Eastern Chad Research Articles

A large outbreak of Hepatitis E virus genotype 1 infection in an urban setting in Chad likely linked to household level transmission factors, 2016-2017.

BackgroundIn September 2016, three acutely jaundiced (AJS) pregnant women were admitted to Am Timan Hospital, eastern Chad. We described the outbreak and conducted a case test-negative study to identify risk factors for this genotype of HEV in an acute outbreak setting.MethodsActive case finding using a community based surveillance network identified suspected AJS cases. Pregnant or visibly ill AJS cases presenting at hospital were tested with Assure® IgM HEV rapid diagnostic tests (RDTs) and some with Polymerase Chain Reaction (PCR) in Amsterdam; confirmed cases were RDT-positive and controls were RDT-negative. All answered questions around: demographics, household makeup, area of residence, handwashing practices, water collection behaviour and clinical presentation. We calculated unadjusted odds ratios (ORs) and 95% confidence intervals (95% CI).ResultsBetween September and April 2017, 1443 AJS cases (1293 confirmed) were detected in the town(attack rate: 2%; estimated 65,000 population). PCR testing confirmed HEV genotype 1e.HEV RDTs were used for 250 AJS cases; 100 (40%) were confirmed. Risk factors for HEV infection, included: having at least two children under the age of 5 years (OR 2.1, 95%CI 1.1–4.3), having another household member with jaundice (OR 2.4, 95%CI 0.90–6.3) and, with borderline significance, living in the neighbourhoods of Riad (OR 3.8, 95%CI 1.0–1.8) or Ridina (OR 3.3, 95%CI 1.0–12.6). Cases were more likely to present with vomiting (OR 3.2, 9%CI 1.4–7.9) than controls; possibly due to selection bias. Cases were non-significantly less likely to report always washing hands before meals compared with controls (OR 0.33, 95%CI 0.1–1.1).DiscussionOur study suggests household factors and area of residence (possibly linked to access to water and sanitation) play a role in HEV transmission; which could inform future outbreak responses. Ongoing sero-prevalence studies will elucidate more aspects of transmission dynamics of this virus with genotype 1e.

A SAR-Based Index for Landscape Changes in African Savannas

Change detection is one of the main applications in earth observation but currently there are only a few approaches based on radar imagery. Available techniques strongly focus on optical data. These techniques are often limited to static analyses of image pairs and are frequently lacking results which address the requirements of the user. Some of these shortcomings include integration of user’s expertise, transparency of methods, and communication of results in a comprehensive understandable way. This study introduces an index describing changes in the savanna ecosystem around the refugee camp Djabal, Eastern Chad, based on a time-series of ALOS PALSAR data between 2007 and 2017. Texture based land-use/land cover classifications are transferred to values of natural resources which include comprehensive pertinent expert knowledge about the contributions of the classes to environmental integrity and human security. Changes between the images are analyzed, within grid cells of one kilometer diameter, according to changes of natural resources and the variability of these changes. Our results show the highest resource availability for the year of 2008 but no general decline in natural resources. Largest loss of resources occurred between 2010 and 2011 but regeneration could be observed in the following years. Neither the settlements nor the wadi areas of high ecologic importance underwent significant changes during the last decade.

The role of collective action in leveraging farmers' performances: Lessons from sesame seed farmers' collaboration in eastern Chad

In recent decades, the role of farmers' associations in developing countries has been increasing due to a number of projects promoted by local and international governmental and non-governmental institutions and organizations. This paper analyses the effectiveness of collective action in enhancing farmers' market performances in terms of production quantity, production quality and profit. Specifically, the study points out the role of associations in leveraging smallholder market performance by providing learning, production and network support. In-depth interviews with local sesame value chain actors and a structural equation model based on a survey involving 97 farmers in East Chad are implemented. The farmers involved are part of the EU Project “Peanut and sesame food chain support: from production to marketing” led by a governmental organization. Results show that collective action supportive activities can effectively leverage farmers' market performances. Some policy implications for research and development organizations are finally discussed.

