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Central African Republic

As crisis persists in Central African Republic, doctors struggle to provide aid

© UNICEF Central African Republic/2013/Nambeanre
Esdras Kossingou and his mother, Isabelle, at Bangui Pediatric Hospital. Esdras was playing football in a Bangui neighbourhood when a stray rocket-propelled grenade exploded in the playing field.

By Colette Boughton and Dede Nambeanre

Since an armed coalition seized power in March, lawlessness and insecurity have become part of everyday life in the capital of the Central African Republic, and violence has taken its toll on the lives of children.

BANGUI, Central African Republic, 26 June 2013 - In April, a group of children ages 5 to 12 were playing football in a Bangui neighbourhood when a rocket-propelled grenade exploded in the playing field. Fourteen children were injured and had to be rushed to Bangui’s pediatric hospital, where they received treatment from the medical NGO Emergency, a UNICEF partner.

Among the children was 12-year-old Esdras Kossingou. His mother, Isabelle, told UNICEF of her anguish: “After the explosion, I saw that Esdras had lost large parts of the back of his calves and thighs,” she says. “I was in tears, not knowing how I could save his life. But once we were at the hospital I was soon reassured by the care of Emergency’s staff.”

Esdras had emergency surgery and then spent three days in intensive care.

A surge in injuries

Unfortunately, what happened to Esdras is not an isolated event in the Central African Republic. Two days after the incident on the football field, a rocket exploded among a congregation in Bangui during morning church services. Seven people were killed, including three infants, and 11 children were taken to Bangui pediatric hospital, where seven received emergency surgery and three had legs amputated.

Other children across the country have been victims of stray bullets. Attacks on villages and sexual violence against girls and women are on the rise.

In the weeks following the March coup, electricity and safe water supplies in Bangui were disrupted. With more people injured and sick, insufficient medicines, a lack of equipment and limited staff, the health care system became severely overburdened.

Yet under these challenging conditions and despite a fragile security situation, UNICEF and its partners have managed to scale up humanitarian response.

© UNICEF Central African Republic/2013/Nambeanre
Dr. Ombretta Pasotti, Medical Coordinator for the NGO Emergency, with supplies provided by UNICEF for the Bangui pediatric hospital.

 “A special mission from Emergency flew into Bangui on 5 April. UNICEF provided us with surgical kits, medical equipment and supplies, as well as materials to maintain clean water and hygiene,” says Dr. Ombretta Pasotti, Emergency’s Medical Coordinator and Head of Mission, “We have been using these supplies to provide free emergency surgery and burns treatment, saving the lives of fifty-eight people.”
Isabelle is visibly relieved as her son continues on the road to recovery. “Now Esdras is getting better,” she says. “He is more cheerful and he eats well, but he is worried that he has missed so much school.”

Multiple risks

Even before conflict began to escalate in December last year, Central African Republic had one of the most underdeveloped health systems in the world. Children under 5 faced the sixth highest rate of mortality in the world, and infant mortality was the third highest in the world.

Added to this, many hospitals and health centres in Bangui and across the country were looted as fighting spread. Medicines, beds, mattresses and equipment were taken. Due to the shortage of refrigerators and insufficient petrol supplies, providing vaccination services has become extremely difficult.

Pierre Signe, UNICEF Central African Republic’s Chief of Child Survival and Development, has witnessed the effects of the crisis. “The conflict has disrupted routine health care. Some people are afraid to go to hospitals or health centres, and when they do go, they may find there are no health facilities open or no staff or medicines available,” he says.

It’s a situation that poses multiple risks to health and survival, particularly to the most vulnerable.

© UNICEF Central African Republic/2013
Restocking medicines at Sibut Hospital, one of the few facilities in the interior of the country that still has a functioning refrigerator.

“The peak season for malaria is coming up, but there is a widespread shortage of anti-malaria drugs,” Mr. Signe says. “With so many people displaced or hiding in the bush to escape the violence, without mosquito nets to protect them, with poor water and sanitation and limited access to health care, we are seeing an increase in illness and deaths of children from malaria and diarrhea. There are outbreaks of measles and we fear there could be other epidemics.” 

Supplies arrive, but not enough

By May UNICEF had chartered planes to bring more than 23 tons of emergency health supplies to Bangui and distributed 164 basic health kits, essential drugs and equipment to cover the needs of 164,000 people for three months.

“This is only the beginning of what is needed to reach those affected by the current conflict,” Signe says. “UNICEF urgently needs an additional $4.7 million to re-establish health services in 2013.”



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