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Tanzania: "I could feel my heart pounding in my chest"
Just two months ago, Mpawenayo (pictured above) was back home in Burundi studying humanities. Now the 22-year-old is in Tanzania, living in an unsanitary and overcrowded refugee camp.
These conditions can cause many health problems, including: diarrhoea, respiratory tract infections, and skin conditions. Children, as well as expectant or new mothers, are often the most vulnerable to falling sick.
Malaria is one of the biggest risks in the camps, particularly during the rainy season, where stagnant water provides a breeding ground for mosquitoes.
In January 2017 alone, Médecins Sans Frontières/Doctors Without Borders (MSF) tested over 31,200 people for malaria, treating the 16,812 found to have the disease.
Mpawenayo is heavily pregnant and has contracted severe malaria; putting her at high risk of losing her unborn baby.
"If my baby dies, I'll feel that it's my fault," she says. "Sitting here, I'm worried about the future. Each day in [the camp] feels like a week.
And with each week that passes, my old life seems further and further away."
According to the UNHCR, nearly 19,000 refugees have settled into camps in Tanzania's north-western Kigoma district: bringing the total number up to over 290,000.
The following stories are from MSF patients in Nduta and Nyarugusu camps, who describe their lives and the problems they face.
patient story: aisha
Aisha, 23, lives in Nduta camp with her husband and two children. She recently gave birth to her third child at the camp's MSF-run maternity hospital. Due to complications during labour, Aisha's baby is being kept in the hospital for ongoing care and observation.
I'm so happy about the birth of my son but I'm also concerned about his future.
He was born after foetal distress. He can't breathe properly, he hasn't been moving, and he still hasn't cried or made any of the noises that babies normally make. He's also unable to feed naturally so he's eating via a tube.
He is only five days old but he has already seen so much suffering. I know that he has a life of hardship ahead of him – what hope is there for a child born in a refugee camp?
"I used to have so many dreams, but now I try to block them from my mind - there's no opportunities for me to plan a future or develop myself anymore."
When I think of the future, I feel sad. I have no money or way to provide for my baby and two older children. I've been in the camp for 10 months now but food is still a problem – I don't have the ingredients I need to make proper meals, and we normally run out of supplies long before we're given our next ration.
I used to have so many dreams, but now I try to block them from my mind - there's no opportunities for me to plan a future or develop myself anymore. I feel trapped here and wish I could find a peaceful place to escape to, but I don't have any other options.
When I remember what happened to me back home, I know it`s better to stay in Nduta. I will never, ever go back to my country. Instead, I just have to try to find a way to keep going here.
paTIent story: ramadhani
Ramadhani, 26, has just been diagnosed with malaria at one of the three health posts MSF runs at Nyarugusu camp. He is one of the 6,802 people MSF treated for malaria in January 2017 in Nyarugusu.
I've been sick since yesterday evening. I have a headache and nausea and feel very cold. I can't stop shivering and shaking.
I came to the MSF clinic and the doctor tested my blood. He told me I have malaria.
I'm waiting to receive some medicine that will help me get better. I have a mosquito net in my tent, and although I use it, I still got sick. I don`t know how I got ill.
"I can't and won't go back home – I will stay in this camp until I die."
I`ve been living here for six months with my wife and two children, who are aged four and five.
My wife is four months pregnant but has been having stomach pains, so she was taken to the camp hospital. She's there now and I'm waiting to hear how she is. I'm really worried about her and our baby.
I have spent most of my life as a refugee. I grew up in another camp in Tanzania after my parents and I were forced to flee our country. I'm still not used to the conditions though and life here is difficult.
Refugees never have a good life - it's a struggle to get enough food and water and living in a tent wears you down. But it's better than living in fear at home.
I can't and won't go back home – I will stay in this camp until I die.
paTIent story: theresa
Sixty-year-old Theresa lives in a one-room shack in Nyarugusu camp, which she shares with her son, his wife and their two-year-old son. She invited us in to see her mosquito net, which hangs from a roof fashioned from corrugated iron and plastic sheeting.
I've been living here for a year-and-a-half now. Life here is very hard – it's hard to get enough food and water, and the conditions we live in are very poor. It's dirty, there's dust everywhere and it's impossible to keep anything clean.
I've been ill a lot but one occasion was particularly bad – I had an awful headache, was feverish and I could feel my heart pounding fast in my chest. I remember being so weak and shaky that my legs could barely support me.
"Being ill made me realise how dangerous malaria is and now I'm scared of my family getting sick, especially my grandson."
My son helped me to go to the camp hospital and the doctor diagnosed me with malaria.
Being ill made me realise how dangerous malaria is and now I'm scared of my family getting sick, especially my grandson. I know that the disease is spread by mosquitos and so I try to protect him.
Until recently, this was difficult because the mosquito net we had was torn, with big holes that the mosquitos could get through easily. But about a month ago, MSF gave us a new net and now I sleep under it every night with my grandson.
I'm so pleased to have it and I hope everyone else in this camp gets one too, so that they are protected from getting sick.
MSF in Tanzania
We have been working in Tanzania since May 2015. Currently our teams are working in Nyarugusu and Nduta camps.
In Nyarugusu, we run a 40-bed stabilisation unit and three malaria clinics, and also provide mental health support.
In Nduta, we are the major medical provider, running a 120-bed hospital and five health posts, and provide mental health support.