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.

With projects all over the country, Doctors Without Borders/Médecins Sans Frontières (MSF) is a first-hand witness to the increasingly worrying state of CAR. In past months, violence reached several locations where we are working. The heaviest toll of this conflict is being paid by the civilian population of the Central African Republic, with 570,000 refugees and almost 690,000 IDPs in a population of approximately 4.5 million. The humanitarian needs have grown alongside difficulties for aid organisations, including MSF, to reach people in need.

Central African Republic back in open conflict; civilians caught up in brutal fighting

The situation in the Central African Republic took a turn for the worse in early April 2018, when a military operation mounted by national and international security forces failed to disarm armed elements in the majority Muslim PK5 neighbourhood of Bangui, and quickly escalated to heavy fighting. Armed groups in the north of the country reacted by threatening to march on Bangui in order to protect their fellow Muslim citizens and prevent further killings.

Furthermore, on May 14, the town of Bambari (which had previously been lauded as an example of successful disarmament following an intervention by UN forces (MINUSCA) in February 2017) was turned into a battlefield—its streets deserted, houses burnt, and official buildings occupied.

These events bear a sad resemblance to the worst moments of the 2013-2014 crisis and have raised fears of further degradation in the security in the country. Hate speech is on the rise, as well as a generalized discontent with the government from opposition politicians, civil society, armed groups of the ex-Seleka coalition and Anti-balaka movements.

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