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Tanzania: Part 1 – “My first week in the camp was a whirlwind of emotions”

03 Apr 2018

Saschveen Singh is an Australian doctor with Médecins Sans Frontières (MSF) who has recently returned from Nduta refugee camp, Tanzania.


  • MSF is providing medical care in Nduta refugee camp, which provides shelter for people who have fled unrest in neighbouring Burundi.
  • For many refugees, it is the second time they have been displaced and crossed the border to Tanzania.


Perth – Sydney – Doha – Geneva – Amsterdam – Dar es Salaam. After transiting through six cities across six time zones in six days I boarded a 6am flight in a light plane to Kigoma, Western Tanzania to start a six-hour land cruiser journey to my new home for six months. I guess good things come in sixes?

“Many people in the camp have been there for a few years already. The majority are sheltered in tents”

My first week in the camp was a whirlwind of emotions. I was astounded by the vastness of the project and the job at hand, but I rapidly settled into life in the field with an incredible team of Burundian, Tanzanian and international staff, in a project that covers everything from emergency cases and trauma, to severe malnutrition, childhood vaccinations, maternity, primary healthcare, mental health, non-communicable diseases and tropical medicine.

This would be my first time working in a refugee camp. Although I studied refugee health in my Masters degree, there is nothing quite like arriving in a camp for the first time and seeing ‘in the flesh’ this bustling microcosm (which is not so micro at all, it’s actually the size of a small city) of semi-organised chaos and activity.

Nduta, unlike other regions, is not in drought, so there are at least many trees and shade, and the weather (when it’s not rainy season) is very tolerable as we lack the extremes of nature’s climate forces. Sadly, due to the original unrest in nearby Burundi, many people in the camp have been there for a few years already. The majority of refugees are sheltered in tents. Others have been there so long that they have started building more solid structures by laboriously hand-making their own mud bricks from the camp’s deep-red earth, in an effort to protect themselves and their families from the elements and to provide at least some stability in a very precarious context. I’ve met many refugees who fled to this same camp in the previous Burundi civil war between 1993 and 2006, only returning home for a few years before having to flee again when the most recent unrest occurred.

“The smoke heralds the beginning of another day for these people in prolonged exile, distanced from their homeland”

The size of the camp doubled from 60,000 in September 2016 to more than 120,000 refugees by March 2017. My colleagues on the ground before I arrived had done an incredible job, trying to maintain essential services for all despite the massive surge in the camp’s population and the heavy burden of the peak malaria season.

We live about an hour away from the camp, so there is a lot of travel time to and from work each day. This time is spent in a variety of different ways depending on the person and how tired they are that morning: sipping a thermos mug (trying not to spill coffee all over yourself on the bumpy road), reading over MSF guidelines or trying to jot down a schedule in your diary for how to fit in the million and one tasks that you need to try to do that day. I’m amazed at how quickly I have become accustomed to reading whilst travelling sideways in the back of a Landcruiser, at 60km per hour along an insanely bumpy unsealed road – without even the slightest hint of motion sickness. Next level adaptation goals: achieved!

Driving into the camp every morning, often the first thing we see are some refugees walking or hitching a bicycle ride the long distance to the market on the outskirts of the camp to get supplies. After sunrise’s gentle quietude, I notice the families huddled closely around their fires. The flames sometimes burn dangerously close to surrounding tents (and to playful children), the smoke rising from the embers fanning out between the trees in the cold air, fracturing the early morning light. They create a beautiful but eerie luminous show, that sadly just heralds the beginning of yet another day for these people in prolonged exile, distanced from their homeland and far from the comfort of having an actual home as shelter.


The MSF project in Nduta refugee camp includes maternal health care, nutrition, emergency and inpatient care for adults and children, immunisation activities, sexual violence care, mental healthcare and health promotion. MSF also provides support to the operating theatre of Kibondo Ministry of Health Hospital with human resources, material and equipment, and with technical advice on water, sanitation and hygiene.