by Rosemarie North in eastern Chad
Assan Yaya looks older than his 40 years. His hair is grey, his face lined. Formerly an engineer working for a government department in Sudan, he now lives in Bredjing refugee camp, home to some 29,500 people who have fled from conflict in the Sudanese province of Darfur.
Assan has more reason than most to feel miserable. Ten years ago he fell ill with a fever and a stomach ache. Afterwards, his joints started to stiffen up. Rheumatism, he says. Today he is nearly paralyzed. He can barely move his head. Someone has to lift his thin frame into a sitting position on his bed, which is a pad of blankets folded on the ground.
He shares a tent with his six-year-old daughter and his brother's family. "When my condition deteriorated, I let my wife go. She is married to another man now," says Assan in English.
In spite of his troubles, Assan's face lights up when he gets a visit from 12 fellow refugees being trained by the Red Cross to do home visits and care for people who are chronically ill, have a disability, are elderly or orphaned.
It will be their responsibility to visit extremely vulnerable people every day, and others a few times a week, in the Red Cross-managed camps of Bredjing and Tréguine, home to a total of 44,000 people. In return for about (CFA 25,000) USD50 a month, the social assistants will spend time with people and if necessary, cook for them, clean their homes and clothes, help them bathe and take them to medical care.
"I am very happy to see you. This is the first time that someone has come to me like this," says Assan, smiling, to International Federation social welfare delegate Annette Molle-Kouoh, who introduces him to his new caregiver, Zainab Malik
"The caregiver will come and see if there is something we can do for you and to take care of you," explains Annette. "We will ask if there is anything you need. The caregiver is at your disposal."
"Everyday she will come to you and ask if she can do anything for you. If you want to go to the hospital, she is there to arrange it. If you need something, just ask us."
The trainees, many of whom already make home visits to people in need, have just completed a short course given in the community centre of Bredjing camp by Annette, who encourages them to smile and liven up the days of the people they visit.
"There are some people who are alone and never talk to anyone. When you visit them, you have to talk to them because it might be the only chance they have," Annette tells her students, 11 women and one man.
"You can also bring other old people together to give them a chance to meet and talk. Or you can bring their grandchildren to them -- they love to have visitors."
Through an interpreter, a woman asks, "what if we don't know the person we are caring for? Do we have to be friendly?"
"Yes," says Annette. "It's your job, even if you don't know them."
Fatimé Adouma, a Red Cross social assistant from the town of Adré, has already started visiting especially vulnerable people.
"We want to help them. These women suffer without their husbands. Sometimes people get sick and die -- who will look after their children? We can give them food and clothes and other things they need."
In another part of Bredjing camp, Mariam Ahmat Idriss, 35, is bringing up five children on her own. Eleven months ago their village in Darfur was attacked. Mariam lost her husband, her brother, and her brother's two sons, aged 15 and 16. Now they are just scraping by, without any help from their neighbours.
The donkey that carried the family to safety in Chad died of starvation soon after the family arrived because there is almost nothing for animals to eat in the camp.
Sitting under a shelter at her home, her tidy vegetable patch nearby, Mariam tells her caregiver, Fatimé, that she is very keen to work to supplement the rations she is given.
"I would like to ask God to give us work for the future so I can stay with my children. I don't know what kind of work. In Sudan we had farms. Here, I don't know what kind of work I can do."
Although she herself is at risk, Mariam asks Fatimé if there might be another job like hers, helping people cope with their new circumstances in the camp. Fatimé promises to talk to her supervisor about Mariam's chances of joining the team.
The 68 trained social assistants will be extremely thinly stretched over a population of 29,500 at Bredjing camp and 14,500 at Tréguine camp 6km away.
A survey found that more than 1,000 households in Tréguine camp needed some help. Among them are 109 older people living alone, 30 people with chronic illnesses, 82 people with physical disabilities, 682 families headed by a sole parent, usually a woman, 79 children separated from their families, and 31 women living on their own.
The proportion of vulnerable households is similar at Bredjing camp, where there are twice as many people.
But Red Cross workers hope to train more social assistants to work in their own communities. And in future, Annette hopes that people who cannot cook for themselves and have no family will be able to eat hot meals prepared at a restaurant the Red Cross is building in Bredjing. It will be staffed by vulnerable refugees learning cooking and business skills.