malnutrition in CAR
Last year, clashes in the Central African Republic, or CAR, between Christian and Islamic militants claimed the lives 2,116 civilians. The CAR is fast becoming home to a ghastly humanitarian crisis, in which violence is exacerbating malnutrition.

In the capital city of Bangui, the number of children facing life-threatening malnutrition has tripled since violence began escalating in December of 2013. Their situation is being complicated by the brutal course that the conflict has taken.

Action Against Hunger collected over 1,000 case studies of parents of malnourished children in the CAR between July 2013 and March 2014, and found that 75 percent presented symptoms of PTSD.

PTSD can significantly impair a mother’s ability to nurse a child. Nurses in health centers around Bangui have reported that some traumatized mothers become convinced that they cannot produce milk. Others simply do not respond to their child’s needs—some have even attempted suicide and infanticide. PTSD in children can also play a role in malnourishment, as traumatized children may refuse to eat.

The conflict in the Central African Republic is not only causing malnutrition—it is also exporting it.

Over the past year, conflict in Nigeria and the Central African Republic has displaced some 1.2 million people. These migrants typically seek refuge in neighboring countries like Chad, Niger and Cameroon, further straining the resources of countries already dealing with rampant malnourishment.

On Feb. 12, the U.N. requested $2 billion in aid for people across Africa’s Sahel belt—a semi-arid strip of land south of the Sahara Desert that stretches from the Atlantic Ocean to the Red Sea.

“The violence and conflict has a devastating effect, it is casting a shadow across the region,” said Robert Piper, U.N. regional humanitarian coordinator for the Sahel.

Parker Carroll

Sources: Eyewitness News, The Guardian 1,  The Guardian 2,   The Guardian 3
Photo: Africa Up Close

central african republic ceasefire
After a year and a half of vicious bloodshed, Christian militia and Muslim Seleka rebels have drawn up a ceasefire in response to the deaths of thousands in Central African Republic. Requests have been subsided for both groups, with one of the failed demands being that the country is split based on the religious line on behalf of the rebel forces.

The warring groups traveled to the Congo to have the ceasefire initiated by the Congolese president, Denis Sassou N’Guesso, the formal mediator of the conflict. After the signing, President N’Guesso made a statement to the press: “We have taken the first step today. The journey is long, but we have made promises. After what has happened here, I am confident.” Both groups hold hope for future democratic elections to replace multiple informal and interim leaders.

The effects of this violence have not gone unnoticed, with over 1 million people fleeing their homes due to the conflict. While the Central African Republic ceasefire appears to be the first step to a different future, both sides took precautions at the signing ceremony with heavy military representation in case the other forgot their capabilities.

Both sides have shown their willingness to enforce the ceasefire, and those that are caught breaking the truce would face arrest.

Head of the Seleka delegation made a statement after the signing. “We have signed this ceasefire agreement today in front of everyone. Our commitment is firm and irreversible,” said Mohamed Moussa Dhaffane.

Seleka’s violent rule began back in March of 2013 when they rose to power, a group made up of various northerners from neighboring countries like Chad and Sudan. The “tit for tat” aggressions quickly developed the anti-balaka militia and the two warring sides immediately fell into an endless cycle of battle, even after the Seleka government stepped down in early 2014. Since then the violence has continued to affect Central African Republic, causing death tolls in the thousands for both sides.

Both the Seleka and anti-Balaka leadership appear willing to concede to the changes required by a ceasefire, but the amount of work to be done to bring the country together will take much more than a few agreements and a little time. The future of CAR is cloudy as both groups are forced to work with one another again and put on a united front for their people, as well as the rest of the world.

– Elena Lopez

Sources: Reuters, Big Story, The Guardian
Photo: The Guardian

flooding_in_central_african_republic
June marked the beginning of the Central African Republic’s extremely rainy season. During this annual season, CAR experiences daily thunderous rainstorms that leave dire destruction in their wake. The heavy downpours destroy homes and tents, and the ubiquitous water pools into stagnant bodies of dirty and diseased water. The flooding in Central African Republic has caused contractions of cholera and infections, especially amongst those with wounds inflicted by local crime and violence.

