Filling the gaps in health care access in Bambari, Central African Republic

The construction of a maternity ward at the Kidjigra health site allows MSF to extend our activities. “MSF also completed the Tongolo building at the end of 2022,” said Matlanyane.

Health centers supported by MSF are facing serious shortages of medicines and essential equipment. “We are ensuring that patients who do not have the means to get to the regional hospital in Bambari, which is almost 40 miles away, have access to care,” explained Matlanyane. “In addition, in collaboration with the Ministry of Health, we are providing comprehensive care for malaria and malnutrition, routine vaccinations, and comprehensive care for survivors of sexual violence in Kidjigra and the Tongolo project.”

Two community-based health care sites have also been established in Digui and Wogra, providing person-centered care for malaria, diarrhea, and uncomplicated respiratory infections, as well as screening for malnutrition, first aid for survivors of sexual violence, and emergency psychological support. The sites also provide referrals, including  to Bambari Regional Hospital.

Support from within communities

MSF is also working with trained community health workers who live in the village to raise awareness on how to handle health issues. This helps people avoid delays in accessing consultations and identify danger signs for referrals to the health center as soon as possible. The aim is to reduce mortality and morbidity in the community.

Another health need is care for survivors of sexual violence, which is a public health emergency in CAR. An MSF report released last November found the number of sexual violence victims treated by our teams across the country tripled from 2018 to 2022. 

“Even though efforts are being made to reduce sexual violence in the area, the numbers of patients I see are alarming,” said Julienne Pousselemé, one of the MSF community workers in the village of Wogra. Julienne provides survivors with the morning-after pill and psychological support, as well as referrals and monitoring. In the last two months, she has referred 10 survivors to the MSF-supported Ngakobo health center.

“We treat between 1,500 and 1,700 patients a month,” said Dr. Boris Béranger Pamatchi, the only doctor on staff in Ngakobo. “The center exists thanks to what MSF gives us. With the six services we have, we are meeting the needs of the people.”

MSF also provides reimbursement for the cost of transportation, which is another barrier to accessing health care for patients from Bambari.

“We receive patients from around Bambari who are referred to us by motorcycle,” said Dr. Narcise Stéphane Ongtiga, who is responsible for treating survivors of sexual violence at Bambari Regional Hospital. “The referral [system] has been very well received by the community, as it improves their access to care, particularly for the most vulnerable, and helps avoid patients being ‘lost to follow-up’—those who arrive just for the first treatment and then  never return for their [next] appointment.”

In a country with inadequate infrastructure and equipment, and frequent shortages of medicines and vaccines, more organizations need to step up in helping the most remote communities. MSF is calling for other humanitarian organizations to scale up activities across the Ouaka region and  to facilitate access to care for the most vulnerable people.