Cholera begins deadly rise in Sudan's camp of despair

Kalma is a place of despair. The refugees in this vast, sprawling city of makeshift tents had escaped from the murders, mutilations, burnings and rapes in the charnel house which is now Darfur. And the future threatens to hold nothing but more misery and fear.

Kalma is a place of despair. The refugees in this vast, sprawling city of makeshift tents had escaped from the murders, mutilations, burnings and rapes in the charnel house which is now Darfur. And the future threatens to hold nothing but more misery and fear.

No one is sure how many people have taken refuge here. The United Nations say it is 76,000, the Sudanese government claims 100,000, and aid agencies say 60,000. But all agree on one point; two weeks ago there were 26,000.

These dispossessed, huddled into the shelters of canvas and tattered patches of clothing, sticks and leaves, are joined daily by others fleeing the fighting and ethnic cleansing. The latest news yesterday afternoon was of 30,000 at Mahajaryah in the south, fleeing this way after an offensive by government troops and their allies, the Janjaweed Arab militia, against the rebel Sudan Liberation Army.

The new arrivals at Kalma and other camps spread around the region are fleeing into new danger. The Sudanese authorities have kept up relentless pressure to get them to return to their home, a journey which has led to many deaths in the hands of the waiting Janjaweed.

The government, it is claimed, is using a mixture of bribery and threats with village chieftains at Kalma in attempts to get them to lead their communities away. This has caused repeated outbreaks of violence in the camp, in the last of which one village chief was seriously injured and 42 people arrested. The refugees may be able to avoid the machetes and Kalashnikovs of the militia, but there is another disaster from which the chances of escaping appear to be slipping away.

Packed with humanity living in appalling squalor, the camps are feared to be the breeding grounds for cholera, typhoid and hepatitis. There is also a huge rise in malnutrition, especially among the young, caused partly by soaring numbers of diarrhoea cases and partly by a shortage of food. Many refugees say government agencies who help distribute international aid have deliberately cut rations.

The aid agencies have begun vaccinations after a cholera outbreak at Kalma. Similar programmes will begin for other diseases through the region. But the pressure is on time, and resources. The UN has launched an appeal for $350m (£190m) for relief work until the end of the year, but only $188m has been raised so far.

The rains are almost a month late, normally a source of great concern in this part of the world, but seen now as gaining a little extra time before further disaster. When the rains come, and that will be very soon, many of the camps will have fetid swamps of human and animal excrement spreading disease. The dirt roads used by relief convoys will turn into churning quagmires.

Kalma, in particular, will suffer. It is in effect in a bowl, and just a couple of days of heavy rain has already created a pond in the centre. The government uses this as a reason that the camp should be moved if the refugees do not return home.

The inmates say the alternative site chosen is on the land of the Razagat, the Arab tribe which is one of the principal suppliers of recruits for the Janjaweed, and, in any case, goes the common refrain in Kalma, by the time the scheme gets to fruition, most here will be dead.

Sajida Ali Hassan cries as she tells how desperately worried she is that her three-year-old daughter Zainab will be among those who will not make it. The girl is tiny, her brown eyes grown big on a face which is beautiful but painfully skeletal. She is suffering from acute diarrhoea, and now has the weight of someone half her age.

"I pray all the time that the medicine will be good and it will save her," Mrs Hassan said. "But she is not getting better. She does not want to eat anything, she no longer smiles. She was always laughing and playing in the past." Her voice fades as she cries.

The family had fled to Kalma from the Merawash region when the village was raided by the Janjaweed four months ago. Mrs Hassan's husband, Abbas, says: "My two brothers were killed, and I cannot even count how many other people I know who have died. But once we arrived here I thought we were safe. I did not expect this to happen to my daughter. I feel very sad."

Khatum Ali Mahmood, 24, from Yasin, is also waiting patiently outside the clinic, carrying her 11-month-old son, Abdul Riaz. "This started a week ago," she said. "He is vomiting all the time. I can see him losing weight, but I don't know what to do. The doctors are very good, but they say he is very weak and may not survive. I do not know why we are made to suffer like this. I would like to go home with my other children, but there is still fighting there, it is not safe."

As she speaks, refugees arrive from the village of Mirwais, 35 miles from the provincial capital Nayla in south Darfur. Yusuf Adem Ahmed describes how the village was attacked the night before. "Five months ago I carried out the body of my father when they first raided our village. We went back and this happened. It was Janjaweed, but there were government troops with them. They attacked with helicopters; the Janjaweed do not have helicopters."

He shrugged off the dangers of epidemics. "We die here, or we get shot outside. What is the difference?"

Pieter Smit, of Medicine Du Monde, said: "We have somehow to cope with all these diseases, and we have more and more people coming in. The system cannot take the pressure. The situation with the diseases cannot be more serious."

Adrian McIntyre, of Oxfam, added: "It is difficult to put across to the world the scale of what is going on here. We need much more resources. We are going to have huge problems, especially when the rains come. We are facing a crisis and the world must understand."