Improving Conditions for Refugees in the Central African RepublicRefugees are beginning to return home to the Central African Republic after years of religious internal conflict. Around 600,000 people have been displaced internally and another 600,000 displaced internationally since the start of the conflict. Now, about 2.6 million people that once resided peacefully in the CAR are reliant on humanitarian assistance. The U.N. has been heavily involved in peacekeeping missions and is beginning the process of transferring the Central African Republic refugees back to home soil.

Political Progress in the CAR

The Central African Republic’s politics are one way that citizens will regain their freedom within the country. The U.N. Security Council is interacting with the CAR government to get humanitarian war crimes accounted for and penalized. The war has led to numerous human rights violations and international forums have condemned the actions. Other political progress is being made to elect leaders based on a democratic method. The proposed elections are seen as a method of peacefully negotiating between political differences without force. This holistic method of finding peace incurs that the problem be examined from all angles and solutions will be diverse.

Refugees’ Experience and Local Aid

Since the CAR is land-locked, refugees have scattered in camps in the Democratic Republic of Congo, the Republic of Congo, Chad, Cameroon and Sudan. The journey for many leaving the territory of the CAR was extreme. Many refugees walked for weeks, hid in forests and were plagued with malnutrition. The resilience of the refugees is coming to fruition in the current transition to peace. Much progress is being made on the ground in the CAR that would create more stability in the government and society.

The problems faced by the displaced are numerous but also change from one area to the next. Much is being done to ease their basic needs, as the area is veiled in violence. The United Nations has adapted to local aid initiatives that provide effective assistance. Additionally, the U.N. has contributed $14.3 million to “help support local aid agencies deliver clean water, education, healthcare, livelihoods support, nutrition, protection and shelter.” Each of these assists makes the return of refugees more possible and more likely.

Humanitarian Aid

One institution committed to helping the Central African Republic refugees is UNICEF. The major ways the organization has contributed to the cause has to do with basic needs being met. For children, the organization is delivering Ready-to-Use-Therapeutic-Food that fights malnutrition and providing immunizations against diseases. Additionally, UNICEF is providing clean water, setting up temporary shelters, training teachers and encouraging education in camps and opening accessible sanitization stations. These major provisions are invaluable and majorly supporting the needs of refugees.

Another high priority for UNICEF is the resettlement of refugees within the country. The Central African Republic refugees, either internally or externally displaced, have begun rebuilding their lives. In 2019, the United Nations Refugee Agency (UNHCR) propelled a $430 million campaign to assist displaced refugees of the Central African Republic. Although funding and donations have not fulfilled this expensive plan, the campaign has certainly made headway. The coordination of funds is extremely beneficial in restructuring the country and enforcing the progress made in the developing peace agreements.

Major strides in assistance, both political and humanitarian, are making peace possible in the Central African Republic. The basic relief provided by both UNICEF and UNHCR is stabilizing the situation for refugees worldwide. As displaced groups transition back to their homes, currently and in the future, the assistance will be instrumental in securing a steady return.

– Eva Pound
Photo: Flickr 

Poverty in the Central African Republic
The Central African Republic (CAR) is a landlocked country in Africa, neighboring Chad, Sudan, Cameroon and more. Although CAR has an abundance of natural resources, including gold, diamonds, uranium and oil, it is one of the poorest nations in the world. Following violence and political turmoil in 2013, the country is still recovering. Here are five important facts about poverty in the Central African Republic.

5 Facts About Poverty in the Central African Republic

  1. The Numbers: Approximately 71% of the Central African Republic’s population lives below the international poverty line. Additionally, due to violence and conflict, there are around 613,114 refugees from the Central African Republic and 641,292 internally displaced persons (IDPs) in the country, as of November 2020. Health is also a major concern, with a maternal mortality rate of 882 per 100,000 live births.
  2. History of Poverty and Conflict: There are many reasons why the Central African Republic has such high poverty rates. The main reason lies in the history of the nation. After CAR gained independence from France in 1960, it had religious rivalries, a variety of ethnic groups and multiple political ideologies. The conflict between different religious and social groups as well as competition over resources caused widespread instability throughout the country. This culminated in a more recent outbreak of violence in 2013, which has left more than half of its population in need of humanitarian assistance.
  3. Major Health Conditions: The leading causes of death in the Central African Republic include tuberculosis, diarrheal diseases, HIV/AIDS, lower respiratory infections and malaria. In 2018, malaria, a mosquito-borne disease, was reported at a rate of 347.3 cases per 100,000 people. This represents a significant decrease from previous years, as there were approximately 471 cases per 100,000 people in 2004. Additionally, there are approximately 100,000 people living with HIV in CAR.
  4. Life Expectancy: Life expectancy in the Central African Republic is among the lowest in the world. As of 2020, it is only 53.35 years. This is a 0.64% increase since 2019 when the life expectancy was 53.01 years. Life expectancy is low in the CAR due to widespread violence and displacement as well as the aforementioned health concerns. In addition to malaria and HIV, more than 40% of the population suffers from chronic malnutrition. On a positive note, the life expectancy of the CAR has been steadily improving since the early 2000s; in 2002, the life expectancy in the CAR was only 44.29 years.
  5. Education and Literacy: The literacy rate in the Central African Republic is also one of the lowest in the world, at 37.4% in 2018. The CAR is struggling to provide high-quality education for its children, particularly girls. Many girls find themselves dropping out of school because of the societal pressures to marry and have children. Only 65% of girls enter the first year of primary school and only 23% of them finish the six years of primary school.

