Chad: Water crisis intensifies as temperatures soar and funds shrink
MSF teams are adapting to fill critical gaps as climate change and aid cuts deepen humanitarian needs.
Faced with deepening gaps in international aid and rising humanitarian needs, Doctors Without Borders/Médecins Sans Frontières (MSF) is increasingly stepping in to provide water and sanitation services for hundreds of thousands of refugees and residents across eastern Chad.
With particularly high temperatures in recent months, the daily search for clean water has become a relentless struggle for most of the 860,000 Sudanese refugees in this region and the communities hosting them. Now, with the rainy season fast approaching, the crisis is only set to worsen. Flood risks, water contamination and overstretched health services loom large. MSF is working closely with Chadian authorities, who shoulder the refugee response and are being hit hardest by shrinking international support.
“I added my three jerrycans to the queue nine days ago. Look here: they still haven’t reached the fountain. I have to keep a constant eye on them. If I don’t move them forward, they get tossed aside. I can’t survive on three jerrycans for my family of nine.”
Leila, a refugee in Metche camp
More than two years of war creating waves of displacement
After over two years of war between Sudan’s Armed Forces and the Rapid Support Forces, tens of thousands of people continue to flee across the border into Chad. More than 85,000 people have arrived in the provinces of Wadi Fira and Ennedi Est since April 23, 2025, according to United Nations High Commissioner for Refugees (UNHCR). Each wave of displacement adds pressure to already fragile water and sanitation systems in the camps and surrounding areas.
Providing large-scale water and sanitation in such conditions is both costly and complex. Few humanitarian organizations have the resources to respond and recent funding cuts are further eroding their capacity. As a result, MSF – already stretched beyond our core medical mandate – is forced to take on more responsibilities.
Not enough clean water, not enough latrines
In refugee camps scattered across Ouaddai, Wadi Fira and Ennedi Est provinces, most people are still receiving far less than the recommended 20 litres of clean water per day. The water crisis is hardest on women and children. With long queues and limited supply, many spend hours each day under the sun to secure water.
“I added my three jerrycans to the queue nine days ago. Look here: they still haven’t reached the fountain,” says Leila, a refugee in Metche camp. “I have to keep a constant eye on them. If I don’t move them forward, they get tossed aside. I can’t survive on three jerrycans for my family of nine. I buy extra using my food vouchers,” she says.
There are also not enough latrines, with many camps failing to meet the minimum standard of one latrine for every 50 people. Both poor sanitation and unsafe water increase the risk of skin infections and the spread of hepatitis E, typhoid and polio. They can also lead to diarrheal diseases including cholera, which prevent the body from absorbing vital nutrients, ultimately causing or worsening malnutrition. In the last two years, MSF treated 43,908 patients for acute malnutrition and responded to hepatitis E and typhoid outbreaks in Adré, Aboutengue and Metche.
“When the rains come, people will start drinking directly from contaminated wadis (or rivers) that people use as latrines,” says Yasmina, a leader for zone three in Metche camp. “The danger of disease spreading will increase.”
MSF, a major provider of water and sanitation amid increasing needs
Since the onset of the crisis, MSF has been a major provider of clean water in three refugee camps in the Ouaddai region – in Adré, Aboutengue and Metche.
In Aboutengue and Metche, MSF initially installed emergency water systems, which were later handed over to partner organizations. Since then, the water supply in Aboutengue has dropped from an average of 12 to nine litres per person per day. This decline is partly due to geological challenges – boreholes in some areas do not reach deep enough to produce enough water to meet the growing demand.
With water needs still unmet for the 46,000 Sudanese refugees in Aboutengue – and 5,000 more people expected to be relocated to the camp soon – MSF is working with partners to upgrade the water system by installing an additional solar-powered network.
In Adré transit camp, MSF-built water systems produced 654,000 litres of water per day in May alone. Since March, one of the 10 boreholes in the camp has been extracting water using a solar-powered pump. MSF is investing in solar-powered boreholes with the goal of making them self-sufficient and sustainable for the community.
“We’re taking action because clean water and sanitation are vital, especially with the rainy season approaching. But every penny spent here is one less for medical care.”
Toussaint Kouadio, MSF water and sanitation coordinator
“This water infrastructure, soon to be handed over to another organization, improves resource management and sustainability by connecting both refugee and host communities to the same water system, strengthening local resilience,” says Toussaint Kouadio, MSF water and sanitation coordinator.
Ahead of the rainy season – when the risk of waterborne diseases linked to flooding peaks – MSF rehabilitated 229 latrines in Adré and built 80 new ones designed for long-term use. In collaboration with other agencies, 539 latrines have also been emptied. To treat all the wastewater from the camp’s latrines, MSF is setting up a new fecal sludge management plant, similar to the one it built in Aboutengue. This permanent infrastructure aims to create sustainable sanitation services for the entire town, as well as potential opportunities for the local economy. To curb disease and improve hygiene, MSF has also distributed soap and jerrycans in Aboutengue camp. We distributed over 26,000 jerrycans in the first week of July alone, along with a monthly supply of soap for each person.
In Metche, where 41,000 refugees still do not have enough water, no other organization has stepped in to improve the infrastructure. As a result, MSF is preparing a new water network to support both refugees and the host community.
As thousands of Sudanese refugees arrive to the north in the arid Wadi Fira province, where clean water is extremely limited, MSF has built 50 emergency latrines and distributed 60,000 litres of water daily at Tine transit camp, in addition to providing basic healthcare services. As relocations continue from transit to refugee camps – already lacking adequate water and sanitation – pressure on scarce resources will only increase.
Mounting needs amid climate emergency, mass displacement and aid cuts
Chad is at risk of recurrent cycles of drought and flooding, made more extreme by the climate crisis. This year’s forecast of heavy rainfall has raised critical concerns, with the government and its partners currently considering a national contingency plan.
Meanwhile, Chad’s refugee situation is unfolding against a backdrop of shrinking global funding. In early 2025, the U.S. cut nearly all foreign assistance, followed by reductions from several European countries. UN agencies such as UNHCR and UNICEF – key organizations in the provision of water and sanitation – are facing budget shortfalls.
The budget reductions faced by other organizations capable of implementing large-scale water services are limiting their ability to respond, placing an increasing burden on MSF to fill the gap.
“We’re taking action because clean water and sanitation are vital – especially with the rainy season approaching,” says Toussaint. “But every penny spent here is one less for medical care. MSF can’t do it alone. We need others with the capacity and funding to step in to meet the growing needs,” he says.