The CAR is already plagued by chronic poverty and deadly crime. Additionally, there are an estimated 220,000 displaced people inhabiting Bangui alone in temporary “homes” that resemble eclectic forts rather than crucial shelter.

The flooding in Central African Republic is destroying the makeshift shelters the locals have made from any materials available, such as tarps, wood, and cloth. It penetrates their temporary roofs and douses them in the night, keeping them from meaningful sleep. UNICEF has rightfully referred to their situation as a ‘watery purgatory.’ The resultant stagnant water is also responsible for cultivating other deadly diseases such as malaria and typhoid, especially among young children who can be less weary of the dangers of playing near diseased, festering water pools. The situation also has people trekking through thick, deep mud.

Jacques Terrenoire, the Country Director for the Central African Republic at Mercy Corps. describes the dire circumstances: “Now that it has rained, people are just walking in the mud… There are often between five and ten people living under a shoddy shelter, and if there is a strong wind it could be torn away.”

Thankfully, Mercy Corps and UNICEF are both intervening in CAR and providing priceless, much needed aid through several means. UNICEF has, in conjunction with other groups, created a precautionary Cholera Treatment Center at the airport in Bangui. Thus, in the event of a cholera outbreak, officials will be prepared to treat the local population.

UNICEF is also distributing soap and water to those present, and they are building latrines throughout the country as well. Mercy Corps is practicing heavy relief in the CAR as well; the organization maintains teams throughout the country to teach displaced peoples about cleanliness and hygiene in addition to distributing clean water and clean hygiene materials such as soap and containers for water.

— Arielle Swett

Sources: MercyCorps, UNICEF Connect
Photo: Save the Children

World Refugee Day
If the current refugees made up their own country, it would be the 26th largest in the world.

Commemorating World Refugee Day, the United Nations High Commissioner for Refugees stated that there are currently 51.2 million asylum-seekers, internally displaced people and refugees worldwide.

The United Nations said that over 50 million people, an increase of six million from previous years, were forced from their homes by the end of 2013, which surpasses World War II peak numbers. Tensions in South Sudan, the Central African Republic and Syria have caused the increase, but the figure is expected to rise even further as the situation in Iraq worsens.

Currently, there are 1.2 million people searching for asylum, 33.3 million internally displaced people and 16.7 million refugees worldwide. About half of these uprooted people are children.

This has put much pressure on UNHCR and other efforts to provide refugees with food, education and healthcare. During 2013, conflict and violence drove about 32,200 people every day out of their homes, as opposed to 14,200 in 2011 and 23,400 in 2012.

In a report on the refugee crisis, UNHCR stressed the problems that host countries are having dealing with the flood of refugees. 86 percent of refugees worldwide find shelter in developing countries, which causes increased strain on those countries’ resources.

Syria was once the world’s second largest refugee-hosting country. The current Syrian conflict has moved it to the second largest refugee-producing country. Neighbors of Syria, such as Jordan, Turkey and Lebanon, are now facing problems on how to deal with this influx of refugees. Jordan, which has been receiving up to a thousand refugees a day, has been attempting to decelerate the wave of refugees across its border, with little luck.

The current crisis in Iraq is also a major problem. UNICEF recently raised Iraq’s crisis to a level three humanitarian disaster, the most severe label. U.N. officials said they were rushing to prepare for the projected 1.5 million displaced people. U.N. High Commissioner for Refugees António Guterres stated that humanitarians can only do so much, and solutions lie within political systems.

“We are seeing here the immense costs of not ending wars, of failing to resolve or prevent conflict,” he said. “Peace is today dangerously in deficit. Humanitarians can help as a palliative, but political solutions are vitally needed. Without this, the alarming levels of conflict and the mass suffering that is reflected in these figures will continue.”

