Although there are many humanitarian organizations in El Geneina, few are prepared to leave the city. The paralysis afflicting aid agencies is visible in this area.

Since late January, people have been streaming from Chad into Sudan's western region of Darfur, which is still gripped by violence and instability. More than 7,000 people fleeing violence and looting in Chad have taken refuge in a small village north of El Geneina, the capital of western Darfur. In this area neglected by aid organizations, Médecins Sans Frontières (MSF) is providing them with assistance.

In early February, hundreds of families coming from Chad began to arrive in the small village of Gellu, 18 miles northwest of El Geneina. Told of their arrival, on February 5, MSF teams went to this area close to the Chad border to assess needs and counted more than 300 families gathered in makeshift shelters.

Driven from their villages, they had managed to round up only a few donkeys to help them as they fled. Gellu's 2,500 residents provided them initial aid, food and a place to stay. The nights are cold, the wadi (streams) are dry, and the winds are fierce.

Hundreds of vulnerable families

"They lacked in blankets, cooking equipment, buckets and jerry cans, mats and plastic sheeting to cover the shelters," says Michael Neuman, MSF head of mission. "But what the families needed most was drinking water."

The MSF assessment team did not detect urgent medical problems or malnutrition. However, the population is not vaccinated - specifically against measles — and are even more vulnerable because people no longer have access to health care. The medical organization that had supported the village health center since summer 2005 ended its regular delivery of supplies at the end of last year because of ongoing insecurity in the region.

The MSF team quickly organized a measles vaccination campaign, with vaccines provided by the Ministry of Health, and distributed basic survival items. Those items were provided by the United Nations, which meant they were available, but the disadvantage of being dependent on the UN delayed the distribution by one day.

"In spite of everything, we were able to vaccinate 700 children and distribute blankets, jerry cans and buckets, clothing, mats and other basic items within two days," says Neuman. A drinking water distribution system was put in place during the same period.

The influx of hundreds of families, composed of women, children and the elderly, continues. Several days after its first visit, our team recorded 1,500 shelters in Gellu and, on February 19, 800 additional Chadian families arrived. Others are still en route. They are all headed to the village, which has quickly become known as a place of relative calm offering access to aid that has long been unavailable. The presence of the Sudanese army and various militias around the village appear to give the new arrivals a sense of safety.

Providing first aid, ensuring that it continues

"We acted on an urgent basis to respond to the needs of this population, which was deprived of assistance," says Neuman. "But the large scale of our operations on behalf of displaced persons, inhabitants and nomadic populations in western Darfur, and also in the rebel-controlled areas, prevents us from launching new aid programs because we want to be able to address other possible emergencies.

"So, we have to organize other aid agencies to continue providing aid to these populations. Although there are many humanitarian organizations in El Geneina, few are prepared to leave the city. The paralysis afflicting aid agencies is visible in this area."

The tensions on the nearby border, attacks against humanitarian convoys and the movements of armed groups in this region all contribute to the widespread failure to act.

The process launched by MSF's operations showed immediate results. After contacting UN agencies and nongovernmental organizations, we were gradually able to disengage from the camp.

"We handed over the water supply system," says Neuman. "There is even talk of drilling new wells. Other groups will take responsibility for health care and vaccinations. Additional distributions of supplies and, if necessary, food items will also - we hope - be taken care of."

For MSF, the task now involves remaining vigilant in Gellu and the Chad-Sudan border region, a theater of continued fighting and ongoing tension.