Solutions

Currently, organizations like the World Food Program (WFP), USAID and the International Rescue Committee (IRC) are working to alleviate poverty in the Central African Republic and address the humanitarian crisis. Efforts include distributing food to internally displaced people, providing specialized nutrition packages for pregnant women, rebuilding educational infrastructure and recovering clean water sources. Moving forward, it is essential that these humanitarian organizations and others continue to provide aid and support to the nation.

Alison Choi
Photo: Flickr

Child Poverty in the Central African Republic
Poverty is an issue the Central African Republic continues to face. In fact, around 71% of the Central African Republic’s population lives below the estimated international poverty line. In particular, child poverty in the Central African Republic is prevalent with an estimated half of the country’s population being under the age of 14. Many of these children are born into poverty, a situation they did not choose.

The Central African Republic is also one of the most impoverished nations in Africa; about 60% of the population lives in poverty. Some of the largest issues that children in the Central African Republic face are low enrollment in primary school, various armed conflicts and malnutrition. While these are significant burdens, there are several solutions that should drastically improve the situation of child poverty in the Central African Republic.

Low Enrollment for School

In countries experiencing poverty, schools can be a safe haven for many children. Not only do they offer a stable and caring environment, but they can also offer a lifeline to many children with hopes and dreams of leaving their situation. There are schools in the Central African Republic, such as the Youth Education Pack, that specifically teach trades and other professions to help young people obtain skills during the COVID-19 pandemic. Youth Education Pack receives funding from Education Cannot Wait, a fund that is working towards providing education during crises.

The Central African Republic enrollment is incredibly low, with only 62% of boys and around 41% of girls enrolled in primary school. This creates a significant gap, with many children already deep into poverty not going to school to progress. One cause of this problem is the various armed groups in the country. One of these is the People’s Army for the Restoration of Democracy, which frequently kidnaps children and forces them to fight.

While some attend school, the problems continue. Around 6% of high schoolers in the Central African Republic complete school. One solution would be to dedicate more resources to education. Through schooling, many children in poverty in the Central African Republic would be able to both learn and grow, while progressing in their education and moving from their current living conditions. After-school programs could be of great use and benefit as well, allowing children to have a safe space away from their home lives. Baha’i communities are an incredible example, where they have found multiple ways to prioritize and bring education to children who need it. There is a definitive aspiration by many to boost education in the Central African Republic and more success stories such as the one in Baha’i are inevitable.

Armed Conflict

Unfortunately, warring groups often recruit or kidnap many children of the Central African Republic to fight as soldiers. While many generally consider the use of children in warfare abhorrent, children are often incredibly susceptible to this. They are much easier to manipulate through coercion and threats of violence to themselves and their families. These children often become physically and mentally scarred by what they have seen and done.

An effective solution is to create more programs to help reintegrate former child soldiers. As stated before, many of these children need psychological help. By being able to discuss their trauma with professionals, they are able to process what happened to them and recover from the lasting effects. Other programs must emerge to make sure children do not even join said groups in the first place, educating them on what happens when they become child soldiers.

There are efforts already on the ground to help reduce child poverty in the Central African Republic. For example, War Child has been successful in helping former child soldiers of the Central African Republic, aiding around 7,947 children in 2018 alone. Another such organization is UNICEF, which has been reintegrating child soldiers for nearly 13 years after signing an agreement with the government as well as a rebel group known as the Assembly of the Union of Democratic Forces. While there is a great deal that needs to happen, there is hope for the children of the Central African Republic who the armed conflicts of the region personally affect.

Malnutrition

A significant problem amongst impoverished children in the Central African Republic is malnutrition. It is almost a residual effect of poverty itself and of the other problems that children face in the Central African Republic, mentioned above.

Around 38% of children in the Central African Republic are chronically malnourished and in need of serious care. This is parallel to the armed conflicts as well as the considerable rise in both food prices as well as shortages. In fact, around 45% of people in the country suffer from some level of food insecurity. These problems create a cycle where a lack of food resources for farming creates poverty and poverty itself creates more food shortages.

