The organisation employs tens of thousands of workers, local and foreign, to respond to crises across several countries.

An internal report by the aid group Doctors Without Borders, known by its French initials MSF, has found that local and foreign staff exploited refugees in Chad, sometimes targeting underage girls and other times trading food aid and jobs for sex.

The report was completed last July but was first reported on by The Associated Press news agency on Saturday.

The organisation acknowledged 59 allegations of abuse, although it said there were likely more as survivors were reluctant to speak out. As a result, 18 local and foreign staff members were dismissed and barred from future employment.

The internal investigation followed an AP investigation published in November 2024, which revealed that Sudanese women seeking refuge in Chad were being offered jobs and assistance in exchange for sex by aid workers and local security forces.

Hundreds of thousands of Sudanese have been displaced into eastern Chad amid a devastating civil war in its fourth year. Thousands have been killed in the conflict.

In refugee camps in Chad, MSF is one of the biggest organisations responding to the crisis. The organisation noted in the internal report that it had allocated extra resources in Chad to prevent and fight abuse, including training staff, but said those measures did not have a lasting impact.

‘Candid analysis’

MSF told the AP its findings were “a candid internal analysis” of where its systems had failed.

The 59 allegations of misconduct ranged from sexual harassment to exploitation and abuse and “represent a serious breach of MSF’s values and responsibilities, and we deeply regret the harm caused”, it said.

MSF said it began the investigation in 2024 and found that Sudanese refugees, as well as a number of Chadian MSF staff, were exploited and abused.

The organisation said it found cases where female refugees, including underage girls, were prostituted.

In one case, seven refugee girls, allegedly hired as daily workers, were put into an MSF vehicle and told they were going to water distribution and construction sites. However, the girls were taken to a different location and “exposed to” sexual abuse and requests for sex, according to the report.

During investigations, some survivors chose to remain silent because they feared jeopardising access to aid. Those who spoke up did not receive help afterwards in some cases, the report found.

MSF, which employs tens of thousands across dozens of countries, said in the report that it could not trace every person involved because of the scale of the refugee crisis and movement of people.

The organisation said it was improving its abuse prevention and detection methods, including through confidential reporting channels.

Similar allegations had been raised in the past, MSF said, including during the 2021 Ebola outbreak in the Democratic Republic of the Congo.