In eastern Tunisia, the road from Sfax to Jebeniana is lined with olive groves and makeshift camps. Thousands of migrants have been living there in dire poverty since the evacuation of downtown Sfax in the middle of 2023.

The camps have taken the names of the nearest kilometer stops: km 19, km 24, km 30… Without any assistance from the State, life is anarchic, without drinking water or sanitation and in an increasingly violent climate.

While access to food is difficult, access to drinking water is even more problematic. Migrants drink dirty water that is used to water the olive trees. Under these conditions, it only took a few weeks for the health situation in the camps to become a concern. After more than a year of living in these improvised camps, the migrants' situation has become dramatic.

According to the group Refugees in Libya, which records the mistreatment suffered by migrants in Libya and Tunisia, the olive groves where the camps are located are also used as a place for draining septic tanks.

'No more antibiotics, no more sterile bandages'

For months, the organization has been warning about the situation. In early September, David Yambio, the founder of Refugees in Libya, launched an online fundraiser to collect donations to provide medical equipment to the inhabitants of the camps.

"Migrants cannot move freely, they simply cannot go to a clinic or pharmacy to buy medicines, so medical volunteers rely on the kindness of locals to buy essential medicines, such as antibiotics, bandages and disinfectants such as iodine and alcohol," Yambio wrote on the fundraiser page.

"However, recently, the middleman disappeared with the money he was given, so now the camps have no more antibiotics, no more sterile band-aids, much less suture kits, it is difficult to close wounds and treat them, let alone prevent infections," he adds.

A stethoscope and a blood pressure monitor

However, the need for medical equipment continues to grow in the camps. Ibrahim comes from Sierra Leone where he was an anesthesiologist. As the only doctor in the area, he tries, with the help of five nurses, to treat as many as he can.

"The only two medical instruments I have are a stethoscope and a blood pressure monitor," Ibrahim tells InfoMigrants. Since January, he has been walking kilometers each day, from one camp to another, to try to see as many patients as possible.

This makeshift medical team is treating many people suffering from serious wounds caused by machete blows. "It happens very often that a person is injured [by a machete] in an ambush. Here, if you are a Black sub-Saharan, you cannot walk alone," says Ibrahim, who says he treats machete wounds "on any part of the body."

The photos taken by the doctor and sent to us show serious and deep injuries, some of which would require surgery.

'70 percent of the camp's inhabitants have a machete'

While machete injuries are often caused by Tunisians, clashes between communities in the camps also result in many injuries.

"About ten people in the camp were injured by machetes, stones or sticks," says Salif*, a young Guinean living in the km24 camp and contacted by InfoMigrants.

Ambushes on the road, attacks in the fields or in the camps... On the phone, the young man describes an untenable security situation where more and more migrants are arming themselves with a machete to defend themselves from a potential attack. So much so that today "70 percent of the camp's inhabitants own a machete," according to him.

Salif has tried three times to cross the Mediterranean to reach Europe, without success. "Every time we leave, about 15 people accompany us with machetes to protect us [...] The attackers want to take the place of the people on the boat or steal the engine," he explained, as a testimony to the growing insecurity.

To treat the most serious cases, the medical team has set up tents that serve as makeshift health centers in two of the camps. But the facilities are not sufficient and there is a lack of equipment to sew and bandage wounds.

Spread of serious diseases

Ibrahim is also concerned about the spread of serious diseases due to the poor living conditions in the camps. He claims to have met many people with symptoms of cholera, dysentery and typhoid, which are usually spread through contact with contaminated food or water. The doctor also says he has observed cases of syphilis, a sexually transmitted disease.

"Between last month and today, I have counted 568 sick people. And this number is only increasing since I cannot treat them properly," Ibrahim said. He stressed that his diagnosis is based only on the observation of his patients' symptoms. He does not have the equipment needed "to take samples and tests."

In the camps, many pregnant women need the help of the improvised medical team. These are high-risk pregnancies because these women do not receive any follow-up care and some of the pregnancies are the result of rape. Sometimes, women even have to give birth in the camps, despite the terrible hygiene conditions.

Migrants harassed and attacked

Since President Kaïs Saïed's xenophobic speech in February 2023, sub-Saharan migrants have been harassed and attacked in Tunisia. They are barred from renting apartments and working, so they must survive in these camps, without access to the basic needs of water, food and sanitation, or any care.

According to a study conducted in July by the Tunisian Forum for Economic and Social Rights among 379 migrants interviewed in three governorates (Tunis, Sfax and Medenine), "40.1 percent of migrants do not have access to drinking water and nearly 70 percent say they know migrants who are in need of food."

Faced with this misery, Ibrahim does his best to relieve the migrants in the olive grove camps, but the task is immense. "I am here to take care of these people but I cannot do it alone. It is really very difficult for me."

*The name has been changed to protect anonymity.