Chad: Malnutrition is a silent crisis
MSF and partners provide community-based care for children and mothers in Chad.
While attention in Chad is focused mainly on the war in neighbouring Sudan and the refugee camps in the east, the country has been confronted with another crisis: malnutrition. At least 5.7 million people in Chad are facing malnutrition — including 3.6 million who are severely food insecure — in a context exacerbated by conflict, displacement, climate shocks and economic deterioration. This situation follows successive nutritional crises that particularly affect children.
In a country already prone to lack of food and malnutrition, Doctors Without Borders/Médecins Sans Frontières (MSF) teams are seeing how international funding cuts in humanitarian assistance are further impacting the crisis. Food assistance from the World Food Programme (WFP) during the lean season (from June to September) has fallen dramatically: from providing support for more than 1 million people in 2024 to just 118,000 in 2025 in the three target provinces of Kanem, Barh El Gazel and Ouaddai.
“I was in the program. Adam was hospitalized in Massakory, three hours from the capital. But after we left, I had to come back for screening (…) because he fell ill again. I have four other children, including two older ones who were also malnourished.”
Zara Adam, mother of a child receiving treatment for malnutrition
Reducing malnutrition requires coordinated actions starting at the community level. This includes early screening and treatment, and the involvement of all agencies to ensure people have access to food and essential services before the situation becomes critical. This approach must also involve adequate medicines and trained staff in health facilities for complicated cases. Even after recovery, malnutrition can have lasting effects.
A chronic crisis
Orange, orange, red, red, red. In Bla Kouka, in Hadjer Lamis province in western Chad, the colours follow one another, as does the bad news. The MUAC band — a tool used to measure the mid-upper arm circumference of a child’s arm — indicates orange for moderate acute malnutrition and red for severe acute malnutrition. In the arid landscape, under a shelter made of wood and canvas, around 20 women wait their turn to have their children screened for malnutrition.
Two ‘MUAC moms’ — women from the community trained in screening for malnutrition — measure each child’s arm circumference. The tape around the arm of nine-month-old Adam Moussa is red.
“I was in the program,” says his mother, Zara Adam. “Adam was hospitalized in Massakory, three hours from the capital. But after we left, I had to come back for screening (…) because he fell ill again. I have four other children, including two older ones who were also malnourished.”
“The goal of physical therapy for these patients is to get them moving early on to prevent orthopedic or functional complications in the future. This means that they no longer walk, no longer use their arms, and lose their ability to function in their environment.”
Lucile Saint-Louis, clinical specialist in pediatric rehabilitation at the MSF Foundation
After a consultation and taking Plumpy Nut — a nutrient rich peanut-based ready-to-eat therapeutic food used to treat malnutrition — Adam joined the community-based care program (ICCM+). Implemented in partnership by MSF, the Ministry of Health (MoH) and the community, the program enables children from six to five years old as well as pregnant and breastfeeding women to receive appropriate care through 21 ICCM+ sites in the Massakory district.
These sites are run by community health workers who are trained by MSF and the MoH and recruited from the community. This community-based approach guarantees access to primary healthcare at numerous treatment points and ensures proper referrals to hospitals as needed, including for concerns like malaria, malnutrition, respiratory infections and vaccination. It also ensures the sustainability of the response through community ownership of healthcare. These sites will be able to continue operating even if MSF leaves the area, provided supplies are guaranteed.
Recurring crises and seasonal malnutrition
Beyond chronic malnutrition, the situation often worsens during critical periods: the rainy season, the lean period before harvests and peaks in diseases such as malaria.
At the Am Timan hospital in eastern Chad, MSF launched an emergency intervention in August 2025. In a hospital room, a health promoter shows Kadija Mahamad Zen an awareness-raising picture book. Zen holds her one-year-old daughter, Youssoura Adam, in her arms.
“First, when my child fell ill at the beginning of the rainy season, […] I had to pressure my in-laws to take her to a health centre,” Zen says. “The health worker told me that her condition was beyond their capabilities and we were referred to Am Timan hospital.”
The massive influx of patients forced the staff to add beds to the hospital. Between September and October, the occupancy rate reached 108 per cent. MSF supervising nurse Harou Habou Rahamatou explains that malnourished patients often have weakened immune systems, which makes them prone to infections and prolongs their hospital stays.
Taking long-term action
Malnutrition does not end with recovery. The physical or cognitive consequences, especially for children, can be long-lasting.
At Toukra hospital, on the outskirts of N’Djamena, MSF is attempting to mitigate the long-term effects of malnutrition in urban areas through a pilot program run by the MSF Foundation. This program involves recruiting three Chadian physical therapists who are currently being trained by a pediatric rehabilitation specialist and empowering patients to treat the psychomotor consequences of malnutrition.
“The goal of physical therapy for these patients is to get them moving early on to prevent orthopedic or functional complications in the future,” says Lucile Saint-Louis, a clinical specialist in pediatric rehabilitation at the MSF Foundation. “Complications could mean they no longer walk, no longer use their arms, and lose their ability to function in their environment.”
After just a few sessions, some children regain their desire to move and make up for their developmental delay.
The crisis won’t disappear on its own
Malnutrition in Chad is not a one-time emergency. It is a decades-long struggle and the result of deep structural vulnerabilities such as poverty, lack of livelihood opportunities and limited access to food, exacerbated by poor harvests due to droughts and delayed rains.
Medical care alone is not enough to break this cycle. It is criitical that the government of Chad, together with humanitarian and development organizations, work together to address the root causes and respond to malnutrition and food insecurity in the long term. This includes developing resilient agriculture, improving access to water as well as community management of water and strengthening community food storage capacities.
