News / Africa

Inside Central African Republic’s Silent Health Crisis

Gabe Joselow
The city of Carnot rests in the peaceful hills of western Central African Republic.  Like many parts of the country, the town’s economy relies on mineral wealth, in the form of diamonds.

But when the foreign-owned diamond exchanges left town in the midst of the global financial crisis in 2009, people began to suffer.

Luke Fagende, a tailor who repairs clothing on a sewing machine outside of a shuttered diamond exchange in Carnot, says when the foreigners left, the local economy dried up.

“Now they are gone,” he says, “there is nobody here.  There is no money to buy drugs to cure our sicknesses and we have become very poor.”

When the diamond money stopped, Carnot suffered a serious malnutrition crisis, prompting the medical aid agency Doctors Without Borders, known by its French initials MSF, to intervene.

The group ran emergency nutrition programs for the first year, but then discovered deeper health problems in the region, including a child mortality rate that is three times above what is considered an emergency level, as well as elevated rates of HIV and tuberculosis.

Serge St. Louis, the head of mission for MSF-France, which runs operations in Carnot, says they decided to set up longer-term projects in the town, assisting the Ministry of Health to improve hospitals.

He says, “You just step, you just put a foot in the hospitals, any hospitals outside the capital, you just find needs.  Big needs.  (A) population that has no access because (there are) no medical personnel in quantity and quality in those hospitals.”

A Chronic Health Crisis

Carnot is just one small example of the dismal health conditions in Central African Republic.  The country ranked 179th out of 187 countries on the United Nations human development index, with a life expectancy of just 48 years of age.

According to MSF, the country has the highest HIV prevalence in Central Africa, with malaria and tuberculosis among the biggest causes of death.

While economic conditions have accounted for the health crisis in the west, conflict has been the cause in the east.

According to the United Nations, over 100,000 people are currently displaced by fighting with rebel groups, including the notorious Lord’s Resistance Army, creating even more difficult conditions for providing medical care.

Throughout the country, the lack of investment in health care systems, including the building of hospitals and training of doctors, remains one of the biggest challenges to improving conditions.

The government is either unwilling or unable to provide that assistance.

Central African Republic is a poor country, and only allocates about $30 million a year to health care for a population of 4.5 million people -- the fifth lowest expenditure rate in the world according to the World Health Organization.

The mayor of Carnot, Pierre Dotwa, says the government’s health care development plan in the country involves continuing the programs established by MSF.  

“MSF has done good work,” he says, “with the government of President Francois Bozize, we have helped the situation together.”

MSF-France's St. Louis said MSF and the government are still trying to negotiate the terms of their cooperation in Carnot.  He described their relationship as “not perfect” but “improving.”

Rebranding

While the government’s own investment in health care is lacking, the international community also has kept its distance from the country.

The United Nations appealed for $140 million in 2011 for humanitarian assistance but only received 45 percent of that amount.

The head of the U.N. humanitarian affairs office in the capital of Bangui, Amy Martin, says the country has to “rebrand” itself by rebuilding universities and improving basic social services.

“Until that happens,” she says, “I don’t see C.A.R. going very far very fast.”

The Central African Republic has made tentative progress in recent years, reaching peace agreements with rebel groups and working to strengthen democratic institutions.

But it is clear that, as was the case in Carnot, the slightest disruption can have devastating consequences for the health of the nation.

You May Like

Video Afghan Refugees Complain of Harassment in Pakistan

Afghan officials and human rights organizations assert that Pakistani authorities are using deadly attack at school in Peshawar as pretext to push out Afghan refugees More

At Boston Bombing Hearing, Sides Spar Over Boat

At final pre-trial hearing, lawyers for suspect Dzhokhar Tsarnaev, prosecutors disagree on whether vessel where he hid from police can be shown to jurors More

Iran Judiciary 'Picks' Lawyer for Detained WP Reporter

Masoud Shafii has been attempting to secure official recognition as Rezaian’s attorney, but is not allowed to see his client in prison More

