CAR: Ongoing Violence Means Ongoing Health Needs in Bambari Area

Jeroen Oerlemans

The volatile security situation in Bambari, in the Ouaka province of Central African Republic (CAR), is disrupting life for the town’s residents and impeding aid agencies’ efforts to respond to urgent health needs. While the barricades set up in recent days have been dismantled, the atmosphere in the area remains tense, and residents of Bambari live in fear. Violence and the armed robbery of civilians by undisciplined groups are still a daily occurrence. A group of armed men even forced their way into Bambari hospital, forcing terrified patients to flee.

Humanitarian organizations such as Doctors Without Borders/Médecins Sans Frontières (MSF) are struggling to provide medical care to those who need it. MSF—which has been working in the Bambari area since May 2014—was forced to temporarily restrict its team’s movements after some team members became trapped by violence on the far side of the river that bisects Bambari. The team has since restarted its medical activities, running mobile clinics for both the Christian and Muslim communities, focusing on those most urgently in need.

In addition to running mobile clinics, the MSF team has been following up with 12 patients with violence-related injuries at Bambari hospital, which is run by the Ministry of Health and other humanitarian actors. Most had wounds from grenades and gunshots, including one with multiple wounds, three with severe abdominal wounds that required laparotomies, and three with fractures. One patient died.

The insecurity is restricting access to medical facilities and hindering aid organizations from providing humanitarian assistance. For some days, MSF’s team was unable to reach the five health centers it supports. However, the team managed to pre-position dressing and stabilization kits for treating wounded patients in case of major needs.

The situation is also tense in the area around Bambari, where medical care is even less available. An MSF mobile team was able to reach Ngakobo, 66 kilometers (about 41 miles) south of Bambari, where some 9,500 displaced people have sought shelter from the violence. In two days, the MSF team provided 427 consultations in the camp and in a nearby village, mainly for patients with malaria and respiratory tract infections. MSF has also launched a response to provide and increase adequate supplies of clean water in the camp.

“On the way to Ngakobo, there was such a contrast between the beauty of the landscape and the emptiness of the ghost villages, left in ruins and emptied of people because of the attacks,” said Martin Braaksma, MSF head of mission in CAR. “In other villages, residents are too afraid to go to the fields to work. People are trapped by the violence.”

The ongoing violence compounds health needs and the shortage of free, quality medical care in CAR. In the Bambari area, MSF is running six “malaria points” to diagnose and treat malaria, which is one of the main health problems in CAR, particularly for children. In January, MSF’s team treated 3,231 patients for malaria in the Bambari area alone, more than 40 percent of whom were children under the age of five.

CENTRAL AFRICAN REPUBLIC, BAMBARI, 27 SEPTEMBER 2014 An MSF staff takes the temperature of a young boy. In the villages around Bambari MSF has established so called 'points palu' or malaria stations, where people get examined to detect malaria in an early stage, especially children. Between 80 and 90% of the patients are tested positive to malaria.
Jeroen Oerlemans