Hydrochemical and Isotopic Characteristics of the Basement Aquifer in the Wadi Fira Area, Eastern Chad

The Wadi-Fira region in eastern Chad is facing dramatic water supply problems, related to the climatic semi-arid context and the reception of refugees from the Darfour, which has increased the local population by 22% these last years. Expansion of agglomerations (temporary new towns), development of agricultural and pastoral practices together with the augmentation of the population have led to dramatic water needs. The basement aquifer of Wadi-Fira constitutes the main source of water supply. However, little is known about this system. Within this context, this work aims at better understanding and identifying hydrogeochemical processes and their relations to groundwater quality within this complex environment, and groundwater recharge mechanisms. 31 groundwater samples were collected at two sites, Am Zoer and Guereda-Iriba, from hand dug wells and deep wells. Major chemical elements were analyzed on all samples and stables isotopes (oxygen-18 and deuterium) on 17 samples. Various methods were used to interpret the hydrochemical data (descriptive and multivariate statistics, Piper and Schoeller diagrams, scatter plots, minerals saturation indices). The stable isotopes were interpreted using conventional IAEA methods. The results permitted to differentiate the laterite reservoir from the deep fractured reservoir. The main process controlling groundwater mineralization is water-rocks interaction and natural minerals dissolution. Ion exchanges, evaporation and anthropogenic activities have also a moderate impact on groundwater quality. Based on isotopes data, it is concluded that groundwater in the basement aquifer is related with modern rainfall. These results provide further insights into this basement aquifer, which is a vital resource for the region of Wadi-Fira.

The Relationship Between Acute Malnutrition, Hygiene Practices, Water and Livestock, and Their Program Implications in Eastern Chad.

The causes of acute malnutrition are complex and time and geography variant and need to be better understood in order to both design more effective nutrition programs and evaluate them. The findings reported here are part of an evaluation of a 4-year multisectoral nutrition program led by Concern Worldwide in the Sila Region of eastern Chad. To present evidence and learning about the relationships between acute malnutrition and potential drivers in Sila, Chad. Quantitative household-level data from a clustered randomized control trial were collected in November/December 2014. The survey was complemented with water quality testing and qualitative data collected in February and March 2013 and 2014. Households who reported not regularly cleaning the container used for transporting water for household consumption were almost twice as likely to have a malnourished child. Households living in villages with larger concentrations of cattle and having more livestock sharing the same water source as for human consumption were significantly more likely to have a malnourished child. However, cleaning the water container mediated the negative impact of living in a village with a large cattle concentration on wasting. These results demonstrate that hygiene practices and livestock water management are correlated with acute malnutrition in Sila, Chad. These findings provide a hypothesis for a possible pathogen driving acute malnutrition rates- Cryptosporidium-as part of a complex water chain, whereby the source of infection may be mitigated by hygiene behaviors with important implications for humanitarian programs.

Impact of inversion tectonics on hydrocarbon entrapment in the Baggara Basin, western Sudan

The Baggara Basin of Sudan is an ENE-WSW trending basin located within the West and Central Africa Rift System (WCARS) and NW of the Muglad Basin. The trend of the Baggara Basin is similar to other basins in eastern Chad, where oil has been discovered. Since there are no published studies for the Baggara Basin, the present paper represents an addition to the geology of eastern extension of the WCARS in Sudan. The 2D seismic data interpretation sheds light on the development and evolution of key regional and local structures of the basin. The Baggara Basin is characterized by graben geometry with two boundary faults, characterized by dextral strike slip movement, and a depocenter at the central part. The interpretation reveals the presence of two types of structures within the Baggara Basin; inversion tectonics restricted to the larger basin-bounding faults in the western part and en-echelon faults in the central part. The timing of inversion tectonics is during the Eocene and it is related to a brief major compressional event due to the collision of the African and Eurasian plates. Although the inversion created a four-way dip closed anticline structure, this anticline postdated the initial migration from the source rock. Accordingly, the anticline structural is unsuccessful for hydrocarbon entrapment.

