Central African Republic (CAR) faces a chronic and prolonged health emergency. The political crisis and violence that has shaken the country since 2013 has exacerbated the problem. The public health system is highly insufficient and almost half the population of 4.6 million people are in need of emergency aid. Many of them are in hiding in the bush, with no reliable access to food, sanitation, shelter or healthcare.

Already in poor condition before the conflict, most of the health facilities are now non- functional, with 72 per cent of public health facilities damaged or destroyed by the violence and looting. Those functioning suffer a shortage of skilled medical personnel, especially in the provinces.

One in five people in this country of 4.5 million was forced to leave their home in 2017 because of the violence. The United Nations' refugee agency (UNHCR) reported at the end of 2017 688,000 displaced people inside CAR, the highest number since the 2013 crisis.  And more than 540,000 are now refugees in neighbouring countries. 

“In the past year, we have treated patients who have been shot, stabbed, beaten, burned in their homes and raped,” says Frédéric Lai Manantsoa, MSF Head of Mission in CAR. “In 2017 we witnessed levels of violence against the civilian population in CAR that evoked the worst months of the conflict of 2013-14.”

Not only have MSF teams in CAR heard horrific stories from their patients, they have also personally experienced violence in all of MSF’s projects in CAR over the past year. In 2017, MSF suffered an average of three attacks per month against its medical facilities, vehicles and staff. These attacks, and the numerous other incidents against civilians and aid organizations in other locations, made CAR one of the world’s most dangerous countries for humanitarian workers in 2017.  

Central African Republic: Continued conflict is leaving people without options

What marked the violence in CAR during 2017 was its effect on people’s access to medical care, especially when they needed it most. This, combined with people’s reduced access to food, water, shelter and education, has brought the population to a state of extreme vulnerability.

Central African Republic: Downward Spiral of Violence

A Canadian coordinator pays tribute to local MSF staff in Central African Republic — and to one particularly exceptional colleague

Canadian project coordinator Will Plowright recently returned from MSF's medical project in the town of Bossangoa. In this article, he shares the story of one of his closest friends and colleagues in CAR, and highlights the crucial role that MSF's locally hired national staff — who make up more than 80 per cent of the organization's employees worldwide — play in our ability to deliver lifesaving care.. 

From the Doctors Without Borders/ Médecins Sans Frontières (MSF) International Activity Report