An escalating insurgency and refugee influxes from conflicts in neighbouring countries have turned Chad into a humanitarian hotspot, with aid agencies struggling to help around half a million people.

• 320,000 refugees from Sudan and Central African Republic
• Armed attacks displace 180,000 Chadians
• Aid agencies face logistic and security nightmare

President Idriss Deby has health problems and is holding on to government by a thread, under regular attack from rebels with a range of regional ties who want to oust him.

Tens of thousands of Chadians are displaced by violence near the border with Sudan. And massive numbers of refugees from Sudan's Darfur region and Central African Republic lead a harsh existence in camps in eastern and southern Chad.

The presence of refugees has put added pressure on scarce water and food resources in the semi-desert east.

Armed Sudanese and Chadian groups roam freely across the border, targeting aid agencies as well as villagers. The insecurity makes it hard for agencies to operate in the area, and violence has escalated since the collapse of a short-lived October 2007 peace deal between the government and four rebel groups.

Some experts say Chad's conflict is part of a competition for regional dominance in which Central African Republic, Democratic Republic of Congo, Eritrea, Libya, Rwanda and Uganda are all vying for influence.

Refugees in Chad	56,000 refugees from Central African Republic, mostly in south 265,000 Sudanese refugees, most in eastern border camps (Source: U.N. Consolidated Appeal 2009)
Internally displaced in Chad	180,000 (Source: U.N. Consolidated Appeal 2009)
Average life expectancy	50.4 (Source: U.N. Development Programme, 2007/2008)
Children dying before the age of five	209 per 1,000 live births (UNICEF, 2009)
Doctors	4 per 100,000 people (Source: U.N. Development Programme, 2007/2008)
Children under five underweight for their age	37 percent (UNICEF, 2009)
Population with access to improved sanitation	9 percent (UNICEF, 2009)
Adult literacy rate	25.7 percent (Source: UNDP, 2007/2008)