A growing humanitarian crisis is unfolding in Chad as over 1.3 million refugees and returnees—primarily women and children—seek safety in a country already struggling with poverty and an underfunded healthcare system, according to a United Nations agency.

Escaping conflict in Sudan

Andrew Saberton, Deputy Executive Director of the UN agency dedicated to sexual and reproductive health (UNFPA), recently returned from a week-long mission in eastern Chad. His visit to cities like Abéché, Adré (in the Ouaddaï region), and the Iridimi refugee camp—located over 1,000 kilometers from the capital N’Djamena—highlighted the dire consequences of the ongoing conflict in neighboring Sudan on refugee women and girls.

In Adré, near the Sudanese border, Saberton toured a UNFPA-supported center where refugee women shared harrowing accounts of the violence they face when leaving the camps to gather firewood. The risks of harassment, assault, and sexual violence make collecting firewood a perilous task. “It’s a moment of fear,” he stated, echoing the testimonies of women in other camps.

Despite these dangers, Saberton praised the resilience of the women supported by the centers, which provide psychosocial care, vocational training, and income-generating activities.

In Abéché, he met a young survivor of obstetric fistula, married at just 15. After enduring three days of labor without medical assistance during her first pregnancy, her baby died, and her husband abandoned her. She lived with the severe complication for nearly a decade before finally receiving treatment. “She still faces pressure to remarry,” Saberton noted.

Overwhelmed health systems

In the Wadi Fira region, home to the Iridimi camp, healthcare facilities are stretched to their limits. Local authorities report over 333,000 refugees spread across eight camps. At the camp’s health center, midwives handle up to 300 deliveries per month with severely limited resources. Medical staff warn that shortages of anesthetics sometimes prevent safe cesarean sections.

“No woman should have to undergo a cesarean section without anesthesia,” Saberton emphasized. He also criticized the sharp decline in humanitarian funding, noting that the UNFPA office in Chad faces a 44% reduction in resources compared to 2025. Of the $18.7 million requested for 2026 to sustain maternal health services and protection programs, only 2.5% has been funded so far.

Chad already has one of the highest maternal mortality rates in the world, with approximately 860 deaths per 100,000 live births. UNFPA is urging the international community to urgently increase support to prevent further crises.

“For the women and girls we met in eastern Chad, assistance means safe childbirth, care after violence, and a chance to survive,” Saberton concluded.