Doctors Without Borders has documented a pattern of sexual abuse and exploitation by staff members working in refugee camps along Chad's border with Sudan, according to an internal report obtained by The Associated Press. The investigation found 59 allegations of misconduct, resulting in 18 staff dismissals and lifetime employment bans.

The organization launched the monthslong investigation in response to AP reporting that documented women's accusations of sexual exploitation in displacement sites housing hundreds of thousands of refugees fleeing Sudan's ongoing civil war. The internal memo, completed in July, credited AP reporting as playing a "fundamental role as an external whistleblower."

The documented abuse included sexual exploitation of female refugees in exchange for food, water, and jobs, as well as cases involving underage girls. In one incident, seven refugee girls hired as daily workers were reportedly taken to a location where they were subjected to sexual abuse. The report also found cases where female Chadian staff were threatened with job loss if they refused sexual demands from supervisors.

Investigators found that many victims remained silent due to fears of losing access to humanitarian assistance or employment. Community leaders told investigators that even when their own family members were victims, they chose not to report incidents to avoid jeopardizing aid access. The organization noted that existing complaint mechanisms, including feedback boxes, proved largely ineffective.

The report revealed that Doctors Without Borders was unaware of most abuse cases before the AP investigation. Despite conducting prevention training in 2023, efforts were undermined by high staff turnover and the absence of reference checks during urgent hiring. The organization acknowledged experiencing similar allegations during the 2021 Ebola outbreak in Congo, noting that a "rather similar diagnosis and recommendations were made in 2021" with "no significant change."

Doctors Without Borders, one of the largest employers in eastern Chad's refugee camps, said it has since strengthened recruitment processes, reference checks, and complaint systems. The organization called the findings "a serious breach of MSF's values and responsibilities" while acknowledging that significant work remains to ensure lasting change in preventing sexual exploitation in humanitarian settings.