— Colleen Moore

Sources: Kuwait Times
Photo: Flickr

central african republic
Although a new United Nations (U.N.) report claims it is too early for the ongoing conflict in the Central African Republic to be considered an ethnic cleansing or genocide, the international community needs to act soon before this violent conflict develops into something more serious.

This report seems to clash with a previous U.N. human rights report that claimed ethnic cleansing transpired in the months of fighting between Christians and Muslims in the Central African Republic.

Since the fighting began in December, the death toll has reached into the thousands and hordes of Muslims have left the country in fear. Children have been beheaded and entire villages have been burned to the ground. Unfortunately, the Central African Republic, one of the world’s most poverty-stricken countries, has been abandoned by its seemingly powerless transitional government.

The new U.N. report also denounces Chad and Sudan for contributing to the violence.

Muslim rebel forces, known as Seleka, have been blamed for atrocities against civilians during their 10-month rule. Violence by Christians ensued after the rule ended in January.

The report states, “The fact that there is an anti-Muslim propaganda from certain non-Muslim quarters does not mean that genocide is being planned or that there is any conspiracy to commit genocide or even a specific intent to commit genocide.”

Amnesty International objected to this statement: “I would say that … the report is ignoring the fact that the massive displacement of the Muslim population in the Central African Republic is not simply a consequence of the violence there, but its goal,” senior crisis response adviser Joanne Mariner states. Christian militia fighters “have made no secret of their intent to kill or forcibly expel all Muslims from the areas under their control.”

The report warns that if the international community does not react quickly, the situation will worsen and could potentially lead to genocide and ethnic cleansing.

There is a significant inadequacy of peacekeepers in the Central African Republic and the 2,000 French troops and 5,800 African Union peacekeepers lack the ability to subdue the violence.

If the international community wants to prevent this tragedy from worsening, protection on the ground needs to be enhanced. Forces would have to defend sites and shield displaced persons more diligently. A.U. and French forces would need to use “all necessary means” to protect civilians.

The U.N. Security Council aims to deploy 12,000 U.N. peacekeepers to the Central African Republic. But this action will not happen until Sept. 15, 2014, and the troops will only be on the ground through April 2015. Additional African countries would have to join the A.U. force, and the U.S. and E.U. countries would also have to increase their involvement.

The transitional government is not adequate and it needs immediate support from donors and international experts to restore it. Only 31 percent of the U.N.’s appeal for humanitarian aid has been matched. It is essential for donors to pay their outstanding pledges as the conflict worsens.

 — Colleen Moore

Sources: ABC News, Time
Photo: Freestock

Conflict_Disrupts_Education_Central_African_Republic
Access to the most basic level of education in the Central African Republic has been limited since the beginning of the rebel uprising.  Despite the efforts of the United Nations Children’s Fund, the country needs at least $7 million to resume regular schooling.  Thousands of children have fled for their lives to neighboring countries where as refugees they may receive some amount of education.  However, in rural refugee camps, older students have no access to education at their higher level.  The mass exodus and ever growing number of internally displaced persons has rendered consistent education nearly impossible.

While religion certainly has played its role in the conflict, preexisting instability created a context in which violence could flourish.  Many of the young soldiers fighting on either side joined solely with the hope of finding work.  The Sahel remains one of the poorest places in the world, filled with endless violence and hunger.

The education system in the CAR was weak long before the most recent interruptions.  Literacy rates stagnated at little over 50 percent for the overall population, and significantly lower for women.  The majority of teachers were unqualified and underpaid.  Still, having joined the Global Partnership for Education, the CAR received a $37.8 million loan to improve national education.  Before the conflict broke out, the CAR saw a 13 percent increase in children attending primary school – a tremendous sign of progress in a few short years.

In the months that have passed since the most recent conflict began, schools in the most war-torn provinces have been looted and destroyed while teachers have fled out of fear.  Students are at risk of losing an entire school year now that over half of all schools across the CAR are closed.  Parents throughout the CAR fear sending their children to the schools that are still open.

