Médecins Sans Frontières remains the main healthcare provider for almost 100,000 Burundian refugees in Nduta camp in northwestern Tanzania.

Tanzania has been spared the internal strife that has struck many African states.

Despite this, domestic stability has not translated into economic prosperity for Tanzania's more than 56 million people. 

Many live below the World Bank poverty line, although the country has had some success in wooing donors and investors.

Tanzania is home to two renowned tourism destinations - Africa's highest mountain, Kilimanjaro, and wildlife-rich national parks such as the Serengeti.

Médecins Sans Frontières/Doctors Without Borders (MSF) first worked in Tanzania in 1993. We returned in 2015 to provide assistance for Burundian and Congolese refugees living in overcrowded camps.

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26-year-old Ramadhani Lubunga is a Burundian refugee living in Nyarugusu refugee camp, Tanzania

“I’ve been living in Nyarugusu for six months but have actually spent most of my life as a refugee: I grew up in another camp in Tanzania after my parents and I were forced to flee our country. I still find the conditions here difficult, though – it’s a struggle to get enough food and water and living in a tent wears you down.

"I’ve just been diagnosed with malaria and I can’t stop shivering and shaking. I have a headache and nausea and feel very cold. I’m also worried about my wife. She is four months pregnant but has been having stomach pains and is now in the camp hospital. I’m scared about what might happen to our unborn baby.

"Refugees never have a good life, but it’s better than living in fear at home. I can’t and won’t go back home. I will stay in this camp until I die.”

MSF's work in Tanzania: 2018

By the end of 2018, Tanzania was hosting 326,942 refugees from both Burundi and the Democratic Republic of Congo,* the majority in three camps: Nyarugusu, Nduta and Mtendeli. 

In Nduta, we run a 151-bed hospital and four health posts, as well as health promotion activities via a network of community health workers. Outpatient services include mother and child care, nutritional support, mental healthcare and treatment for victims of sexual and genderbased violence. In 2018, we also rehabilitated the operating theatre and the sterilisation room at nearby Kibondo district hospital and donated specialist equipment to enable lifesaving surgery for both refugees and the local community. 

Malaria remained a major medical problem in Nduta camp, particularly during the rainy season. We have been running comprehensive malaria prevention and control activities since 2016, including biological larviciding and mass distribution of second generation insecticide-treated mosquito nets. These measures have proven effective, reducing the number of cases by more than half in our facilities in 2018. 

In March, the governments of Burundi and Tanzania and the United Nations refugee agency, UNHCR, confirmed their commitment to facilitating the voluntary repatriation of more than 70,000 Burundian refugees by the end of the year, adding yet another element of uncertainty for many. 

Our teams in Nduta registered a significant increase in the mental health needs among refugees, the main diagnoses being depression and anxiety, but psychiatric disorders as well. In addition to a sense of helplessness about what the future holds, many patients reported having experienced traumatic events and lost family members or friends. 

*UNHCR Tanzania Refugee Situation Statistical Report, 31 December 2018

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