Featured Videos

Your JavaScript is turned off or you have an old version of Adobe's Flash Player. Get the latest Flash player.
US Supreme Court Hears Hijab Discrimination Casei
X
Katherine Gypson
February 25, 2015 11:30 PM
The U.S. Supreme Court has heard opening arguments in a workplace religious discrimination case that examines whether a clothing store can refuse to hire a young woman for wearing the headscarf she says is a symbol of her Muslim faith. Katherine Gypson reports from the Supreme Court.
Video

Video US Supreme Court Hears Hijab Discrimination Case

The U.S. Supreme Court has heard opening arguments in a workplace religious discrimination case that examines whether a clothing store can refuse to hire a young woman for wearing the headscarf she says is a symbol of her Muslim faith. Katherine Gypson reports from the Supreme Court.
Video

Video Falling Gas Prices Hurt Nascent Illinois Hydraulic Fracturing Industry

Falling oil prices are helping consumers purchase cheaper petroleum at the pump. But that’s made hydraulic fracturing or “fracking” less economically viable for the companies in the United States invested in the process. VOA’s Kane Farabaugh reports on one Midwestern town that was hoping to change its fortunes by cashing in on the next big U.S. oil boom.
Video

Video Fighting in Sudan's South Kordofan Fuels Mass Displacement

Heavy fighting in Sudan's South Kordofan state is causing hundreds of thousands to flee into uncertain conditions. Local aid organizations estimate as many as 400,000 civilians have been internally displaced since the conflict began more than three years ago, while another 250,000 have fled across the border to refugee camps in South Sudan. VOA's Adam Bailes reports.
Video

Video Lao Dam Project Runs Into Opposition

A Lao dam project on a section of the Mekong River is drawing opposition from local fishermen, international environmental groups and neighboring countries. VOA's Say Mony visited the region to investigate the concerns. Colin Lovett narrates.
Video

Video A Filmmaker Discovers Her Biracial Identity in "Little White Lie

Lacey Schwartz grew up in an upper middle-class Jewish family, in a town in upstate New York where almost everyone she knew was white. She assumed that she was, as well. Her recent documentary, Little White Lie, tells the story of how she uncovered the secret of her true racial background. VOA’s Carolyn Weaver has more on the film.
Video

Video Deep Under Antarctic Ice Sheet, Life!

With the end of summer in the Southern hemisphere, the Antarctic research season is over. Scientists from Northern Illinois University are back in their laboratory after a 3-month expedition on the Ross Ice Shelf, the world’s largest floating ice sheet. As VOA’s Rosanne Skirble reports, they hope to find clues to explain the dynamics of the rapidly melting ice and its impact on sea level rise.
Video

Video US-Cuba Normalization Talks Resume Friday

Negotiations aimed at normalizing diplomatic relations between the U.S. and Cuba resume Friday. On the table: lifting a half-century trade embargo and easing banking and travel restrictions. There's opposition in Congress, but some analysts say there may be sufficient political and economic incentives in both nations for a potential breakthrough this year. VOA's Mil Arcega reports.
Video

Video Pakistan's Deadline For SIM Registration Has Cellphone Users Scrambling

Pakistani cell phone users have until midnight Thursday to register their SIM cards, or their service will be cut off. While some privacy experts worry about government intrusion, many Pakistanis are just worried about keeping their phone lines open. VOA Deewa reporter Arshad Muhmand has more from Peshawar.
Video

Video Myanmar Warns Factory Workers to End Strikes

Outside Myanmar's main city Yangon, thousands of workers walked off their jobs earlier this month demanding a doubling of their wages, pay raises after a year and input from labor unions on industrial regulations. Since Friday, the standoff has grown more tense as police moved in to disrupt the sit-ins, resulting in clashes that injured people from both sides. VOA correspondent Steve Herman visited industrial zones which have become a focus of Myanmar's fledgling workers rights movement.
Video

Video Oscar Winners Do More Than Thank the Academy

The Academy Awards presentation is Hollywood’s night to reward the best movies from the previous year. It’s typically a lot of glitter, a lot of thank you’s, a lot of speeches. But many of this year’s speeches carried messages beyond the thank you's. VOA’s Carolyn Presutti takes a look.

All About America

Circumventing Censorship

An Internet Primer for Healthy Web Habits

As surveillance and censoring technologies advance, so, too, do new tools for your computer or mobile device that help protect your privacy and break through Internet censorship.
More