UNICEF has responded to the crisis by working with the Ministry of Education in the CAR and NGOs throughout the region.  Together they have seen the following success:

  • 65,000 students have returned to school
  • 120 temporary learning centers have opened in areas where violence is minimal
  • More than 1000 teachers have returned to their schools

The following months will require the financial support found only in the larger international community.  This support is crucial to the eventual eradication of poverty and prevention of future violence.

– Erica Lignell

Sources: Livewire, Central Intelligence Agency, Global Partnership, UNICEF, United Nations, Time, United Nations, UNHCR

Doctors Without Borders
Doctors Without Borders, an international humanitarian organization that seeks to provide high-quality medical care to needy people around the world, has halted their work in Boguila, Central African Republic.

The organization–also known by its French acronym MSF–stopped offering services after 16 civilians and three MSF staff members were killed in an attack by ex-Seleka rebels on Saturday. The rebels surrounded the hospital where MSF staff were meeting with local community leaders to discuss medical access and care. They proceeded to rob the MSF office at gunpoint and opened fire on the participants of the meeting.

This incident is especially troubling provided that MSF was the only international humanitarian organization working in the area. As violence increases, thousands of people are left without access to medical attention. Not only is this a devastating blow to MSF, it also prevents further humanitarian aid to an increasingly desperate group of people.

This attack follows the continual pattern of rampant violence in the Central African Republic since March of 2013, when Seleka militants ousted President Francoise Bozize and drove the country into a spiral of escalating violence. A transitional government disbanded Seleka in September of 2013, but ex-Seleka militants continue to destabilize the country by wreaking havoc on both urban and rural areas. Sectarian violence between Christians and Muslims has further deteriorated any remaining order in the Central African Republic.

Prior to Saturday’s events, the MSF hospital in Boguila has been operational since 2006 and provided medical care to over 45,000 locals. In addition to their 115-bed hospital, MSF also supports seven health posts in the region that help treat malaria. MSF reports that “each month, between 9,000 and 13,000 general consultations are provided and between 5,000 to 10,000 people are treated for malaria.”

“This appalling incident has forced us to withdraw key staff and suspend activities in Boguila. While we remain committed to providing humanitarian assistance to the community, we also have to take into account the safety of our staff,” said Stefano Argenziano, MSF Head of Mission in the Central African Republic. “In reaction to this unconscionable act, we are also examining whether it is feasible to continue operations in other areas.”

– Madisson Barnett

Sources: Voice of America, Medecins Sans Frontieres, The Telegraph
Photo: Rebel Mom

liberia-health-care
The World’s Health Organization (WHO) ranked the world’s health systems in the year 2000. WHO ranked Liberia, Nigeria, Democratic Republic of Congo, Central African Republic and Myanmar as the top 5 countries in need of better healthcare and as the nations with the lowest healthcare quality. While these nations have undergone reforms since the 2000 assessment, they continue to face critical healthcare obstacles. The countries are listed in descending order based on the World’s Health Organization Ranking of the World’s Health Systems. 

 

Top 5 Countries in Need of Better Healthcare

 

1. Liberia

According to Doctors Without Borders, Liberians suffer from epidemic disease, social violence and healthcare exclusion. During the past twelve years, Liberia’s Ministry of Health has taken steps to address healthcare issues but disease and access to adequate healthcare remain crucial issues in the country. In March 2014, the media announced an outbreak of the Ebola virus in Liberia, suggesting epidemic disease continues to be a primary healthcare concern.  Liberian health authorities expressed a concern over the virus spreading to other countries while attempting to quell public panic. Furthermore, access to sufficient healthcare and healthcare equipment remains limited. In a 2012 Korle-Bu Neuroscience Foundation report, Jocelyne Lapointe stated that Liberia has only one medical center, John F. Kennedy Memorial Medical Center (JFKH), with up-to-date medical imaging systems. JFKH has a modern CT scanner, ultrasound and x-ray equipment. However, the hospital does not have adequate staffing to install and operate all the imaging equipment and desperately seeks the aid of radiologists.

