At a refugee camp in remote eastern Chad, Amné Moustapha is close to giving birth. Her contractions are dizzying and her feet swell in the baking heat. Her husband is building a shack from sticks and string to shelter their coming newborn.
Moustapha, 28, fled her village of Tibelti in neighbouring Sudan eight days ago, one of thousands of people to pour from the north African country since fighting between rival factions began two weeks ago.
But many of the countries hosting new arrivals, including Chad, face their own problems including food shortages, drought and high prices, creating a humanitarian crisis beyond Sudan's borders that international agencies are struggling to contain.
"I don't know what to do. I hear that there are midwives but since we took refuge here several women have given birth without medical assistance. I am waiting for my turn," said Moustapha, her belly protruding beneath her blue robe as she sat in the shade of a tree, her only shelter from the daytime heat and the nightly winds.
Moustapha is not alone. Her husband said that eight other women had given birth without help in the camp in Koufroun, where temperatures soar to 45 degrees Celsius (113 degrees Fahrenheit). The World Food Program is providing rations but officials say more funding is needed.
"We are getting food to the field but we will need a lot more," said Pierre Honnorat, WFP's director in Chad. "We really need massive help."
The conflict between Sudan's army and the paramilitary Rapid Support Forces started in the capital Khartoum, where residents are trapped in their homes under bombardment and fighters roam the streets.
It has since spread into other regions including Moustapha's Darfur where a two-decade-old conflict and simmering violence has been re-ignited by the latest fighting.
Around 10,000 to 20,000 Sudanese have already crossed the border into Chad, WFP says.
"Several women have given birth here but have no shelter," said Moustapha's husband Khamis Asseid Ahmat Haron beside the unfinished stick frame of their new home. "Even to build this simple shelter, this is not accessible to everyone."
(Writing by Edward McAllister; Editing by Ros Russell)