Cooperation or conflict? Identity and scarce resources of prehistoric Saharan pastoralists

Nomadic or transhumant pastoralists in the Ennedi Highlands in north eastern Chad have always had to cope with scarce resources. When the region was first made use of by pastoralists circa 3000 BC, aridification had already started. Despite progressing aridification, the landscape was used for herding cattle and goats, and later also for keeping horses and cam- els in the following millennia. Hundreds of rock art sites are witness to this appropriation. While demographic data are still missing, it appears that comparatively intense dwelling ac- tivities inevitably put pressure on the scarce resources. In the art motifs from the last five mil - lennia a fine-grained regionalization is expressed, indicating that in rather small neighbouring spatial units different identities were manifested, notwithstanding the common economic base. Different rock art traditions articulate different appropriation of the landscape by mapping markers of identity onto the land. Rock art depicts an ambiguous portrait of the social relations among the groups within the area since there are indications of cooperation on the one hand, whereas on the other hand many pictures of mounted warriors and numerous sentinel figures point at the potential for conflict — yet without ever depicting it.

Supply and Marketing of Local Chicken in the Town of Abeche in Eastern Chad

3 Abstract: The study characterized the supply and marketing of local chicken in the markets of the city of Abeche. It involved 38 traders including 23 wholesalers retailers, 13 retailers and two hawkers selling in five poultry markets located in the 2nd, 3rd and 6th districts of the city. Traders, aged 36.21±10.9 years, are mostly Muslims (100%) of whom 52.62% schooled and 47.36% illiterate who started their activities between the 1990s and 2000s (89.47%). Wholesalers and retailers get their supply especially in the regions of Ouaddai, Wadi Fira and Sila (97.36%). As for hawkers (5.26%), they get their supply from the selling markets in Abeche. Transportation is done by trucks (50.01%), carts (34.21%) and motorcycles (32.21%). Packaging consists mostly of cages (89.5%). Of the 156 birds lost during transportation, chickens constitute 86.5% of the number and pigeons 13.5%. These losses are estimated to the amount of 395,283 FCFA. The major customers are housewives (40%), restaurant's owners and braisers at drinking spots (60%). The average selling prices are 2,926 FCFA/chicken, 2,241 FCFA per guinea fowl, 8,125 FCFA per duck and 646 FCFA/pigeon. The average gross margin on less sold ducks is higher (p<0.001) than that which realized on the other species. Organizing the actors, allocating some facilities at the markets as well as improvin g storage and transport will allow for a better supply of local chickens in the city.

