17 Dec 13 17 Dec 13

CAR:10 days after violence breaks out in Bangui, MSF is still responding to emergencies

On 5th December 2013, several hundred people were killed during armed clashes that shook the city of Bangui, the capital of the Central African Republic (CAR). Médecins Sans Frontières/Doctors Without Borders (MSF) immediately began treating patients wounded in the fighting and has since been working to provide care to the large numbers of people who were forced from their homes by violence.

Ten days after the unrest began, the Office for the Coordination of Humanitarian Affairs (OCHA) estimates that 189,000 residents of Bangui – or one of every four people – have been displaced.

What follows is an overview of MSF’s activities in CAR.

Treating the wounded

On the morning of 5th December, MSF teams were working at the main city hospital, the Bangui Community Hospital, providing support to Ministry of Health personnel. We had rebuilt a surgical unit there the week before and prepositioned a team.

The early hours of the fighting were horrific, with an uninterrupted stream of patients arrived at the hospital. The corridors overflowed with patients; some had to be stabilised on the ground or on benches in the triage area.

Our teams in the hospital treated more than 100 patients, while other MSF staff members evaluated and referred wounded patients in several nearby neighbourhoods.
In the 10 days that followed, we treated 390 wounded people at the Community Hospital and performed more than 200 surgeries.

Tensions eased slightly, as armed men who had stationed themselves in front of the hospital left the scene and the flow of wounded people slowed. Seven tents were set up to add 100 beds to the initial hospital capacity.  
In the midst of the violence, on 7th December, we began working at the Castor Health Centre, which had been a labour and maternity unit before the crisis. Our teams provided support for prenatal activities, including prenatal visits and labour and delivery.

Mainly, though, we focused on developing surgical capacity, so we could treat larger numbers of wounded patients. To date, MSF staff working at Castor have treated 124 patients and performed approximately 20 operations.

Responding to the medical needs of the displaced

In addition to treating the wounded, our teams responded to the massive displacement of people terrorised by violence and looting. Working at three of the roughly 40 gathering sites in Bangui, our teams focused primarily on providing medical aid to children under five-years-old, pregnant women and the wounded.
Twenty thousand people are living in the Don Bosco camp. We have dug latrines, improved water supplies and held 548 medical consultations there.

At the Boye Rabe monastery, where 12,000 displaced people have gathered, the teams have helped to reorganise the health centre. More than 1,300 consultations have been held since 8th December (half of those for children under five-years-old).
However, the situation at the Mpoko camp, on the outskirts of Bangui airport, is the most dramatic today. More than 45,000 displaced people have gathered there in the mud, living under makeshift tarps and have not received any significant assistance.

We have been working there since 7th December, setting up a clinic where nearly 400 consultations are now held each day.

Living conditions worsening

Our teams are working in a makeshift operating room to carry out minor operations, treat less serious wounds and stabilise the most serious cases. Hundreds of wounded people have been treated. The most critical are referred to the two hospitals where MSF is working.

In a second room, three doctors see an endless stream of patients, primarily children under five-years-old. A third room is used for labour and delivery; to date, 32 children have been born in the clinic. Outside, patients are cared for in three tents, one of which serves as a maternity unit.
The many cases of malaria, respiratory infections and diarrhoeal illnesses illustrate the worsening living conditions inside the camp. The displaced people at the airport are trying to survive without adequate assistance.

They have been without latrines, food, shelter or mosquito nets for too long. Children under five-years-old, single mothers and pregnant women are paying the price of this neglect.

MSF in the Central African Republic

MSF has been working in the CAR since 1997 and is currently managing seven regular projects (in Batangafo, Boguila, Carnot, Kabo, Ndéle, Paoua and Zémio) and four emergency projects (in Bangui, Bossangoa, Bouca and Bria). A mobile emergency team covers the displaced persons’ camps in Bangui.

By the end of the year, MSF hopes to be able to launch activities in the hospitals in Bangassou and Ouango. We currently offer free medical care to approximately 400,000 people and provide approximately 800 hospital beds. We are working in seven hospitals, two health centers and 40 health posts. Our teams are composed of more than 100 expatriate health care workers and around 1,100 Central African Republic staff.

Find out more about MSF’s work in Central African Republic