protect patients as human beings, not just medical cases. Dignity is not a luxury in a refugee camp-it is a form of healing.

I was the first Tanzanian doctor hired by MSF in Nduta, and over the years I helped establish the NCD department, strengthen infectious disease services, expand maternity care, improve referrals, and develop staff health systems. One initiative I am particularly proud of is our push to elevate midwives into prescribing midwives, empowering them to respond faster in emergencies and ultimately saving more mothers and babies. Through training with medical experts from Geneva, our skilled plain midwives were validated as prescriber midwives, granting them the authority to dispense essential medications for common conditions, fundamentally transforming maternal care and empowering our national staff.

None of this would be possible without the people behind it. Tanzanian clinicians, nurses, midwives, laboratory experts, and international specialists work side-by-side in a rhythm built over years. We learn from each other, sharpen each other. Even when international colleagues leave, the skills, knowledge, and standards stay behind. That continuity is MSF’s true legacy.

Our hospital treats everyone equally; the Burundian refugee, the Tanzanian community, anyone in need. Many travel over 100 kilometers to receive care they can trust. That trust is sacred, earned through consistency, respect, and compassion. That trust is something we guard carefully.

MSF has never worked alone. Our collaboration with Tanzania’s Ministry of Health ensures our practices meet national standards while maintaining independence. Together, we respond to outbreaks like Marburg and Cholera, train health workers, and strengthen systems, proving that even in the most remote places, high-quality care is possible.

With MSF’s constant training and international mentorship, I learned to think faster, decide faster, and trust myself more. And slowly, this place shaped me not only as a doctor but as a person. Humanitarian work teaches you that time is everything. One minute can save a life or take it. It taught me discipline, empathy, teamwork, and above all, the value of serving people who have nowhere else to turn.

People often ask why I’ve remained in Nduta for a decade. My answer surprises them: impact. I stay because here, medicine means something. It changes outcomes immediately. Working with Médecins Sans Frontières (MSF) showed me what healthcare looks like when bureaucracy steps aside and humanity steps forward. When a mother is hemorrhaging, the team moves instinctively. When a newborn struggle for breath, oxygen arrives before the next gasp. It is medicine in its purest form: immediate, purposeful, deeply human. I found purpose here, but more surprisingly, Nduta found me. It shaped me into a doctor who thinks faster, trusts more, and never takes a single minute lightly. As a doctor, it is the closest thing to pure purpose I have ever known.

One of the darkest moments of my career happened in our emergency room. I will never forget the young man brought in after a neurotoxic snakebite. We had ordered antivenom long before, but due to national importation delays beyond MSF’s control, the shipment had not arrived. I watched the patient deteriorate minute by minute, second by second. We fought for him with everything we had. And I knew, painfully, that if bureaucracy moved as quickly as venom, he might have survived. That loss stays with me because it reminds me that in humanitarian medicine, the enemy is not just disease but also the systems that fail people when they are most vulnerable. Even today, it remains one of the hardest experiences I’ve faced.

Despite the difficult days, there are moments that remind me why this work matters. If there is one place in Nduta that holds my heart, it is the neonatal ward. I have held premature infants no heavier than my hand, silent, fragile, and fighting for every breath. Some weighed less than one kilogram, born to mothers who had escaped violence or endured unimaginable journeys. Watching a premature infant grow from 900 grams to 3 kilograms, open their eyes, or seeing a mother cry when her baby finally breastfeeds, or a father hold his child for the first time; these moments have written themselves onto my soul. Those babies taught me something profound: life does not need perfect conditions to thrive; it simply needs a chance.

The true victory in Nduta is not simply in the number of lives saved, but in the enduring change we have forged: a generation of Tanzanian medical professionals equipped to lead the fight against high mortality. This is the ultimate legacy of MSF, a relentless pursuit of dignity and survival, proving that even in the most remote areas, high-quality medical care is not a privilege, but an absolute human right. In the end, medicine is not just about curing disease; it is about nurturing dignity, empowering humanity, and leaving behind a world where care and compassion are not luxuries, but the foundation of life itself.