May 27, 2014

 

Doctors Without Borders/Médecins Sans Frontières (MSF) operations coordinator Maria Simón has worked amidst the escalating conflict in Central African Republic (CAR) for over one year. Here, she describes her experience in Kabo, in the north of the country.

Tension in the Air

When I arrived in October, there had already been attacks from the anti-Balaka militia against the Séléka coalition, [which was] then in power. Tension and uncertainty about what was to come were in the air. Everything happening in Bangui, CAR’s capital, echoes across the country. In November, tension between Christians and Muslims rose, and in December conflict finally broke out. The change of government, the anti-Balaka offensive, and the withdrawal of the Séléka gave rise to very dangerous, unpredictable groups.

And, at the same time, we witnessed hundreds and hundreds of trucks full of Muslim people heading for exile towards Chad in search of shelter to save their lives. Terrible.

They were traveling in very difficult conditions, sitting on top of their belongings at the rear of the trucks, in the sun, sometimes injured, many pregnant women and also children. We have seen women and children with gunshot wounds on their arms and backs. The anti-Balaka’s weapons are not very sophisticated, so in many cases injuries were minor and people could be treated as outpatients. Gunshot injuries, civilians fleeing on trucks—overwhelming indeed.

Complex Conflict

The population of Kabo itself, like the rest of the population in the country, has been battered over and over again by political turmoil. They were crushed by the Séléka when they took power. They had to flee and hide in the bush and endure the excesses, the violence. And now, they must endure the anti-Balaka’s revenge.

In Kabo, under Séléka control, the population also suffers from inner tensions caused by the clashes between farmers (most of them Christian) and nomadic pastoralists (Muslim), which is another source of violence on top of everything else.

This year an agreement has been reached, according to which the pastoralists, the Mbarara, will search for pastures far from the fields. It is a local agreement, which has not scaled up to other areas and which may generate problems because the Mbarara are armed. We have treated patients injured by arrows from the Mbarara. Last year the conflict prompted population displacements as entire villages were set on fire. Herds invade the fields, farmers attack the cows or the Mbarara, who then take revenge. It is worrying.

Dire Consequences

The population has been fleeing for one year, hiding in the bush when they feel threatened. There have been many such instances this past year, meaning they have to discontinue farming. In Kabo, farmers are able to plant now because they have reached an agreement with the Mbarara, unlike in other locations.

If farmers don’t sow, they cannot harvest. Malaria will arrive at its peak in a couple of months and fatality may rise when combined with malnutrition. Last year, malaria was at its highest. We fear this year it will be even worse.

We will try to prevent infection in a more aggressive manner, taking treatment to people before malaria hits the hardest. We are going to try even if people are not at home, even if they are hiding in the bush, through mobile clinics. This is a challenge.

Shortly before I left CAR, MSF scaled down activities for one week, in reaction to the killing of 16 civilians, including three MSF colleagues, at the Boguila hospital, presumably by an uncontrolled Séléka group. Over the weekend the Séléka were organizing a congress in Ndele, also in the north, to appoint a new commandant, to rebuild; to regroup.

Ghost Villages

I drove back to Bangui and the scenes I passed were incredible: ghost villages, forsaken. Between Dekoa and Sibut, two locations 100 kilometres [about 62 miles] apart, we only saw two men in a village, who most probably had gone to collect some of the belongings they had left behind when they were forced to flee. As they heard the vehicle engine, they ran to hide. This means that many people are hiding in the bush, people that are living without anything, unprotected and helpless.

Due to the geographical situation of Kabo, we have witnessed the flight of Muslim people. I recall a young woman who came from Bouca, 150 kilometers [about 93 miles] away. The anti-Balaka had set the neighborhood on fire. The woman told us that three of her children, none older than ten, had burned to death inside their house. She explained this with resignation, full of sorrow.

In Bouca, there are no Muslims left—before they were a vibrant community. In Kabo and Batangafo there are a few traders left. Most people left Batangafo between December and January and those still remaining sent their families far away. From December to February, trucks full of Muslim people were leaving all day long, even causing traffic jams in Kabo, a town of 15,000 people.

An Uncertain Future

It does not seem that the situation is going to improve in the short term. Of course, the population is still unprotected. The presence of French troops and the MISCA (International Support Mission to the Central African Republic) forces is not enough, and the transitional government does not have any capacity whatsoever.

In Bangui the situation appears to be “normal,” but in the neighborhoods violence is pervasive. The rebuilding of the Séléka and their condemnation of the atrocities perpetrated by some of their most autonomous groups may bring an uncertain calm. It remains to be seen if they will seek to regain control over lost territory, and head south. The situation is tremendously complicated and the population has been and still is subject to abuse and atrocities from all the parties involved. 

So far this year MSF staff have carried out 315,600 outpatient consultations and treated more than 3,250 patients with violence-related wounds in CAR.