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Preserving Healthcare in the Central African Republic

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

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The Central African Republic’s Poverty Rate

Central African Republic's Poverty Rate
The Central African Republic (CAR) is a country located in the middle of Africa. It is bordered by Chad, Cameroon and South Sudan. Despite its supply of gold, diamonds, oil and uranium, the CAR is incredibly impoverished. The Central African Republic’s poverty rate is considered to be one of the worst in the world, with a GDP per capita of $639.

Political instability in the CAR affects the prosperity of its citizens. In 2013, the Seleka group–a Muslim-affiliated group–seized power in the Christian country. The Anti-Balaka showed Christian resistance and rose up to counter the Seleka. This conflict created a legion of problems in the Central African Republic. In September 2013, Seleka was dissolved. However, there are still remaining rebel groups to this day, known as Ex-Seleka. This conflict has resulted in the use of child soldiers, causing a lack of enrollment in schools and internally displaced persons (IDP) throughout the country. Moreover, this political uncertainty has impaired food rates, health and increased the percentage of people living at less than $1.90 a day.

Unsustainable agriculture practices in the CAR have contributed to its alarming food insecurity rates. Years of conflict and political instability have damaged agricultural activities, and nearly 75% of the country’s population relies on these agricultural activities for food and income.

Malnutrition in the Central African Republic is one of the top concerns for the country. Nearly one-third of the population (1.3 million people) is food insecure, with 47.7% of the entire population undernourished. More than 10% of children suffer from malnutrition. Highly chronic malnutrition rates remain a concern in the CAR. The average life expectancy, for both males and females, is 51.4 years. This is below the international average of 71.4 years. In 2008, 66.26% of the population was living at less than $1.90 a day. This shows incredible under-development. The Central African Republic’s poverty rate shows characteristics of scarcity and hardship.

The Central African Republic’s poverty rate demonstrates a multitude of problems related to the country’s food insecurity, malnourishment and political instability. However, there is hope for the citizens of the Central African Republic. The United States has provided assistance to strengthen the U.N.’s mission to address the continuing humanitarian crisis in the CAR. The United States has provided approximately $500 million in development and security assistance, helping the people of the CAR to find long-term stability and peace. The World Food Programme (WFP) has begun its first food voucher program to assist more than 100,000 people affected by conflict. The organization plans to provide more than 1.2 million people in the CAR with nutrients for life-saving assistance.

– Lucy Voegeli

Photo: Flickr

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Fear of Genocide in Central African Republic

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In the Central African Republic (CAR) broils a sectarian conflict that has left 210,000 fleeing its capital and over 500 dead. Violent clashes between Muslim and Christian militias in the nation’s capital of Bangui have world leaders scrambling to avoid a possible genocide in the strife-ridden country.

In fear of the mass killings, kidnappings and rapes ravaging the capital, hundreds of refugees have risked boat rides across a branch of the Congo River to escape the violence while 40,000 have decided to camp outside the French-controlled Bangui airport, a place of stability and safety for the displaced Africans.

Half a century’s worth of political chaos has left the land-locked country easy pickings for its current rebel terrorists.

After the CAR gained freedom from France in 1960, it remained under despotic rulers for three decades. In 1993, the country began its first civilian rule, which fell a decade later to a military coup led by then rebel Francois Bozize. He instated himself as president and ruled uninterrupted until the rebel coalition Seleka, meaning “alliance” in the Sango language, overran the capital in March and ousted him.

Since the most recent coup, the country has fallen even further into disorder, with the dissembled rebel and Christian militias fighting one another. The reappointed Prime Minister Nicolas Tiangaye, a former human rights lawyer, expressed dismay at the deterioration of his country.

“It’s anarchy, a nonstate,” said Tiangaye. “Looting, arson, rape, massacres of the civilian population—they are sowing terrorism.”

France sent 1,600 troops to support the African Union-led forces on the ground, with hopes that other United Nations forces will help to restore order to the area. A visit by Samantha Power, the American ambassador to the United Nations, to CAR has reinforced her opinion that further action is necessary.

“I come away from our time in CAR very concerned about the extent of the polarization, the tautness of the society and the temptation that families and communities that have been victimized have to take justice into their own hands,” said Power.

Power’s fears arise from concerns that the conditions in the CAR may engender genocide. With both Christians and Muslims facing casualties, a desire for revenge may drive civilians to join militias. The Security Council passed a resolution to send 6,000 African troops to help bolster the 1,600 French troops already stationed. Whether that will be enough to quell the rebels, CAR refugees can only wait and see.

– Emily Bajet

Sources: Al Jazeera, Al Jazeera, BBC, BBC, New York Times, New York Times, New York Times, New York Times
Photo: The Washington Post

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Conflict in the Central African Republic

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Since President Francois Bozize of the Central African Republic (CAR) was ousted by a coalition of fighters by the name of Seleka in March of 2013, the nation has devolved into anarchy.  Seleka leader Michel Djotodia declared himself president after the fall of Bozize’s government, but he has little control over his Seleka fighters.