Luckily, many organizations, like the World Food Programme (WFP), are helping combat child malnutrition in the Central African Republic. WFP began the Central African Republic Interim Country Strategic Plan in 2018, a plan which aspires to help many children and at-risk families receive food daily. This can and will tremendously help combat the issue at hand and ensure that many children do not go hungry.

WFP’s efforts extend towards schools with its school feeding programs as well. These programs have both had positive effects on school attendance as well as the nutrition of many children. Malnutrition might be a definitive problem facing the Central African Republic, but much effort is going into making sure children receive the proper nutrients daily.

While the impoverished children in the Central African Republic seem to be in an incredibly tough spot physically, mentally and emotionally, there is a future for them. Many organizations have dedicated themselves to helping them. Moreover, the granting of awareness about child poverty in the Central African Republic should help prompt others into swift action.

Remy Desai-Patel
Photo: Flickr

Hunger in the Central African Republic
The Central African Republic (CAR), a landlocked country in Central Africa, has one of the highest rates of hunger in the world. In fact, it ranks second-to-last on the 2019 Human Development Index. After gaining independence from France in 1960, the country has struggled with weak markets, low productivity, gender inequality and hunger following years of political instability and conflict.

Hunger in the Central African Republic has become a more drastic concern as a result of a 2013 coup, which ousted President François Bozizé and led to a 36% reduction in the country’s GDP. The country’s ongoing civil war, with renewed violence starting in 2017, has displaced people from their homes and has led to rising food prices due to weakened food production. While much of the country is self-sufficient in food crops like cassava, peanuts and millet, the tsetse fly has hindered livestock development.

Natural Impacts on Agriculture

In the Central African Republic, the tsetse fly has contributed to a disease called animal trypanosomiasis, a fatal disease that impacts cattle and wild animals. The tsetse fly is responsible for killing off a significant portion of CAR’s livestock. Tsetse flies also cause sleeping sickness in humans. This can lead to seizures, central nervous system failure, fever and weight loss. With little food or clean water, people with sleeping sickness are often unable to recover from these symptoms.

According to researcher Paterne Mombe in a Wilson Center interview, the government of CAR enacted agricultural policies over the last 50 years that shifted focus towards importing food instead of growing it themselves. This has resulted in underperforming agricultural output. As a result of poor agricultural practices, Mombe stated that this has led to conflict against the government, the destruction of farmland and lack of policy reform. From 2012 to 2016, agricultural production of the country dropped to 65%.

Of the country’s 4.8 million people, 79% live in poverty, caused by not only displacement and conflict but also a below-average agricultural season and COVID-19 prevention measures. Although the rainfall level in 2020 has been generally average, the vegetation index is slightly in deficit due to the low rainfall that occurred between January and February 2020, subsequently leading to increasing prices for agricultural goods. The CDC has deemed the COVID-19 risk in CAR as high, meaning that movement restrictions have contributed to sharp increases in the price of essential food items, diminishing the ability of poor households to purchase food. The IPC predicts that COVID-19 will “have a drastic impact” on the economy and food supply chains.

Internally Displaced Persons (IDPs) in the Central African Republic

According to USAID, there were more than 697,000 IDPs in CAR in March 2020, as well as 616,000 Central African refugees in neighboring countries. Although the Government and 14 armed groups in the country signed a Peace Agreement in 2019, escalating conflict in the northeast of the country displaced another approximately 27,000 people between December 2019 and March 2020. As much of the population relies heavily on farming for their food, those who have experienced displacement have struggled to adjust to new climates or geographies; others have fled to areas prone to high food prices, poor access to clean water and few employment opportunities.

Concerning hunger in the Central African Republic, the latest Integrated Food Security Phase Classification (IPC) report found that 750,000 people are in a food insecurity emergency (which is a phase below famine), while 1.6 million are in a food insecurity crisis (which is a stage below emergency). Around February 2013, estimates determined that slightly over 20% of the country’s population were in urgent need of assistance, as opposed to over 40% in 2020.

CAR Ranks Unhealthiest Country in the World

The United Nations reported that an estimated 1.3 million people in CAR will require assistance to prevent and treat malnutrition in 2020, which includes nearly 50,000 children under 5 years of age suffering from severe malnutrition. A study by researchers at the University of Seattle in 2016 found that CAR ranks first in unhealthiest countries, due to malnutrition, AIDS and lack of resources. The UN World Food Programme has also noted that around 40% of children aged between 6 months and 5 years are stunted due to a lack of nutrients in their diet. The IPC has projected that some households in northwestern, southeastern and southwestern CAR will require emergency food assistance in the coming months to avoid emergency levels of acute food insecurity.

