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Chad - Central African Republic

CAR refugees in Chad face difficult choice between food or healthcare

The sun is high in the sky at 3pm and Marceline Huila noisily stirs a metal pot with her wooden spoon-- there is not much in there, no bouillon cube or oil, and it is supposed to feed the 10 members of her family who are waiting nearby. The wild sorrel, a green leaf used for soup in fancy restaurants in Paris, will be their only meal of the day. Its nutritional value is far below the required daily calorie allowance for adults and children, but Huila is just one of 146,500 Central African refugees trying to cope with lack of food in southern Chad.

Bienvenu Mbokoto, CAR refugee in Diba 2 camp, southern Chad, needs malaria medication for his son
Bienvenu Mbokoto, CAR refugee in Diba 2 camp, southern Chad, needs malaria medication for his son LA Bagnetto
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“I used to eat four meals a day,” says Huila, who would feed her family breakfast, lunch and dinner. “In the evening, before we went to bed, we had dessert. We would have seasonal fruits, like mangoes. But now there’s none.”

Huila fled to Diba 2 refugee site outside of Baibokoum in southern Chad from the Central African Republic (CAR) where armed groups such as ex-Seleka rebels and anti-Balaka militia fight each other and kill civilians with impunity. Central Africans have been fleeing across the border to Chad since 2003. They are welcomed and far from the violence of their own country. However, they live in the shadow of other refugee crises-- they are safe, but hungry. Aid has dried up for these refugees, forgotten by the rest of the world.

The United Nations is a mainstay in the southern Chad region, along with local non-governmental groups such as the Catholic Emergency and Development Organisation (SECADEV). The UN Central Emergency Response Fund gave SECADEV a small six-month grant to help the organisation, which was working in the camps without funding. A number of well-known international aid organisations had to close their bureaus in the area because they ran out of money to help. The UN has only received 12 per cent of the funding needed to help Central African refugees-- it is a pervasive problem.

Daily allowance

At Amboko refugee camp, a three-hour bumpy ride from Baibokoum, it’s a boisterous day as scores of people line up to receive their 3000 francs (4.50 euros) monthly stipend. The cash should cover half the monthly 2100 calories needed daily to sustain the average human being, according to the World Food Programme (WFP).

Reke, a CAR refugee in southern Chad, is making the only meal of the day for her family-- wild sorrel
Reke, a CAR refugee in southern Chad, is making the only meal of the day for her family-- wild sorrel LA Bagnetto

The situation is compounded by the fact that the region is not only home to refugees from CAR, but also returnees, believed to be originally from Chad. They also face hardship and are unable to provide for themselves.

“I’ll buy millet, sauce, sugar, Maggi bouillon cubes,” says 80-year-old Halima Mahabas, originally from Pawa, CAR. Many people are finding it hard to survive and the stipend is not enough per person, says Ahmed Mahmat, who lives nearby in Kobiteye camp.

“You go to the market to buy a banana for 50 francs, a cup of tea for 50 francs, and it’s finished,” says Mahmat, explaining that the stipend works out to be around 100 francs (0.15 euros) per day.

Officials from the World Food Programme are well aware of the situation. During one of his regular trips to the camps, WFP’s deputy country director Issa Sanogo said that one Central African woman told him the money does not stretch very far.

“When there’s a health emergency, she uses the food stipend to pay for it,” says Sanogo, referring to the refugee he spoke to. When factoring in money spent on emergencies, this often means that many will only eat once a day if at all.

“As there is no other monetary support…this cash will never meet their food needs,” he says. “The same money is being used for multiple purposes and it can’t continue like that.”

Health is closely tied to lack of food in the refugee camps, and it is an issue that affects everyone. In Beureuh village, Suzanne, a CAR refugee, is waiting with other patients outside the health clinic to see the nurse.

“We go to be seen for free, but then we have to pay for medication, and we don’t have any money for this, we’re refugees,” says Suzanne. Local Chadians are also faced with the same problem. “The locals don’t have any money to pay for medication, either.”

No medication

While many are worried about the lack of food, healthcare, particularly in treating the top three illnesses of malaria, flu, and diarrhoea, is a big concern.

The system differs from camp to camp, but UN agencies work with local partners and the Chadian government to set up and maintain the health centres that serve both refugees and locals in the area.  But it is sometimes unclear whether the provision is entirely free or not.

The consultation and medication is free for everyone and paid by the state, says Belun Gartendung, a Chadian nurse who works at Diba 1 refugee site health clinic, which also services the newest Diba 2 site, too.

At Diba 2 site, a ten-minute walk from the clinic, Bienvenu Mbokoto, 42, a CAR refugee, is sitting on the ground with his son, who is covered in a heavy grey blanket on this hot day. He sees the healthcare provision a little differently than the Chadian government worker.

“Every day we go to the clinic and there’s no medication,” says Mbokoto, as he rests a reassuring hand on his lethargic son. It is the same reality for everyone, he says, recounting a story of a woman who became violently ill at 2am and needed to bring her to the clinic, located over a kilometre from Diba 2. A passing motorcyclist helped them.

“Thanks to our local brothers, because we live together in peace, he gave us half a litre of petrol and we took the woman to the hospital at 3am,” he says. “But when we got there, the nurse said, ‘there’s no medication.’”

The refugees say that trying to balance healthcare and food with 4.50 euros a month is exhausting, and aid seems farther away than ever.

There is no better time to help, according to WFP’s Chad-based Sanogo. WFP has not received any donations to provide funding beyond September. They have stretched the donor aid as far as it will go, but will be unable to continue giving out even the small stipend per month.

“It’s becoming a forgotten crisis,” he says.

Many refugees have children, and keeping them healthy and fed has become a near-impossible task, says Oumar Saleh, a truck driver originally from Bosangoa, and father of six.

“It’s difficult. We breathe, but we don’t live,” he says.

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