EASTERN CHAD — Doctors Without Borders completed an internal report in July documenting 59 allegations of sexual exploitation and abuse by staff in displacement camps in eastern Chad. These allegations involved local and foreign staff, and the organization dismissed or disqualified 18 staff members from future employment, including international, local, and contract workers.

The organization launched the investigation into staff misconduct in the fall of 2024 after external reporting detailed sexual exploitation by aid workers. The internal memo stated that repeated patterns of exploitation suggested potentially organized sexual trafficking. Some allegations included targeting underage girls or exchanging food, water, milk, or jobs for sex with refugees. Investigators reported that seven refugee girls hired as daily workers were transported to an unlisted location and subjected to sexual abuse. Additionally, an internal investigation found that some female Chadian employees were threatened with termination if they refused sexual advances from supervisors or colleagues.

Investigators stated that some allegations could not be verified or perpetrators identified due to population movement and emergency conditions. The report noted that many survivors remained silent about abuse due to fears that reporting could jeopardize access to care. Community leaders in a refugee camp block implemented a curfew to prevent young girls from entering staff areas. The report also indicated that some existing feedback mechanisms, such as physical complaint boxes, were largely ineffective.

The organization stated that urgent hiring needs and insufficient reference checks led to the employment of individuals with prior misconduct histories. The organization acknowledged that the absence of a centralized database for flagged local staff could allow dismissed employees to secure positions elsewhere. The report noted that similar abuse allegations and recommendations were documented during a 2021 Ebola response in the Democratic Republic of the Congo.

The organization stated it has strengthened recruitment procedures, reference checks, and complaint systems since issuing the report. The organization stated, "The 59 allegations of misconduct ranged from sexual harassment to exploitation and abuse and represent a serious breach of MSF's values and responsibilities, and we deeply regret the harm caused."

No independent assessment of Doctors Without Borders’s claims was available.