Response to the Central African Republic’s Hunger Crisis

In response to heightened food insecurity in CAR, the World Food Programme (WFP) and non-governmental organizations, have worked to prevent and treat malnutrition with funding from USAID’s Office of Food for Peace. In collaboration with the European Commission and countries like Germany and South Korea, WFP has provided emergency food and nutrition assistance to conflict-affected people throughout the country. These efforts reached over 920,000 people in 2018.

The WFP has recently scaled up its general food distributions and has conducted a food security program for children under 5 and pregnant and nursing mothers. It has also helped strengthen CAR’s Zero Hunger policies, including doubling producer incomes and adapting food systems to eliminate waste. The WFP also offers rehabilitation programs like Food Assistance for Assets, which provides people with work like repairing roads and bridges. Another program is Purchase for Progress, which helps poor farmers gain access to reliable markets to sell crops at a surplus.

Started in 2007, the organization ACTED provides emergency relief to the most vulnerable and displaced populations. It also works to strengthen the resilience of populations and local authorities. ACTED currently has teams in Ouham Pendé, Ouaka, Basse Kotto, Mbomou, Haut Mbomou and the capital Bangui. Meanwhile, other organizations like Concern Worldwide, Mercy Corps and Oxfam International are helping combat food insecurity through food-for-assets activities, food vouchers and local agriculture initiatives.

However, as COVID-19 continues to negatively impact the lives of thousands of civilians in CAR, hunger in the Central African Republic needs increased attention and aid to battle the rise of acute malnutrition in the midst of a civil war. The IPC advises that organizations implement urgent actions targeted at the most critical regions to facilitate access to food, put in place measures to prevent and combat COVID-19’s spread and improve food utilization by facilitating the access of populations to drinking water sources and awareness of hygiene and sanitation protocols.

– Noah Sheidlower
Photo: Flickr

Trypanosomiasis in the Central African Republic
Trypanosomiasis, a parasitic infection that is transmittable to humans through bites from the tsetse fly, is an illness common only among those living in sub-Saharan Africa. People living in rural areas and those who depend on agriculture, hunting or fishing for their food are most exposed to the infection. Poverty, war and failed healthcare systems can contribute to the spread of trypanosomiasis. Proper diagnosis requires a skilled staff and early treatment can help prevent the infection from worsening. The Central African Republic (CAR) has the highest number of cases of the disease in the world. Trypanosomiasis in the Central African Republic is a pressing health issue, which demands sustained funding for treatment and medical training.

About the Infection

Also known as human African sleeping sickness, trypanosomiasis is most prevalent in the 36 sub-Saharan African countries, including the CAR. There are two types of trypanosomiasis. Depending on which parasite causes the disease, an infected individual could have Trypanosoma brucei rhodesiense or Trypanosoma brucei gambiense (the more common of the two). If an individual becomes sick with the latter, symptoms can go unnoticed for months or years before the infection begins to affect their central nervous system. Symptoms include fever, headaches, confusion, poor coordination and irregular sleep patterns. Transmission of trypanosomiasis can occur from mother to child, a tsetse fly bite or sexual contact with an infected person.

If trypanosomiasis goes untreated, an individual can experience worsening symptoms and can eventually enter a coma — hence the infection’s nickname (sleeping sickness). People in the CAR are especially susceptible to contracting the disease from doing agricultural work. Much of the population of the CAR lives in rural areas, depending heavily on subsistence farming to survive. More than 55% of the nation’s GDP stems from agriculture and 80% of the workforce is in the farming industry. Since citizens are dependent on farming and hunting for their food, they are at a higher risk of exposure to the tsetse fly and thus, have an increased rate of contracting trypanosomiasis.

Treating Trypanosomiasis

Infected individuals’ symptoms often go unnoticed or untreated. The CAR’s political climate, high poverty rate and lack of proper healthcare centers all facilitate the spreading and worsening of the infection. As of 2018, more than 71% of the population lived below the world’s poverty level, meaning that medical staff and treatment were inaccessible to most citizens living with trypanosomiasis in the Central African Republic. The country is also recovering from the violence of late 2013, which left many hospitals and offices ransacked or closed. Due to these various factors, citizens suffering from trypanosomiasis in the Central African Republic have few options for testing and medication.

There is one well-known medication that can treat the disease, called nifurtimox-eflornithine combination therapy (NECT). Though NECT can significantly help patients with trypanosomiasis, the treatment includes multiple injections and close monitoring of the symptoms — both of which are usually unavailable or difficult to follow through to completion.