 

2. Nigeria

Nigeria also suffers from epidemic diseases such as malaria, HIV/AIDS and typhoid which affect a large portion of the population. The lack of government aid in response to these diseases has led to distrust in government healthcare initiatives.  The Guardian’s September 2013 article, “The toughest job in Nigerian healthcare,” Dr. Ado Jimada Gana Muhammad, the chief executive of Nigeria’s National Primary Healthcare Development Agency, stated, “If customers – I call patients ‘customers’ – attend a health facility and the level of care is not what he or she expects the confidence is eroded even further.” Muhammad strives to reinstate Nigerians’ lost trust in the healthcare system, hoping that the public will become consumers of recent additions to the system, including better access to vaccinations and new distribution of resources.  In April 2014, Nigeria’s National Health Bill will attempt to revitalize the country’s healthcare system via a $380 million pledge. The bill will focus on primary healthcare, offering free healthcare to many Nigerians.

 

3. Democratic Republic of the Congo

A 2013 IRIN News article, “Boost for healthcare in DRC,” stated, “Civil war has destroyed much of the country’s health infrastructure, as well as the road networks and vital services such as electricity, meaning patients often have to travel long distances to health centers that may not be equipped to handle their complications.” In a country with high rates of infant/maternal mortality, HIV/AIDS, malaria and sexual violence, access to medical care plays an essential role in the success of the country’s healthcare system. Currently, a British program, providing $179 million to the country, is attempting to help six million people in the Congo access healthcare.

 

4. Central African Republic

Lack of healthcare access and healthcare workers plague Central African Republic. After a 2010 rebel attack, volunteer medical workers fled dangerous regions of the country. Thus, large portions of the country’s population have been cut off from all medical resources. Furthermore, an IRIN News article, “Central African Republic: Struggling for healthcare,” states, “Since 2008, the government has spent only 1.5% of GDP on public health, hence its dependency on some 19 medical NGOs to provide drugs and medical equipment and improve the skills of health workers.” For the people of Central African Republic, health care depends on NGO’s rather than the government and therefore, when NGO workers do not feel safe in the country, the healthcare system suffers drastically. IRIN news also noted that vaccination coverage dropped with NGO displacement. The government needs to increase healthcare funding or increase safety measures for medical volunteers to improve the ailing healthcare system.

 

5. Myanmar

Despite Myanmar’s history of wealth via international trade, Myanmar’s economy has changed significantly in recent years. Poor road infrastructure and low government contribution to healthcare systems has led to healthcare inaccessibility for a large portion of the nation’s population. According to the Burnet Institute, an organization that conducts research on public health in Myanmar, the country has high rates of malaria, tuberculosis and HIV. Ten percent of the population suffers from HIV and tuberculosis simultaneously.  Myanmar needs more government funding and outside support from other nations to establish an effective healthcare system and build access to healthcare centers.

– Jaclyn Ambrecht

Sources: Think Africa Press, Burnet Institute, Doctors Without Borders, IRIN News, IRIN News, KBNF, The Guardian, The Inquirer, WHO
Photo: International Rescue Committee

peace_keeping_central_africa
With violence in the Central African Republic continuing, and complaints of little effectiveness towards the forces from the West coming in, the United Nations Security Council voted unanimously on April 10 to send in 12,000 peacekeeping troops.

Currently France is holding its 2,000 peacekeeping troops in the nation until the UN force is ready. The hope is that this influx will bring some stability to a struggling nation torn by religious and ethnic violence.

Help from neighboring African nations has been offered, and there are currently 5,000 African Union troops in the nation. However, troops from Chad were recalled earlier in April as reports spread that they were shooting civilians in the capital of Bangui.

Reports like those of the Chadian peacekeepers are troubling and continue to raise questions over who incoming peacekeepers should support. When the efforts began at the end of 2013, the concern was over Muslim militia killing Christians in the region. However, once the peacekeepers came in, retaliatory killings by Christian “anti-balaka” militia resulted in migrations by Muslims and perilous refugee camps set up in the capital of Bangui.

