“What's happening right now in southern Chad is unacceptable,” - MSF head of Mission in Chad, Sarah Chateau.

NDJAMENA, Chad, March 18, 2014/African Press Organization (APO)/ -- MSF has been in Bitoye for the past three weeks, setting up a primary health facility in the small town of 10,000 which has seen its population double due to the influx of refugees. With approximately one hundred consultations per day – mostly women and children - MSF's waiting room is never empty.

Nursing a baby barely a month old, one woman reports that she was forced to flee, barefoot, into the bush with her seven children after the anti-balaka forces attacked Bocaranga, her native village. The same story is told by many other women who have come to Bitoye from Chad seeking refuge, most of whom are from the Fulani ethnic group. Their husbands are either dead or stayed behind in the bush with their remaining cattle.

“I've never seen this before,” reports Dr. Aaron Zoumvournai, an MSF physician who led the MSF assessment missions in Bitoye, Goré and Sido, the three largest entry points into Chad for refugees from CAR. He describes the injuries that refugees, mostly from Bangui, arrived with: scars on the heads of children caused by machete blows, a little girl who had had two of her fingers cut off with scissors 'as a reminder', multiple bullet wounds, and evidence of torture.

He tells the story of one patient at the Bitoye health centre who was later referred to the hospital in Baibokoum. “He came from a village in the Bouar region. That day he was alone at home when the anti-balaka forces came down and attacked his village. They set fire to his home. He managed to escape through a window, but as he was leaving, he saw at least four persons being hacked to death with machetes and wondered how many others had been burned alive in their houses.” He was later captured by the anti-balaka forces. “They ordered him to place his feet on a white-hot barrel and threatened to kill him it he didn't obey. When they no longer found amusement in torturing him, they left.” He was brought to the side of the road by an old man who happened by and was finally picked up by a passing truck. “He does not know what happened to his family, but has not much hope left for them.”

Sido: In Sido, the distress is all the more intense because of the numbers involved – 13,000 refugees have settled there. MSF is the only international agency on the ground in Sido.

Just three days ago, the eighth and final convoy escorted by the Chadian army brought another 3,500 people. Kaltouma was one of them. She was forced to flee Yaloke, her native village, more than six weeks ago because it was attacked and then occupied by the anti-balaka forces. She spent 20 days in the bush with her eldest child, who is 13, and her one year old twins. 20 of her family members disappeared during the attack, including her husband and eight year old son.

Thanks to the help of relatives in Bangui, she found out that the French army was coming to escort them from the mosque in Yaloke to the Bangui airport. Then, after three weeks of waiting, she fought to gain a place on one of the Chadian army's trucks.

On-site, the local authorities are doing everything they can as they attempt to deal with the crisis and defuse some of the conflicts that have begun to arise between refugees and the local populations, but they are sorely lacking in means and support. As yet the UN High Commission for Refugees (UNHCR) is not there to assess the situation.

“As long as these families are unable to exercise their right to claim asylum in Chad, they will not be able to obtain refugee status and will not qualify for UNHCR assistance, or they could be sent unwillingly to a final destination where there will be absolutely no one to help them,” says Sarah Chateau, MSF's head of mission in Chad.

“Close to half the patients that I have seen so far have told me that they were hungry”, states Antoine, an MSF doctor in Sido. “All you have to do is take a walk around the alleys here where refugees have been able to settle, and you will see with your own eyes the effects of a lack of food.” But the food emergency is not the only concern. There are only 20 latrines, 300 tents and four water distribution points for the 13,000 persons currently in Sido.

In late March, the first rains will come and could sweep away the makeshift shelters. The risk of epidemic will be all the more serious because not even the minimum number of sanitation facilities has been put into place. And even now, the need to survive is pushing the most vulnerable women into prostitution just to be able to feed their children.

In Goré, 6,000 people are crowded into and around an old hospital. Many of them come originally from Bossangoa. They often sleep right on the ground, and build makeshift shelters using branches and cloths to provide some sort of protection. When the first rain comes, everything will be washed away.

Food is also an issue – one doctor reports treating a premature baby who has not been able to breastfeed. “This child is simply hungry,” says Dr. Francis Koné, an MSF doctor in Chad. For the last two weeks this newborn has had nothing to eat and is clinging miraculously to life by a thread.

“It is critical that, on the one hand, recognition be given to the fact that the vast majority of these persons have fled violent situations in order to just save their own lives, and they are therefore indeed refugees and, on the other hand, that they receive international assistance here immediately, in the form of food, tents, water distribution points and sanitation facilities,” states Chateau. What's happening right now in southern Chad is unacceptable.”