The Good News

However, with combined efforts from the government and other organizations, more patients suffering from the illness are receiving treatment. With help from the World Health Organization (WHO), CAR’s government is monitoring the cases and number of deaths from trypanosomiasis and working to provide more clinics, healthcare professionals and medication. The WHO and CAR’s health sectors aim to eliminate transmission of the disease by 2030. With only 997 cases and 164 deaths reported in 2018 (the lowest number in the 80-year battle with the disease), the CAR is on track to reach this goal partially due to consistent outside aid.

One notable international organization, Médecins San Frontières, mobilizes doctors and nurses throughout the CAR to provide free diagnoses and medication for those who have trypanosomiasis. Citizens are made aware of the free medical care and the organization can screen thousands of patients.

Over the next few years, help from organizations like the WHO and Médecins San Frontières can lead to adequate testing and medication for citizens with trypanosomiasis in the Central African Republic. It is imperative that organizations and countries in a position to help — contribute trained medical staff, funding and medicine to aid in the CAR’s fight against trypanosomiasis.

Danielle Kuzel
Photo: Flickr

Measles in the Central African Republic
Measles is a viral infection spread through airborne respiratory droplets from an infected individual. Measles can cause typical flu-like symptoms and a skin rash, and, under certain circumstances, it can lead to death. While the illness is virtually obsolete in more developed countries, other countries, such as the Central African Republic, struggle with keeping it at bay. Here are four important facts you should know about measles in the Central African Republic.

4 Facts About Measles in the Central African Republic

  1. Measles primarily affects children. The viral infection is especially taxing on those with weakened immune systems. Thus, children, especially those who are malnourished or HIV-positive, are more likely to become infected and die from the measles. In 2017, only 49% of Central African children under five years of age received vaccinations against measles. In the resurgence of measles in 2019, 90% of cases in the Central African Republic affected children aged 10 or younger. Although a safe vaccine is available, many Central African families have been displaced, live in rural areas or do not have access to a nearby healthcare center. With the help of foreign aid, the government can initiate more vaccinations and widespread awareness – two critical components in combating measles.
  2. The fight against measles in the Central African Republic is ongoing. For more than 40 years, Central African citizens have struggled with measles. The epidemic is a health crisis and is at the top of the country’s political priorities. In 2014, with the help of the Red Cross and the United Nations, the government of the Central African Republic rolled out a vaccination campaign. It aimed to provide free measles vaccines for more than 115,000 children. However, in January 2019, a resurgence of the measles appeared in the Central African Republic. Since then, the citizens have been fighting widespread outbreaks of the disease. From January 2019 to February 2020, there were more than 7,000 new cases of the measles and 83 deaths.
  3. Vaccines are hard to distribute in the Central African Republic’s war-torn political climate. As of 2017, nearly 900,000 Central Africans had fled violence and unrest. More than half of these displaced people were children. Children and adults are more likely to contract measles and die if they are subjected to overcrowding, malnutrition, immunosuppression or poor healthcare systems. The political turmoil throughout the country can cause these factors to become more prevalent and inhibit effective immunizations. Furthermore, the looting and closing of healthcare facilities across the country has stifled the progress made by previous vaccination campaigns.
  4. The government is working with other international organizations to eradicate measles in the Central African Republic. As a response to the recent outbreaks, the Ministry of Health partnered with the World Health Organization to develop specialized courses of action and vaccination campaigns. They have increased epidemiological tracing, communication about the disease’s risks and vaccination and medicine availability. Additionally, the Center for Emergency Operations in Public Health has aided government officials in devising plans for dealing with outbreaks. Another important international program is Gavi, an alliance that promotes free access to vaccinations all over the globe. Gavi has helped the Central African Republic fund measles treatment and follow-up vaccines by donating more than $1 million to the cause. Similarly, USAID has helped in the fight against measles by making financial donations that fund testing and vaccinations.

Although the prevalence of measles in the Central African Republic is serious, the government and other organizations are committed to fighting it. Moving forward, continued efforts are needed to reduce the prevalence of measles in the nation.

– Danielle Kuzel
Photo: Flickr

HIV in the Central African Republic

The Human Immunodeficiency Virus (HIV) has affected millions of people around the world for many decades. If left untreated, HIV can slowly develop into Acquired Immunodeficiency Syndrome (AIDS) and leave those infected with a compromised immune system. Thousands of individuals have suffered from the disease or lost their life to it since the first reported case in the Central African Republic in 1984. The country has mobilized numerous efforts to combat the disease but still requires assistance to ensure that the citizens have adequate testing and access to medicine. Here are five important facts to know about HIV in the Central African Republic.

