June 08, 2017

“Will Bambari be next?” This is the question on everyone’s lips in this market town on the Ouaka River in Central African Republic (CAR). Its residents worry that the violence that has engulfed the cities of Bangassou and Bria since early May 2017 could spread here.

The river splits the city in two—one part is predominantly Christian, the other mainly Muslim. Bambari has been calm in recent months, with its ethnic and religious groups living relatively peacefully, side by side. In February, the United Nations Multidimensional Integrated Stabilization Mission in the Central African Republic (MINUSCA) declared Bambari a “city without arms,” strengthening the perception that it is a safe area for those fleeing violence elsewhere in the country.

Currently, about half of Bambari’s population is made up of those who were forced from their homes in other parts of CAR, with 10,300 people having arrived in the city since mid-March. Most of these recently displaced people live in nine camps that ring the city—improvised settlements without running water, electricity, or basic health services. Such living conditions breed disease and increase the risk of epidemics.

These displaced people, along with Bambari’s permanent residents, rely on the city’s hospital for medical care. The facility is supported by Doctors Without Borders/Médecins Sans Frontières (MSF), and an MSF team also supports two other health centers, one in the Christian part of the city and another in the Muslim area.

An Uneasy Calm

Nearby events have recently shaken Bambari’s calm. On May 8, a massacre took place in Alindao, a town 120 kilometers [about 75 miles] away, during which 133 people were killed and entire neighborhoods were burned to the ground. This triggered a resurgence of violence in Alindao and led to much of the town’s population leaving for Bambari.

MSF teams in Bambari treated 22 people for violence-related injuries in May, in contrast to just eight in April. Four children were among the wounded from Alindao treated by MSF, including a three-year-old who had been shot in the face. “He lost most of his lower lip due to a gunshot and has a severe infection,” says Nicole Hart, an MSF nurse and medical referent.

Most of those injured in Alindao had gunshot wounds, but some had knife injuries and burns. “I attended a man whose throat had been cut,” says Hart. “He had spent two days in the forest near Alindao before being brought to Bambari. The look on his face was full of panic. We operated [on] him and he is now slowly recovering.”

"People are Afraid"

Speaking from his hospital bed, Anga, the man treated for the throat slashing, describes the attack: “As I was lying on the ground, protecting myself from the shooting, a man approached me, lifted my head, and cut my throat with a knife,” he says. “I thought I had died, but it seems that a part of my throat was saved, and I continued breathing.”

“Another young girl had most of her body burned,” says Hart. “She was locked up with her family in her house, and they [armed groups] set the house on fire. Sadly, she passed away some days ago.”

With the influx of displaced people, MSF teams are also seeing increasing numbers of sick patients. “The health center in the Muslim part [of Bambari] is located next to a field where displaced Fulani people [a Muslim group] are living,” says MSF outreach nurse Andrea Blas. “Currently we are providing 120 consultations each morning. We are seeing a considerable increase in cases of malnutrition, diarrhea, and malaria.”

The number of people with severe acute malnutrition seen by MSF teams in Elevage Health Center, in the Muslim area of the city, increased from just three new cases in January to 17 in May, while patients with moderate malnutrition increased from 36 in January to 126 in May.

Bambari may be peaceful at present, but no one knows how long it will last. “After the incidents in Alindao, people are increasingly worried,” says MSF project coordinator Cédric Chapon. “Instability has already affected most of the major cities, with the exception of Bambari. But people are afraid. Even if it’s peaceful between the two communities at present, there’s the risk that any small criminal incident could be interpreted as an act of provocation, which could ignite a wave of violence between the communities in Bambari.”

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