Central African Republic (CAR) has been plagued by almost constant unrest in recent decades and remains one of the poorest countries in the world. Life expectancy is only 47, and just under half of the population are able to read. With numerous armed groups operating throughout CAR, internal displacement and refugee movements are common. In 2010, the number of internally displaced persons rose to some 192,000 people.
CAR is also surrounded by unstable neighbours – Chad, Darfur, South Sudan, and Democratic Republic of Congo. Refugees from these neighbouring countries reside in camps, primarily near the border. The weakness or absence of government security, health, education, and agricultural services has created a complex humanitarian emergency.
In December 2012, an alliance of rebel groups seized control key towns throughout the north of the country, accusing CAR President Francois Bozizé of failing to comply with the terms of a peace treaty signed in 2007. The escalation of violence has restricted the access of humanitarian organisations to reach those most in need and caused further displacement of vulnerable communities.
International Medical Corps works primarily in the insecure northern and eastern provinces of CAR, namely Haute-Kotto, Vakaga, Bamingui-Bangoran, and Ouaka. Since 2007 we have provided assistance and protection to Darfurian refugees, with services including maternal and child health care, child protection, therapeutic and supplementary nutrition services, HIV/AIDS prevention, health education, gender-based violence (GBV) prevention and response, and hygiene promotion activities. These services are provided to both refugees and host communities.
International Medical Corps also supports government health facilities with medicines, supplies, health care services, and the rehabilitation of health posts. To help those most in need we operate mobile medical units that travel – sometimes up to three days by motorbike – throughout the country to offer vital health care services to the country’s most isolated villages.
To provide primary health care services to these vulnerable populations, International Medical Corps rebuilt and re-equipped two health centres in the isolated north-eastern border region. Our assessment teams found the IDPs, refugees and host populations extremely vulnerable to malnutrition and disease, as water, sanitation, food, and health care were limited, if not completely nonexistent.
For the first time in two years, Central Africans near the health centre in Sam Ouandja are receiving primary health care services as well as safe deliveries, surgical procedures, pharmaceutical prescriptions and vaccinations. Another health centre in Ouadda Djalle is the only functional referral service for over 200 miles. It has made services available to 18,000 otherwise isolated residents, including 3,000 refugees. To ensure that good health becomes sustainable, we have also trained traditional birth attendants and community health workers.
In December 2009, International Medical Corps organised eight training sessions in Ouadda Djalle and Tiringoulou in the Vakaga region. Community leaders learned how they could better ensure the safety of their communities whilst parents and teachers were brought together to build common projects to develop their schools. Religious leaders who operate in Islamic schools were shown new ways of teaching that preach for peace and respect among children.
Many of the participants came from villages 80 to 120 km away, walking and biking for several days to attend. For many, it was the first time they were given such an opportunity to learn. In a survey conducted at the end of the trainings, 92% of the participants expressed that they had learned new and important skills.
Just 22 hours after the devastating 7.0-earthquake hit in January 2010, International Medical Corps’ Emergency Response Team was on the ground in Haiti providing medical care to survivors. Our doctors and nurses were able to mobilise on an unparalleled scale to provide 24-hour emergency care to the acutely injured at the Hôpital de l’Université d’État d’Haiti (HUEH), a 700-bed hospital in Port-au-Prince. HUEH was badly damaged in the earthquake and many local health care professionals were missing. We were able to save thousands of lives through emergency and trauma care in the critical days following the earthquake.
At the height of emergency operations at the hospital, International Medical Corps treated approximately 1,000 patients per day. Our early entry also gave us the foundation to rapidly expand our operations to 15 mobile clinics throughout Haiti to provide critical services. Through the hospital and mobile and fixed clinics, International Medical Corps teams provided more than 110,000 patient consultations during the first year following the emergency.
When reports of acute diarrhoea emerged from the north of Haiti in October 2010, International Medical Corps doctors and nurses immediately deployed to the region providing emergency relief for the growing cholera crisis. Our network of rapidly constructed cholera treatment centres, supported by 820 community health volunteers to educate communities on how to prevent and identify cholera, meant that more than 30,000 cholera patients received life-saving treatment within the first year following the outbreak.
International Medical Corps was among the first organisations to enter Libya once the conflict began in February 2011, providing emergency medical care to casualties from the fighting and support to hospitals with medical staff and supplies. Among the first challenges our Emergency Response Teams encountered was a chronic shortage of nurses, as thousands of foreign nurses had fled the country. In partnership with the Jordan Health Aid Society, International Medical Corps immediately deployed volunteer nurses to health centres across eastern Libya moving them to towns and cities throughout the country as access permitted. Volunteer nurses trained the local counterparts while working alongside them.
At the country’s borders and within Libya, we supplied those displaced by the fighting with essential relief items, including blankets, bottled water and food. Recognising the danger posed by communicable diseases, our sanitation and hygiene specialists constructed latrines and washing stations in transit camps along the Tunisia borders.
As the fighting went on International Medical Corps worked as close to the front line as possible, providing emergency treatment to those injured in the conflict, and medicines and supplies to besieged towns and cities. In Misurata, inaccessible by road, we evacuated nearly 500 injured civilians by boat. International Medical Corps’ mobile field hospitals treated the wounded from battles in Tripoli, the Western Mountains, Bani Walid, Sabha, Jufrah and Qaddafi’s hometown of Sirte.
International Medical Corps mobilized an emergency response in Mali in January 2013 after rebel armed forces from the north began moving south, triggering French military intervention. In Timbuktu, which had spent months under the control of armed Islamist rebel our team were amongst the first international organisations to arrive and found pillaged clinics, missing medical personnel and damaged health infrastructure.
We immediately began supporting eight strategically targeted health clinics in remote areas around Timbuktu, where the Malian Ministry of Health has been unable to maintain adequate services to local communities. By providing medicines, training staff and recruiting qualified doctors and nurses, we can ensure local people will now have access to basic primary and secondary health care for the first time in months
True to our mission to build self reliance, International Medical Corps is also already training community health workers to go out to local markets and spread essential hygiene, reproductive health and nutrition messages. We are also working to rehabilitate clinics damaged during the conflict, by building or repairing latrines, water systems, solar panel systems and other infrastructure repairs, enabling health workers to have stable and well-equipped facilities to help the people of Mali.
Basanti, a young mother of two in Nepal, returned home from fetching water for her family to find her 8-month old son Bishal had fallen into the open cooking fire. Basanti was in shock, but she wrapped her baby in blankets and ran for help. No one in their village or at the local health post knew what to do so she had to travel more than six hours by bus to seek emergency care at the closest hospital. The district hospital could only stabilize Bishal and wasn’t able to treat his wounds properly. As a result, his little fingers contracted into a fist as the burned skin contracted and “healed” over the coming year, making it impossible for him to use his hand. His cheek, lips and eyelid also contracted and tightened, threatening his vision.
After selling part of their farm to pay for transportation to Kathmandu, Basanti sought further treatment for her baby. However, two hospitals in the nation’s capital could not help either. Adding to Basanti’s struggles, her husband abandoned the family, leaving her alone to care for Bishal and his four-year-old sister.
Thankfully, Basanti heard about the surgical care available through ReSurge International, our trusted partner with a 43-year history of serving burn victims. Dr. Rai, ReSurge’s Outreach Director in Nepal, and his team restored Bishal’s eyelid and his hand will soon be surgically repaired as well.
Even though it took more than a year for him to get appropriate treatment, Bishal is one of the lucky ones. Thousands of children never get the care they need to live a normal life after a disabling burn.