5 Facts About HIV in the Central African Republic

  1. Around 5,000 citizens die each year from HIV/AIDS in the Central African Republic. In 2018, more than 5,000 individuals died from AIDS-related causes and an estimated 110,000 citizens were living with illness. Though the infection rate still remains high, the efforts being made to stop the spread of HIV have been effective. In 2010, the prevalence of HIV in the Central African Republic was 5% and according to recent data acquired in 2018, the rate has decreased, with only 3.6% of the population living with the disease.
  2. HIV in the Central African Republic primarily affects homosexual men and sex workers. In the Central African Republic, the number of HIV infections are extremely high in the sex worker population, with a prevalence of 9.2%. Similarly, gay men are also at an increased risk for contracting the virus, with a prevalence of 25.4%. Though these two demographics make up a smaller portion of the nation’s population, the lack of testing and awareness affects every citizen in the Central African Republic. With the help of funding from other countries and organizations, the Central African Republic can begin to provide more medicine and diagnostic centers for individuals.
  3. ART can treat HIV yet is seldom available in every community. While there is no cure for the virus, there is a well-known therapy for slowing it down. The treatment for HIV is a multi-drug regime known as antiretroviral therapy (ART). ART can alleviate the severity of HIV if a person begins treatment after diagnosis. While ART does not kill the virus, it stops the virus from creating DNA in the fourth phase of cell formation and slows the spread of HIV in the body. However, in remote cities like Zemio, medicine and supplies are hard to find. The prevalence of HIV is more than 12% higher in remote regions than it is in the rest of the Central African Republic. The HIV-positive residents in these areas seek comfort and support in Community Antiretroviral therapy Groups (CAGs). Some preemptive strategies for HIV-prevention include condom use, using new needles and premature testing. It is imperative that the citizens, especially those already diagnosed with HIV in the Central African Republic, have suitable access to new condoms and needles.
  4. Due to the political turmoil in the Central African Republic, testing and medicine have become inaccessible to some regions. Because of the conflict arising in the country and other surrounding areas in 2013, ransacking or closing of medical centers weakened the already struggling healthcare system. The political unrest and violence that ensued also resulted in individuals with HIV to avoid seeking treatment or to stop taking their medication. With an increase in displacement, poverty levels and closing of healthcare facilities, individuals in the Central African Republic are in dire need of trained medical staff, consistent medical treatment and more testing sites. It is imperative for the citizens living with HIV in the Central African Republic that other nations continue to increase funding for testing locations, training and medicine.
  5. Other countries and organizations are helping in numerous ways. The Central African Republic depends heavily on funding from other countries to provide treatment for its citizens, with more than 90% of the money spent on individuals with HIV coming from international sources. After the political instability faced by the country in 2013, The United Nations Refugee Agency, also known as the UNHCR, assisted the healthcare facilities in rebuilding their database and providing immediate treatment for refugees and asylum-seekers. UNICEF, another global organization, also provides technical services and financial aid for the Central African Republic. With the help of UNICEF, the country can provide more testing, ARV treatment and care for pregnant women with HIV.

HIV has been prevalent in the Central African Republic since the first case was reported in 1984. While the virus impacts many people, weakening their immune systems, organizations are stepping in to help. Outside funding and support from agencies like UNHCR and UNICEF are helping reduce the prevalence of HIV in the country. 

Danielle Kuzel
Photo: Flickr

Healthcare in Central African RepublicViolent conflict that has surged since 2007 in the Central African Republic (CAR) has created challenges for the nation’s healthcare system. Humanitarian organizations, which provide the majority of the health services available, have continued working to provide adequate healthcare despite threats of violence from militia groups.

Providing Healthcare Amid Conflict

The CAR is facing a humanitarian emergency. Even after the introduction of a peace agreement among the 14 armed groups in the country in 2019, attacks against civilians and humanitarian workers persist. It is estimated that out of more than 4.6 million people living in the CAR, 2.9 million people are in need of humanitarian assistance. NGOs have not stopped attempting to provide services to those displaced and hurting from the violence.

There are inadequate numbers of trained health workers in the CAR, as reported by the World Health Organization. Therefore, it has become a primary concern to increase the number of healthcare providers. This year, in addition to providing water, sanitation and hygiene assistance, the Norwegian Refugee Council (NRC) has begun training 500 individuals to respond to the protection and healthcare needs of vulnerable communities in the CAR.

After the conflict damaged or destroyed 34% of the CAR’s healthcare infrastructure, NGOs are focused on supporting the remaining hospitals and clinics. ALIMA, an NGO committed to providing quality healthcare services to those in need, has been working in the CAR since 2013. They have provided nutritional and medical care in the Bimbo and Boda health districts and outside the nation’s capital of Bangui. Pregnant women and children under the age of five have received free healthcare through ALIMA. Just in 2016, the organization carried out more than 17,320 prenatal consultations and treated close to 75,000 children for malaria.

The International Rescue Committee (IRC) began its involvement in CAR in 2006. The health services provided by this organization target the mental health consequences of gender-based violence. Psychosocial support to women survivors of violence has remained a priority. The IRC also implemented discussion groups aimed to expand gender-based violence awareness and share strategies for prevention.

