One month after Koukou floods, dire humanitarian situation remains

In eastern Chad, thousands of people have been displaced and health centers are unable to function following floods.

A child wades through a flood plain following heavy rains in Chad.

A child wades through a flood plain in the town of Koukou. | Chad 2024 © Julie Melichar/MSF

Thousands of people displaced by the floods in Koukou Angarana, in Sila province, eastern Chad, are still living in makeshift shelters without reliable access to clean water, food, or sufficient health facilities a month later. Water levels continue to fluctuate, and although the fear of another flood is decreasing, needs are only rising.

Teams from Doctors Without Borders/Médecins Sans Frontières (MSF) have assessed that people’s most immediate needs are food, water and sanitation, shelter reinforcement, and primary and secondary health care.

“The living conditions of displaced people in Koukou are extremely difficult,” explains Julie Melichar, MSF project coordinator. ”They are exposed to the risk of epidemics given the lack of drinking water, people living on top of one another in the camps, and the absence of health facilities.”

Urgent need for clean drinking water

Access to clean drinking water is almost nonexistent in Koukou. The quality of the water at the few functional sources needs to be assessed, and the quantity available does not cover the needs of huge numbers of people in displacement sites.  

Water sources were contaminated during the flood by a mixture of sewage and waste, including feces. Water is not always available, pushing people to use water from flood plains. 

Julie Melichar, MSF project coordinator

“Water sources were contaminated during the flood by a mixture of sewage and waste, including feces,” explains Melichar. “Water is not always available, pushing people to use water from flood plains. Although MSF is cleaning water wells, they are at risk of being contaminated again in the event of further rains or flooding. The situation remains precarious and requires an effective water, sanitation, and hygiene response to reduce the risk of communicable disease outbreaks.”

The town of Koukou in Chad has been flooded after unprecedented rains.
After massive flooding in eastern Chad, an MSF team based in Sila has been helping authorities rescue survivors and is providing emergency health care. | Chad 2024 © MSF

Lack of protection from the elements

In the shelters, there are very few blankets, and insufficient tarpaulins to protect people from repeated rains and storms. This lack of physical protection promotes the development of diseases such as acute respiratory infections and malaria.  

MSF has set up a health post where our teams provide primary health care. Between August 14 and September 9, MSF teams carried out 1,850 health consultations. Over 340 people had acute respiratory tract infections, 265 tested positive for malaria, and more than 220 were treated for diarrhea. MSF also provided prenatal consultations to 232 pregnant women who were also tested for malaria and provided with intermittent preventive treatment.  

Makeshift shelters of those fleeing flooding in eastern Chad.
People have set up camp on the hillsides of Koukou after fleeing unprecedented flooding, but are struggling from a lack of clean water, food, and other supplies. | Chad 2024 © MSF

“People can’t wait much longer” 

MSF teams on the ground consistently hear from people that hunger is an immediate concern. The floods destroyed much of the food supply and made essential activities such as collecting firewood and working in the fields impossible. Many fields of sorghum, peanuts, and millet have been destroyed or are no longer suitable for cultivation. Prices have skyrocketed so what little food is available is unaffordable for many.

Despite the massive needs, international organizations have yet to materialize a significant response.

“An immediate food distribution would significantly help many people here in Koukou,” says Melichar. “This would be a crucial and much-needed first step, but despite these floods happening a month ago there has been very little in terms of international response. People can’t wait much longer.”  

A view of massive flooding in eastern Chad.
Massive flooding in eastern Chad has decimated the town of Koukou, where thousands are now stranded with inadequate food, shelter or drinking water. | Chad 2024 © MSF

Concerns for people outside Koukou  

Nearly 1,500,000 Chadians have been affected by the floods countrywide, with nearly 260,000 hectares of fields destroyed as of September 3, 2024, the government announced.

With roads still largely impassable due to flooding, information about affected villages on both sides of the Wadi Bahr Azoum river in Sila Province is beginning to trickle in. People describe many flooded villages, destroyed fields, and multiple displacements. Reaching these people is a logistical challenge and a rapid response from other organizations is essential to meet people’s most urgent needs, particularly access to health care in areas affected by the floods.

Chad is particularly vulnerable to climate change. It is frequently hit by recurrent droughts and floods, and weather projections indicate that the country will experience more days of heavy rainfall in the future.