Some 30,000 people have fled violent clashes in Central African Republic (CAR) between fighters from the armed groups Revolution and Justice (RJ) and the Movement for the Liberation of the Central African Republic People (MNLC). The two groups have been fighting in the northwest of the country since December 27, 2017. People fleeing the violence have taken refuge in the town of Paoua, arriving with stories of torched villages, extortion, and indiscriminate attacks against anyone found in the conflict zone. The situation remains extremely tense.
"We Are Very Concerned by the Situation"
At Paoua hospital, where Doctors Without Borders/Médecins Sans Frontières (MSF) has worked since 2006, teams treated 13 victims of fighting and attacks. But the true number of victims is likely much higher.
"[The number of patients] is very small, taking into account the number of displaced people who reached Paoua and the extreme violence they report to our teams," said MSF head of mission Gwenola François. "Many tell of men on horseback shooting at anything that moves, of dead and wounded people left behind in the bush. We are very concerned by the situation there." Because of the fighting, MSF has had to suspend its work in seven health centers in outlying districts of Paoua. Three of these centers have reportedly been looted.
Thirty-three-year-old farmer Léonard Gangbe was one of the wounded people who made it to the hospital in Paoua. When the fighting broke out, he and several neighbors fled their village to a house in the forest. He was shot in the left cheek while trying to stop armed men from stealing the cattle he had taken with him. The bullet tore through his nose and upper lip.
The Paoua region experienced relatively low levels of fighting even as violence escalated in CAR over the course of 2017. Yet even here, people live with pervasive violence fostered by the incapacity of state authorities to provide security. Armed men operate with impunity and can use any excuse to impose a tax on someone for being on a particular road, owning cattle, or even simply living in one’s own home.
The story of thirty-seven-year-old Josianne Wankian, mother to nine children, is just one example of this atmosphere of lawlessness and fear. Now living in Paoua, Josianne is originally from the village of Betokomia a few kilometers away. At 5:00 in the morning on December 28, she heard gunshots near her home.
Josianne’s husband and 13-year-old son fled because it was rumored that men would be killed immediately—while women were to be spared. She was alone with her children when armed men came demanding food and money. Josianne borrowed 12,000 francs CFA (about $21) from a goat trader so that she and her children could leave their village unharmed and seek refuge with her older sister, who lives in Paoua.
A Fragile Refuge
This wasn’t the first time that armed men had demanded money from Josianne and her family. In August 2017, they even burned her home. "My husband’s a farmer," she explains. "We had four cattle, so we were able to grow more and sell our produce to increase our income. When armed men see a decent house, they demand food, cattle, or money. They ordered us to pay a tax of 50,000 francs (about $91) for our cattle and 120,000 francs ($219) just to carry on living in our home. We don’t have that kind of money. I gave them 25,000 francs ($45), which was everything I had. As the house didn’t have a roof yet, they said they’d come back when it was finished. But it didn’t stop them from stealing our belongings and setting the house on fire. After that, my eight children and I spent several months living out in the fields. We’d just started rebuilding our house in Betokomia when the fighting flared up again a few days ago."
Josianne is one of tens of thousands in the Paoua region who have fled their villages and sought refuge in the town. But Paoua is also becoming less safe, and the influx of displaced people has stretched local resources to the limit. It’s not unusual for a single Paoua household to host more than 40 displaced people, and the provision of sufficient food and safe drinking water will soon become an issue.
MSF has been working in Paoua since 2006. The organization supports the emergency room and pediatric ward of Paoua hospital and ensures access to primary health care to children and pregnant women in seven peripheral health centers.
MSF now provides medical aid to populations in Bria, Bambari, Alindao, Batangafo, Kabo, Bossangoa, Boguila, Paoua, Carnot, and Bangui. Since the beginning of 2017, when armed conflict once again began to escalate across the country, MSF has adapted several of its programs to respond to the urgent needs of people directly affected by the violence.