To the credit of the United Nations, they appear to be taking a pro-active response to these complaints. The arrival of more troops meets a pressing need as there had been many complaints over the lack of troops and their reluctance to enter the more dangerous regions of the nation. Hopefully a troop influx will meet victims’ needs.

In the weeks before the vote by the UNSC violence appeared to be escalating in the region. In the days before the vote at least 30 people died in attacks by the anti-balaka militia. UN estimates that were published in the lead-up to the vote estimated that a quarter of the population was “in desperate need of aid.”

The violence in the Central African Republic has gotten little of the media attention that conflicts in Ukraine and Syria have gotten, yet it is a burgeoning problem in a region of growing importance. The peacekeeping announcement is a step in the right direction for the international community. Organizations like the Borgen Project advocate for assistance in regions of turmoil like the Central African Republic is currently dealing with.

While this mission may be meant to encourage peace in the region, it may be some time before that goal is achieved. The work in nations like the Democratic Republic of the Congo shows how difficult that peace efforts in out-of-the way posts are for the West. The efforts will be monitored and followed by the members of the Borgen Project, in the hope that the citizens of the CAR will live better lives soon.

-Eric Gustafsson

Sources: The Week, Reuters, New York Times
Photo: ISN

burundi
The Central African region has been receiving a lot of humanitarian attention this new year. Furthermore, while this area has been going through a lot of tumult in the past few months, South Sudan’s instability has been a major concern of the United States and other countries. However, though the situations such as these in larger countries highlight the troubles in the region, the tiny nation of Burundi has gotten a small amount of attention. The UN has, on the other hand, just announced that they will extend their mission in Burundi until the end of the year, the effort being done to guide the nation to safe elections in 2015.

The fact is, Burundi has come a long way in the past 20 years and is an example of the good work that international aid can do for ailing countries. For instance, in the early 1990s there were worries of genocide in Burundi as the violence in Rwanda threatened to spread to Burundi. In 1993, the President of the country was assassinated, resulting in “genocidal acts” taking place against the Tutsi ethnic group. While the violence did not reach the levels seen in Rwanda, ethnic violence was a problem until 2003, even after the ceasefire in 2000 between the government and rebel groups.

After it was clear that the 2000 ceasefire was not having the immediate effect the United Nations hoped, a mission was established in 2004 to bring stability to the nation. As a result, the United Nations Operation in Burundi (ONUB) was established in 2005  to end the violence in the region by sending out disarmament details and providing protection for those felt to be threatened by the violence. In 2006, the UN Office in Burundi (BNUB) was, furthermore, established to continue this work, as well as assisting with democratic administration and setting up the infrastructure for the government.

The mission has been seen as an overall success for the United Nations. Peace has held after a long period of fighting and the Burundi government had felt so confident that they thought the UN should leave by the summer. On the other hand, the UN Security Council felt differently, with the upcoming election serving as the impetus for their extended stay. In fact, a recent changeover in the government prompted some worries, yet Burundi’s ambassador to the United Nations maintained that “[t]he apparent differences between politicians in Burundi… are political exaggerations that are linked to the democratic learning process.”

The bigger worry for Burundi, however, is economic advancement. The nation routinely ranks low in economic development rankings, not a surprise given the disruption that such an extended period of violence brings to a nation. Furthermore, the recent floods in the area don’t look to make the situation much better in Burundi. The nation hopes that with this period of peace, an improved economy will follow.

The United Nations and Burundi both agree that their peacekeeping office should close up shop soon, with the current state of the region being seen as a success for BNUB. However, the troubled economy and the number of hungry citizens is still a major concern to the nation. As it stands, it may only take these conditions to plunge the country back into the violence the nation just got out of. The work that advocacy organizations do should concern emphasizing the need for continued attention in areas like Burundi, and though catastrophe may not be an issue, a further push in the right direction is key.

– Eric Gustafsson

Sources: UN, Reuters, Ref World, The World Bank
Photo: National Geographic