Thousands of people left without healthcare after a coup d’etat in Central African Republic (CAR) are now receiving treatment from Médecins Sans Frontières/Doctors Without Borders (MSF).

Three months after the coup we are still scaling up our response. Our teams have opened a new emergency health project in Bossangoa – north of the capital, Bangui – where we hold more than 300 out-patient consultations a day.

Our teams are also holding mobile clinics in areas where people are still hiding in the bush due to the presence of armed men.

“The health challenges in CAR are huge, especially outside the capital, where the healthcare system has been weak for many years. This is a crisis on top of a crisis,” says Ellen van der Velden, MSF’s Head of Mission in CAR.

Healthcare workers flee

In Bossangoa, we are responding to an acute lack of healthcare for approximately 150,000 people after some healthcare workers in the town fled their posts. The focus is on treatment of malaria, diarrheal diseases, malnutrition and sexual and gender based violence.

To date, 53 percent of children under the age of five, seen in the out-patient department, have been confirmed with malaria. Fifty percent of pregnant women receiving antenatal care have also been diagnosed with the disease.

This week we have begun a two month emergency initiative to provide antiretroviral drugs to HIV/AIDS patients at the Bossangoa hospital who have been without medication since the crisis.

“There are approximately 11,000 thousand HIV positive people in CAR who have had their treatment interrupted due to a lack of drugs which were looted during the political upheaval,” says Chury Baysa, MSF Medical Coordinator.

“This initiative reflects MSF’s ongoing commitment to patients to improve their health and reduce the suffering and mortality due to HIV/AIDS.”

HIV/AIDS patients

Ministry of Health officials estimate there are approximately 310 HIV/AIDS patients who were registered in the Bossangoa hospital programme before the coup, 170 of whom were on antiretroviral treatment (ART) and approximately 140 who were pre-ART patients. In the last two weeks 88 patients have approached staff at the hospital asking for drug refills.

In our project in Batangafo, in the northwest, teams are assessing a situation where approximately 8,000 people were displaced when more than a dozen villages were burned down in April as a consequence of clashes between the local population and a nomadic group from Chad.

Next week, teams will start mobile clinics in the areas where internally displaced people are congregating and carry out a distribution of non-food items, including mosquito nets, blankets and soap.

Return to calm

Relative calm has now returned to Bangui where MSF has just ended its three month emergency response at the Community Hospital. The MSF team provided treatment to 1,072 patients; 36 percent of whom were suffering from bullet wounds and 149 patients who required surgery.

Activity at the hospital is now back to normal as staff that fled during the coup have returned. The operating theatre and sterilisation unit are now properly fitted out and the team has pre-positioned supplies of drugs in case of need.

But, as the malaria season begins in CAR, there is fear the already high mortality rate will escalate because most of the country is without any medical assistance. “The biggest needs are access to basic healthcare, including adequate amounts of drugs in the health facilities,” says Ellen van der Velden.

“Import into the country and distribution throughout the country are the biggest bottlenecks. We are calling on other non-governmental organization, donors and the United Nations to come into the country to help the population.”

MSF in Central African Republic

MSF has worked in the Central African Republic since 1996 and has projects in Batangafo, Boguila, Carnot, Kabo, Ndele, Paoua and Zemio.