Since the start of conflict in December 2012, despite widespread violence and insecurity, International Medical Corps has maintained a presence in the northeastern regions of Vakaga and Haute-Kotto in the Central African Republic (CAR), providing lifesaving health care and nutrition services to conflict-affected populations. In late May 2013, following improved security conditions, International Medical Corps started to expand its activities to reach the many remote and isolated communities surrounding the city of Bria.
“Many of these sites have been inaccessible for years because of the chronic insecurity that affected the region,” says Boakai Dempster Ngaima, International Medical Corps’ Project Manager. One such place is Aigbando, a small town located approximately three hours by road from Bria, the capital of Haute-Kotto prefecture. What was once a thriving commercial center, fueled by the diamond business, in 2011 became the military base and headquarters for one of the country’s main rebel factions, the Convention of Patriots for Justice and Peace (CPJP), and has since been cut off from the other towns and cities in the region.
As a consequence of the crisis, CAR’s population has been susceptible to abuse, including physical and sexual violence. The health post in Aigbando was used as the intelligence office for the day-to-day running of the rebel movement, leaving 8,600 people, including 1,480 children under five, deprived of basic health care services for several years. Says Boakai:
“During our assessment, we found that the health facility in Aigbando lacked everything needed to be considered a functional health post, including trained staff, essential drugs, medical supplies, and equipment. It even lacked tables and chairs. As well as a complete absence of basic outpatient consultations, there have been no vaccination services or maternity services available. As a result the local community has been forced to turn to traditional healings.”
During the assessment, International Medical Corps identified malaria, respiratory infections and diarrheal diseases as major health problems. It also conducted nutritional screening for more than 900 children under five, which revealed an acute malnutrition rate of 15.8%, which is classified as “critical” by the World Health Organization.
Some of the other communities that International Medical Corps visited had no health post at all; the closest health facility is Bria Hospital, which is 24 miles away for villages such as Kolongo. Other communities have access to a functioning health facility but they run a “cost recovery system,” which pays for the replenishment of essential drugs. “The fees can reach 4,000CFA (approximately $8), which is unaffordable for the majority of people in the area who survive on less that $1 a day and low scale agricultural activities,” says Boakai.
International Medical Corps’ team in Bria has been working tirelessly to expand the reach of its two Mobile Medical Units to include eleven communities, like Aigbando—meaning an addition 18,000 people now receive the free health care services that they desperately needed. The Mobile Medical Units, consisting of a doctor and team of nurses and midwives, make weekly visits to all the supported communities, providing essential primary health care services, including outpatient consultations, preventative and curative treatments, vaccinations, nutrition services and community health awareness and education activities.
“Our teams take the risks to reach the unreachable. Without International Medical Corps, many people would have no basic health care services at all,” concludes Boakai.