Sudanese refugees in Chad: safe from bombs, but struggling to survive

An estimated 80,000 people have crossed the border from North Darfur, Sudan, to eastern Chad, arriving in or passing through Wadi Fira and East Ennedi provinces, since the end of April.¹ These newly arrived refugees, a majority of whom are women and children, fled El Fasher and its surrounding camps after intense attacks from the Rapid Support Forces. While they are safe from bombs in Tine and Oure Cassoni camps, which are separated by 130 kilometers, they are now enduring severe overcrowding and have only limited access to essential medical services.

For them, the road from El Fasher to Chad, which can take up to 10 days travelling, was plagued by violence and hardship. In both camps, our teams are hearing harrowing stories of violence suffered in North Darfur and on the journey to eastern Chad. Many people have been hurt or seen men and boys beaten, injured or killed, and women and girls raped. Some people reportedly died of thirst on the way.

Sudanese refugees crossed the border into Chad at sunrise. After registering, they will move on to either Tine transit camp, a couple of kilometres from the border, or north to Oure Cassoni camp. (Julie David de Lossy/MSF)Sudanese refugees crossed the border into Chad at sunrise. After registering, they will move on to either Tine transit camp, a couple of kilometres from the border, or north to Oure Cassoni camp. (Julie David de Lossy/MSF)People fleeing the violence in Sudan arrive in Chad with barely anything. Women usually use their own few left toub (Sudanese women’s clothes) to preserve a bit of privacy. Makeshift shelters at dusk, Tine transit camp (Julie David de Lossy/MSF)A water distribution in Tine transit camp. (Julie David de Lossy/MSF)

Patients waiting in the triage area, seated in the shade. The clinic in Tine transit camp provides essential healthcare services, vaccinations, clean dressings for trauma wounds, malnutrition care, and care for pregnant women and victims and survivors of sexual violence. (Julie David de Lossy/MSF)Afra fled the violence of the war with her four sisters. Tine transit camp. (Julie David de Lossy/MSF)Afra fled the violence of the war with her four sisters. Tine transit camp. (Julie David de Lossy/MSF)Halima Suleyman, 40 years old, tells her family story from Tine transit camp. “I was first displaced 16 years ago, from our home in Shangal Tubai, and settled in Zamzam. Recently, the enemy burned our house in Zamzam and took everything from us. We were uprooted again. When we arrived here in Tine, we received so much support from local people, blankets and food. Soon after we arrived, Kaltoum (her daughter) started her labour. I took her to the MSF clinic, and they referred her to the Centre de Santé where baby girl Arafa was born.” Ashia (Halima’s mother) continues: “When Zamzam was bombed, my daughters, Halima and Mariam, and my son put me on a horse to flee. We saw a lot of killed people along the road, we saw the enemy burning houses with people in it. We saw men wanting to save their children burning being shot dead.” (Julie David de Lossy/MSF)

Salwa, health promotion supervisor, listens to the needs of people in Oure Cassoni’s refugee camp. People are lacking water, sanitation, food, and medical care (Julie David de Lossy/MSF)Patients waiting for a consultation at a clinic in Tine camp. Here, people receive essential health services, vaccinations, clean dressings for trauma wounds, malnutrition care, and care for pregnancy and sexual violence. (Julie David de Lossy/MSF)saac is 17 years old. His father, Saad explains what happened to him. “A bomb exploded on our house in El Fasher in April (2025), Isaac’s foot was torn apart and our house was burned afterwards. We took him to Saoudi hospital, then fled to Korma. We arrived in Tine three days ago.” Issac came to the MSF clinic to have a change of dressing to keep his wound clean. (Julie David de Lossy/MSF)MSF staff Knut Gunnar Maehlumshagen next to some ready-to-use therapeutic food called Plumpy-nut. (Julie David de Lossy/MSF)Eleven-year-old Mahanat lost his left hand on 11 April, when the Rapid Support Forces (RSF) launched a massive ground offensive on the 500,000 displaced people of Zamzam camp, in Sudan. He waits in Tine’s health centre to be referred to a more specialised structure for surgery follow-up (Julie David de Lossy/MSF)

A water distribution in Tine transit camp. (Julie David de Lossy/MSF)MSF guards at the Tine transit camp have received a training on how to organise the flow of patients and inform medical staff in case of visible distress. (Julie David de Lossy/MSF)A woman collects water from a puddle. Safe water is by far too scarce in Oure Cassoni camp. After assessment of the situation, for the time being, we are supplying water through Water Trucking whilst exploring more sustainable interventions. (Julie David de Lossy/MSF)Manasit moves painfully back to the car. Herself, her sister Aami, and their mother Hadidja were all hit by stray bullets. Right after crossing the border, they are being referred to a nearby hospital. (Julie David de Lossy/MSF)

