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 neighboring Sudan eight days ago, one of the 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 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 Programme (WFP) 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 need is huge,” said Alpha Koita, Chad’s chief mission of Premiere Urgence Internationale – a French NGO operating in Chad. “They are mostly women and children coming with nothing, they have left everything behind,” he said as his team deployed a mobile hospital in Adre, a town in the eastern Chadian province of Ouaddai.

The conflict between Sudan’s army and the paramilitary Rapid Support Forces started in the capital, Khartoum, where residents are trapped in their homes amid 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 reignited by the latest fighting.

After fierce fighting broke out in Sudan on April 15, the United Nations said an estimated 20,000 people had entered Chad and at least 100,000 were set to arrive, raising concerns about the stability of a fragile region. The WFP has also given a similar estimate.

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