MSF support to the populations of Bangassou and Ndu

Central African Republic

Thousands of people have been killed or wounded and millions displaced during years of bloody – but largely neglected – conflict in the Central African Republic.

MSF sees the direct consequences of violence on the health of the individuals and entire communities we serve. Wounded people needing care. Children unable to reach medical facilities during malaria season. The interruption of vaccination coverage and treatment for HIV and tuberculosis (TB). Women left without assistance before, during and after giving birth.

 

 

Our activities in 2021 in Central African Republic

Data and information from the International Activity Report 2021.

MSF in Central African Republic in 2021 In 2021, the Central African Republic (CAR) was plagued by continuous violence, forcing hundreds of thousands of people to flee their homes and gravely affecting the provision of humanitarian support.
media:orange_logic_image:bd33f38f-7f31-43e7-b19c-0f5306146c50

Around 1.5 million Central Africans were internally displaced or refugees in neighbouring countries, following the resurgence of the hostilities in the country, marking the highest number since the peak of the conflict in 2013-14. Widespread violence has placed increased pressure on the fragile healthcare system, making it even harder for people with chronic diseases or in need of specialised care to obtain treatment.

The year started with clashes between government forces and a coalition of armed opposition groups formed in December 2020, ahead of the elections that ratified Faustin-Archange Touadéra as president. Rapidly, violence swept over the country and continued throughout the year. Civilians were frequently caught in the middle; injured, forced from their homes and cut off from healthcare. In the context of a state-of-emergency already affecting the provision of care, the high level of insecurity and the increasing presence of foreign armed groups made it extremely difficult for Médecins Sans Frontières (MSF) and other humanitarian organisations to deliver assistance where it was needed, particularly in remote rural areas where the situation remained volatile.

While this overall situation affected our capacity to provide care, we continued to run 13 basic and specialist healthcare projects, focusing on maternal and child health, surgery, sexual violence, treatment for HIV and tuberculosis (TB), and responded to outbreaks of disease. We also ran various emergency responses and assisted people affected by conflict, treating a total of 390 war-wounded patients between mid-December 2020 and mid-March 2021.

In Bangassou, where we support the Regional University Hospital, more than 1,000 people arrived in search of shelter following attacks by armed groups in January. Another 10,000 fled across the Mbomou river into Ndu, in the Democratic Republic of Congo, where we increased our support to the local health centre and installed water purification systems.

In the same month, 8,000 people were displaced when the densely populated town of Bouar became the scene of intense fighting. MSF provided basic healthcare, as well as water and sanitation services, to people who had taken refuge in a cathedral and five makeshift displacement camps.

The warring parties did not spare medical or humanitarian workers. Our teams witnessed dozens of health facilities being ransacked, damaged and occupied, and patients subjected to violence, physical abuse, interrogation and arrest during armed incursions into hospitals. Community health workers in rural areas were also threatened and assaulted.

In early June, a camp hosting around 8,500 internally displaced people on the outskirts of Bambari was burned to the ground and an MSF malaria treatment point in the camp was destroyed. Days later, a patient’s carer was killed and three other people wounded when an MSF motorbike referral on its way to Batangafo came under attack.

The increasing presence of landmines and improvised explosive devices further hampered access to health facilities, for both staff and patients, in areas such as Bocaranga. In the last quarter of 2021, our emergency team ran an intervention there, assisting victims of sexual violence, administering vaccinations for measles, diphtheria, tetanus, polio, yellow fever or hepatitis B, to address the low coverage, and improving the provision of water and sanitation services.

SICA, MSF’s trauma surgery hospital in the capital, Bangui, frequently received patients referred from other provinces requiring emergency and longer-term surgical care, including physiotherapy and mental health support.

Community-based care
While most of MSF’s activities in CAR continue to be based in hospitals, in recent years we have scaled up our community-based projects. In 2021, we continued to train volunteer health workers to diagnose and treat people for some of the most prevalent diseases, such as malaria and diarrhoea, in their own communities. These workers receive medicines, as well as financial and technical support, from MSF. In Kabo and Batangafo, our teams supported this network to carry out early detection and treatment for malaria at designated treatment points.

We also implemented a community-based model of care for patients requiring longer-term treatment, such as antiretroviral (ARV) medication for HIV. In places like Carnot, Bossangoa, Boguila, Bambari and Zémio, members of community patient groups take it in turns to pick up each other’s drugs, thereby providing peer support and helping each other to adhere to treatment. As CAR has the highest rate of HIV in West and Central Africa, and extremely limited access to ARV treatment, this initiative represents a lifeline to many people.

Reducing maternal deaths and treating victims of sexual violence
Family planning and maternal and obstetric care is another of MSF’s priorities in CAR. The country has one of the highest maternal mortality rates in the world, and outside of MSF supported facilities, few women have access to free, quality care during pregnancy and childbirth. While maintaining our maternal care services in Bangui, we worked all year long on the rehabilitation of the emergency obstetric and newborn care units of one of the capital’s main public health facilities.    

Sexual violence is a major health issue in CAR. While a substantial number of sexual assaults are linked to armed conflict, many are perpetrated within the community. Almost all of MSF’s projects in the country, including those in Bambari, Batangafo, Bangassou, Bossangoa, Bria, Carnot and Kabo, have incorporated treatment and mental health support for survivors of sexual violence into their medical services. Through our Tongolo project in Bangui, we offer a holistic programme of medical and psychological care for sexual violence that is accessible and inclusive, with specific adaptations for men, children and adolescents.

 

in 2021
 
Mobile clinic in Southern Madagascar
Central African Republic

MSF condemns the killing of our colleague in Central African Republic

Statement 31 May 2022
 
EMERGENCY INTERVENTION IN IPPY
Central African Republic

Violence and displacement in Ippy mirror people’s daily reality in CAR

Project Update 23 May 2022
 
CAR: Conflict hits the countryside
Central African Republic

MSF forced to reduce medical activities in Kabo

Press Release 17 Feb 2022
 
The journey of a wounded woman at MSF'SICA hospital in Bangui
Central African Republic

A visual journey through a year of renewed violence in an old conflict

Project Update 17 Dec 2021
 
Friend of Sallet Abdoulay, 17
Photo Story

As cycle of violence in CAR continues, people struggle to find support

11 Oct 2021
Photo Story
 
CAR: Conflict hits the countryside
Central African Republic

Renewed conflict has displaced hundreds of thousands of people in Central African Republic

Project Update 20 Aug 2021
 
The journey of a wounded woman at MSF'SICA hospital in Bangui
Central African Republic

Repeated attacks on medical care leave people vulnerable to disease and death

Press Release 19 Jul 2021
 
Central African Republic: Thousands displaced after attack on makeshift camp in Bambari
Central African Republic

People in Bambari living in deplorable conditions following camp destruction

Project Update 17 Jun 2021
 
République Centrafricaine / Central African Republic
Sexual violence

Healing the visible and invisible wounds of sexual violence in CAR

Project Update 13 Apr 2021

find us online

Up Next
1 December 2020