The Central African Republic has suffered armed conflict between rebel groups and the government for the past five years. People face enormous difficulties in accessing healthcare. Many live in extremely isolated regions, and travelling is dangerous as banditry is widespread. In 2010, Médecins Sans Frontières supported hospitals and health centres in violence-affected areas in the north of the country, and responded to emergency health needs in the southwest and southeast.

Ouham-Pendé prefecture

Since 2006, our team has been working in the referral hospital in the town of Paoua in the northwest of the country. Teams provide paediatric, surgical, maternal, emergency and outpatient care. More than 35,150 consultations were carried out in 2010, and over 6,900 patients were admitted to hospital. Staff held more than 7,400 antenatal consultations, and assisted more than 1,500 births. Teams also cared for 320 HIV/AIDS patients, including patients infected with both tuberculosis (TB) and HIV. Staff worked in seven health centres in the surrounding area, carrying out nearly 4,000 consultations every month.

Médecins Sans Frontières provided a paediatric service in Bocaranga hospital, 100 kilometres west of Paoua. Teams admitted around 160 children to the hospital and held an average of 1,000 consultations with children under five every month.

Ouham prefecture

In Ouham prefecture, east of Ouham-Pendé, our staff work in rebel-controlled territory on the border with Chad.

The Boguila project was opened in May 2006 on the site of a former missionary hospital, and it has since become the referral hospital for the region. The hospital has 115 beds and a laboratory, and offers surgery, maternity care, mental healthcare, HIV and TB treatment, outpatient services and a maternity waiting house. Women at risk of complicated deliveries can spend the last few weeks of pregnancy at the waiting house, where they are within easy reach of medical care. In November a four-week “surgical camp” was set up in the grounds of the hospital to help women suffering from obstetric fistula, a debilitating injury to the birth canal that causes incontinence. Seventy-eight women received repair surgery at Boguila.

Staff train community members to provide basic health services and treatment at seven health centres in the surrounding area. Among other tasks, the community health workers diagnose malaria, one of the main causes of death in the country, and treat milder cases of the disease.

Maitikoulou clinic was opened in early 2009 to treat sleeping sickness (human African trypanosomiasis), after our teams recorded a high prevalence of the disease in the district. Sleeping sickness is a parasitic infection transmitted by tsetse flies that occurs in sub-Saharan Africa. It attacks the central nervous system, causing severe neurological disorders. If not treated it causes death.

In 2009, more than 1,000 people were treated for sleeping sickness, but screening in 2010 resulted in only 50 people being diagnosed and treated. The clinic was therefore converted into a 70-bed general hospital. More than 48,320 consultations were carried out, and more than 2,370 people were hospitalised. Staff also provided medical care in four health centres in the area.

Not far from Maitikoulou clinic, Médecins Sans Frontières worked in a Ministry of Health hospital in Markounda town. Staff operated an outpatient department and a 26-bed inpatient department. In October, we handed our work in these departments over to Ministry of Health staff. Teams continued to work in several health centres in the district, most of which were located along the Chadian border.

Many of the people living in the town of Kabo have been repeatedly displaced by violence. Our staff provided emergency medical care, maternal and paediatric care, surgery and treatment for HIV/AIDS and TB at Kabo health centre, and supported four neighbouring health centres. Staff conducted almost 104,000 consultations and admitted more than 2,850 people to hospital. We also supplied basic survival kits containing hygiene products, food and blankets to families displaced by conflict.

Batangafo is in an isolated area around 60 kilometres from Kabo. The facility here was originally a health centre, and has now become a referral hospital with more than 170 beds. Teams provide maternal and paediatric care, surgery, and general and emergency medical care. Médecins Sans Frontières supports five health centres on the outskirts of the town and has one mobile clinic. Nearly 48,000 people were treated for malaria, more than 1,000 surgeries were performed, and staff assisted almost 1,300 births.

Bamingui-Bangoran prefecture

Armed conflict in Bamingui-Bangoran, in the north of the Central African Republic, is displacing people from their homes for months at a time. Some have found refuge with host families in Ndele, the prefecture’s capital, while others are in hiding in the bush. Almost all are living in very poor conditions. Médecins Sans Frontières started working in Ndele hospital in July 2010 and set up mobile clinics to make basic healthcare accessible to as many people as possible. More than 28,700 consultations were held and 300 patients were admitted to the hospital.

Treatment for child malnutrition

In the southwest of the country, our team treated more than 2,800 children for malnutrition in emergency programmes in Carnot, Mbaïki and Pissa. Children with malaria, diarrhoea and respiratory infections also received treatment. In Gadzi, we supplied and hired staff to support several health centres and ran a feeding programme for children under 15.

Emergency care for displaced people

In November 2009, Médecins Sans Frontières launched a programme on the Ubangi River, on the border between the Central African Republic, the Republic of the Congo and the Democratic Republic of the Congo (DRC). The population in this area had grown by tens of thousands as refugees crossed the river to escape violence in DRC.

Our staff provided medical care to 15,000 refugees as well as the host population, carrying out 5,000 consultations each month on average. In February, 12,500 children aged between six months and five years were vaccinated against measles.

In May, thousands of people flocked into the town of Zémio, on the border with DRC, fleeing attacks from the rebel group the Lord’s Resistance Army. An Médecins Sans Frontières team opened an outpatient department in the town’s hospital and a health centre near the refugee and displaced people’s camps. Staff carried out more than 14,750 consultations, set up a feeding programme and conducted a measles vaccination campaign in an effort to prevent an outbreak of the disease in the crowded camps.

Médecins Sans Frontières has worked in the Central African Republic since 1997.