MSF TANZANIA: Overcrowded departure center threatens refugees’ health and dignity in Nduta
Nduta Camp – Dar Es Salam – Geneva: As the return of Burundian refugees from Nduta camp to their country of origin accelerates, Médecins Sans Frontières (MSF) warns that the current conditions of repatriation are creating serious risks for people’s health and dignity.
While the repatriation process is officially presented as voluntary and part of broader efforts to support reintegration in Burundi, MSF teams on the ground are witnessing increasingly critical conditions, particularly in departure areas. Ongoing shelter demolitions and the shrinking size of the camp are leaving around 18,000 people with limited access to water and basic services. As a result, thousands are being forced through overcrowded departure facilities, increasing health risks and undermining their dignity.
“Up to 4,000 people have been staying in the departure area, which is only slightly larger than a football field,” reports Tommaso Santo, MSF Country Director, back from Nduta. “It is extremely overcrowded and littered with trash, making it difficult to move around.”
MSF teams report extreme overcrowding in the departure area and a lack of basic infrastructure, including waste management, hygiene stations and latrines.
“Waste is everywhere. Children, who make up 60% of the camp’s population, are playing in the mud and among the rubbish, while families sleep on the ground in extremely poor hygienic conditions,” Santo adds.
At the same time, the rapid withdrawal of humanitarian actors due to funding cuts is leaving significant gaps in essential services across the camp. By the end of 2025, several key organizations had already withdrawn, while others are planning to end their activities by 31 March 2026. As services are reduced or withdrawn and the camp is dismantled, thousands of people remain at risk of being left without healthcare, basic services, or shelter, creating an unfolding humanitarian crisis.
These dynamics are raising serious concerns about the conditions under which people are returning. MSF teams report a growing sense of resignation among refugees, many of whom feel compelled to accept return in the absence of viable alternatives. The demolition of shelters and the deterioration of living conditions further reduce people’s ability to make a free and informed decision.
“Refugee returns must follow protection standards rather than deadlines and must be accompanied by strong humanitarian safeguards,” says Santo.
Without these safeguards, the current approach risks exposing thousands of people to avoidable harm and deepening an already dire humanitarian situation.
About MSF in Nduta
After violence erupted in Burundi in 2015, thousands of people fled into Tanzania’s refugee camp Nduta, one of the most chronically underfunded camp in the world that hosted up to 120 000 people in 2019. By the end of 2025, 50,000 people were still living in Nduta.
Since then, MSF has been one of the main healthcare providers in the camp, offering services such as primary and secondary healthcare, maternity and newborn care, mental health support, and care for survivors of sexual violence. MSF teams have cared for hundreds of thousands of people, both refugees and members of nearby host communities.
Over the past decade, MSF teams have witnessed the evolution of the crisis from an acute emergency to a prolonged situation marked by uncertainty and declining humanitarian support.