Central African Republic - No place like home?

CAR Crisis

The Central African Republic is slipping deeper into crisis. With almost half the population of 4.6 million people in need of emergency aid, and with no functioning government in CAR, people are living in fear in the bush without food, hygiene, shelter or healthcare.

Violence in the capital, Bangui, has been raging since the 5th of December 2013 and security is proving to be a challenge for our teams. Despite this, MSF has treated 2,340 wounded people and provided 21,630 general consultations in Bangui since then.   

As well as our emergency response in the capital, we have three other emergency interventions in Bossangoa, Bouca, and Bria, and seven regular projects running in Batangafo, Boguila, Carnot, Kabo, Ndéle, Paoua and Zémio. New projects are also expected to open soon in Bangassou, Ouango and Berbérati.

Despite the security situation, the United Nations and other NGOs should not use the ongoing violence as an excuse not to act and help the millions of people in need of assistance. MSF is calling on all other groups to scale up their response.

Latest UN figures for CAR, as of 6th January 2014

  • 935,000 internally displaced people
  • 512,000 internally displaced people in Bangui (a 40 percent increase from 24th to 31st December)
  • Around 245,000 people have fled CAR: 98,500 in Cameroon, 80,300 in Chad, 56,000 in DR Congo and 11,000 in Congo

CAR Crisis: Latest news from MSF

Our work

Background: 2012

This is an extract from our latest Activity Report, looking back on our work in the previous year.

Conflict across large areas of the Central African Republic at the end of 2012 increased health needs and further destabilised the fragile health system.

A military campaign by an alliance of rebel forces, Séléka, took a number of major towns and territory in eastern and central regions. By early 2013, Séléka forces had reached the gates of the capital Bangui.

Thousands of people fled into the bush, and hospitals and health posts were abandoned. Médecins Sans Frontières/Doctors Without Borders (MSF) teams, already working in five regions across the country, continued activities and launched extra mobile clinics to attend to the medical needs of the displaced.

An emergency surgical team began work in Kaga-Bandoro, and donations were made to hospitals and clinics in locations affected by violence.

Urgent health crisis

The conflict only exacerbated medical needs, which were already huge even in stable areas of the country. The health system suffers from a lack of qualified staff and there are few public facilities outside the capital.

Shortages of essential medicines are frequent and many people cannot afford to pay the fees required for treatment. In short, a large proportion of the population does not have access even to the most basic healthcare, and mortality rates are above emergency levels.

MSF teams work with the Ministry of Health in seven hospitals and more than 30 health posts, providing a wide range of services: basic and specialist healthcare, maternity and paediatric services, surgery, HIV and TB care, and treatment for neglected diseases, including sleeping sickness (human African trypanosomiasis).

Malaria is one of the main causes of death in the country, and is a major priority for MSF programmes. The goal is to boost prevention and offer communities diagnosis and treatment in more locations.

  • In the report State of Silent Crisis, published in 2011, Médecins Sans Frontières/Doctors Without Borders (MSF) called for greater medical assistance in the Central African Republic.
An MSF nurse makes her morning rounds, checking on patients at Zémio hospital.

An MSF nurse makes her morning rounds, checking on patients at Zémio hospital. © Sarah Elliott/MSF

Testing new tools for sleeping sickness

The Central African Republic is one of the few countries where sleeping sickness remains a problem. Sleeping sickness attacks the central nervous system and is deadly if untreated, but both diagnosis and treatment are complex and difficult to administer.

In Batangafo, MSF is using a new rapid diagnostic test for the disease and participating in clinical trials of a new oral treatment for last-stage sleeping sickness developed by the not-for-profit research and development organisation, the Drugs for Neglected Diseases initiative (DNDi).

The mobile sleeping sickness team screened more than 4,500 people for the disease in the southeast of the country. Access to the region has been difficult for some years due to attacks by the Lord’s Resistance Army, but in 2012 many displaced people left Zémio, returning to their home villages to start farming again.

At the end of 2012, MSF had 1,300 staff in Central African Republic. MSF has worked in the country since 1996.

Patient story

Melissa is the mother of a seven-month-old girl who arrived at Batangafo hospital with malaria and anaemia, requiring a blood transfusion.

“I had to leave my other children with my family to come to the hospital. My baby had a fever for three days. When she started having convulsions I decided to search for help.

"After two days walking to the health centre in Boulam, they referred us to the hospital by motorbike taxi.”

After two days at the hospital, Melissa’s daughter’s condition had improved.

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