The Seleka is a predominately Muslim, rebel coalition made up of several militia factions from the CAR’s civil war.  The Convention of Patriots for Justice and Peace, the Patriotic Convention for Saving the Country, the Union of Democratic Forces for Unity as well as other anti-government groups formed the alliance in mid-2012.

Djotodia cut ties with the group after they were blamed for attacks across the CAR.  In an interview with Al-Jazeera in early September, he admitted the Seleka no longer obey his orders.

On October 26, 2013, the Seleka forces of the CAR took part in a massacre a few miles outside Bouar, killing 18 people.  At least 10 people were killed at Bangui’s Amitie hospital after Seleka troops attacked patients.  Executions, rapes and burglaries by Seleka troops in predominately Christian areas have been reported.

A Christian militia called anti-balaka was formed to fight back against the Muslim Seleka.  The United Nations has expressed concern that the CAR situation may develop into a genocide given the historical tension between Christians and Muslims in the area.  With no legitimate governing body or police force there is a great risk of increased violence between the two groups.

As violence has escalated, President Francoise Hollande of France visited the country to evaluate the conflict.  So far, France has deployed 1,600 peacekeeping troops to the CAR with plans to send up to 6,000 if the fighting continues.

The African Union has sent 2,500 troops and plans to send more in the coming weeks. The U.N. has authorized foreign intervention using “all necessary measures” to support the efforts of the African Union and France.  The troops have been monitoring travel in and out of major towns, checking homes for weapons, and policing neighborhoods in an attempt to mitigate violence.

The United States has promised to donate $100 million in aid to the African Union’s efforts.  Al Jazeera reported that the funding will go to training, logistical operations, planning and non-lethal equipment.  State Department spokeswoman Marie Harf says “The United States remains deeply concerned about the horrific violence committed by the armed groups against innocent civilians.”

President Djotodia released a statement saying he will consider granting amnesty for the militia members in exchange for a ceasefire between the two groups.

– Stephanie Lamm

Sources: Al Jazeera America, Al Jazeera America, Al Jazeera America, Al Jazeera America, Al Jazeera America, Al Jazeera America
Photo: Giphy.com

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Refugees: The Forgotten Problem in Central Africa

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In Central Africa and the Great Lakes region, countries with already large numbers of Internally Displaced Persons (IDPs) are burdened with refugee influx from neighboring conflicts. Many of the IDPs and refugees in Central Africa are served by U.N. camps across the region. Others are housed by local populations or public buildings. With recent outbreaks of violence humanitarian services have become unavailable in  regions.

In April, a UNHCR spokesman gave the number of Central African Republic (CAR) refugees in the Democratic Republic of Congo (DRC) at 30,000. Many of these were forced to flee the violence in the capital Bangui. UNHCR also estimated that the number of IDPs in CAR reached 173,000. While this situation is grim the added strain on refugee camps and humanitarian services is exacerbated by the refugees crossing into CAR. Driven by conflict in the Western Darfur region and recent fighting in the DRC capital of Goma, Sudanese and Congolese refugees are seeking care in CAR. In April UNHCR estimated 21,000 refugees from the DRC and Sudan have sought refuge in CAR.

Despite peace talks currently taking place between the DRC government and the M23 rebel forces, the environment in the DRC remains uncertain and rife with tension. Rebel troops briefly held the capital, Goma, in November 2012 but lost control again to the government after a short period. The current standoff between the two sides has boosted the potential for forced recruitment in the countryside. Citizens fleeing the conflict and young men trying to avoid forcible recruitment spill into neighboring countries. In the last six months of 2012 UNHCR estimates that 60,000 Congolese refugees fled to Uganda and Rwanda. Many more were internally displaced.

Recent violence in the DRC has led the U.N. to deploy troops with one of its strongest mandates yet: counter insurgency operations. Despite a 20,000 U.N. peace force deployed in the region the rebel forces took and held Goma for 10 days last November, committing many atrocities including mass rape. The new U.N. deployment, consisting of troops from South Africa, Tanzania, and Malawi is intended to prevent new atrocities. The effectiveness of this newest deployment is uncertain. Troops will be engaging in joint operations, requiring coordination in an unfamiliar setting and already logistics and bureaucracy have delayed troop deployment.

Other military forces also have a presence in CAR. South Africa deployed 200 soldiers in January this year with the potential to deploy an additional 200. These forces will assist in training the CAR army and are not intended to engage directly with rebel forces. Ugandan soldiers with U.S. Special Forces support are also deployed in CAR. The Economic Community of Central Africa has authorized forces to deploy in the country as well. And France recently boosted their troop presence in CAR from 250 to 600.

The global and regional community recognizes the need for military intervention in the region demonstrated by the troop deployments. Whether this leads to a cessation in violence or even a lasting peace is uncertain.

– Callie D. Coleman

Sources: IRIN, The Economist, UNHCR
Photos: IRIN