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Central African Republic
MSF in Central African Republic, 2006/2007
Field Staff: 448
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Chronic insecurity, fueled both by rebels and government forces, caused numerous disruptions in MSF medical aid in CAR during 2006/2007. On June 11, 2007, all activities came to an abrupt halt after the fatal shooting of MSF logistician Elsa Serfass. Following discussions with all parties involved in ongoing conflict and a careful evaluation of humanitarian space, only a portion of activities had resumed one month later.
Ongoing fighting between government and various rebel forces in northern Central African Republic (CAR) since late 2005 has caused massive displacement of the population. Civilians, suspected of supporting one side or the other, are systematically targeted by armed groups or caught in the crossfire. Many villages have been looted or burned, forcing those that live there to flee. Bandits also take advantage of the general lawlessness to attack and rob civilians. By mid-2007, an estimated 70,000 people had sought refuge in neighboring Cameroon and Chad, but 200,000 others remained hiding in the bush, exposed to harsh elements and lacking adequate shelter, food, clean water, and healthcare. People live in makeshift shelters with no blankets or mosquito nets.
The health risks are enormous. Those displaced are particularly vulnerable to respiratory infections, diarrheal diseases and general hazards such as snakebites. People live in fear, too afraid to venture far from their hideouts to visit health centers, most of which have long been abandoned. In 2006/2007 MSF focused on providing medical assistance to populations affected by the conflict through a network of mobile clinics, hospitals and health centers across the northwest in Kabo, Batangafo, Kaga Bandoro, Markounda, Paoua, Boguila, and also in the northeastern areas of Birao and Gordil. In 2006, over 145,000 outpatient medical consultations were conducted and MSF carried out emergency surgery and treated patients for diseases such as TB, HIV/ AIDS and sleeping sickness.
In many areas, MSF has been one of few aid organizations present, yet over 2006/2007, many mobile medical clinics were forced to suspend activities because of insecurity. At the end of October 2006, one rebel group (UFDR) launched an attack on Birao in northeastern CAR, rapidly heading southwards. For over a month, it was impossible for MSF and other humanitarian agencies to assess the needs of the civilian population there. Access to Vakaga province was finally granted in mid–December and MSF offered the only healthcare available in the region.
Insecurity has continued with scattered attacks and constant intimidation in the northwest. During the first five months of 2007, MSF treated more than 95,000 patients, over a third of which were seen through mobile clinics. With threats and violence–including targeted attacks on humanitarian workers–reaching this population continues to be extremely difficult.
MSF has worked in the Central African Republic since 1997.