Pastoralism in Africa: past, present and future

Chapter 1. Specialisation and Diversification among African Pastoral Societies Michael Bollig and Michael Schnegg PART A: THE PREHISTORY OF PASTORALISM IN AFRICA Chapter 2. Herders Before Pastoralism - Prehistoric Prelude in the Eastern Sahara Rudolph Kuper and Heiko Riemer Chapter 3. 'I hope Your Cattle Are Well' - Archaeological Evidence for Early Cattle-Centred Behaviour in the Eastern Sahara of Sudan and Chad Friederike Jesse, Birgit Keding, Tilman Lenssen-Erz and Nadja Poellath Chapter 4. Trajectories to Pastoralism in Northern and Central Kenya: an Overview of the Archaeological and Environmental Evidence Paul Lane Chapter 5. From first Stock Keepers to Specialised Pastoralists in the West African Savanna Veerle Linseele Chapter 6. A Short History of Early Herding in Southern Africa Karim Sadr PART B: HISTORICAL AND CONTEMPORARY DYNAMICS OF PASTORALISM Chapter 7. Establishing a Pre-Colonial 'Modern' Cattle and Gun Society: (Re-)pastoralisation, Mercantile Capitalism and Power Amongst Herero in Nineteenth Century Central Namibia Dag Henrichsen Chapter 8. The Emergence of Commercial ranching Under State Control and the Encapsulation of Pastoralism in African Reserves Christo Botha Chapter 9. Land, Boreholes and Fences: the Development of Commercial Livestock Farming in the Outjo District, Namibia Ute Dieckmann Chapter 10. The Political Ecology of Specialisation and Diversification: Long-term Dynamics of Pastoralism in East Pokot District, Kenya Michael Bollig and Matthias OEsterle Chapter 11. Social-Ecological Change and Institutional Development in a Pastoral Community in North-Western Namibia. Michael Bollig Chapter 12. Pastoral Belonging: Causes and Consequences of Part-Time Pastoralism in North-Western Namibia Michael Schnegg, Julia Pauli and Clemens Greiner PART C: VIOLENCE, TRADE AND CONSERVATION AND PASTORALISM IN AFRICA Chapter 13. State, Conflict and Pastoralism in Contemporary Eastern Chad: The Case of Zaghawa-Tama Relationships Babett Janszky and Grit Jungstand Chapter 14. Unofficial Trade When States are Weak: The Case of Cross-Border LivestockTrade in the Horn of Africa Peter D. Little Chapter 15. Pastoralism and Trans-Saharan Trade: Transformation of a Historical Trade Route between Eastern Chad and Libya Meike Meerpohl Chapter 16. Pastoralism and Nature Conservation in Southern Africa Susanne Berzborn and Martin Solich PART D: PASTORAL MODERNITIES IN AFRICA Chapter 17. The Indigenization of Pastoral Modernity: Territoriality, Mobility, and Poverty in Dryland Africa John G. Galaty

Territoriality through Migration: Cases among the Tubu Teda Guna (Niger)

Abstract The present article discusses whether migration can be a means in order to realize territoriality. It is based on pre-colonial, colonial and recent cases found among the Tubu Teda who live in eastern Niger and western Chad. It will be argued here that migration, in these cases, does not mean the uprooting of persons and the loss of a territory, but can lead to the amelioration of the territorial situation for the migrating group, including the enhancement of its socio-political status and economic situation.

Invitation withdrawn: humanitarian action, United Nations peacekeeping, and state sovereignty in Chad

This paper looks at the three-way relationship between the Government of Chad, humanitarians, and the United Nations Mission in the Central African Republic and Chad (MINURCAT) from 2004 until June 2011. Chad was never comfortable with the international presence of either humanitarians or peacekeepers and asserted its sovereignty increasingly during this period. MINURCAT was deployed in 2008 to protect humanitarian workers and to facilitate the provision of humanitarian assistance in eastern Chad. This association between the UN mission and humanitarian agencies contributed to making the latter the target of repressive practices by the government, such as the imposition of armed escorts. Facing a steep learning curve, Chad and its state officials gradually appropriated the discourse of the humanitarian and international community and ultimately, in 2010, requested the departure of MINURCAT, claiming that they could meet the protection needs of vulnerable populations in eastern Chad on their own.

Protecting child health and nutrition status with ready-to-use food in addition to food assistance in urban Chad: a cost-effectiveness analysis

BackgroundDespite growing interest in use of lipid nutrient supplements for preventing child malnutrition and morbidity, there is inconclusive evidence on the effectiveness, and no evidence on the cost-effectiveness of this strategy.MethodsA cost effectiveness analysis was conducted comparing costs and outcomes of two arms of a cluster randomized controlled trial implemented in eastern Chad during the 2010 hunger gap by Action contre la Faim France and Ghent University. This trial assessed the effect on child malnutrition and morbidity of a 5-month general distribution of staple rations, or staple rations plus a ready-to-use supplementary food (RUSF). RUSF was distributed to households with a child aged 6–36 months who was not acutely malnourished (weight-for-height > = 80% of the NCHS reference median, and absence of bilateral pitting edema), to prevent acute malnutrition in these children. While the addition of RUSF to a staple ration did not result in significant reduction in wasting rates, cost-effectiveness was assessed using successful secondary outcomes of cases of diarrhea and anemia (hemoglobin <110 g/L) averted among children receiving RUSF.Total costs of the program and incremental costs of RUSF and related management and logistics were estimated using accounting records and key informant interviews, and include costs to institutions and communities. An activity-based costing methodology was applied and incremental costs were calculated per episode of diarrhea and case of anemia averted.ResultsAdding RUSF to a general food distribution increased total costs by 23%, resulting in an additional cost per child of 374 EUR, and an incremental cost per episode of diarrhea averted of 1,083 EUR and per case of anemia averted of 3,627 EUR.ConclusionsAdding RUSF to a staple ration was less cost-effective than other standard intervention options for averting diarrhea and anemia. This strategy holds potential to address a broad array of health and nutrition outcomes in emergency settings where infrastructure is weak and other intervention options are infeasible in the short-term. However, further research is needed to establish the contexts in which RUSF is most effective and cost-effective in preventing acute malnutrition and morbidity among vulnerable children, compared to other options.

