The challenges and our response
One of the world’s poorest countries, the Central African Republic (CAR) has been plagued with bouts of political turmoil and unrest since it won independence from France in 1960.
Since late 2013, more than 500,000 CAR citizens have fled armed violence in their homeland for the relative safety of neighbouring Chad, Democratic Republic of Congo and South Sudan. At the same time, fighting has driven nearly 700,000 others to seek refuge elsewhere within their own country as internally displaced persons (IDPs).
In early 2018, more than 18,000 CAR citizens fled renewed fighting in their homeland to take refuge in neighbouring Chad. The violence and subsequent spike in the flow of Central African refugees into Chad added new pressure to a major displacement crisis that has grown in the region.
With CAR’s total population listed at around 4.7 million, the rise in refugees during 2018 means that more than one-quarter of the country’s population has been displaced by armed conflict, and the overall situation in the country remained uncertain. On one hand, ongoing negotiations for an enduring peace have led to a reduction of fighting in some areas. However, UN peacekeepers struggle to prevent attacks on villages and provide effective protection for civilians and humanitarian workers.
International Medical Corps has been providing lifesaving medical relief in CAR, especially in remote, under-served areas of the country, since 2007.
Due to ongoing conflict within CAR, International Medical Corps staff members often operate under intense pressure, as teams deliver emergency medical care and conduct surgeries for victims of conflict. Many people have fled their homes and reside in makeshift settlements throughout the country. Internally displaced persons (IDPs), refugees and host populations are extremely vulnerable to malnutrition and disease, as water, sanitation, food and health care is limited, if not completely nonexistent. International Medical Corps provides health consultations through all of its supported health centers, hospitals and mobile clinics, and conducts immunization campaigns in remote villages. To address the severe shortage of maternal and reproductive healthcare services, International Medical Corps provides family-planning services, prenatal and postnatal care, and emergency obstetric and neonatal care.
About 1.5 million people require food assistance in CAR. The conflict has greatly affected people’s ability to move freely, which diminishes their ability to grow crops, buy food and access healthcare. In these types of complex conflict situations, vulnerable populations, such as pregnant women and children under 5 years of age, often are at an increased risk of acute malnutrition.
- International Medical Corps’ nutrition program includes:
- Community mobilization to increase the understanding, engagement and participation of the target population
- Supplementary feeding programs
- An outpatient therapeutic program for those with severe acute malnutrition
- A stabilisation centre for those with severe acute malnutrition with medical complications
In addition, International Medical Corps conducts surveillance of malnutrition within the most affected communities, to ensure that individuals receive appropriate and timely treatment.
Often used as a weapon in the conflict in CAR, gender-based violence (GBV) affects the physical, psychological and social health of women and girls, as well as their families and communities. International Medical Corps conducts training in remote areas, such as the Vakaga and Ouham regions, to raise awareness among community members about GBV and to advocate for the safety and protection of children and youth. Community leaders, local authorities, healthcare providers and representatives from local women’s associations participate in training programs on gender-based violence and children’s rights. International Medical Corps collaborates with the training participants through the local women’s association to reinforce their capacity and provide refresher training. In addition, the team provides on-site training and supervision to healthcare providers who work directly with survivors of GBV. Though cultural and sociopolitical factors are obstacles to reporting GBV in the community, our teams work to strengthen community awareness of GBV and child-protection concerns while ensuring that survivors have access to necessary resources.