CAR 2012 © Corentin Fohlen/Divergence

CAR has the second-lowest life expectancy in the world (48 years). Several studies conducted there found extremely high mortality rates—sometimes three to five times higher than emergency thresholds—which signal the need for immediate medical assistance. #

CAR 2012 © Corentin Fohlen/Divergence

Sixty percent of children under five years of age die at home in CAR. Access to medical care is a critical problem, particularly for preventable, curable diseases such as malaria, respiratory infections, and diarrheal illnesses. #

CAR 2012 © Corentin Fohlen/Divergence

People in CAR have endured decades of conflict, woeful living standards and infrastructure, and a pronounced lack of health care facilities and health care staff beyond the capital city. And yet what international funding does make it to the country is now threatened by the ongoing political instability. #

CAR 2012 © Corentin Fohlen/Divergence

MSF has been working in the Paoua Hospital in northwestern CAR since March 2006. MSF teams work in the hospital's pediatrics, surgery, maternity, medicine, HIV, and tuberculosis (TB) departments. MSF also supports several health centers in the area and an expanded program on immunization. #

CAR 2012 © Corentin Fohlen/Divergence

One MSF doctor says working in CAR "was shocking. I was really upset by what I saw . . . Everything is a question of survival here . . . We do what we can with what we have . . . We experience the best and the worst." #

CAR 2012 © Corentin Fohlen/Divergence

Between January and December 2012, 3,475 children were hospitalized and 1,198 were admitted into MSF's nutrition program. "The children are very weak when they arrive," says an MSF doctor. "They’re at death’s door—and a few days later, they’re ready to leave. That’s the most gratifying part." #

CAR 2012 © Corentin Fohlen/Divergence

CAR also has Central Africa's highest rate of AIDS, but facilities frequently run out of important antiretroviral medications. Between January and December 2012, teams followed 478 patients in MSF's HIV program (including 332 on antiretrovirals) and monitored 214 patients in the TB program. #

CAR 2012 © Corentin Fohlen/Divergence

Between January and December 2012, MSF held nearly 80,477 consultations at the hospital and health centers, including for victims of sexual violence. Nearly 7,462 patients were hospitalized, more than 1,400 operations were performed, and 1,666 babies were delivered, including 132 by Caesarean section. #

CAR 2011 © Talia Bouchouareb

Every month, MSF teams also treat approximately 30 snakebite cases at the Paoua Hospital. Snakebites can have serious medical complications and may require multiple operations and several days’ hospitalization. #

CAR 2012 © Corentin Fohlen/Divergence

Due to the poor roads and limited transportation options, MSF runs a motorcycle service that provides free transportation for health center patients who need to go to the hospital. #