Implementation and utilisation of community-based mortality surveillance: a case study from Chad.

BackgroundProspective surveillance is a recognised approach for measuring death rates in humanitarian emergencies. However, there is limited evidence on how such surveillance should optimally be implemented and on how data are actually used by agencies. This case study investigates the implementation and utilisation of mortality surveillance data by Médecins Sans Frontières (MSF) in eastern Chad. We aimed to describe and analyse the community-based mortality surveillance system, trends in mortality data and the utilisation of these data to guide MSF’s operational response.MethodsThe case study included 5 MSF sites including 2 refugee camps and 3 camps for internally displaced persons (IDPs). Data were obtained through key informant interviews and systematic review of MSF operational reports from 2004–2008.ResultsMortality data were collected using community health workers (CHWs). Mortality generally decreased progressively. In Farchana and Breidjing refugee camps, crude death rates (CDR) decreased from 0.9 deaths per 10,000 person-days in 2004 to 0.2 in 2008 and from 0.7 to 0.1, respectively. In Gassire, Ade and Kerfi IDP camps, CDR decreased from 0.4 to 0.04, 0.3 to 0.04 and 1.0 to 0.3. Death rates among children under 5 years (U5DR) followed similar trends. CDR and U5DR crossed emergency thresholds in one site, Kerfi, where CDR rapidly rose to 2.1 and U5DR to 7.9 in July 2008 before rapidly decreasing to below emergency levels by September 2008.DiscussionMortality data were used regularly to monitor population health status and on two occasions as a tool for advocacy. Lessons learned included the need for improved population estimates and standardized reporting procedures for improved data quality and dissemination; the importance of a simple and flexible model for data collection; and greater investment in supervising CHWs.ConclusionsThis model of community based mortality surveillance can be adapted and used by humanitarian agencies working in complex settings. Humanitarian organisations should however endeavour to disseminate routinely collected mortality data and improve utilisation of data for operational planning and evaluation. Accurate population estimation continues to be a challenge, limiting the accuracy of mortality estimates.

An Observational Study of Material Durability of Three World Health Organization–Recommended Long-Lasting Insecticidal Nets in Eastern Chad

A total of 876 nets (229 Interceptor®, 363 Olyset®, and 284 PermaNet®) were collected 14 months post-distribution of long-lasting insecticidal nets (LLINs) from 811 households of internally displaced and host communities in Dar Sila District in eastern Chad to examine their physical condition. Holes were recorded by using three hole categories (average diameter = 2, 3.5, and 15 cm) and a Proportionate Hole Index (pHI). A total of 69.5% were in poor or very poor condition. There was no significant difference in the performance between the polyester 75 denier LLINs, but they had 4.22 times the odds of having a pHI ≥ 175 (poor or very poor condition) than polyethylene 150 denier LLINs; and 39.2% were unserviceable (pHI ≥ 300) compared with only 7.7% of the polyethylene LLINs. These results provide the first comparative data on LLIN material durability to guide procurement and replacement practice, and to inform urgently needed changes in LLIN international minimum specifications and product standards.