Combating Infectious Disease

Malaria, HIV and tuberculosis are a few of the prominent diseases that require intense prevention and treatment in the CAR. Doctors Without Borders has been one of the principal actors in delivering these services, treating nearly 547,000 malaria cases in 2018. The organization generated community-based groups in multiple cities to pick up antiretroviral medications needed to treat HIV, while also working to decentralize HIV and AIDS treatment in the city of Carnot. UNICEF has given additional HIV screening to pregnant women during prenatal consultations, and those who tested positive were promptly placed on antiretroviral treatment.

On Jan. 24, 2020, the Ministry of Health declared there to be a measles epidemic in the CAR; cases had been on the rise since the previous year. Between January 2019 and February 2020, there were 7,626 suspected measles cases. A significant public health response has begun to target the spread, including the development of vaccination campaigns, an increase in epidemiological surveillance and the distribution of free medical supplies.

CAR has been impacted by the current coronavirus pandemic, as the country has recorded nearly 4,000 cases as of July 3. UNICEF and partners have been able to provide free essential care, sanitation services and psychological support.

The Need for Humanitarian Assistance

The United States Agency for International Development (USAID) is a major contributor to humanitarian aid in the CAR. It was with the financial assistance of USAID in the 2019 fiscal year that the IRC and the NRC were able to provide healthcare resources for risk prevention. The preservation of humanitarian funding to the CAR has proven to be crucial, as conflict has further weakened the healthcare system.

Humanitarian organizations have made significant progress in recent years to combat the spread of infectious disease and provide more widespread healthcare in the Central African Republic. There is a need to expand these efforts and improve quality of life during the nation’s continued fight for peace.

Ilana Issula
Photo: Flickr

Homelessness in the Central African RepublicCurrent ethnic conflicts have resulted in the destruction of over 1.1 million people’s homes in the Central African Republic. Here are the causes and impacts of homelessness in the Central African Republic.

Causes of Homelessness

The causes of homelessness in the Central African Republic are poverty, a devastating Civil War and recent floods. In 2018, around 70% of the Central Africans lived in extreme poverty on less than $1.90 a day. Poverty makes it even more challenging to escape homelessness in a country full of conflict. Also, Over one million people are homeless in the Central African Republic as a result of their Civil War. Currently, more than 643,000 people are internally displaced in the Central African Republic while 500,000 people have become refugees in Chad, the Democratic Republic of Congo, the Republic of Congo and Cameroon. On top of that, recent 2019 floods have destroyed more than 10,000 homes. Of the 44,918 people affected 20,000 of those people were displaced from the capital city of Bangui. Homes and livelihoods were defenseless as major flooding occurred in over 16 cities.

Impacts of Homelessness

Homelessness has contributed to the fragility of the nation and child soldiers, and it has negatively affected certain religious groups as well. The Central African Republic is the 6th most fragile country in the world. A fragile nation is measured by the indicators of instability like homelessness, for example, in a country. The high numbers of refugees and displaced people without a home are examples of social indicators of the fragility of the Central African Republic. Political indicators include the amount of humanitarian aid needed and the violent conflicts civilians face.

Homelessness has also contributed to war resulting in child soldiers and the destruction of communities. The exploitation of homeless children occurred as 10,000 children were forced into joining army groups in the civil war. Additionally, the number of people who fall under displacement and homelessness is still on the rise. Expected attacks by armed groups force residents to find safety in other towns or in displacement camps with poor living conditions. Most recently, around 5,000 people became homeless from May 18 to May 20 of this year as a result of violence between army groups and government forces.

Muslims living in Bangui had to flee the city due to violence against them. Most of their empty homes were illegally sold and are now occupied. There is a complicated process when it comes to returning homes to owners since few people have title deeds; therefore, the number of cases that have been solved is only 18 out of 475. Muslims are afraid to return, and those who do return find other people living in their homes. The Norwegian Refugee Council in Bangui and local mayors are working to solve housing disputes and return stolen land to end homelessness.

The Future of the Central African Republic

The Central African Republic needs humanitarian aid more than ever. In 2018, there were 396 attacks against humanitarian workers. As fighting ensues, violence against humanitarian aid groups is causing them to leave areas that need their support the most. This places strains on the amount of help that Central Africans receive. Over 50% of the population needed humanitarian aid in 2019, but less than 30% of people received support.

The government of the Central African Republic has been successful in its creation and implementation of the Humanitarian Response Plan, which provides more aid to ensure internal security. In 2019, donors raised 300.3 million dollars to improve the living conditions of citizens and prevent conflict. This Humanitarian Response Plan supported 1.1 million people, including those facing homelessness in the Central African Republic.

