A team of motorcyclists prepares to refer patients from rural areas. CAR, 2023. © Max Landry Kassaï/MSF
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Central African Republic: Spike in attacks against staff and patients in Batangafo threaten continuation of healthcare

Humanitarian workers, patients and their caretakers are suffering unbearable levels of violence perpetrated by local armed groups while moving around the town of Batangafo, in northern Central African Republic (CAR), says Doctors Without Borders/Médecins Sans Frontières (MSF). Two grave incidents in the space of less than a week are jeopardising our ability to continue providing healthcare in the area. MSF urges armed groups to respect and protect patients and staff.

So far in 2023, MSF teams have suffered at least 16 incidents in Batangafo, generally on the town’s outskirts. The latest attacks occurred on Aug. 26 and 30. The assaults consist mostly of violent robberies. They are perpetrated by groups of armed men who attack motorbike riders who transport patients, community health workers who provide care in rural areas, or convoys of vehicles with staff on their way to outreach activities.

Moreover, on two occasions in March and August this year, attacks entailed sexual violence against an MSF worker and caretakers of patients.

“We are outraged by any violence committed against patients, their caretakers, our staff and referral motorbike riders while they move as being clearly identified as belonging to a humanitarian organisation,” says Gisa Kohler, manager of operations for the Central African Republic. “Our teams are robbed relentlessly at gun point, and the evasive responses provided by local armed groups, who always attribute the actions to uncontrolled elements to avoid any responsibility, are unacceptable.”

The incidents suffered by MSF staff and patients near Batangafo have involved a range of armed groups.

A woman and her baby are transported by MSF motorcycle back to their village after treatment. Car, 2023. © Max Landry Kassaï/MSF

“While the conflict in CAR may not be in the spotlight, violence against the local people is happening here all the time. They are the first ones to be impacted by it,” says Kohler. “The repeated attacks affecting MSF endanger the continuation of our medical activities in the periphery of Batangafo. If we were forced to leave, this would severely limit access to healthcare for people in rural areas.”

Following those incidents, MSF is temporarily suspending movements to supported health centers on the outskirts of Batangafo, and the referral of patients living in areas between Batangafo and Ouogo, where one of the latest incidents occurred.

“We are committed to stay here to save lives in an area that is quite neglected, but we can’t do it at any cost, by putting our patients and staff at risk,” Kohler continues. “We call on all armed groups to respect and protect healthcare staff, humanitarian workers, patients and their caretakers.”

Last year, MSF was forced to close our project in Kabo, in northern CAR, after 16 years, following an attack on a convoy in January 2022. We closed the project due to the inability to ensure safe movement for our teams in this volatile area of the country.

MSF has been present in Batangafo since 2006. Our teams are currently running a hospital, supporting a network of community health workers trained to treat malaria and moderate cases of diarrhea, and supporting two health centers on the town’s outskirts with regular visits. Between January and July 2023, we provided nearly 115,000 medical consultations and referred more than 2,000 patients in need of more sophisticated care from rural areas to the town hospital.