News from Bardai.

There have been growing tensions in the Tibesti between the Chadian government and the “Self-defence militia” of a village, Miski, about a day's drive (125 miles) from Bardai. Following battles in 2018 and a subsequent stand-off, the village and surrounding area has been without the presence of any government appointed administration or forces of law and order.

The militia have continued to exploit the rich goldfields even levying their own traditional taxes on non Teda miners. We previously mentioned a peace agreement that was signed in April, and by August the government wanted to establish a planned presence in the town and potentially have outside companies come in to improve on the rudimentary and dangerous mining methods and the exploitation of migrant workers: the local militia threatened armed resistance. A significant army column was mobilised to the north of Chad and thankfully a new agreement was reached without any combat. Local government is now present, as are the military and the ministry of mines, along with promises of improved local infrastructure schools, healthcare and jobs.

At the same time a Chadian mining company based across the road from us in N'Djamena, is starting work with the government on rich antimony deposits, this time near a town, Aouzou, north of Bardai.

Antimony is a heavy metal that has been known since antiquity, the ancient Egyptians used a black powder of crushed stibnite (antimony sulphide) as eye make-up and it was also used medically by Greek physicians to induce vomiting and purging. Its use continued through to comparatively modern times as a treatment for intestinal worms and syphilis, both thankfully superseded by much more effective and less toxic medicines.

Recently antimony has been in the news as it is a critical raw material, similar in importance to the rare earths. China has the largest world deposits of stibnite which is used in matches, fireworks and percussion caps for firearms, and exports the refined metal which is used in small quantities to make specialist alloys (for bullets and other uses) semiconductors for electronics and computers. The price of the ore has trebled in the past 4 years. So, it is not surprising that the Chadian government wants to exploit the rich deposits. Progress always comes at a price but we hope that all this mining both for gold and other minerals won't engender further conflict with the local population, that the benefits will be distributed equitably, locally and throughout the whole of Chad, that the environment will be respected and not simply despoiled and finally that the conditions of those working in the mines will be improved. A long list.

Paradoxically, at the same time, we have a shortage of the antimony-based drug, sodium stibogluconate, at the hospital in Bardai. We have been using it to treat the parasitic disease leishmaniasis since 2019. Such toxic drugs have been used to treat Leishmaniasis since the causative agent was discovered in the early 20th century. A delicate balance has to be struck, as the heavy metal injected daily over 30 days is a blunt instrument that is toxic both to the parasite and humans and can cause liver, kidney and heart damage and sometimes sudden death. As the risk of dying with visceral leishmaniasis is 99%, the risk of the drug is deemed acceptable. Thankfully the Ministry of Health and WHO have supplied us with a shorter more effective regime, sodium stibogluconate in combination with an antibiotic paramomycin which is used for a mere 17 days.

Last year about 80 patients were treated in Bardai and about 150 in the National Reference Teaching hospital .In Bardai it is often children who are treated, in the capital the cases are usually gold miners who caught the disease in the Tibesti and decided to go south towards their home. This year the promised drugs have not arrived. Since March we have been asking questions of the National co-ordinator and trying to contact the WHO offices to find out where the problem lies. Is it due to lack of funding due to the complete cuts in WHO budgets by the USA, and lesser cuts by the UK and others? We spoke with the Minister of Health about it in July and at his suggestion we asked the development arm of the British embassy about funding but they were unable to help. Now, Dr Abdelkerim in Bardai has only enough to treat a few cases with supplies left over from last year. The generic drugs which cost about £60 per adult patient are supplied free of charge. In the capital and elsewhere there are no drugs, but a similar branded drug can be bought privately and costs around £600-£1000 per adult patient, way out of reach of most Chadians. This week we contacted the Minister again, (he gave us his WhatsApp number in case we needed his help!) We did get a very friendly reply, and he suggested a meeting but it looks like that will be when we are next in N'Djamena.

In the meantime, we have approached a specialist generic medicines importer for aid supplies that has an office in N'djamena. If we get a suitable response, we can send it to the minister. On my way back home, I called in at the two biggest pharmacies by the National Reference Teaching hospital, to assess the private supplies for rich people, they too have none in stock.

Please pray for

Peace and justice in the exploitation of the mineral resources of the Tibesti.

That supplies of leishmaniasis drugs can be found to save the lives of about 250 patients over the coming year.

Our personal news is that we leave for the UK on Wednesday 29th October for 3 months with home assignment visits, holidays and treatment for Mark's heart. We look forward to meeting with you either in person or in one of two online meetings.

With love Mark and Andrea

Program of visits:

Sun 9/11/25 morning Lydbrook BC

Sun 16/11/25 morning Acomb BC

Mon 17/11/25 evening Hyde BC

Tues 18/11/25 12:30 -13:30 BMS Online

Wed 19/11/25 14:30 All Saints Macclesfield

Sun 23/11/25 Eastwood, Notts.

Mon 24/11/25 morning Moortown BC

Tues 25/11/25 evening Dewsbury BC

Sat 29/11/25 morning Galashiels BC

Sun 30/11/25 morning Stockton BC

Mon 1/12/25 evening online High Wycombe

Thus 4/12/25 20:00- 21:00 BMS Online

Sun 7/12/25 morning Wakefield BC