Hannah Nelson

Photo: Wikimedia Commons

Newly released U.N. data suggests that violence decreased in the Central African Republic in the aftermath of a peace deal between the government and armed groups in February 2019. While it is yet unclear whether this peace deal will be successful in the long-term, this represents a small bit of hope for the Central African Republic, which has been entrenched in a civil war since 2012.

Organizations including the U.N., USAID and Mercy Corps have been providing humanitarian aid in the Central African Republic, and a successful peace agreement may change the humanitarian context in the country.

Conflict Overview

In December 2012, armed Muslim groups, organized into a coalition known as the Seleka, attacked the Central African Republic government, seizing the capital city and staging a coup in early 2013. Anti-Balaka — Christian armed forces — rose up in response, committing violence against primarily Muslim civilians and contributing to the displacement of innocent citizens.

Although the new government officially disbanded Seleka forces, many ex-Seleka fighters initiated revenge attacks. Both the ex-Seleka and anti-Balaka groups have committed war crimes and crimes against humanity, according to the U.N. and other human rights groups. The continuing violence caused thousands of deaths.

The government maintains control of the capital, but armed groups who continued fighting dominate the rest of the nation. In addition to ex-Seleka and anti-Balaka forces, a number of other armed groups joined the conflict, many of which were already in existence. These include The Central African Armed Forces (FACA), Revolution and Justice (RJ), The Democratic Front of the Central African People (FDPC), The Convention of Patriots for Justice and Peace (CPJP), The Movement of Central African Liberators for Justice (MLCJ), Union of Republican Forces (UFR), The Popular Front for Recovery (FPR) and The Lord’s Resistance Army (LRA).

The widespread conflict caused by these groups has had disastrous effects on the economy of the Central African Republic, causing approximately three-quarters of the population to live in poverty, with nearly 650,000 civilians displaced.

Humanitarian Aid

In response to the crisis, several international actors became active in the nation, providing humanitarian aid in the Central African Republic.

Mercy Corps began working in the Central African Republic in 2007, in response to its already high poverty rate. It estimates that 2.9 million people in the Central African Republic need humanitarian assistance, noting that basic services, including clean water, health care and education, are scarce.

In the Central African Republic, some of the work that Mercy Corps does involves providing assistance to displaced families, operating support centers for victims of gender-based violence, leading child protection committees, constructing wells to provide clean water and training community leaders to manage disputes and help maintain peace.

In addition to Mercy Corps, USAID also provides humanitarian aid in the Central African Republic primarily through funding for humanitarian partners. USAID helps fund programs by organizations such as Oxfam, Plan International and UNICEF in the Central African Republic to provide relief to victims of violence and displacement.

According to USAID, the U.S. government provides the most humanitarian funding to the Central African Republic, with more than $173 million provided in 2018 and early 2019. Following the U.S. are Germany and the European Commission, both contributing just over $50 million. Other countries, including Sweden, the United Kingdom and Canada, also made significant contributions.

Finally, the U.N. is active in the Central African Republic through its peacekeeping organization known as MINUSCA (United Nations Multidimensional Integrated Stabilization Mission in the Central African Republic). MINUSCA was established to protect civilians and disarm militia fighters. The U.N. has 15,000 personnel providing humanitarian aid in the Central African Republic and working towards peace.

New Developments

The government and 14 armed groups reached a peace deal in February 2019, after talks began on Jan. 24. Though whether the deal will ultimately be successful is still unknown, this represents a crucial step in ending the cycles of violence that kept the Central African Republic trapped in poverty and suffering.

In the aftermath of the peace deal, MINUSCA noted that between January and June 2019 there were only 565 incidents of human rights violations or abuse, including rapes, violent attacks and the recruitment of children into armed groups. Between January and June in 2018, there were 1,674, nearly three times as many incidents. MINUSCA is reluctant to be optimistic, however, as peace talks failed in 2014, 2015 and 2017. Musa Gassama, the director of the human rights division of MINUSCA, stated the armed groups still control much of the nation.

The U.N. Special Representative for the Central African Republic, Parfait Onanga-Nyanga, noted that support from the international community is crucial to successfully implementing a peace agreement.

Moving Forward

A successful peace deal would not stop the need for humanitarian aid in the Central African Republic in the near future, but it could alter the humanitarian context. Increased assistance may actually be needed if peace is achieved. Indeed, internally displaced persons and refugees will need assistance in returning to their homes and re-establishing their lives there.

The need for humanitarian aid in the Central African Republic will continue to be high, even in the aftermath of the conflict. Hopefully, organizations such as USAID and Mercy Corps will continue to be active in the nation, adapting to new contexts and working to benefit as many civilians as possible.

– Sara Olk
Photo: Flickr