Despite its scale and huge population, Nduta camp is not widely known. Situated in Tanzania`s north-western Kigoma region, close to the border with Burundi, it is now the size of a small town. Though the number of new arrivals has decreased since April 2017, prior to that month there has been a huge influx in Burundian refugees seeking safety in the camp, which has become severely overcrowded.
The camp was first established in December 1996 in response to the crisis taking place at the time in Burundi. People fleeing the civil war, which took place between 1993 and 2005, constituted the majority of the population, though some refugees had been in Tanzania since fleeing earlier ethnic conflict in the 1970s. As the war in Burundi ended and stability improved, many refugees returned home and the camp was finally closed in 2008.
However, new unrest in Burundi during 2015 caused a sudden influx of refugees into Tanzania. Nearby Nyarugusu camp initially received these refugees but became overwhelmed. Nduta was reopened in October 2015. A third camp, Mtendeli, was opened in January 2016, but reached its full capacity of 50,000 in early October 2016. Now, all new arrivals from Burundi are hosted in Nduta camp, which had to be expanded. By the end of September 2017, Nduta hosted more than 125,000 people — more than double the number of people originally anticipated.
The facilities – including the provision of shelter, medical care, education, water and food – were planned to cater for 55,000 people. These services are now being stretched and as such, conditions are rapidly deteriorating.
Unsanitary and overcrowded conditions cause a host of health problems including diarrhoea, respiratory tract infections, and skin conditions. Malaria is one of the biggest health challenges in the camp, particularly during the rainy season, where stagnant water provides a breeding ground for mosquitoes. Between January and June 2017, MSF treated 91,115 patients for the disease.
MSF began responding to the Burundian refugee crisis in Tanzania in May 2015 when violence flared and the first influx of people arrived. MSF is the main medical provider in Nduta camp, running a 175-bed hospital delivering comprehensive inpatient and outpatient care. Teams are also running six health posts, providing medical screening for newly arrived refugees and delivering much-needed mental healthcare. MSF treats between 34,000 to 40,000 patients at the health posts each month.