Central African Republic

Background

Central African Republic (CAR), a landlocked country located in the center of Africa, has long been neglected by humanitarian aid despite being ranked as the world's 10th most instable country on the failed states index. It is surrounded by conflict in the neighboring countries (Chad, Sudan, Democratic Republic of Congo (DRC), Congo and Cameroon) and has seen the displacement of more than 305 000 people from its seven northern prefectures after a decade of coups and mutinies destabilizing the country.
Though 2005 brought in an elected François Boizizé as head the state, the peace and stability that was hoped for never happened. Various armed militant groups quickly formed in the northern prefectures leading to regular rebel assaults on the government by the ARPD, FDPC and the UFDR from 2005 through to 2007. Conflict across this region had devastating impact on the population. Civilian communities were targeted, many villages were burnt to the ground and torture, executions, forced recruitment and sexual and gender based violence (SGBV) characterized these common attacks, forcing whole communities to flee, seeking safety in surrounding forest areas or refugee camps in neighboring Chad.

Several attempts to obtain peace and stability have been made. During 2007 - 2008 rebel groups signed up to three different peace agreements and the UN established a peace building commission for CAR on June 12th of 2008. Although the overall situation has stabilized significantly with the initiation of these peace processes, fruits of a comprehensive dialogue are yet to be fully seen. Nevertheless the overall situation has improved; the insecurity has gradually decreased, allowing greater access to the humanitarian community. However, the severe lack of functioning state infrastructure, including the health system, has left the population with a huge gap in access to essential services and an ongoing dependency on emergency health systems supported by humanitarian organizations. Health infrastructure currently only serves less than 20% of the population in this region and it will require several years of peace and significant investment to reconstruct to meaningful levels. However, until this time, emergency community based services are essential to ensure basic access to health care.
The health statistics of the 4.7 million population are staggering with 8 physicians/100000 people, an infant mortality rate of 106/1000 live births, a child mortality rate of 176/1000 live births and a maternal mortality rate of 1355/100000 live births. These rates have been worsening annually and the 2015 millennium development goals (MDGs) are far from achievable with current levels of support to the population. Malaria remains the main cause of morbidity and mortality in the country with more than 50% of health facility visits attributed to malaria. Tragically most do not have access to effective health care services and many vulnerable children and pregnant women die unattended to and their deaths unrecorded.
CAR should be a major priority of the international humanitarian community, but international donors have been, and remain very slow to commit serious funding to respond to this ongoing crisis.