Gisma, 30 years old, Tine transit camp. “I suffer from psychological issues, I need tablets to sleep. It worsened after I gave birth four years ago. My husband took my baby from me because my body was full of medication. When I got better we all reunited. Since the bombing in Zamzam, I don’t know where my husband is. My eldest son has kidney failure and I don’t have the means to provide for my four children. On the road when we fled, I faced the enemy, they took my blankets, my money, some clothes. Now I can only hope for support from the community.” (Julie David de Lossy/MSF)An MSF water and sanitation team is searching nearby options to provide Oure Cassoni camp with safe water. Meanwhile, the team has rehabilitated the local water plant by donating equipment and training staff. (Julie David de Lossy/MSF)Hassania Mansour Mahamet, 35 years old, sits with her eight children in Oure Cassoni camp. The oldest is 14 years old, the youngest 14 days old. “I am from El Fasher where I graduated from El Fasher University, I hold a first aid certificate. I used to work for an international organisation. When the war came to El Fasher, my husband and I left with our seven children on foot, I was heavily pregnant. The armed men were burning everything as they moved on. As soon as we arrived in Zamzam, we had to flee the war again, that’s where I lost my husband, I don’t know where he is, I don’t know what happened to him. When I fled Zamzam with my children and the group we stayed with, I saw a lot of suffering on the road. The armed men take everything from people. They take water from children dying of thirst. They kidnap young boys (16+) and then kill them. My older brother was taken in front of my eyes, then killed. I had no choice but to keep going, I had no time to look back and care for his body. I ran away with my children. I gave birth at sunrise between Shagra and Tawila. I was walking with my children and the group. The cramps started, I found a small tree by the road, covered myself with my toub (Sudanese women’s cloth) told my children to stay close, and with the help of an old woman from the group, I gave birth to Sabir, my eighth child. I rested for one day, then told the group to keep going without me. I begged for money, and traveled to Korma on a donkey. I kept bleeding and healed myself with traditional medicine. I felt better after six days. The children and I gather the needed money from telling our story, and we paid a driver to Serif where I saw a doctor. We went on to Tine where we were told it was a safe place. My sister-inlaw was already in Oure Cassoni with her family, and as I’m alone with eight children, I needed to keep going to guarantee help. I arrived here several days ago. We lack food, we lack water, the wadi (a dry pool filling during rainy season) is far, and after 4pm it’s not safe to go there. I’m afraid for my girls, and afraid for all my children due to lack of water. Today, I could gather just a little bit of water for all of us. (Julie David de Lossy/MSF)Doctor Abamé Mahamat, who works for MSF’s medical coordination team, calls a colleague for an extra opinion on Mahanat’s medical case. Mahanat had his left hand amputated because of shrapnel. (Julie David de Lossy/MSF)

Eleven-year-old Mahanat lost his left hand on 11 April, when the Rapid Support Forces launched a massive ground offensive on the 500,000 displaced people of Zamzam camp, in Sudan. His mother shares their story. “Mahanat’s father was killed during the attack on the Zamzam camp. His left hand got ripped off by a shrapnel bomb, some got stuck in his right eye. He was first amputated of his hand in Sudan, but the surgeons there did not disarticulate the needless bones of the hand, leaving the wound hard to heal. He arrived at the MSF clinic in the Tine camp several weeks ago. Each time, doctors and nurses struggled to even access the wound as the child was traumatised and in immense pain. Over the days, with time, patience and trust, Mahanat accepted care. He was referred to the Centre de Santé of Mabruka, in Tine town, to get his wound properly cleaned up under anaesthesia.” (Julie David de Lossy/MSF)People conduct trade at the border (Julie David de Lossy/MSF)Moahid, 22 years old, Tine transit camp. His mother, Aziza tells their story. “We come from El Fasher. It all became very dangerous there, the armed men entered houses and killed people. My son lost his leg in Mowashi in June 2024 during shelling. There is still shrapnel stuck inside his good leg. We left Zamzam because it became too dangerous, my husband and other son were killed during the bombing of the camp. We fled to Tawila, went on to Tine and finally we arrived 20 days ago. On the way we saw a lot of fighters, they were asking a lot of questions.” (Julie David de Lossy/MSF)People fleeing the violence in Sudan arrive in Chad with barely anything. Women usually use their own left toub (Sudanese women’s clothes) to preserve a bit of privacy. The few trees around Oure Cassoni camp provide much-needed shade. (Julie David de Lossy/MSF)