Gender-Sensitive Protection and the Responsibility to Prevent: Lessons from Chad

Helping states to fulfil their duty to protect their citizens and those seeking refuge within the sovereign terrain of the given state belongs to the second pillar of the Responsibility to Protect (R2P). The R2P concept, however, relates as much to preventing mass atrocities as to halt already on-going ones. This article emphasises the gender dimensions of prevention of and protection against violence and other threats, in order to stress the importance of implementing and mainstreaming gender into R2P. The case study of interest here is the UN support mission to Chad and the Central African Republic (MINURCAT) that provided a fairly encouraging, albeit short-lived, example of gender-responsive prevention and protection measures at the community level for refugees and IDPs in eastern Chad. Chad exemplifies a case with low-intensity conflicts and responses made at the local level, like the MINURCAT-supported community conflict resolution initiative, proved constructive in preventing violent responses. Here, deliberate integration of female police officers was a first step towards facilitating contact with women not allowed to talk to male strangers. Further, ensuring gender training for the entire police unit as an integrated part of their protection responsibility helped in avoiding male-as-norm approaches. The forced withdrawal of the UN was questioned as premature. However, the security situation has remained fairly stable, and the government seems able to provide at least some of the more hard-end forms of protection measures, although rule of law and other forms of protection for vulnerable groups remain elusive in eastern Chad.

On the Original Understanding of the Crime of Genocide

This article is an extended exercise in 'genocide originalism.' To wit, some leading genocide scholars have propounded a supposedly “legal” definition that is unduly narrow. Purportedly based on the drafting history of the Genocide Convention, this narrow definition actually rests upon incomplete and selective references to legal sources. This narrow definition also has important effects on debates concerning whether partial genocides, such as by 'ethnic cleansing' may constitute the crime of genocide. In this article, I survey evidence that the drafters and ratifiers of the Genocide Convention did not adopt a requirement of genocidal intent that would be nearly impossible to satisfy, namely an intent to totally destroy a race. Efforts to equate genocidal intent with total racial destruction have been disturbingly common within the United Nations system over the past decade, including in the findings of International Court of Justice (ICJ) on genocide in Bosnia and Herzegovina, of the International Commission of Inquiry on Darfur (ICID) on genocide in western Sudan and eastern Chad, and of the trial chamber of the U.N.-backed International Criminal Court (ICC) on genocide in Darfur. At the root of this misunderstanding is the equation of the intent to destroy a group required by Article II of the Genocide Convention with a deliberate plan or policy of a state to exterminate the members of an entire racial group, or a total genocide. Contrary to this distortion of the Convention, its drafters rejected efforts to limit genocide to total destruction, a plan or policy of destruction, or a motive of racial hatred. This article contends that the original understanding of the crime of genocide did not require a total genocide, and that this original understanding is reflected in the text of the Genocide Convention, the 'travaux preparatoires', and the course of performance of the treaty by the United Nations and its member states.

Evidence from detrital zircons for recycling of Mesoproterozoic and Neoproterozoic crust recorded in Paleozoic and Mesozoic sandstones of southern Libya

The geodynamic history of the Precambrian basement in central North Africa as well as the age and provenance of its sedimentary cover sequence are still poorly constrained. Here we present first detrital zircon ages (obtained by LA-SF-ICP–MS and SHRIMP) from Paleozoic and Mesozoic sandstones of the eastern Murzuq Basin, southern Libya, which unconformably overlie the Saharan Metacraton. Establishing the age and provenance of these sandstones has important implications for our understanding of the evolution of northern Gondwana during the Paleozoic, especially for reconstructions of paleo-source areas and transport paths. Detrital zircons from the sandstones show mainly early Paleozoic to Neoarchean ages with four main age populations, at 2750–2500 Ma (8%), 2200–1750 Ma (16%), 1060–920 Ma (18%), and 720–530 Ma (39%). About 13% of all concordant grains yield ages of 1600–1000 Ma. In addition, there are 9 zircon grains (0.7% of all concordant grains) with ages of 3600–2800 Ma. The presence of a high number of ca. 1 Ga zircons is enigmatic and their origin is controversial. Besides direct sourcing from ca. 1 Ga igneous rocks in eastern Chad and ca. 1 Ga igneous rocks along the southeastern margins of the Congo and Tanzania cratons, recycling of Neoproterozoic sediments containing ca. 1 Ga zircons is another alternative hypothesis to explain the presence of ca. 1 Ga zircons in the Paleozoic sedimentary sequence of central North Africa. The ubiquitous occurrence of ca. 1 Ga zircons in Paleozoic sediments of southern Libya provides insights into the correlation and paleotectonic arrangement of Gondwana-derived terranes, present, for example, in the eastern Mediterranean and in southwestern Europe. Current paleotectonic models of dextral terrane transport along the northern Gondwana margin during the early Paleozoic may need to be revised.

