Tens of thousands of Central African refugees living in parts of Cameroon face tough conditions ahead because funding for badly needed assistance is slow to come, said the UN’s most senior humanitarian officer for the Sahel.

Relief workers will soon be forced to scale back their interventions or even terminate second-priority operations, said Robert Piper, after touring refugees camps and talking with Cameroonian officials last week.

In addition, “refugees are adding to the difficulties of an already vulnerable host population,” said Cyprien Fabre of the European Commission’s humanitarian aid and civil protection office (ECHO).

There is a great risk that seven million Cameroonians in the north, where “an erratic climate, limited access to basic services and increasing insecurity” have created a separate humanitarian crisis will also suffer, Piper said.

On Friday, Piper called for help during a news conference, as the number of refugees and needs continue to rise beyond earlier projections.

UN humanitarian organisations working in Cameroon have jointly asked for $117 million to fund their operations, but only $22 million or 19% has come in so far. Pledges worth $11.7 million are still pending.

“What happens when we have insufficient funds is that we make some very bad trade-offs,” Piper said. This might involve abandoning important activities like education to focus on life-saving emergencies such as healthcare and nutrition, he said.

Humanitarian needs have been rising in Cameroon as a result of both internal and external factors.

More than 106,000 Central Africans have crossed the border into Cameroon this year alone as relentless violence in their country continues to force thousands to flee. With thousands still coming every month, the number of new arrivals could reach 180,000 by the close of the year, relief organisations forecast. The number since last year is already well over 215,000.

Some refugees have walked for months, hiding during the day and trekking at night. Often, they are severely malnourished, dehydrated, exhausted, sick and injured when they reach the border. Most are women and children.

“Refugees from CAR have lived through nightmare with few equivalents,” Piper said.

Meanwhile, in northern Cameroon “chronic health, nutrition and food issues are further compounded today by the influx of nearly 19,000 refugees fleeing violence in Nigeria,” the UN office for the coordination of humanitarian affairs said in a statement.

“Recurring droughts, floods and the ongoing cholera and measles epidemics are making people more vulnerable to food insecurity and malnutrition, especially young children and women,” said Najat Rochdi, the UN resident coordinator in Cameroon.

The UN estimates that 1.8 million people in all are at risk of food insecurity. Six million face epidemics while nearly 200,000 children already suffer from either severe acute malnutrition or milder forms. Some 10,000 people were affected by floods last year.

“The impact of reduced resources is very real. We have to keep food moving, we have to keep drugs ordered in order not to have a break in our work,” Piper told a news conference here on Friday.

“In the refugee camps, the impact is very direct. It’s reduction in the size of rations. It’s potentially a break in the distribution of rations, this is absolutely catastrophic when it happens. It’s potentially a reduction in the level of services provided in healthcare.”

More problems are expected as refugees continue to outnumber host communities in many areas along the border, putting additional strain on already fragile resources and infrastructure. There is now the fear that conflicts may arise as competition increases for grazing fields, water resources and few places in schools.