The oddest sight is all the camels, cows and goats. You expect people to only carry the clothes on their backs and a few belongings when fleeing attacks, but some refugees brought their cattle. And I guess you can understand it. This is their livelihood, currency, a means of trading. This is how their families will eat and their children will marry.

Camels © Ruby Siddiqui/MSF

Everyone has been moved out of KM18. The weather held and the remaining 800 refugees, newly arrived from the border at El Fuj were transferred to the transit camp (T3). Our medical team at K18 stayed until the last of the refugees had been transferred, dismantled the clinic and transported everything back to Jamam camp. And the Channel 4 team were there to film it. We have a lot of journalists passing through. And we understand that some of these crises would never reach the general public without their important work. But at the same time we do feel protective of our patients. I always feel the anger levels rise when some journalist pushes a camera lens into a refugee’s face, having no respect for that person’s privacy and dignity. So we are a bit naughty and accidentally on purpose block their shot. But we all loved the Channel 4 crew. They got it. They wanted to tell the story of these refugees with as much dignity and respect as possible. They seemed to care and we appreciated that.

It’s the end of a chapter in this acute emergency but certainly not the end of the crisis. These refugees that have endured bombings, violence, dehydration, exhaustion, malnutrition and illness and have lost family members in the bombings or have had to abandon family members during this arduous journey, too weak or sick to continue, must still make the final journey to Batil refugee camp.

And all agencies there, already overwhelmed by the needs of the existing refugees must ensure that a second emergency does not unfold at the camp where the water, food, shelter and medical needs of the refugees are not met and mortality rates increase.

This seems to have occurred at Jamam camp. Our mortality surveillance has revealed unacceptably high mortality rates, above the emergency thresholds. These are mainly due to diarrhoea (70%) so we need to ensure that the population has access to clean water (still below the recommended 15L per person per day), prioritises hygienic practices and has access to oral rehydration solution (ORS) before the diarrhoea becomes serious. MSF has therefore initiated decentralised ORS points throughout Jamam camp such that the population can access this life-saving treatment easily, our outreach teams have started educating the population in how to protect themselves from diarrhoeal diseases and our WatSan teams continue to work closely with OXFAM to increase the water supply to Jamam camp.

And we must be ready to reopen the clinic at KM18 at short notice. There are reports that another 15,000-20,000 refugees are expected to cross the border any day now, desperately trying to cross the border before the frontlines and the rain prevent further movement.

People in T3 camp © Ruby Siddiqui/MSF