The international humanitarian group Doctors Without Borders (MSF) has uncovered a pattern of sexual abuse and exploitation by several local and foreign workers operating in Chad, near the border with Sudan. In some cases, the victims of these abuses were underage girls, while in other cases the workers are alleged to have offered food or jobs in exchange for sex with refugees. The findings are contained in a confidential internal memo obtained by the Associated Press (AP).
The Doctors Without Borders report, completed in July and first reported on Saturday by the Associated Press, documents a total of 59 allegations of abuse. As a result of the investigation, 18 staff members have been dismissed and permanently banned from future employment with the organization. In some cases, the organization said, the allegations could not be verified or the perpetrators could not be identified. The report also notes that the repetitive nature of some of the cases of exploitation suggests the possibility of an organized form of “sex trafficking.” The organization said it had launched a months-long investigation after reports by the Associated Press that several women had accused aid workers of sexual exploitation in camps for internally displaced persons in Chad. The refugees had fled the devastating civil war in Sudan, now in its fourth year. The report says the AP has played “a fundamental role as an external whistleblower of wrongdoing.”
Findings by Doctors Without Borders, one of the world’s largest humanitarian organizations and a major employer in refugee camps in eastern Chad, suggest that abuse may have been far more widespread than previously reported. Sexual exploitation has repeatedly emerged in humanitarian crises around the world, despite years of efforts by aid organizations to prevent such cases.
In cases documented by the Associated Press in Chad in 2024, women said that people they were supposed to protect, including aid workers and members of local security forces, offered them money, easier access to humanitarian aid or jobs in exchange for sex. This form of sexual exploitation is considered a criminal offense in Chad. In its report, the organization emphasizes that the cases discovered in Chad are particularly worrying, as additional resources have been invested in preventing and combating abuse. The memorandum also highlights that the findings of the investigation are likely to represent only part of the problem, as many women have been reluctant to speak openly about their experiences. In response to questions about the memorandum, Médecins Sans Frontières describes the report as “a candid internal analysis” that clearly highlights the points where the organization’s mechanisms have failed.
According to the report, the 59 allegations of inappropriate behavior cover a wide range of violations, from sexual harassment to sexual exploitation and abuse. The organization stressed that these cases constitute “a serious violation of MSF’s values and responsibilities” and expressed deep regret for the harm caused to the victims.
MSF noted that it operates primarily in settings where people are particularly vulnerable and dependent on humanitarian aid, which creates imbalances in power relations and increases the risk of abuse. The organization stressed that the investigations were undertaken precisely to identify and proactively address these problems. In some of the cases investigated, identification and tracing of the people involved was not possible due to the sheer scale of the humanitarian emergency and the constant movement of displaced populations. Since the report was published, MSF has strengthened its recruitment procedures, staff reference checks and complaints mechanisms, according to information provided to the Associated Press. However, the organization acknowledged in its statement that much work remains to be done to ensure lasting change and to ensure that such cases do not recur in the future.
DIFFERENT FORMS OF ABUSE
MSF launched its investigation in the fall of 2024 and identified allegations of exploitation and abuse against Chadian citizens, Sudanese refugees, as well as the organization’s employees and contractors.
According to the report, the organization was investigating several cases of sexual exploitation of refugee women in exchange for food, water and milk. The investigation also uncovered cases where sexual intercourse was demanded in exchange for jobs, as well as cases of prostitution of refugee women, including underage girls. The report mentions a specific area within a refugee camp where MSF staff were seen soliciting young girls. Because of this situation, community leaders had imposed a curfew for young girls in order to prevent them from “visiting” MSF staff. In one of the incidents described in the report, seven refugee girls, who were allegedly employed as daily laborers, were put in an MSF vehicle and informed that they would be taken to water distribution points and a construction site. However, according to the report, the girls were taken to another location, where they were subjected to sexual abuse and demands for sexual intercourse.
In addition, the investigation revealed that several Chadian employees of the organization had been threatened with losing their jobs if they refused to have sexual relations with their supervisors or colleagues.
During focus group discussions organized by the investigators, many women stated that they often chose to remain silent because they feared that reporting cases could jeopardize their access to care and assistance. Some of them said that they did not know that they had the right to raise concerns or submit complaints and comments. MSF staff and local community leaders told investigators that they were afraid to report cases of abuse, as they feared they might lose their jobs or humanitarian assistance. The report notes that about half a dozen community leaders admitted that, even though their daughters or sisters had been victims of abuse, they had chosen not to report the cases to the organization.
The report also notes that some people who had decided to speak out and report abuse had not received the necessary help, as some of their complaints had not received any follow-up or further treatment.
The internal memo notes that some of the mechanisms set up to receive complaints, such as boxes where people could file complaints, were largely ineffective and failed to function as intended. MSF employs tens of thousands of people in dozens of countries around the world. Its staff includes doctors, nurses, midwives, epidemiologists, human resources specialists, logistics experts, construction professionals and hygiene and sanitation specialists. The report does not specify what job titles the people accused of abuse held. In its response to the Associated Press, the organization stated that it would not release details such as the employment category of the suspects due to privacy and security concerns. In its communication to the Associated Press, MSF emphasized that it has now implemented more advanced and secure reporting methods, as well as integrated more effective measures to prevent and detect cases of abuse into its operations.
As an example, the organization cited the inclusion of confidential reporting channels in its current response to the Ebola outbreak in the Democratic Republic of Congo.
MSF WAS NOT AWARE
The report notes that in 2023, MSF organized several weeks of training for local community workers and leaders on the prevention of sexual abuse and exploitation. However, these efforts failed to have a lasting impact and were undermined by high staff turnover, which meant that the knowledge and measures put in place were not implemented in a sustainable manner.
The internal memo states that the urgent need for staff and the lack of verification of candidates’ references had led to the hiring of individuals who may have had a previous history of inappropriate or abusive behavior. As a result of the investigation, the report states that 18 employees – including international staff, local staff and contractors – had been classified or were expected to be classified on the “Do Not Hire” list, meaning that they would no longer be employed by the organization. However, the report highlights a serious problem: there was no centralized system for sharing information on people included on this list, especially for local employees. As a result, some of them could find work in another MSF mission or office without being identified as excluded. The report presents a series of recommendations to prevent similar cases in the future. These include clearer communication of standards and expected behaviors for all employees, conducting serious and detailed background checks on employment candidates, and creating a single and effective database of individuals classified as “Do Not Hire.”
However, the report acknowledges that the organization has faced similar allegations before. Notably, the 2021 Ebola outbreak in the Democratic Republic of Congo, as well as reports of widespread exploitation and abuse by humanitarian workers and peacekeepers in several West African countries in 2002, are mentioned. Despite these previous experiences and warnings, the report notes that the changes made have not led to significant improvements overall. “As a reminder, a very similar analysis and recommendations were made in 2021,” the memo says. “However, this did not lead to any significant change.” (Associated Press)