Between the tents there are areas with fireplaces where the women prepare traditional Burundian dishes such as Ugali, beans and peas. Photo: Louise Annaud/MSF

As large numbers of refugees fleeing unrest in Burundi cross the border to neighbouring Tanzania, the overcrowded refugee camp of Nyarugusu “has reached breaking point”, MSF emergency coordinator Sita Cacioppe, explains.

With the influx of people, services in the camps are massively overstretched, and aid agencies are struggling to provide people seeking refuge with sufficient food, water, shelter and healthcare. Up to 3,000 people are crossing the forested border between Burundi and Tanzania every week. Many travel under cover of darkness, on foot and without belongings.

One of five water distribution points in Nyarugusu. In total, MSF distributes over 270,000 liters of water per day and is currently working to increase its water points. Photo: Eveline Meier/MSF

An estimated 78,000 Burundians are currently sheltering in Nyarugusu camp, joining 64,000 Congolese refugees who have been in the camp since 1997. The camp was originally set up to host a maximum of 50,000 refugees fleeing the civil war in Democratic Republic of Congo.

“People are staying in mass shelters for months at a time – in areas intended as transit areas – while they wait; for a tent,” says Cacioppe. "Our teams have seen more than 200 people sheltering in a tent measuring just 8m x 22m – which is less than one square metre of space per person.”
 
In May, MSF set up a cholera treatment centre in the camp after an outbreak of the waterborne disease. Since then, MSF teams have vaccinated more than 107,000 people against cholera, and are distributing 270,000 litres of clean drinking water per day at five sites across the camp.

During the triage, a rapid malaria test is carried out to determine immediately if patients with fever suffer from malaria. If the test is positive, the patient is then examined at the mobile clinic. At the same time, children are screened for malnutrition. Photo: Eveline Meier/MSF
Alongside the Tanzanian Red Cross, MSF teams are also running mobile clinics to provide refugees with basic healthcare and refer the most severe cases to hospital. The most common health issues are malaria, diarrhoea and respiratory tract infections, due to the cold nights and ever-present dust.

In the camp’s hospital, managed by the Tanzanian Red Cross, an MSF team is running a 30-bed inpatient therapeutic feeding centre for children suffering from acute malnutrition with complications.
 
“The refugees desperately need to be provided with new areas to settle, and basic services, so that they can live more dignified lives,” says Cacioppe.Conditions in the mass shelters are extremely cramped, with more than 200 persons sharing a shelter. People sleep, sit and eat on the same mat. Photo: Louise Annaud/MSF

Find out more about MSF's work in Tanzania.