Ayman and Amani playing in their makeshift shelter under a tree in Tine transit camp while their aunt, Halima Suleyman, 40 years old, tells their family story. “I was first displaced 16 years ago, from our home in Shangal Tubai, and settled in Zamzam. Recently, the enemy burned our house in Zamzam and took everything from us. We were uprooted again. When we arrived here in Tine, we received so much support from local people, blankets and food. Soon after we arrived, Kaltoum (her daughter) started her labour. I took her to the MSF clinic, and they referred her to the Centre de Santé where baby girl Arafa was born.” Ashia (Halima’s mother) continues: “When Zamzam was bombed, my daughters, Halima and Mariam, and my son put me on a horse to flee. We saw a lot of killed people along the road, we saw the enemy burning houses with people in it. We saw men being shot dead as they wanted to save their burning children.” (Julie David de Lossy/MSF)Sa’adia Youssoufie, 26 years old, Oure Cassoni camp. “I am a student at the University of El Fasher, faculty of arts, I’m studying my master’s degree with a major in English language and Crisis and Disaster Management. I arrived at the Oure Cassoni camp a year ago. I want to continue my education, but it’s very hard. I worked here for an international NGO, if I work, I don’t study. My three sisters joined me here, and recently my parents too, I’m the breadwinner of the household. My brother is still in Sudan, he got shot twice, but is okay. We are still in contact. He wants to join us, but the road is too dangerous for young men.” Many young men do not dare to cross, as they are being targeted by armed groups, arrested, beaten and killed. (Julie David de Lossy/MSF)saac is 17 years old. His father, Saad explains what happened to him. “A bomb exploded on our house in El Fasher in April (2025), Isaac’s foot was torn apart and our house was burned afterwards. We took him to Saoudi hospital, then fled to Korma. We arrived in Tine three days ago.” Issac came to the MSF clinic to have a change of dressing to keep his wound clean. (Julie David de Lossy/MSF)Teenagers and children playing volleyball early in the evening in Tine transit camp. The heat during the day reaches 46°C in the shade. Tine transit camp at dusk. (Julie David de Lossy/MSF)

Care after surgery

Mahanat, who is 11 years old, lost his left hand on 11 April, when the Rapid Support Forces (RSF) launched a massive ground offensive on Zamzam camp, which housed 500,000 people, near El Fasher. According to the UN, hundreds of people were killed in April alone and the camp has been completely emptied.² Mahanat escaped the deadly attacks and is now in Tine camp with his mother.

“Mahanat’s father was killed during the attack on Zamzam camp. His left hand got ripped off by a shrapnel bomb, some got stuck in his right eye,” says Mahanat’s mother. “He arrived at the MSF clinic in the Tine camp several weeks ago. Each time, doctors and nurses struggled to even access the wound as the child was traumatised and in immense pain. Over the days, with time, patience and trust, Mahanat accepted care.”

Our teams have been treating people’s physical wounds from gunshots, shrapnel bombs and landmines. We are helping patients with amputations through pain management and infection prevention and control measures, such as applying sterile bandages to keep wounds clean and dry. In Tine, we have recently added a mental health component to our work to better support patient recovery.

Meeting people’s growing needs

While we scaled up our activities in Tine camp in April, the overall situation remains largely unchanged due to people’s overwhelming needs. MSF continues to do our utmost but a coordinated and strengthened response from other humanitarian actors is essential to meet the urgent demands on the ground.

“Again, we ask donors, the UN and humanitarian organisations to start providing or scale-up support in terms of food, shelter, sanitation and medical care including mental health services. The current response is grossly insufficient,” says Claire San Filippo, MSF's emergency coordinator for Sudan.

We are increasing the availability of essential healthcare services in Tine and Oure Cassoni camps.

Since April 2025 to the time of writing of the article, we have carried out over 7,700 consultations at the Tine health post. We are concerned about the global rate of malnutrition among children under five in the camp, which is as high as 18%, with 3% being severely malnourished. To assist in curbing the spread of measles in the camp, we have vaccinated 5,755 children.

Pregnant women and survivors of sexual violence can receive care at the health post, and our staff are able to refer critical patients to local hospitals. From April 2025 until now, 1,322 consultations on sexual and reproductive health have been carried out. During the last four weeks of activities, 16 survivors of sexual violence were seen at the health post. To support people’s overall health in the camp, we have built 40 emergency latrines. MSF is the only organisation in the camp providing people with water, which remains a huge problem for residents. Whilst we were providing the minimum requirement per person per day, the sudden increase of the number of people in the camp due to the halt of relocations means that the needs have now increased.

In Oure Cassoni camp, we carried out a rapid evaluation of the situation in order to understand people's needs and prepare for an appropriate response. For the time being, we are supplying water through Water Trucking whilst exploring more sustainable interventions. While this camp was already home to 56,000 people, an additional 40,000 refugees have been accommodated there last April. These new arrivals have set up with what they have, but they are living in makeshift shelters and without latrines and other basic infrastructure. While a humanitarian response in underway for these newly arrived refugees, our teams are aware of the many unmet needs, and of the many more people expected to arrive from North Darfur.

“The number of people arriving at the Tine border point is not expected to decrease over the coming weeks,” says San Filippo. “The upcoming rainy season is likely to worsen the already poor living conditions, spread disease, exacerbate food insecurity and the lack of sanitation. We are deeply alarmed by the difficult conditions in the Tine and Oure Cassoni camps. Large-scale humanitarian action is urgently needed to prevent the situation from deteriorating further.”

¹ Flash Update #17 New Sudanese Refugee Influx into Chad - Chad | ReliefWeb

² Hundreds killed in RSF attacks in Sudan’s North Darfur | OHCHR