Forgotten crises: Healthcare in the Central African Republic

Central African Republic: Many people have no access to medical care

Central African Republic: Many people have no access to medical care, © Sébastien Duijndam / Doctors of the World

09.01.2021 - Article

The Central African Republic has experienced one of the world’s most protracted crises. In the midst of it, however, there are individuals such as Gilles Mbassade, who are working to alleviate suffering.

He looks after the sick and those in need with Doctors of the World. The German Government supports the project.

There are 4.7 million people living in the Central African Republic, around 75 percent of whom below the poverty line. Half of the population is suffering from starvation, while a quarter is displaced. The Central African Republic gained its independence from France in 1960 and the country has not been at peace ever since. Under the command of local warlords, rebel groups have de facto control of two thirds of the country’s territory, which is the second poorest in the world.

In early 2019, the government under President Touadéra signed a peace agreement with 14 rebel groups. However, this did not halt the violence against the civilian population. Following the military offensive by a rebel coalition in the run-up to the presidential elections in December 2020, the fate of the peace agreement and of the country are more uncertain than ever.

“The majority of the population has no access to healthcare”

Gilles Mbassade works with the relief organisation Doctors of the World to alleviate suffering in the country. The organisation recently set up a health station in Bouca province. “The majority of the population has no access to healthcare”, says Mbassade. “For many healthcare workers have left rural areas.” For instance, in the prefecture where Mbassade works there are only 46 medical staff left for the 90,000 inhabitants. Many medical facilities are completely empty. The lack of medical care has had a negative impact on many other spheres, states Mbassade: “Maternal and infant mortality are steadily rising because no medical care is available.”

Support for health stations in the region

While others are leaving the area, doctors from the NGO Doctors of the World launched their project there last summer. They support the health stations in the region, which are caring for the sick and injured with rudimentary equipment. Doctors of the World help, for instance, to train personnel and provide drugs. The team also deals with the refurbishment of the often crumbling facilities. What is more, motorcycles will be procured in the coming months. These will enable the aid workers to transport sick patients who have to be transferred to better equipped hospitals – even in remote areas with inadequate road links.

An attack on humanitarian workers every day

The staff of Doctors of the World put themselves at considerable personal risk to carry out their work. The Central African Republic is one of the world’s most dangerous countries for humanitarian workers: in 2020, on average there was at least one attack on humanitarian personnel every day. The violence which flared up again in December 2020 has already had a negative impact on the Doctors of the World project: many of the staff are currently unable to leave their accommodation and thus cannot do their vital work.

2020: 30 million euro in humanitarian assistance from Germany

In 2020, Germany provided almost 30 million euro for humanitarian assistance in the Central African Republic and is thus the second largest humanitarian donor to this country. It was possible to finance many projects, such as the one in Bouca, with this funding.

Germany is also working at the political level to ensure that individuals such as Mbassade can continue their work in safety: together with France, Germany launched the Humanitarian Call for Action (CfA), intended to improve access and protection for humanitarian workers, in the UN Security Council in 2019.

This humanitarian engagement is flanked by comprehensive support for the UN Peacebuilding Fund and the EU’s Bêkou Trust Fund, which are being used to finance a whole host of peacebuilding projects in the Central African Republic.


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