March 04, 2014

New clashes have erupted between the the Séléka and  the Anti-Balaka armed groups in the Central African Republic (CAR), continuing violence that has forced hundreds of thousands of people to flee their homes. Thousands have taken refuge in areas such as PK 12, a district in the north of the capital, Bangui, where they remain under threat. Martine Flokstra, Doctors Without Borders/Médecins Sans Frontières (MSF) head of mission in CAR, describes the situation in PK 12.

What is the humanitarian situation in PK 12 camp?

Near the mosque in PK 12 camp, on the northern outskirts of Bangui, there is a small enclave with a population of around 1,800 Muslims and members of the Peuhl ethnic group, surrounded by armed Anti-Balaka forces. They have no access to basic needs such as food, safe drinking water and medical care, besides what NGOs and the UN are able to sporadically provide them, and they fear for their lives.

This population has lived in the enclave for two months, having fled from areas outside of Bangui under the grave threat of violence. Now families, including women, children and elders, are crowded into the small, 200-by-500-meter area surrounded by armed men. Grenades are thrown into the camp almost daily.

We have found the population in PK 12 to be in dire health. Significantly, 20 percent of the children under 5 years old suffer from severe acute malnutrition. The mobile health team has vaccinated children against measles, provides primary health care on a regular basis and tries to administer first aid for the wounded, as well as refer them to hospitals. This besieged population is isolated under the constant threat of violence and is desperate to leave. The situation for these people is verging on catastrophic.

How has the situation evolved in the last weeks?

Over the past two weeks, 14 grenades were thrown into the PK 12 camp, causing one death and an estimated 15 wounded. Shooting also happens regularly around the camp. Even though these grenade attacks have caused limited casualties, they terrorize the displaced population and have left many traumatized. This targeted population has told us they desperately want to leave, but risk being killed if they do. Several times, convoys of Muslim civilians have been attacked. In one incident, a man fell off a truck and was lynched, and in another a grenade was thrown into a truck. During one of these grenade attacks, an MSF team was present.

This level of violence makes it very difficult for humanitarian aid organizations to reach the population and guarantee their access to health care and other forms of assistance. Various organizations, including MSF, have received threats at the Anti-Balaka checkpoint near the entrance, and not all organizations have been able to provide assistance.

On February 18, the Chadian army sent in a few trucks to evacuate some of the displaced population from PK 12. However, there was only room for 200 to 250 people on the trucks. Desperate to leave the camp, 2,000 people started to panic, and in the subsequent chaos, five children, including a baby, were crushed to death in the transit camp.

How is MSF reacting?

In the past days MSF has made a few quick visits to the area to treat only the most severe medical cases. We are currently conducting an analysis of the situation to determine the possibilities of working in PK 12. The team is dealing with a population which supports and appreciates our presence, but is begging to be evacuated from this area where the provision of health care seems quite in vain.

Are there other situations like the PK 12 camp within CAR?

In addition to Bangui there are many other areas where people are besieged and living in fear of violence. The entire population, Muslim and non-Muslim alike, are facing this. For instance, in the northern area of Boguila, our team found a Christian population surrounded by an armed group. Their fields have been destroyed. We are currently operating in at least three similar sites. We face major problems in gaining access to the wounded. A big part of the population in CAR cannot reach health centers as they fear their lives are in danger if they try and are too scared to be transported by the few ambulances available. Patients with life-threatening conditions do not accept hospital referrals as they do not feel safe.

Additionally, security conditions still hamper medical teams and humanitarian aid workers from providing aid, especially to the besieged population. In the northern part of the country, thousands of people are trapped, while there are still hundreds of thousands of people displaced in Bangui as well as in the countryside. In the countryside we see some of the displaced population returning from the bush to their villages, but often villages have been burned down and need rebuilding. These returnees were often not able to access their fields and are facing severe food shortages now and in the future.

How do people cope when they return to their villages from the bush?

In Bolio, a village near Boguila, people had just arrived from hiding in the bush two weeks ago, and were still wary when they heard engine sounds. They had fled to the bush in June 2013, the moment the Séléka arrived in the area. The Séléka had not only targeted the Anti-Balaka in the area, but also shot at innocent women and children. During their time in the bush, the people ate whatever they found, including wild yams, vegetables and leaves. Now, back in their village, they are in desperate circumstances. Everything was looted and so they are trying to rebuild their lives. But since they are under siege, they have few opportunities to gather food and are also deprived of medication.

Is there a story that has impressed you particularly?

An elder member of the displaced Muslims living in the PK 12 camp told us: "Our stomachs hurt, our muscles hurt, our heads hurt, but what hurts most are our hearts. The uncertainty of our fate, as well as the fate of those who fled this site and we don't know what happened to them, keeps our hearts in pain." I think this best sums up this catastrophic situation.

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