A nervous calm prevails as the Central African Republic (CAR) awaits the final round of presidential elections, due to take place in early February. Renewed outbreaks of intercommunal violence have kept the population on edge in recent months, with many fearing that tensions could flare anew at any moment. The worsening security situation has also crushed hopes of returning home for some 450,000 people who were displaced internally by violence, along with a similar number of refugees who fled to neighboring countries.
In Bangui, the capital, more than 30,000 people have taken refuge in overcrowded, unsanitary makeshift camps across town, or in churches and schools. To enable access to free quality health care for this vulnerable population, Doctors Without Borders/Médecins Sans Frontières (MSF) is providing health care and running mobile clinics in five of these camps. MSF also runs a hospital and a maternity clinic in the Mpoko area and provides medical care once a week at the central mosque in the Muslim enclave of PK5.
Shocking Scenes of Violence
Many people in the camps have witnessed shocking scenes of violence and have had their homes pillaged and looted. Lucienne, a woman in her forties, fled her home two years ago when four of her neighbors were killed during an outbreak of fighting. Since then, she has been seeking safety in Mpoko together with her family.
"Life is too difficult in the camp. It’s unsafe, dirty, and the flies are everywhere," she says, as she helps her sick daughter make an appointment at the MSF hospital in the camp.
Another 2,000 people are staying in the Benzvi camp. Many had to flee their homes with few or no belongings and are sleeping in makeshift tents or in the open. In order to have something to eat, many rely on small plots of land to grow crops.
MSF teams visit Benzvi twice a week to deliver medical care. On an average day, teams see around 150 patients. Most seek care for malaria, respiratory infections, and diarrhea, diseases that stem the deplorable conditions in the camp.
To ensure camp residents have access to safe drinking water, MSF also runs a water pumping and purifying station in collaboration with partner organizations to deliver purified water to Benzvi and other camps in case of a breakdown of the city water supply.
"Conditions in the Sites are Very Difficult"
Ethna and Nadege have "lived" in Benzvi since their homes in the PK5 district were attacked by armed groups. They have been friends for years, and are both single mothers with several children to feed. Their children have fallen ill with malaria several times since they moved to Benzvi, but they have received free treatment from MSF’s mobile clinic.
To survive, Ethna and Nadege bake cakes and sell them in the street: "We only have enough food for ourselves and our children for one meal a day," says Ethna.
"During the day, many people return to the neighborhood where they lived, but they are too afraid to stay there at night so they sleep here in the camps," says Reims Pali, MSF's assistant field coordinator. A Central African, he has witnessed the situation in the country descend further into lawless chaos over the last two years.
"In comparison to the abuses, killings, robberies, and lootings that the people have witnessed in their neighborhoods, they feel relatively safe here," says Pali. "But the living conditions in the sites are very difficult. They live in tents built of waste tarpaulins that are full of holes. They sleep on mats on the ground and are exposed to mosquitoes [that] may carry malaria. Unless the security situation gets better, they will have to stay here in these camps."
MSF has worked in CAR since 1996. The organization currently has over 300 international and more than 2,000 Central African staff deployed in the country. In addition to its activities in Bangui, MSF also provides services in 15 locations across the country, in addition to assistance for Central African refugees in the neighboring countries of Chad, Cameroon, and Democratic Republic of Congo.