Occurrence of water-borne enteric viruses in two settlements based in Eastern Chad: analysis of hepatitis E virus, hepatitis A virus and human adenovirus in water sources

Hepatitis E virus (HEV) is a common cause of water-borne acute hepatitis in areas with poor sanitation. In 2004 an outbreak of HEV infection affected around 2,000 people in Eastern Chad (Dar Sila). This paper describes the decrease in the incidence of acute jaundice syndrome (AJS) from 2004 until 2009 when a mean incidence of 0.48 cases/1,000 people/year was recorded in the region. Outbreaks of AJS were identified in some of the camps in 2007 and 2008. Moreover, water samples from drinking water sources were screened for human adenoviruses considered as viral indicators and for hepatitis A virus and HEV. Screening of faecal samples from donkeys for HEV gave negative results. Some of the samples were also analysed for faecal coliforms showing values before disinfection treatment between 3 and >50 colony forming units per 100 mL. All water samples tested were negative for HEV and HAV; however, the presence of low levels of human adenoviruses in 4 out of 16 samples analysed indicates possible human faecal contamination of groundwater. Consequently, breakdowns in the treatment of drinking water and/or increased excretion of hepatitis viruses, which could be related to the arrival of a new population, could spread future outbreaks through drinking water.

Provision of healthcare in a remote base of operations in southern Chad

The Irish Defence Forces maintained a presence in south eastern Chad under the authority of the United Nations Security Council from January 2008 until May 2010, operating in a peace support role as the lead contingent in a multinational battalion. In September 2009 the task of establishing a forward operating base in a remote location within the area of operations was ordered by mission headquarters. Irish and Finnish troops duly deployed and began the task of establishing a safe and secure base from which to operate. This involved securing the location, installing accommodation, electricity, lighting and facilities for ablutions, removing natural hazards, establishing secure communications and ensuring rapid access and egress in the event of hostile contact or emergency. The incidence of disease at this location was low, with the notable exception of a limited outbreak of gastroenteritis. The high standard of engineering work carried out around the camp, especially the latrines, washing facilities and other hygiene measures, significantly contributed to minimising the transmission of infectious disease. The past experiences of the Defence Forces in Congo, Lebanon, East Timor, Eritrea and Liberia have led to a high standard of forward planning and logistical awareness within the organisation which served personnel well in this latest mission.

Rates and impact of trauma and current stressors among Darfuri refugees in Eastern Chad.

Darfur refugees face hardships associated with chronic displacement, including lack of basic needs and safety concerns. Psychiatric research on refugees has focused on trauma, but daily stressors may contribute more to variance in distress. This article reports rates of past trauma and current stressors among Darfur refugees and gauges the contribution of each to psychological distress and functional impairment. A representative sample of 848 Darfuris in 2 refugee camps were interviewed about traumatic events, stressors faced in the camps, psychological distress, and functional impairment. Basic needs and safety concerns were more strongly correlated with measures of distress (rs = .19-.31) than were war-related traumatic events (rs = .09-.20). Hierarchical regression supported models in which effects of trauma on distress were mediated by current stressors. Although war-related traumatic events are the initial causes of refugees' hardship, findings suggest that the day-to-day challenges and concerns in camps mediate psychological distress associated with these events.