ABU SHOUK CAMP, Sudan - With her health options limited, one woman in this Darfur refugee camp is considering a risky alternative: a traditional healer who promises his potion of holy water, charcoal, and glue, touched by verses of the Quran, can cure her uterus inflammation.
It's not a choice 22-year-old Mastoura Hussein would have considered before the Sudanese government threw out some of the biggest aid groups working in war-torn Darfur. The order forced the departure of the doctors she had been seeing at a specialized women's-health clinic.
The expulsion has raised fears of a humanitarian crisis across Darfur, where several million rely on agencies for food, health care and shelter.
Aid workers warn that the greatest impact will be on women and children, who make up more than 60 percent of the 2.7 million people driven from their homes in the six-year-old war. Health facilities focused on women and children have been gouged, and workers fear women will resort to so-called baladi methods, a mixture of traditional herbs and magic.
They also fear they will be less able to deal with sexual assaults against women in a conflict where observers say rape has been used as a weapon, particularly by Arab militias allied with the government.
Hussein has had an inflammation for years, but only recently started to get it treated at the women's health clinic. Those doctors have been thrown out, so the mother of two has turned to a general clinic set up by an Egyptian military team, but she's not sure whether it will have the medications she needs. And with fewer health facilities in Abu Shouk camp after the expulsion, there are longer lines at the remaining ones.
Waiting in line for five hours one recent day, Hussein mused about her other option.
"We will all have to go back to baladi healing," she told a woman next to her in line. That woman had been trying for a week to get treatment for her 9-year-old son's diarrhea because the camp's remaining clinics can't cope with all of those in need.
Health efforts in Darfur have long focused on women, since they are usually the primary providers and caregivers of the family in refugee camps. Aid workers say they had made modest gains in health benchmarks for women and children in recent years. Now they fear those will be reversed.
The expulsion of 13 international and three Sudanese aid agencies from Darfur in March interrupted nutritional programs for malnourished children and pregnant and nursing mothers and shut down many programs to train midwives, promote hygiene, and help women suffering from violence.
It has also removed many of the experts who were dealing with and tracking sexual assaults. Getting women to report attacks has always been difficult. With trusted experts now gone, it gets even harder, U.N. officials say. Women may also be less likely to report attacks to government aid agencies, which are taking a larger role in treating refugees.
"We may not have information" on violence, one U.N. official said, speaking on condition of anonymity because of the sensitivity of the issue. Even non-governmental Sudanese aid groups "won't be free to report" harassment or sexual violence for fear of government reprisals, the official said.
The issue is a highly contentious one for the government, which denies systematic rape or violence against women ever took place. If supplies like water in the camp diminish, women may have to leave the camps more often, exposing them to attacks, aid workers fear. Rapes often occur when women venture out to fetch water or firewood.
Zahra Abdel-Rahman, a women's leader in Abu Shouk camp, fears an increase in attacks, even inside Abu Shouk. "When the aid groups are gone, violence comes inside our camp," she said. Abdel-Rahman said she had recorded five cases of violence against women in the last month.
A peacekeeper, speaking on condition of anonymity because she was not allowed to speak to the media, said she had heard of three cases recently but had not been able to verify them.