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.