“I came to help my sisters”: As Chad grapples with record floods and a refugee crisis, midwives are bridging the divide

N'DJAMENA/OUADDAÏ REGION, Chad – “The water ruined everything – the rice, the money... Everything is under water.” In October 2024, Gloria Nadjitessem, 31, lost her home in Chad’s capital N'Djamena to devastating floods that submerged towns across the country.

Along with her four children, Ms. Nadjitessem is among more than 4,000 people now sheltering in the Chari-Baguirmi displacement camp in N'Djamena’s Toukra district. “This is where I live now,”  she told UNFPA, the United Nations sexual and reproductive health agency. “There is no other way, but we make it work.”

Since July 2024, some of the worst flooding to ever hit Chad has wiped out lives, homes and livelihoods and affected nearly 2 million people. More than 13,000 have been displaced, most of them seeking refuge in overcrowded, makeshift camps.

Climate crises are known to drastically increase dangers for women and girls, especially those forced from their homes, as access to healthcare, food and shelter dwindles. In these conditions, childbirth can be perilous, malnourished mothers struggle to produce milk for their newborns, and the risks of sexual violence and exploitation soar.

“The floods have really threatened these women,” said 38-year-old Lucille Denembaye, a midwife at a UNFPA-supported mobile health clinic operating at the Chari-Baguirmi camp. “I met a woman whose husband infected her with HIV – she has five children, she is 27 years old and her house has collapsed on her – the situation is really horrible for her.”

UNFPA has deployed 148 humanitarian midwives across Chad in 2024, equipped with supplies for safe birth and trained to deal with obstetric emergencies and support survivors of gender-based violence.

“I recently came to this site, and I have been here for three months,” explained midwife Florence Denemadji, 36. “UNFPA trains us for emergency situations like these before we go to the field. If there are any shortages or needs, we call our supervisors and they send everything immediately.”

An unequal crisis 

Hunger and malnutrition have risen with the crisis, particularly in the displacement and refugee camps, further endangering lives and pregnancies. Chanceline Milamem, 24, fled her home in N’Djamena while heavily pregnant, giving birth in the camp at the end of October, assisted by UNFPA midwives. 

“If there was food, I would eat, and the milk would come for the baby,” she told UNFPA. “But there’s no food, and the baby is getting thinner. I’m losing weight all the time. The midwives have taken good care of me, they are very kind. They took care of me until I delivered in good time, in their arms.”

Like many other countries facing recurrent climate disasters, Chad was already grappling with another humanitarian crisis; since the war in Sudan broke out in April 2023, Chad has taken in more than 700,000 refugees – the largest influx in its history. Over 200,000 people have also returned to Chad from Sudan, numbers that make conditions in displacement camps even more tenuous.

The vast majority of refugees and returnees are women and children, many scarred by the horrors they have witnessed. In the Ouaddaï region on Chad’s eastern border with Sudan, the town of Adré hosts a refugee camp that has swelled its population from 40,000 people to 230,000, severely stretching already scarce resources. 

Yet at the Adré district hospital, Soliri Adete, 32, a UNFPA-supported midwife, is committed to providing care for all women in need. “Every day I come into the hospital to help my sisters who are ill and suffering,” she told UNFPA. “I come to help them recover their health and also to help those who are victims of sexual violence.”

A struggle for survival

As new arrivals to Adré rise, many are being relocated to Farchana, a cramped, underserved camp set up to accommodate refugees fleeing Sudan 20 years ago. “The most pressing challenge women face here is deliveries,” said Souat Oumar, 39, a women’s community leader in Farchana.

“There is no hospital at the camp and we don’t have an ambulance. So we struggle to support these pregnant women to deliver.”

For those experiencing complications, childbirth can quickly turn life threatening. “Sometimes they come to my home, and if I have some money I order a rickshaw to take them to a hospital. Other times a woman might be bleeding seriously or have a miscarriage or other critical issues… From that, some women die.”

UNFPA supports a new health centre in Farchana town, as well as one near the camp and a one-stop centre at the district hospital in Adré, which provide critical services for both Chadian and Sudanese women and girls. The centres offer assisted childbirth, pre- and postnatal care, family planning, counselling, clinical management of rape and a safe space for survivors of gender-based violence. 

Overall in Chad, UNFPA supports 27 safe spaces for women and girls and reached more than 35,000 people with sexual and reproductive health services in 2024. But its humanitarian appeal for Chad was only 40 per cent funded this year, meaning women went without supplies for safe birth and support for sexual violence survivors were limited. In 2025, UNFPA needs $27.8 million to serve the most critical needs of women and girls in Chad and ensure these life-saving services.