Les Roberts, Clinical Associate Professor at Columbia University’s Mailman School of Public Health has worked extensively in countries ranging from Zimbabwe to the Democratic Republic of Congo. For the last month he’s been coordinating a blog series for ONE on the Central African Republic. You can read the full series here.

His most recent post, on the impact of conflict on the Central African Republic, is below.

The impact of conflict on Central Africans is obscured if one only counts up the number of violent deaths or war-related causalities, each a tragedy in its own right. There is no doubt that the six organized rebel groups and the ever present threat of poachers and road bandits contribute to an insecurity that rarely escapes the minds of most of the rural population. But any active fighting is contained in small pockets of the country and the majority of the population lives in areas with little to no rebel or bandit activity.

It is conflict’s ability to prevent a population from accessing life’s basic services that cultivates disaster. CAR’s health system is in ruins, with even the most basic of services out of reach for many. People are dying because pharmacies aren’t stocked and the nation’s few trained doctors tend to remain in the capital, Bangui, due to the rest of the country’s insecurity, poor transportation links, and the inability to access any salary the government manages to pay them from rural areas.

In Mobaye we met a young man in agony three days after he had been in a devastating motorcycle accident. He wasn’t from the town and had no family nearby; he was traveling through there as an apprentice to a team running a trucking business. Their truck had broken down. He walked with a limp, leaning on a large stick, his shoulder and shattered right arm were supported with a sling made from a small strip of cloth and he wore a t-shirt draped over his head to hide the extensive damage to his face.

After his accident, three days earlier, he was taken to the hospital. They had given him the cloth that supported his broken arm, and possibly some pain medication. The only other thing they could give him was something called an ‘evacuation paper.’ This sheet stated that the hospital could not treat him and that he needed to be taken to Bangui. But his truck had broken down and there was no other transport. When we arrived in town with our UNICEF vehicles, we were the only hope he had. We took him to the next largest town – five hours away – and from there he found family to travel with him to the capital. In Bangui we hope he could have his broken limbs set, receive antibiotics for the infections spreading in his open wounds, and maybe something for his pain. We hope. But what if we hadn’t arrived in Mobaye on that day? What could he have done?

In our nation-wide survey, when we asked Central Africans what problems they and their communities were facing, people throughout the country primarily mentioned disease, lack of food, and water, even in the insecure areas. When asked what would help them and their communities cope with these problems, the answer was never UN peacekeepers or a military response to the conflict; It was health care, water, food, medicine, and trained health staff. One might call these “the basics.” CAR’s civil war is complicated, but the needs of the civilian population are not. How can we help to assure that Central Africans have reliable access to these “basics,” at the very least?

-Les Roberts, Clinical Associate Professor at Columbia University’s Mailman School of Public Health