Like many of its public institutions, the Chadian healthcare system is vastly underfunded, overcrowded, and spread unequally throughout the country. Due to the political instability that has affected the country for many years, the public healthcare system is almost nonexistent, and current estimates show that there are fewer than three physicians, 15 nurses, and two midwives per 100,000 people.
As a result, many expatriates living in Chad will travel to their home country, or nearby nations, for treatment. You are advised to stock up on prescriptions medicines before travelling. Some international facilities in the capital provide emergency service, and they expect an immediate cash payment.
Although Chad has a compulsory education system, it is estimated that only 68% of children attend school, whilst the illiteracy rate stands at 50%. Therefore, expatriates living in Chad will either send their children to an international school, or to school in their home country. Currently, Chad only has two international schools, both of which are located in N'Djamena, the American International School of N'Djamena (AISN) and the N'Djamena English International School (NEIS). Chad currently only has two universities, Université de N'Djamena and Université Roi Fayçal au Tchad.
As a developing country, Chad does not have a stable, well-managed transportation network. In N'Djamena, the capital, and other major cities, there will be paved roads, but the quality will deteriorate the further you move out of the city. In addition, rural areas will usually not have paved roads, so a 4X4 vehicle is recommended if you are travelling outside of the cities. However, expatriates living in Chad should be aware that, during the rainy season, even paved roads are often unusable due to flooding. Chad currently has no rail network, but in 2012 a network was planned that will have connections between three of the major cities, N'Djamena, Moundou, and Koutéré, and to nearby Central African nations like Sudan and Cameroon. In the cities, many people will use taxis instead of driving, as they are cheaper and often easier than navigating the roads.