Médecins Sans Frontières (MSF), the international medical charity also known as Doctors Without Borders, has dismissed 18 employees following an internal investigation into the sexual abuse and exploitation of Sudanese refugees in eastern Chad. The organisation has acknowledged that at least 59 refugees were victims of misconduct by its staff, with offences including the exchange of food and employment for sex. In some cases, young girls were among those exploited.

The abuses took place in 2024, roughly a year after the outbreak of Sudan's civil war — a conflict that has since become widely recognised as the world's worst humanitarian crisis. More than 11 million people have been displaced and 28 million face acute hunger, with estimates of the death toll ranging from 150,000 to as many as 400,000. Hundreds of thousands of Sudanese have crossed into eastern Chad, a vast landlocked country in central Africa, seeking safety and humanitarian assistance — making them acutely dependent on the very aid workers accused of exploiting them.

MSF's own internal report, completed in July, found patterns of exploitation that the organisation itself said might amount to "sexual trafficking." Compounding the harm, many victims did not come forward because they feared that reporting abuse would result in their access to vital aid being cut off. Those who did report incidents frequently received no response or support, and official complaints procedures were found to be largely ineffective.

"This misconduct represents a serious breach of MSF's values and responsibilities, and we deeply regret the harm caused," the organisation said in a statement issued after the American news agency AP first reported the scandal. The dismissal of 18 staff members represents MSF's most visible disciplinary response to date, though questions remain about the adequacy of the accountability mechanisms that failed to catch the abuse earlier.

The revelations add to a broader pattern of sexual exploitation by humanitarian workers that has come to light across multiple countries and organisations in recent years, despite repeated institutional pledges to root out such abuses. For refugees already fleeing violence and deprivation, the exploitation of aid dependency represents a profound betrayal of the humanitarian mission — and underscores the urgent need for more robust and accessible reporting systems within the sector.