CAR: Seeking refuge as violence escalates

22 Jan 2021
In violence linked to the recent elections, the security and humanitarian situation is deteriorating rapidly in Central African Republic as clashes escalate between coalition armed groups and government forces supported by foreign troops.
In addition to those who are direct victims of the violence, thousands of people across the country find themselves with reduced access to essential services as a result of the growing insecurity. MSF teams are providing medical care to those displaced or injured in the current crisis.

An MSF staff member transports medicines and water purification materials to the Bondeko Health Center in Ndu, northern DRC, where more than 12,000 people from the Central African Republic have sought refuge following an attack on Bangassou. © Marco Doneda/MSF

Responding to the needs of those displaced

Tens of thousands of people have been displaced from their homes by the latest cycle of violence, which began in December 2020. Many are living in very precarious conditions, both within Central African Republic and in neighbouring countries.  

In the southeast of the country, more than 10,000 people fled Bangassou during an offensive on the city on 3 January and crossed the Mbomou River to find refuge in the village of Ndu, Democratic Republic of Congo. MSF teams, who have been supporting mother and child healthcare in the local health centre in Ndu since 2017, have been responding to the needs of those who have been displaced.

“With the massive influx of refugees in Ndu, we immediately increased our support to the health centre by bringing in extra medicines, vaccines and additional staff,” says MSF project coordinator Marco Doneda. “The number of medical consultations has exploded, with more than 110 patients seen each day on average, mainly women and children suffering from for malaria, diarrhoea and respiratory infections.

"In view of the needs, we will continue to increase our medical capacity in the health centre in the coming days, as well as our capacity to respond to potential epidemics by reinforcing routine vaccination.”

As well as providing the refugees with medical care, MSF teams have installed a water purification system which supplies three containers with river water that has been treated to make it safe for drinking. 

“Access to water is crucial to prevent the spread of waterborne diseases,” says Doneda. “Living conditions in Ndu are very poor, with very little access to sanitation.”


MSF staff cross the Mbomou river to reach Ndu, in DRC, where thousands of people from the Central African Republic sought refuge. © Dale Koninckx/MSF

Nearly 150 kilometres from the border with Cameroon, the town of Bouar has been living in fear since the end of December when clashes began in the area. The situation is particularly critical for the thousands of people who have fled their homes to take refuge in several religious sites and plots of land in the city. More than 8,000 people, including many families and young children, have been forced to leave their homes. Nearly half of them are currently living in the city's former cathedral, the largest of the six makeshift camps for displaced people where MSF has just started an emergency intervention.

"I don't know where to go because the rebels have set up their base in my neighbourhood. It's very difficult to live here with my baby who is just one month old. We sleep outside in the cold without a mosquito net," explains Rolande, a young displaced woman. "My child is sick but I can't take him to the hospital because of the insecurity and I don't have money to pay for the treatment."


More than 8,000 internally displaced persons are now living in dire conditions in makeshift camps in Bouar after fleeing post electoral violence and attacks. Nearly half of them are currently living in the city's former cathedral, the largest of the six makeshift camps for displaced people. © Vivien  Ngalangou/MSF

Offering shelter in MSF's hospital

On the Central African side of the Mbomou River, MSF teams are continuing their medical activities at Bangassou regional hospital, supported by MSF since 2014. On 3 January, the day of the offensive, nearly 800 people—most of them women and children—sought refuge within the hospital grounds, where MSF teams provided them with shelter, clean water and medical care.  

“Although the security situation has calmed down relatively in Bangassou, people are still scared and nearly 1,600 people are spending the night in the hospital as we speak,” says Doneda.

“As some non-governmental organisations are providing support, we are now assessing the need for us to support people in this area as well.”

For the past four weeks, MSF teams across the country have been treating the wounded and responding to people’s health needs as a result of this new outbreak of violence. In a country already hard-hit by eight years of civil war, where people live in a situation of chronic medical crisis, the current insecurity is further exacerbating their vulnerability. As well as MSF’s emergency response, MSF teams continue to provide vital medical care in Bangui, Bambari, Bria, Bangassou, Batangafo, Bossangoa, Boguila, Carnot, Kabo, Paoua et Zemio. 

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